1. Treatment with non-selective beta-blockers affects the systemic inflammatory response to bacterial DNA in patients with cirrhosis.
- Author
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Gimenez P, Garcia-Martinez I, Francés R, Gonzalez-Navajas JM, Mauri M, Alfayate R, Almenara S, Miralles C, Palazon JM, Carnicer F, Pascual S, Such J, Horga JF, and Zapater P
- Subjects
- Adrenergic beta-Antagonists adverse effects, Aged, Ascites microbiology, Ascitic Fluid microbiology, Bacterial Translocation drug effects, Cytokines blood, Female, Humans, Hypertension, Portal complications, Linear Models, Male, Middle Aged, Monocytes drug effects, Multivariate Analysis, Neutrophils drug effects, Nitric Oxide blood, Prospective Studies, Adrenergic beta-Antagonists therapeutic use, DNA, Bacterial blood, Hypertension, Portal drug therapy, Inflammation drug therapy, Liver Cirrhosis physiopathology, Respiratory Burst drug effects
- Abstract
Background & Aims: The use of non-selective beta-blockers has been associated with lower rates of infection and reduced infection-associated morbidity in patients with cirrhosis. However, it is unknown if these drugs modify the systemic inflammatory response to circulating bacterial DNA., Methods: Sixty-three patients with cirrhosis were included during an episode of decompensation by ascites. Thirty of those patients were on beta-blockers. Blood samples were obtained after each patient had been in the supine position for at least 30 minutes in a quiet atmosphere. Bacterial DNA, serum cytokines, nitric oxide, and LPS were determined. Phagocytic and oxidative burst activities were determined in polymorphonuclear cells from the patients., Results: The detection rate of bacterial DNA in the blood was the same (33%) for patients not treated and treated with non-selective beta-blockers. Patients naive to non-selective beta-blockers showed significantly higher serum levels of IL6, IFN-gamma and IL10 in response to the presence of bacterial DNA. Patients treated with non-selective beta-blockers showed higher basal inflammatory activity that did not change with the presence of bacterial DNA. Monocytes and granulocytes from patients treated with non-selective beta-blockers showed a significantly increased phagocytic capacity in the presence of bacterial DNA., Conclusions: In patients with cirrhosis, chronic treatment with beta-blockers is associated with a higher unstimulated production of serum cytokines and an increased phagocytic activity in the presence of bacterial DNA., (© 2018 The Authors Liver International Published by John Wiley & Sons Ltd.)
- Published
- 2018
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