The soluble mannose receptor is released from the liver in cirrhotic patients, but is not associated with bacterial translocation

TY - JOUR

T1 - The soluble mannose receptor is released from the liver in cirrhotic patients, but is not associated with bacterial translocation

AU - Laursen, Tea L

AU - Rødgaard-Hansen, Sidsel

AU - Møller, Holger J

AU - Mortensen, Christian

AU - Karlsen, Stine

AU - Nielsen, Dennis T

AU - Frevert, Susanne

AU - Clemmesen, Jens O

AU - Møller, Søren

AU - Jensen, Jørgen S

AU - Bendtsen, Flemming

AU - Grønbaek, Henning

N1 - © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background & Aims: Intestinal bacterial translocation is involved in activation of liver macrophages in cirrhotic patients. Macrophages play a key role in liver inflammation and are involved in the pathogenesis of cirrhosis and complications. Bacterial translocation may be determined by presence of bacterial DNA and macrophage activation, by the soluble mannose receptor. We hypothesize that the soluble mannose receptor is released from hepatic macrophages in cirrhosis and associated with bacterial DNA, portal pressure and complications. Methods: We investigated 28 cirrhotic patients set for transjugular intrahepatic portosystemic shunt insertion as a result of refractory ascites (n=17), acute (n=3), or recurrent variceal bleeding (n=8). We analysed plasma from the portal and hepatic veins for bacterial DNA and soluble mannose receptor with qPCR and ELISA. Results: The median soluble mannose receptor level was elevated in the hepatic vein compared with the portal vein (0.57(interquartile range 0.31) vs 0.55(0.40) mg/L, P=.005). The soluble mannose receptor levels were similar in bacterial DNA-positive and -negative patients. The soluble mannose receptor level in the portal and hepatic veins correlated with the portal pressure prior to transjugular intrahepatic portosystemic shunt insertion (r=.52, P<.008, both) and the levels correlated with Child-Pugh score (r=.63 and r=.56, P<.004, both). We observed higher soluble mannose receptor levels in patients with acute variceal bleeding compared to other indications (P<.05). Conclusion: This study showed hepatic soluble mannose receptor excretion with a higher level in the hepatic than the portal vein, though with no associations to bacterial DNA. We observed associations between soluble mannose receptor levels and portal pressure and higher levels in patients with acute variceal bleeding indicating the soluble mannose receptor as a marker of complications of cirrhosis, but not bacterial translocation.

AB - Background & Aims: Intestinal bacterial translocation is involved in activation of liver macrophages in cirrhotic patients. Macrophages play a key role in liver inflammation and are involved in the pathogenesis of cirrhosis and complications. Bacterial translocation may be determined by presence of bacterial DNA and macrophage activation, by the soluble mannose receptor. We hypothesize that the soluble mannose receptor is released from hepatic macrophages in cirrhosis and associated with bacterial DNA, portal pressure and complications. Methods: We investigated 28 cirrhotic patients set for transjugular intrahepatic portosystemic shunt insertion as a result of refractory ascites (n=17), acute (n=3), or recurrent variceal bleeding (n=8). We analysed plasma from the portal and hepatic veins for bacterial DNA and soluble mannose receptor with qPCR and ELISA. Results: The median soluble mannose receptor level was elevated in the hepatic vein compared with the portal vein (0.57(interquartile range 0.31) vs 0.55(0.40) mg/L, P=.005). The soluble mannose receptor levels were similar in bacterial DNA-positive and -negative patients. The soluble mannose receptor level in the portal and hepatic veins correlated with the portal pressure prior to transjugular intrahepatic portosystemic shunt insertion (r=.52, P<.008, both) and the levels correlated with Child-Pugh score (r=.63 and r=.56, P<.004, both). We observed higher soluble mannose receptor levels in patients with acute variceal bleeding compared to other indications (P<.05). Conclusion: This study showed hepatic soluble mannose receptor excretion with a higher level in the hepatic than the portal vein, though with no associations to bacterial DNA. We observed associations between soluble mannose receptor levels and portal pressure and higher levels in patients with acute variceal bleeding indicating the soluble mannose receptor as a marker of complications of cirrhosis, but not bacterial translocation.

KW - Aged

KW - Ascites/etiology

KW - Bacterial Translocation

KW - Biomarkers/blood

KW - DNA, Bacterial/analysis

KW - Denmark

KW - Esophageal and Gastric Varices/etiology

KW - Female

KW - Gastrointestinal Hemorrhage/etiology

KW - Humans

KW - Lectins, C-Type/blood

KW - Liver Cirrhosis/immunology

KW - Macrophage Activation

KW - Macrophages/immunology

KW - Male

KW - Mannose-Binding Lectins/blood

KW - Middle Aged

KW - Portal Pressure

KW - Portasystemic Shunt, Transjugular Intrahepatic

KW - Receptors, Cell Surface/blood

KW - Solubility

U2 - 10.1111/liv.13262

DO - 10.1111/liv.13262

M3 - Journal article

C2 - 27706896

SN - 1478-3223

VL - 37

SP - 569

EP - 575

JO - Liver International

JF - Liver International

IS - 4

ER -