Large intestine permeability is increased in patients with compensated liver cirrhosis.

K.E. Pijls*, G.H. Koek, E.E. Elamin, H.D. Vries, A.A. Masclee, D.M. Jonkers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

29 Citations (Web of Science)


Intestinal barrier dysfunction, facilitating translocation of bacteria and bacterial products, plays an important role in the pathophysiology of liver cirrhosis and its complications. Increased intestinal permeability has been found in patients with liver cirrhosis, but data on small and large intestine permeability and tight junctions (TJs) in patients with compensated cirrhosis are scarce. We aimed to investigate both small and large intestine permeability in stable compensated cirrhotic patients compared to healthy controls, and evaluated the expression of TJ proteins in mucosal biopsies at duodenal and sigmoid level. Intestinal permeability was assessed in 26 patients with compensated cirrhosis and 27 matched controls using a multi-sugar test. Duodenal and sigmoid biopsies were available from a subgroup for analyses of gene transcription and expression of key TJ proteins by qRT-PCR and ELISA, respectively. Median 0-5 h urinary sucrose excretion and lactulose/rhamnose ratio were comparable between patients with compensated cirrhosis and controls, while 5-24 h urinary sucralose/erythritol ratio was increased in these patients. Down-regulation of gene transcription was found for claudin-3 in duodenal biopsies and claudin-4 in sigmoid biopsies and at the protein level occludin expression was significantly increased in both duodenal and sigmoid biopsies. This study shows that gastroduodenal and small intestine permeability are not altered, while large intestine permeability is increased in stable compensated cirrhotic patients. Only limited alterations were found regarding the expression of TJ proteins in both the small and large intestine.
Original languageEnglish
Pages (from-to)G147-G153
JournalAmerican Journal of Physiology-Gastrointestinal and Liver Physiology
Issue number2
Publication statusPublished - 1 Jan 2014

Cite this