TITLE

IMPROVEMENT IN INDOCYANINE GREEN CLEARANCE FOLLOWING SYNBIOTIC TREATMENT IN CIRRHOSIS

AUTHOR(S)
Kurtovic, J.; Ruettimann, U.; Adamson, H.; Bihari, D.; Bengmark, S.; Williams, R.; Riordan, S.M.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA3
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Intervention aimed at reducing intestinal levels of endotoxin containing Gram-negative bacteria is reported to improve systemic haemodynamic disturbance in cirrhosis. Any beneficial effect on hepatic blood flow is unknown. This study addressed this issue. Methods: We studied 15 cirrhotic patients (hepatitis C virus, n = 7; alcohol, n = 6; primary biliary cirrhosis, n = 1; idiopathic, n = 1; Child-Pugh grade A, n = 6; B, n = 5; C, n = 4) and 11 patients with chronic hepatitis (hepatitis C, n = 9; hepatitis B, n = 1; non-alcoholic steatohepatitis, n = 1). Indocyanine green retention at 15 min (ICGR15) following an intravenous bolus of 0.5 mg/kg body weight was assessed as an index of hepatic blood flow, using a non-invasive transcutaneous system (LiMon, Pulsion, Germany). ICGR15 was measured at baseline and following oral supplementation for 7 days with a synbiotic (probiotic and Fermentable fibre) preparation including Lactobacillus plantarum 2362, L paracasei subsp paracasei 19, Pediacoccus pentoseceus 5-33:3, and L raffinolactis 32-77:1, designed to increase the intestinal content of Gram-positive bacteria (Synbiotic 2000, Medipharm, Sweden). Results: ICGR15 was significantly higher in cirrhotic patients (median 38.3, range 5.0-60%) than those with chronic hepatitis (median 5.3, range 1.8-9.7%) (p < 0.0005). Supplementation with the synbiotic regimen was associated with a significant reduction in ICGR15 in the cirrhotic group (p = 0.003). ICGR15 was reduced by a median 17.5% (range 1.4-65%) of baseline values in 14/15 (93%) such patients and increased by 4.1% in the other patient. Treatment led to no significant change in ICGR15 in patients with chronic hepatitis (p = 0.65). Conclusions: Use of a Gram-positive synbiotic preparation significantly improves ICG clearance in cirrhotic patients, presumably by reversing a disturbance in gut flora occurring in cirrhosis but not chronic hepatitis that adversely affects hepatic blood flow.
ACCESSION #
9747258

 

Related Articles

  • Lipopolysaccharide as a Target for the Development of Novel Therapeutics in Gram-Negative Bacteria. Yethon, J.A.; Whitfield, C. // Current Drug Targets - Infectious Disorders;Aug2001, Vol. 1 Issue 2, p91 

    Lipopolysaccharide (LPS) constitutes the lipid portion of the outer leaflet of Gram-negative bacteria, and is essential for growth. LPS is also known to be responsible for the variety of biological effects associated with Gram-negative sepsis. In recent years, tremendous progress has been made...

  • endotoxin.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p772 

    A definition of the medical term "endotoxin," which refers to a lipopolysaccharide that is part of the cell wall of gram-negative bacteria, is presented.

  • A CD14-independent LPS receptor cluster. Triantafilou, Kathy; Triantafilou, Martha; Dedrick, Russell L. // Nature Immunology;Apr2001, Vol. 2 Issue 4, p338 

    Bacterial lipopolysaccharide (LPS), the major structural component of the outer wall of Gram-negative bacteria, is a potent initiator of an inflammatory response and serves as an indicator of bacterial infection. Although CD14 has been identified as the main LPS receptor, accumulating evidence...

  • The Omp85 protein of Neisseria meningitidis is required for lipid export to the outer membrane. S. Genevrois; L. Steeghs; P. Roholl; J-J. Letesson; P. van der Ley // EMBO Journal;4/15/2003, Vol. 22 Issue 8, p1780 

    In Gram-negative bacteria, lipopolysaccharide and phospholipid biosynthesis takes place at the inner membrane. How the completed lipid molecules are subsequently transported to the outer membrane remains unknown. Omp85 of Neisseria meningitidis is representative for a family of outer membrane...

  • MIF regulates innate immune responses through modulation of Toll-like receptor 4. Roger, Thierry; David, John; Glauser, Michel P.; Calandra, Thierry // Nature;12/20/2001-12/27/2001, Vol. 414 Issue 6866, p920 

    Presents migration inhibitory factor (MIF) as essential regulator of macrophage responses to endotoxin and Gram-negative bacteria. Characterization of macrophages; Comparison between wild-type cells and MIF-deficient macrophages; Decrease production of tumor necrosis factor.

  • Endotoxin Modifications in the Bacterial Outer Membrane: Lipopolysaccharide Lipid A Remodeling in Salmonella Typhimurium. Kawasaki, Kiyoshi // Immunology, Endocrine & Metabolic Agents - Medicinal Chemistry;Dec2009, Vol. 9 Issue 4, p224 

    Adaptation to the environment is essential for pathogenic bacteria during the infection of host tissues. Remodeling of the lipid A portion of lipopolysaccharides in the outer membrane is involved in the adaptation of Gram-negative bacteria. Modifying lipopolysaccharides which are also known as...

  • Re LPS Biogenetic Pathway: Enzyme Characterisation and Synthetic Efforts Towards Inhibitors. Cipolla, Laura; Airoldi, Cristina; Galliani, Paolo; Polissi, Alessandra; Nicotra, Francesco // Current Organic Chemistry;May2008, Vol. 12 Issue 7, p576 

    Lipopolysaccharides (LPSs) constitute the lipid portion of the outer leaflet of Gram-negative bacteria; they are essential for growth, and are also responsible for the variety of biological effects associated with Gram-negative sepsis. Recent advances have elucidated the exact chemical structure...

  • Endotoxins from Cyanobacteria and Gram-negative Bacteria as the Cause of an Acute Influenza-like Reaction after Inhalation of Aerosols. Annadotter, Hel�ne; Cronberg, Gertrud; Nystrand, Rolf; Rylander, Ragnar // EcoHealth;Sep2005, Vol. 2 Issue 3, p209 

    Endotoxins (lipopolysaccharides) in aerosols, originating from cyanobacteria and gram-negative bacteria, were the likely etiological agent behind outbreaks of a transient, flu-like syndrome, described from four Scandinavian towns and Harare, Zimbabwe. The syndrome with fever, malaise, muscle...

  • Lipid-mediated resistance of Gram-negative bacteria against various pore-forming antimicrobial peptides. Gutsmann, Thomas; Hagge, Sven O.; David, Alexander; Roes, Stefanie; B�hling, Arne; Hammer, Malte U.; Seydel, Ulrich // Journal of Endotoxin Research;2005, Vol. 11 Issue 3, p167 

    Lipopolysaccharides (LPSs) play a dual role as target and as effector molecules. The knowledge of the LPS-induced activation of human immune cells is increasing; however, surprisingly, much less effort seems to be directed towards the understanding of the mechanisms leading to the killing of the...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics