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Circulating endotoxin and interleukin-6 levels are associated with Doppler-evaluated pulmonary vascular resistance in cirrhotic patients

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Abstract

Purpose

Endotoxin and interleukin-6 levels (IL-6) have been involved in the development of pulmonary hypertension (PH) in non-cirrhotic experimental models and subjects. High circulating levels of both substances have been detected in cirrhosis. The association between circulating endotoxin and IL-6 levels and echocardiographically evaluated pulmonary vascular resistance (PVR) in cirrhotic patients are investigated.

Methods

Thirty-seven cirrhotic patients were studied: 25 with PVR <120 dynes s cm−5 (group 1) and 12 with PVR >120 dynes s cm−5 (group 2). Plasma endotoxin and serum IL-6 levels were measured. The PVR and cardiac output (CO) by Doppler ultrasound, mean arterial pressure (MAP), and systemic vascular resistance (SVR) as the ratio MAP/CO were evaluated.

Results

Child–Pugh scores, MAP, CO, and SVR were similar in both groups. Endotoxin levels were correlated significantly with IL-6 levels (r = 0.342; P = 0.03). Endotoxin and IL-6 levels were significantly higher in group 2 compared to group 1 (2.26 [0.39–8.4] vs. 0.85 [0.37–7.6] EU/mL; P = 0.04 and 37.4 [7.85–106.5] vs. 8.36 [3.15–53.7] pg/mL; P < 0.001, respectively). The PVR was correlated significantly with endotoxin levels in group 2 (r = 0.587; P = 0.04) and with IL-6 levels in group 1 (r = 0.529; P = 0.01) and group 2 (r = 0.760; P = 0.004), respectively.

Conclusions

Our results suggest that endotoxin and IL-6 may contribute to cirrhosis-associated PH. In this regard, modulation of these substances could improve pulmonary pressures in cirrhotic patients.

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Authors and Affiliations

  1. First Division of Internal Medicine and Hepato-Gastroenterology Unit, Medical School of Ioannina, University Hospital, 45110, Ioannina, Greece

    Georgios N. Kalambokis & Epameinondas V. Tsianos

  2. Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, Patras, Greece

    Athanasia Mouzaki & Maria Rodi

  3. Department of Cardiology, University Hospital, Ioannina, Greece

    Konstantinos Pappas & Panagiotis Korantzopoulos

Authors
  1. Georgios N. Kalambokis
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  2. Athanasia Mouzaki
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  3. Maria Rodi
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  4. Konstantinos Pappas
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  5. Panagiotis Korantzopoulos
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  6. Epameinondas V. Tsianos
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Correspondence to Georgios N. Kalambokis or Epameinondas V. Tsianos.

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Kalambokis, G.N., Mouzaki, A., Rodi, M. et al. Circulating endotoxin and interleukin-6 levels are associated with Doppler-evaluated pulmonary vascular resistance in cirrhotic patients. Hepatol Int 6, 783–789 (2012). https://doi.org/10.1007/s12072-011-9337-0

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  • DOI: https://doi.org/10.1007/s12072-011-9337-0

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