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Effect of acute portal hypertension on gut mucosa
Naoki Hashimoto1, Harumasa Ohyanagi
1Second Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka, Sayama, Osaka 589-8511, Japan.
Background/Aims:
Patients with cirrhosis are predisposed to develop spontaneous bacteremias and peritonitis, mainly by enteric bacteria. Portal hypertension, by producing congestion and edema of the bowel wall, could increase the passage of bacteria from the intestinal lumen to regional lymph nodes to the systemic circulation or to both, a process termed bacterial translocation. The aim of this study was to investigate bacterial translocation, brush border enzyme activity and intestinal permeability of experimental acute portal hypertension.
Methodology:
Twenty-six male Wistar rats were used for all experiments. Rats were studied two days after the induction of portal hypertension (n = 13). Control animals were also studied two days after sham operation (n = 13). Samples of mesenteric lymph nodes for standard bacteriological cultures and a fragment of ileum for histological examination and mucosal contents of protein, Alp were obtained. Moreover, we evaluated the intestinal permeability by using the phenolsulfonphthalein test.
Results:
Two days after surgery, a significantly greater properties of rats with acute portal hypertension (12 of 13, 92%) had positive mesenteric lymph node cultures compared with control group: sham operated (2 of 13, 15%). A significant increase in disappearance of phenol red from the luminal solution was observed in rats with acute portal hypertension. Brush border enzyme of Alp was also significantly decreased in acute portal hypertension, compared with in sham operated controls.
Conclusions:
The results of our study suggested that acute portal hypertension may be a major factor in the development of spontaneous infections in cirrhosis.
Insights
Acute portal hypertension significantly increases bacterial translocation and intestinal permeability in rats, suggesting it drives spontaneous infections in cirrhosis. This study highlights the gut
Area of Science:
- Gastroenterology
- Hepatology
- Microbiology
Background:
- Cirrhosis patients are susceptible to spontaneous bacterial infections, often from enteric bacteria.
- Portal hypertension may increase bacterial translocation from the gut to systemic circulation.
- Bacterial translocation is a key factor in the pathogenesis of infections in liver disease.
Purpose of the Study:
- To investigate bacterial translocation in experimental acute portal hypertension.
- To assess brush border enzyme activity and intestinal permeability in this model.
- To elucidate the role of portal hypertension in gut barrier dysfunction.
Main Methods:
- Wistar rats underwent induction of acute portal hypertension or sham operation.
- Mesenteric lymph nodes were cultured for bacteria; ileum was examined histologically.
- Intestinal permeability was assessed using the phenolsulfonphthalein test; alkaline phosphatase (Alp) levels were measured.
Main Results:
- 92% of rats with acute portal hypertension showed positive mesenteric lymph node cultures versus 15% in controls.
- Intestinal permeability significantly increased in rats with acute portal hypertension.
- Alkaline phosphatase (Alp) brush border enzyme activity was significantly decreased in the portal hypertension group.
Conclusions:
- Acute portal hypertension promotes bacterial translocation and gut barrier dysfunction.
- These findings suggest acute portal hypertension is a significant factor in spontaneous infections associated with cirrhosis.
- Targeting gut barrier integrity may be crucial for preventing infections in cirrhotic patients.