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Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?

BACKGROUND: Bacterial translocation plays important role in the complications of liver cirrhosis. Antibody formation against various microbial antigens is common in Crohn's disease and considered to be caused by sustained exposure to gut microflora constituents. We hypothesized that anti-microb...

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Autores principales: Papp, Maria, Norman, Gary L., Vitalis, Zsuzsanna, Tornai, Istvan, Altorjay, Istvan, Foldi, Ildiko, Udvardy, Miklos, Shums, Zakera, Dinya, Tamas, Orosz, Peter, Lombay, Bela, Par, Gabriella, Par, Alajos, Veres, Gabor, Csak, Timea, Osztovits, Janos, Szalay, Ferenc, Lakatos, Peter Laszlo
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944893/
https://www.ncbi.nlm.nih.gov/pubmed/20886039
http://dx.doi.org/10.1371/journal.pone.0012957
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author Papp, Maria
Norman, Gary L.
Vitalis, Zsuzsanna
Tornai, Istvan
Altorjay, Istvan
Foldi, Ildiko
Udvardy, Miklos
Shums, Zakera
Dinya, Tamas
Orosz, Peter
Lombay, Bela
Par, Gabriella
Par, Alajos
Veres, Gabor
Csak, Timea
Osztovits, Janos
Szalay, Ferenc
Lakatos, Peter Laszlo
author_facet Papp, Maria
Norman, Gary L.
Vitalis, Zsuzsanna
Tornai, Istvan
Altorjay, Istvan
Foldi, Ildiko
Udvardy, Miklos
Shums, Zakera
Dinya, Tamas
Orosz, Peter
Lombay, Bela
Par, Gabriella
Par, Alajos
Veres, Gabor
Csak, Timea
Osztovits, Janos
Szalay, Ferenc
Lakatos, Peter Laszlo
author_sort Papp, Maria
collection PubMed
description BACKGROUND: Bacterial translocation plays important role in the complications of liver cirrhosis. Antibody formation against various microbial antigens is common in Crohn's disease and considered to be caused by sustained exposure to gut microflora constituents. We hypothesized that anti-microbial antibodies are present in patients with liver cirrhosis and may be associated with the development of bacterial infections. METHODOLOGY/PRINCIPAL FINDINGS: Sera of 676 patients with various chronic liver diseases (autoimmune diseases:266, viral hepatitis C:124, and liver cirrhosis of different etiology:286) and 100 controls were assayed for antibodies to Saccharomyces cerevisiae(ASCA) and to antigens derived from two intestinal bacterial isolates (one gram positive, one gram negative, neither is Escherichia coli). In patients with liver cirrhosis, we also prospectively recorded the development of severe episodes of bacterial infection. ASCA and anti-OMP Plus™ antibodies were present in 38.5% and 62.6% of patients with cirrhosis and in 16% and 20% of controls, respectively (p<0.001). Occurrence of these antibodies was more frequent in cases of advanced cirrhosis (according to Child-Pugh and MELD score; p<0.001) or in the presence of ascites (p<0.001). During the median follow-up of 425 days, 81 patients (28.3%) presented with severe bacterial infections. Anti-microbial antibody titers (p = 0.003), as well as multiple seroreactivity (p = 0.036), was associated with infectious events. In logistic regression analysis, the presence of ascites (OR:1.62, 95%CI:1.16–2.25), co-morbidities (OR:2.22, 95%CI:1.27–3.86), and ASCA positivity (OR:1.59, 95%CI:1.07–2.36) were independent risk factors for severe infections. A shorter time period until the first infection was associated with the presence of ASCA (p = 0.03) and multiple seropositivity (p = 0.037) by Kaplan-Meier analysis, and with Child-Pugh stage (p = 0.018, OR:1.85) and co-morbidities (p<0.001, OR:2.02) by Cox-regression analysis. CONCLUSIONS/SIGNIFICANCE: The present study suggests that systemic reactivity to microbial components reflects compromised mucosal immunity in patients with liver cirrhosis, further supporting the possible role of bacterial translocation in the formation of anti-microbial antibodies.
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spelling pubmed-29448932010-09-30 Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity? Papp, Maria Norman, Gary L. Vitalis, Zsuzsanna Tornai, Istvan Altorjay, Istvan Foldi, Ildiko Udvardy, Miklos Shums, Zakera Dinya, Tamas Orosz, Peter Lombay, Bela Par, Gabriella Par, Alajos Veres, Gabor Csak, Timea Osztovits, Janos Szalay, Ferenc Lakatos, Peter Laszlo PLoS One Research Article BACKGROUND: Bacterial translocation plays important role in the complications of liver cirrhosis. Antibody formation against various microbial antigens is common in Crohn's disease and considered to be caused by sustained exposure to gut microflora constituents. We hypothesized that anti-microbial antibodies are present in patients with liver cirrhosis and may be associated with the development of bacterial infections. METHODOLOGY/PRINCIPAL FINDINGS: Sera of 676 patients with various chronic liver diseases (autoimmune diseases:266, viral hepatitis C:124, and liver cirrhosis of different etiology:286) and 100 controls were assayed for antibodies to Saccharomyces cerevisiae(ASCA) and to antigens derived from two intestinal bacterial isolates (one gram positive, one gram negative, neither is Escherichia coli). In patients with liver cirrhosis, we also prospectively recorded the development of severe episodes of bacterial infection. ASCA and anti-OMP Plus™ antibodies were present in 38.5% and 62.6% of patients with cirrhosis and in 16% and 20% of controls, respectively (p<0.001). Occurrence of these antibodies was more frequent in cases of advanced cirrhosis (according to Child-Pugh and MELD score; p<0.001) or in the presence of ascites (p<0.001). During the median follow-up of 425 days, 81 patients (28.3%) presented with severe bacterial infections. Anti-microbial antibody titers (p = 0.003), as well as multiple seroreactivity (p = 0.036), was associated with infectious events. In logistic regression analysis, the presence of ascites (OR:1.62, 95%CI:1.16–2.25), co-morbidities (OR:2.22, 95%CI:1.27–3.86), and ASCA positivity (OR:1.59, 95%CI:1.07–2.36) were independent risk factors for severe infections. A shorter time period until the first infection was associated with the presence of ASCA (p = 0.03) and multiple seropositivity (p = 0.037) by Kaplan-Meier analysis, and with Child-Pugh stage (p = 0.018, OR:1.85) and co-morbidities (p<0.001, OR:2.02) by Cox-regression analysis. CONCLUSIONS/SIGNIFICANCE: The present study suggests that systemic reactivity to microbial components reflects compromised mucosal immunity in patients with liver cirrhosis, further supporting the possible role of bacterial translocation in the formation of anti-microbial antibodies. Public Library of Science 2010-09-23 /pmc/articles/PMC2944893/ /pubmed/20886039 http://dx.doi.org/10.1371/journal.pone.0012957 Text en Papp et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Papp, Maria
Norman, Gary L.
Vitalis, Zsuzsanna
Tornai, Istvan
Altorjay, Istvan
Foldi, Ildiko
Udvardy, Miklos
Shums, Zakera
Dinya, Tamas
Orosz, Peter
Lombay, Bela
Par, Gabriella
Par, Alajos
Veres, Gabor
Csak, Timea
Osztovits, Janos
Szalay, Ferenc
Lakatos, Peter Laszlo
Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?
title Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?
title_full Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?
title_fullStr Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?
title_full_unstemmed Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?
title_short Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?
title_sort presence of anti-microbial antibodies in liver cirrhosis – a tell-tale sign of compromised immunity?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944893/
https://www.ncbi.nlm.nih.gov/pubmed/20886039
http://dx.doi.org/10.1371/journal.pone.0012957
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