The relationship between endotoxin and the phagocytic activity of the reticuloendothelial system

The frequency of endogenous endotoxemia caused by gram-negative bacteria in the intestine of patients with liver cirrhosis, is attracting much attention in the clinical study of endotoxin. To clarify the reason for such high frequency, the indices of the phagocytic activity of reticuloendothelial system (RES), alpha 2-macroglobulin (alpha 2-M) and endotoxin were studied in patients with chronic liver disease, and in normal controls. In the case of liver cirrhosis, the phagocytic activity of RES (K value) was markedly diminished, and a negative correlation between the K value and alpha 2-M was recognized in endotoxemia. These results suggest that endotoxemia in liver cirrhosis is based on spillover of endotoxins from portal flow.