NDLI: Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Miele, Luca Valenza, Venanzio La Torre, Giuseppe Montalto, Massimo Cammarota, Giovanni Ricci, Riccardo Mascianà, Roberta Forgione, Alessandra Gabrieli, Maria L. Perotti, Germano Vecchio, Fabio M. Rapaccini, Gianlodovico Gasbarrini, Giovanni Day, Chris P. Grieco, Antonio
Description	Country affiliation: Italy Author Affiliation: Miele L ( Institute of Internal Medicine, Catholic University of Rome, Rome, Italy.)
Abstract	UNLABELLED: The role played by the gut in nonalcoholic fatty liver disease (NAFLD) is still a matter of debate, although animal and human studies suggest that gut-derived endotoxin may be important. We investigated intestinal permeability in patients with NAFLD and evaluated the correlations between this phenomenon and the stage of the disease, the integrity of tight junctions within the small intestine, and prevalence of small intestinal bacterial overgrowth (SIBO). We examined 35 consecutive patients with biopsy-proven NAFLD, 27 with untreated celiac disease (as a model of intestinal hyperpermeability) and 24 healthy volunteers. We assessed the presence of SIBO by glucose breath testing (GBT), intestinal permeability by means of urinary excretion of (51)Cr-ethylene diamine tetraacetate ((51)Cr-EDTA) test, and the integrity of tight junctions within the gut by immunohistochemical analysis of zona occludens-1 (ZO-1) expression in duodenal biopsy specimens. Patients with NAFLD had significantly increased gut permeability (compared with healthy subjects; P < 0.001) and a higher prevalence of SIBO, although both were lower than in the untreated celiac patients. In patients with NAFLD, both gut permeability and the prevalence of SIBO correlated with the severity of steatosis but not with presence of NASH. CONCLUSIONS: Our results provide the first evidence that NAFLD in humans is associated with increased gut permeability and that this abnormality is related to the increased prevalence of SIBO in these patients. The increased permeability appears to be caused by disruption of intercellular tight junctions in the intestine, and it may play an important role in the pathogenesis of hepatic fat deposition.
File Format	HTM / HTML
ISSN	02709139
Issue Number	6
Volume Number	49
e-ISSN	15273350
Journal	Hepatology
Language	English
Publisher	Wiley
Publisher Date	2009-06-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline Hepatology Fatty Liver Metabolism Intestine, Small Ultrastructure Tight Junctions Adult Female Humans Microbiology Male Middle Aged Permeability Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Hepatology

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