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PMID: 18000721 Published · ppublish English Journal Article

Lipopolysaccharide-binding protein plasma levels and liver TNF-alpha gene expression in obese patients: evidence for the potential role of endotoxin in the pathogenesis of non-alcoholic steatohepatitis.

Obesity surgery ·Vol. 17 ·No. 10 ·2007-10-00 ·Pages 1374-80

Ruiz AG, Casafont F, Crespo J, Cayón A, Mayorga M, Estebanez A, Fernadez-Escalante JC, Pons-Romero F

Abstract

Some lines of evidence suggest that endotoxin may induce non-alcoholic steatohepatitis (NASH) in a background of fatty liver. However, a clear association between increased endotoxemia and development of steatohepatitis in obese patients has not been confirmed. We aim to assess the endotoxemic state of patients with non-alcoholic fatty liver disease (NAFLD) and its relationship with the liver expression of TNF-alpha and the presence of NASH. Prospective study comprising 40 patients with morbid obesity who were diagnosed with NAFLD. Blood samples and liver biopsies were collected. Endotoxemia was assessed by the evaluation of circulating level of LPS-binding protein (LBP). Plasma levels of LBP and TNF-alpha were assessed by ELISA. The expression of TNF-alpha in liver tissue was evaluated by real-time PCR. Histological examination was performed to evaluate the presence of steatosis or NASH. Levels of LBP were increased in obese patients with NAFLD. In addition, plasma level of LBP was increased in patients with steatohepatitis (14.2 +/- 3.9 microg/mL) when compared with patients with simple steatosis (11.5 +/- 3.2 microg/mL), P=0.041. The TNF-alpha mRNA expression in liver tissue was significantly higher in patients with NASH. This increment correlated with the rise in plasma levels of LBP (r=0.412, P=0.036). NAFLD patients have elevated plasma levels of LBP and they are further increased in patients with NASH. This increase is related to a rise in TNF-alpha gene expression in the hepatic tissue which supports a role for endotoxemia in the development of steatohepatitis in obese patients.

MeSH Terms
Acute-Phase Proteins Adult Biliopancreatic Diversion Carrier Proteins/blood Endotoxins/physiology Fatty Liver/genetics Gene Expression/physiology Gene Expression Regulation Hepatitis/genetics Humans Liver/physiology Membrane Glycoproteins/blood Middle Aged Obesity/genetics Obesity, Morbid/genetics,surgery Tumor Necrosis Factor-alpha/genetics
Chemicals
Acute-Phase Proteins Carrier Proteins Endotoxins Membrane Glycoproteins Tumor Necrosis Factor-alpha lipopolysaccharide-binding protein
Authors & Affiliations
8 authors, click to expand affiliations / ORCID
Ruiz Armando Guerra
Gastroenterology Unit, University Hospital Marques de Valdecilla, School of Medicine, Santander, Spain.
Casafont Fernando
Crespo Javier
Cayón Amalia
Mayorga Marta
Estebanez Angel
Fernadez-Escalante José Carlos
Pons-Romero Fernando
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Article Info
Journal
Obesity surgery
Abbr.
Obes Surg
ISSN
0960-8923
DOI
10.1007/s11695-007-9243-7
Published
2007-10-00
Pages
1374-80
Language
English
Region
United States
NLM ID
9106714
Subset
IM
External Links
PubMed source DOI: 10.1007/s11695-007-9243-7 View journal details
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