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Low-grade endotoxemia and platelet activation in cirrhosis.
- Source :
-
Hepatology (Baltimore, Md.) [Hepatology] 2017 Feb; Vol. 65 (2), pp. 571-581. Date of Electronic Publication: 2016 Nov 05. - Publication Year :
- 2017
-
Abstract
- Patients with cirrhosis may display impaired or enhanced platelet activation, but the reasons for these equivocal findings are unclear. We investigated if bacterial lipopolysaccharide (LPS) is implicated in platelet activation. In a cross-sectional study, conducted in an ambulatory care clinic and hospital, comparing 69 cirrhosis patients and 30 controls matched for sex, age, and atherosclerotic risk factors, serum levels of LPS, soluble cluster of differentiation 40 ligand and p-selectin (two markers of platelet activation), and zonulin (a marker of gut permeability) were investigated. Ex vivo and in vitro studies were also performed to explore the effect of LPS on platelet activation. Compared to controls, cirrhosis patients displayed higher serum levels of LPS (6.0 [4.0-17.5] versus 57.4 [43.4-87.2] pg/mL, P < 0.0001), soluble cluster of differentiation 40 ligand (7.0 ± 2.2 versus 24.4 ± 13.3 ng/mL, P < 0.0001), soluble p-selectin (14.2 ± 4.05 versus 33.2 ± 15.2 ng/mL, P < 0.0001), and zonulin (1.87 ± 0.84 versus 2.54 ± 0.94 ng/mL, P < 0.006). LPS significantly correlated with zonulin (r = 0.45, P < 0.001). Ex vivo studies showed that platelets from cirrhosis patients were more responsive to the agonists independently from platelet count; this phenomenon was blunted by incubation with an inhibitor of Toll-like receptor 4. In vitro study by normal platelets showed that LPS alone (50-150 pg/mL) did not stimulate platelets but amplified platelet response to the agonists; Toll-like receptor 4 inhibitor blunted this effect.<br />Conclusion: LPS may be responsible for platelet activation and potentially contributes to thrombotic complications occurring in cirrhosis. (Hepatology 2017;65:571-581).<br /> (© 2016 by the American Association for the Study of Liver Diseases.)
- Subjects :
- Adult
Aged
Case-Control Studies
Cross-Sectional Studies
Endotoxemia physiopathology
Female
Humans
Male
Middle Aged
P-Selectin metabolism
Platelet Count
Reference Values
Severity of Illness Index
Statistics, Nonparametric
Endotoxemia blood
Lipopolysaccharides pharmacology
Liver Cirrhosis blood
Liver Cirrhosis physiopathology
Platelet Activation drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3350
- Volume :
- 65
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Hepatology (Baltimore, Md.)
- Publication Type :
- Academic Journal
- Accession number :
- 27641757
- Full Text :
- https://doi.org/10.1002/hep.28853