Significance of endotoxemia and related cytokines in patients with liver disease

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1) High levels of endotoxin (Et) was detected in the precipitate of HC10_4 treated plasma from severe cirrhotics. Plasma Et was increased in cirrhotics after rupture from esophageal varices. Serum levels of various acute phase proteins were positively correlated to Et Levels.2) In cirrhotics, Et binding capacity of albumin was significantly lower and those of HDL and transferrin were significantly higher than those in healthy subjects. Plasma Et binding capacity of albumin and Et inactivating rate was decreased in patients with severe cirrhosis. Et inactivating rate was positively correlated to serum HDL-cholesterol level and Et binding capacity of albumin. In the assay system albumin inhibited Et activity.3) Plasma IL-1beta, IL-6 and TNF were elevated in cirrhotics with terminal hepatic coma, in those with high plasma Et levels or in those with low Et binding capacity of albumin.4) In rat treated with alcohol Et clearance was prolonged and plasma TNF was elevated.