Studies on bacterial endotoxin and intestinal absorption function in patients with chronic heart failure
- PMID: 21190739
- DOI: 10.1016/j.ijcard.2010.12.016
Studies on bacterial endotoxin and intestinal absorption function in patients with chronic heart failure
Abstract
Background: Small intestinal function may be altered in decompensated chronic heart failure (CHF) and translocating LPS may contribute to systemic inflammation observed in CHF.
Methods: We measured intestinal permeability (melibiose and rhamnose), active (3-O-methyl-d-glucose (3-OMG)) and passive (d-xylose) carrier-mediated absorption in 20 CHF patients (12 edematous and 8 non-edematous) and 8 controls by saccharide absorption technique assessing urinary recovery of orally administered sugars. We additionally measured LPS concentrations in 42 patients with decompensated heart failure and after recompensation.
Results: CHF patients had a 54% reduction of active carrier-mediated intestinal transport compared to controls (p<0.0001). This reduction was strongest in edematous compared to non-edematous patients and controls (recovery in urine: 13.2±2.0% vs. 20.8±2.4% vs. 36.0 ± 3.7%, all p ≤ 0.05). Patients showed a 34% reduction of passive carrier-mediated transport, strongest in edematous patients (p=0.006). A greater impairment of active carrier-mediated transport remained significant after adjustment for non-mucosal factors in CHF (p=0.0004). Non carrier-mediated intestinal permeability was not altered. Data from 42 decompensated patients showed a decrease in LPS after recompensation (p=0.004). Edematous patients had highest blood concentrations of LPS, TNF and sTNF-R1 (p<0.04). CHF patients with abnormal LPS concentrations >0.50EU/mL (n=7) had the highest concentrations of TNF (7.0 ± 1.6 vs. 3.1 ± 0.3pg/mL, p<0.02), and sTNF-R1 (3499 ± 52 vs. 1599±219 pg/mL, p=0.02).
Conclusion: Active carrier-mediated intestinal transport is reduced in decompensated CHF indicating epithelial dysfunction possibly as a consequence of intestinal ischemia. Higher LPS concentrations in edematous CHF relate to inflammation. LPS decreased after recompensation. This suggests a cause/effect relationship between edematous gut wall, epithelial dysfunction and translocating LPS.
Copyright © 2010. Published by Elsevier Ireland Ltd.
Similar articles
-
Altered intestinal function in patients with chronic heart failure.J Am Coll Cardiol. 2007 Oct 16;50(16):1561-9. doi: 10.1016/j.jacc.2007.07.016. Epub 2007 Oct 1. J Am Coll Cardiol. 2007. PMID: 17936155
-
Endotoxin hypersensitivity in chronic heart failure.Int J Cardiol. 2007 Feb 7;115(2):159-63. doi: 10.1016/j.ijcard.2006.03.003. Int J Cardiol. 2007. PMID: 16766065
-
Intracellular monocyte cytokine production and CD 14 expression are up-regulated in severe vs mild chronic heart failure.J Heart Lung Transplant. 2005 Jul;24(7):854-9. doi: 10.1016/j.healun.2004.04.017. J Heart Lung Transplant. 2005. PMID: 15982613
-
The emerging role of the gut in chronic heart failure.Curr Opin Clin Nutr Metab Care. 2008 Sep;11(5):632-9. doi: 10.1097/MCO.0b013e32830a4c6e. Curr Opin Clin Nutr Metab Care. 2008. PMID: 18685461 Review.
-
The gut and intestinal bacteria in chronic heart failure.Curr Drug Metab. 2009 Jan;10(1):22-8. doi: 10.2174/138920009787048374. Curr Drug Metab. 2009. PMID: 19149510 Review.
Cited by
-
Cardiovascular Comorbidities and Inflammatory Bowel Disease: Causes and Consequences.Gastroenterol Hepatol (N Y). 2024 Apr;20(4):204-215. Gastroenterol Hepatol (N Y). 2024. PMID: 38682122 Free PMC article.
-
The Correlation Between Heart Failure and Gut Microbiome Metabolites.Infect Microbes Dis. 2020 Nov 4;2(4):136-143. doi: 10.1097/IM9.0000000000000042. eCollection 2020 Dec. Infect Microbes Dis. 2020. PMID: 38630083 Free PMC article. Review.
-
Associations between the gut microbiome, gut microbiology and heart failure: Current understanding and future directions.Am Heart J Plus. 2022 Jun 11;17:100150. doi: 10.1016/j.ahjo.2022.100150. eCollection 2022 May. Am Heart J Plus. 2022. PMID: 38559891 Free PMC article. Review.
-
Pulmonary Hypertension and the Gut Microbiome.Biomedicines. 2024 Jan 12;12(1):169. doi: 10.3390/biomedicines12010169. Biomedicines. 2024. PMID: 38255274 Free PMC article. Review.
-
Targeting gut microbiota in aging-related cardiovascular dysfunction: focus on the mechanisms.Gut Microbes. 2023 Dec;15(2):2290331. doi: 10.1080/19490976.2023.2290331. Epub 2023 Dec 10. Gut Microbes. 2023. PMID: 38073096 Free PMC article. Review.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical