Increased Endotoxin Activity Is Associated with the Risk of Developing Acute-on-Chronic Liver Failure
Acute-on-chronic liver failure (ACLF) leads to systematic inflammatory response syndrome and multiple organ failure. This study investigated the relationship between endotoxin (Et) and ACLF with the aim of determining whether Et activity (EA) is useful as a predictive biomarker of ACLF development a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/5/1467 |
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| author | Hiroaki Takaya Tadashi Namisaki Shinya Sato Kosuke Kaji Yuki Tsuji Daisuke Kaya Yukihisa Fujinaga Yasuhiko Sawada Naotaka Shimozato Hideto Kawaratani Kei Moriya Takemi Akahane Akira Mitoro Hitoshi Yoshiji |
| author_facet | Hiroaki Takaya Tadashi Namisaki Shinya Sato Kosuke Kaji Yuki Tsuji Daisuke Kaya Yukihisa Fujinaga Yasuhiko Sawada Naotaka Shimozato Hideto Kawaratani Kei Moriya Takemi Akahane Akira Mitoro Hitoshi Yoshiji |
| author_sort | Hiroaki Takaya |
| collection | DOAJ |
| description | Acute-on-chronic liver failure (ACLF) leads to systematic inflammatory response syndrome and multiple organ failure. This study investigated the relationship between endotoxin (Et) and ACLF with the aim of determining whether Et activity (EA) is useful as a predictive biomarker of ACLF development and whether rifaximin treatment decreased the risk of ACLF development. Two hundred forty-nine patients with liver cirrhosis were enrolled in this study. Et concentration was determined in the whole blood by a semiquantitative EA assay. Predictive factors of ACLF development and the risk of ACLF development with and without rifaximin treatment were identified by univariate and multivariate analysis using Fine and Gray’s proportional subhazards model. EA level was higher in Child-Pugh class B than in class A patients, and class B patients had an increased risk of ACLF development compared with class A patients. Multivariate analysis showed that EA level was a predictive factor independently associated with ACLF development. Rifaximin decreased EA level and the risk of ACLF development in Child-Pugh class B patients. Et levels were associated with functional liver capacity and were predictive of ACLF development in cirrhotic patients. Rifaximin decreased Et level and the risk of ACLF development in advanced cirrhotic patients. |
| first_indexed | 2024-03-10T19:50:29Z |
| format | Article |
| id | doaj.art-4b1b7d8f69e2450182148009b78ce7b9 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T19:50:29Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4b1b7d8f69e2450182148009b78ce7b92023-11-20T00:23:12ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0195146710.3390/jcm9051467Increased Endotoxin Activity Is Associated with the Risk of Developing Acute-on-Chronic Liver FailureHiroaki Takaya0Tadashi Namisaki1Shinya Sato2Kosuke Kaji3Yuki Tsuji4Daisuke Kaya5Yukihisa Fujinaga6Yasuhiko Sawada7Naotaka Shimozato8Hideto Kawaratani9Kei Moriya10Takemi Akahane11Akira Mitoro12Hitoshi Yoshiji13Department of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanDepartment of Gastroenterology, Nara Medical University, Kashihara, Nara 634-8522, JapanAcute-on-chronic liver failure (ACLF) leads to systematic inflammatory response syndrome and multiple organ failure. This study investigated the relationship between endotoxin (Et) and ACLF with the aim of determining whether Et activity (EA) is useful as a predictive biomarker of ACLF development and whether rifaximin treatment decreased the risk of ACLF development. Two hundred forty-nine patients with liver cirrhosis were enrolled in this study. Et concentration was determined in the whole blood by a semiquantitative EA assay. Predictive factors of ACLF development and the risk of ACLF development with and without rifaximin treatment were identified by univariate and multivariate analysis using Fine and Gray’s proportional subhazards model. EA level was higher in Child-Pugh class B than in class A patients, and class B patients had an increased risk of ACLF development compared with class A patients. Multivariate analysis showed that EA level was a predictive factor independently associated with ACLF development. Rifaximin decreased EA level and the risk of ACLF development in Child-Pugh class B patients. Et levels were associated with functional liver capacity and were predictive of ACLF development in cirrhotic patients. Rifaximin decreased Et level and the risk of ACLF development in advanced cirrhotic patients.https://www.mdpi.com/2077-0383/9/5/1467endotoxin activityacute-on-chronic liver failurerifaximin |
| spellingShingle | Hiroaki Takaya Tadashi Namisaki Shinya Sato Kosuke Kaji Yuki Tsuji Daisuke Kaya Yukihisa Fujinaga Yasuhiko Sawada Naotaka Shimozato Hideto Kawaratani Kei Moriya Takemi Akahane Akira Mitoro Hitoshi Yoshiji Increased Endotoxin Activity Is Associated with the Risk of Developing Acute-on-Chronic Liver Failure Journal of Clinical Medicine endotoxin activity acute-on-chronic liver failure rifaximin |
| title | Increased Endotoxin Activity Is Associated with the Risk of Developing Acute-on-Chronic Liver Failure |
| title_full | Increased Endotoxin Activity Is Associated with the Risk of Developing Acute-on-Chronic Liver Failure |
| title_fullStr | Increased Endotoxin Activity Is Associated with the Risk of Developing Acute-on-Chronic Liver Failure |
| title_full_unstemmed | Increased Endotoxin Activity Is Associated with the Risk of Developing Acute-on-Chronic Liver Failure |
| title_short | Increased Endotoxin Activity Is Associated with the Risk of Developing Acute-on-Chronic Liver Failure |
| title_sort | increased endotoxin activity is associated with the risk of developing acute on chronic liver failure |
| topic | endotoxin activity acute-on-chronic liver failure rifaximin |
| url | https://www.mdpi.com/2077-0383/9/5/1467 |
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