Translocation of bacterial DNA from Gram‐positive microorganisms is associated with a species‐specific inflammatory response in serum and ascitic fluid of patients with cirrhosis
Translocation of bacterial‐DNA in patients with cirrhosis and ascites triggers an innate immune response. Identification of characteristics to which this response is sensitive is relevant from a clinical standpoint. The aim of this study has been to determine if the proinflammatory immune response established in vivo in cirrhotic patients with ascites as a consequence of bacterial‐DNA translocation is related to the identified bacterial species and their frequency of cytosine‐guanosine content in serum and ascitic fluid. Patients with advanced cirrhosis and ascites were included in the study and distributed into groups I and II according to the absence or presence of bacterial‐DNA translocation, respectively. Serum and ascitic fluid levels of proinflammatory cytokines after normalization of bacterial‐DNA concentration and the activated form of nuclear factor‐kappa B in ascitic fluid pellets were measured by enzyme‐linked immunosorbent assay techniques. Translocation of bacterial‐DNA with higher cytosine‐guanosine content induced the highest cytokine response, which was higher than that in patients without bacterial‐DNA translocation. The activated form of nuclear factor‐kappa B in ascitic fluid pellets of patients with bacterial‐DNA translocation was greater in patients with higher bacterial‐DNA cytosine‐guanosine content, whereas the amount of total nuclear factor‐kappa B remained unaltered. Bacterial‐DNA translocation induces a marked immune reaction in vivo in patients with advanced cirrhosis and ascites which is related, among other factors, to the bacterial‐DNA cytosine‐guanosine content. Therefore, the host's immune response to bacterial‐DNA translocation constitutes a species‐specific phenomenon.