TY - JOUR

T1 - Increased intestinal permeability to macromolecules and endotoxemia in patients with chronic alcohol abuse in different stages of alcohol-induced liver disease

AU - Parlesak, Alexandr

AU - Schäfer, Christian

AU - Schütz, Tatjana

AU - Bode, J Christian

AU - Bode, Christiane

N1 - Funding Information: This study was supported by the Robert-Bosch Foundation, Grants F 1/2 - 92/93. Further generous financial support was granted by Hoffmann-La Roche, Grenzach, Germany. The kits for endotoxin measurements were a kind gift from Chromogenix, Mölndal, Sweden.

PY - 2000

Y1 - 2000

N2 - Background/Aims: No information is yet available about the influence of alcohol abuse on the translocation of larger molecules (M(r)>1200) through the intestinal mucosa in man. The present study aimed to determine the intestinal permeability to macromolecules in patients with chronic alcohol abuse and mild to more advanced stages of liver disease, and to measure the concentration of endotoxins in the plasma, as these compounds derive from the intestinal flora and are suspected to contribute to the development of alcoholic liver disease (ALD). Methods: The permeability to polyethylene glycol M(r) 400, M(r) 1500, M(r) 4000, and M(r) 10 000 and endotoxin plasma concentrations were measured in 54 patients with alcoholic liver disease, 19 of them with cirrhosis, and in 30 non-alcoholic healthy controls. Results: Permeability to polyethylene glycol M(r) 400 was found to be unchanged in patients with ALD in comparison to healthy controls, whereas polyethylene glycol M(r) 1500 and M(r) 4000 were recovered in about twice as high concentrations in the urine of ALD patients (p<0.01). Polyethylene glycol M(r) 10 000 was detected significantly less frequently in urine from healthy controls (0/30) than in urine of patients with alcoholic liver disease (20/54, p<0.01). Endotoxin concentrations in the plasma of alcoholics were increased more than 5-fold compared to healthy controls (p<0.01). Conclusions: The results of this study indicate that alcohol abuse impairs the function of the intestinal barrier, which might enhance the translocation of bacterial toxins, thereby contributing to inflammatory processes in alcoholic liver disease.

AB - Background/Aims: No information is yet available about the influence of alcohol abuse on the translocation of larger molecules (M(r)>1200) through the intestinal mucosa in man. The present study aimed to determine the intestinal permeability to macromolecules in patients with chronic alcohol abuse and mild to more advanced stages of liver disease, and to measure the concentration of endotoxins in the plasma, as these compounds derive from the intestinal flora and are suspected to contribute to the development of alcoholic liver disease (ALD). Methods: The permeability to polyethylene glycol M(r) 400, M(r) 1500, M(r) 4000, and M(r) 10 000 and endotoxin plasma concentrations were measured in 54 patients with alcoholic liver disease, 19 of them with cirrhosis, and in 30 non-alcoholic healthy controls. Results: Permeability to polyethylene glycol M(r) 400 was found to be unchanged in patients with ALD in comparison to healthy controls, whereas polyethylene glycol M(r) 1500 and M(r) 4000 were recovered in about twice as high concentrations in the urine of ALD patients (p<0.01). Polyethylene glycol M(r) 10 000 was detected significantly less frequently in urine from healthy controls (0/30) than in urine of patients with alcoholic liver disease (20/54, p<0.01). Endotoxin concentrations in the plasma of alcoholics were increased more than 5-fold compared to healthy controls (p<0.01). Conclusions: The results of this study indicate that alcohol abuse impairs the function of the intestinal barrier, which might enhance the translocation of bacterial toxins, thereby contributing to inflammatory processes in alcoholic liver disease.

KW - Alcohol abuse

KW - Alcohol-induced liver disease

KW - Endotoxins

KW - Gut permeability

KW - Intestinal absorption

KW - Lipopolysaccharides

KW - Macromolecules

KW - Molecular mass

KW - Polyethylene glycols

UR - http://www.scopus.com/inward/record.url?scp=0342699553&partnerID=8YFLogxK

U2 - 10.1016/S0168-8278(00)80242-1

DO - 10.1016/S0168-8278(00)80242-1

M3 - Journal article

C2 - 10845660

AN - SCOPUS:0342699553

VL - 32

SP - 742

EP - 747

JO - Journal of Hepatology, Supplement

JF - Journal of Hepatology, Supplement

SN - 0169-5185

IS - 5

ER -