The role of small intestinal bacterial overgrowth, intestinal permeability, endotoxaemia, and tumour necrosis factor alpha in the pathogenesis of non-alcoholic steatohepatitis - PubMed (original) (raw)
The role of small intestinal bacterial overgrowth, intestinal permeability, endotoxaemia, and tumour necrosis factor alpha in the pathogenesis of non-alcoholic steatohepatitis
A J Wigg et al. Gut. 2001 Feb.
Abstract
Background: Small intestinal bacterial overgrowth may contribute to the development of non-alcoholic steatohepatitis, perhaps by increasing intestinal permeability and promoting the absorption of endotoxin or other enteric bacterial products.
Aims: To investigate the prevalence of small intestinal bacterial overgrowth, increased intestinal permeability, elevated endotoxin, and tumour necrosis factor alpha (TNF-alpha) levels in patients with non-alcoholic steatohepatitis and in control subjects.
Patients and methods: Twenty two patients with non-alcoholic steatohepatitis and 23 control subjects were studied. Small intestinal bacterial overgrowth was assessed by a combined (14)C-D-xylose and lactulose breath test. Intestinal permeability was assessed by a dual lactulose-rhamnose sugar test. Serum endotoxin levels were determined using the limulus amoebocyte lysate assay and TNF-alpha levels using an ELISA.
Results: Small intestinal bacterial overgrowth was present in 50% of patients with non-alcoholic steatosis and 22% of control subjects (p=0.048). Mean TNF-alpha levels in non-alcoholic steatohepatitis patients and control subjects were 14.2 and 7.5 pg/ml, respectively (p=0.001). Intestinal permeability and serum endotoxin levels were similar in the two groups.
Conclusions: Patients with non-alcoholic steatohepatitis have a higher prevalence of small intestinal bacterial overgrowth, as assessed by the (14)C-D-xylose-lactulose breath test, and higher TNF-alpha levels in comparison with control subjects. This is not accompanied by increased intestinal permeability or elevated endotoxin levels.
Comment in
- Is bacterial ash the flash that ignites NASH?
Farrell GC. Farrell GC. Gut. 2001 Feb;48(2):148-9. doi: 10.1136/gut.48.2.148. Gut. 2001. PMID: 11156629 Free PMC article. No abstract available. - Alcohol, obesity, and TNF-alpha.
Poullis A, Mendall MA. Poullis A, et al. Gut. 2001 Aug;49(2):313-4. doi: 10.1136/gut.49.2.313. Gut. 2001. PMID: 11476082 Free PMC article. No abstract available. - Is coeliac disease a confounding factor in the diagnosis of NASH?
Grieco A, Miele L, Pignatoro G, Pompili M, Rapaccini GL, Gasbarrini G. Grieco A, et al. Gut. 2001 Oct;49(4):596. doi: 10.1136/gut.49.4.596. Gut. 2001. PMID: 11589191 Free PMC article. No abstract available. - Small intestinal bacterial overgrowth, intestinal permeability, and non-alcoholic steatohepatitis.
Riordan SM, Duncombe VM, Thomas MC, Nagree A, Bolin TD, McIver CJ, Williams R. Riordan SM, et al. Gut. 2002 Jan;50(1):136-8. doi: 10.1136/gut.50.1.136-a. Gut. 2002. PMID: 11772983 Free PMC article. No abstract available.
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