1. Bacterial load and cytokine profile in patients with cirrhosis following therapy with proton pump inhibitors: a prospective cohort study
- Author
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Konstantinos Thomopoulos, Charalambos Gogos, Christos Triantos, Maria Kalafateli, Efstratios Koutroumpakis, Dimitris Goukos, Panagiota I. Spantidea, Georgios Daikos, Athanasia Mouzaki, Stelios F Assimakopoulos, and Christos Konstantakis
- Subjects
medicine.medical_specialty ,Cirrhosis ,medicine.medical_treatment ,liver cirrhosis ,cytokine profile ,Gastroenterology ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Internal medicine ,Ascites ,medicine ,Outpatient clinic ,Prospective cohort study ,business.industry ,medicine.disease ,infection ,Cytokine ,Bacterial translocation ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Immunology ,030211 gastroenterology & hepatology ,Original Article ,medicine.symptom ,proton pump inhibitors ,business ,Esophagitis - Abstract
Background The aim of this study was to explore the presence of bacterial products and the cytokine profile in outpatients with cirrhosis before and after short-term (4-8 weeks) administration of proton pump inhibitors (PPIs). Methods Seventeen patients with cirrhosis—male/female: 12/5; age: median 59.2 years (49-65); etiology: HBV±HDV 23.5%, HCV 17.7%, alcohol 41.2%, other 17.6%; Child-Pugh score: median 7.5 (5-12); Model for End-stage Liver Disease: 10.5 (7-21); ascites (%): 3 (17.7)—attending the outpatient clinics were included. None had hepatocellular carcinoma. Indications for PPIs were: esophagitis (n=6, 35.3%), peptic ulcer (n=10, 58.6%) and other (n=1, 5.9%). Bacterial DNA in serum and the levels of endotoxin, lipopolysaccharide binding protein, transforming growth factor-β, interleukin -1β, -6, -8, -12, -10, tumor necrosis factor-α and nitric oxide were assessed at baseline (time 1) and at the end of treatment (time 2). The Wilcoxon signed rank test was used to evaluate significant differences in the parameters assayed before and after PPI administration. Results No patients developed infection during the study period. Bacterial DNA was not detected before or after treatment. No significant differences were observed between the concentrations of any indices between times 1 and 2 (P>0.05). Subgroup analysis according to Child-Pugh stage yielded similar results. Conclusion Short-term administration of PPIs had no effect on bacterial DNA, bacterial products or cytokine concentrations in patients with liver cirrhosis. Keywords Bacterial translocation, cytokine profile, infection, liver cirrhosis, proton pump inhibitors Ann Gastroenterol 2017; 30 (4): 450-456
- Published
- 2017