Alcohol, Altered Gut Permeability, and Endotoxins (original) (raw)

2004

Abstract

This chapter discusses the effects of alcohol on gut permeability and endotoxins. Chronic alcohol abuse is the leading cause of progressive liver disease in Western countries. The more advanced stages of Alcoholic Liver Disease (ALD) are associated with both hepatic infiltration and activation of leukocytes, findings that support the assumption that the unspecific immune system may play an important role in the pathogenesis of ALD. Besides other factors such as changes associated with the metabolism of ethanol and genetic susceptibility, strong evidence has accumulated during the last two decades that bacterial toxins of intestinal origin—namely, endotoxins can be considered to be important inducers of hepatic damage after chronic alcohol abuse. In alcoholics, elevated plasma levels of endotoxin were suggested to occur already at early stages of ALD. In chronic alcoholics, this increase was found to be paralleled by both bacterial overgrowth of the small intestine and increased permeability to macromolecules. Several studies revealed a close correlation between the plasma endotoxin concentration and several laboratory markers of ALD, both of which improved after alcohol withdrawal. The reduction of bacterial toxin concentration in the intestine by oral administration of broad spectrum antibiotics resulted nearly in the prevention of ALD.

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