{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:43:12Z","timestamp":1786977792197,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":1735,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Systemic activation of the in\ufb02ammatory immune system contributes to the progression of cir-rhosis with ascites. Immune cells become activated after interacting at the mesenteric lymph nodes (MLNs) with bacteria translocated from the gut, and thereafter reach the bloodstream through recirculation. It is unknown whether systemic activation of the immune system is present in pre-ascitic cirrhosis, in which gut bacterial translocation has not been described. The purpose of this study was to determine whether systemic activation of the immune sys-tem initiates in rats with compensated carbon tetrachloride (CCl\n                      <jats:sub>4<\/jats:sub>\n                      )-induced cirrhosis, and if so to establish the activation site of immune cells. We studied the activation status of immune cells in peripheral blood, MLNs, and hepatic lymph nodes (HLNs). Systemic in\ufb02ammation was present in rats with cirrhosis, as shown by expansion (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) of circulating total and in\ufb02ammatory monocytes and recently activated CD134\n                      <jats:sup>1<\/jats:sup>\n                      T helper (T\n                      <jats:sub>h<\/jats:sub>\n                      ) cells. The same popu-lations of cells were increased (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) in MLNs and HLNs. Bacterial translocation was absent in rats with cirrhosis or control rats, but bacterial DNA fragments were present in the MLNs of 54% of rats with cirrhosis. The liver was the source of activated immune cells pres-ent in the blood, as shown by the direct correlation between activated T\n                      <jats:sub>h<\/jats:sub>\n                      cells in the blood and HLNs, but not in MLNs, and the normalization by gut decontamination with antibiotics of activated cells in MLNs, but not in the blood or HLNs.\n                      <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                      In experimental cir-rhosis, systemic activation of the immune system occurs before ascites development and is driven by recirculation of cells activated in HLNs. In addition, in compensated cirrhosis, bacterial DNA fragments reach the MLNs, where they elicit a local in\ufb02ammatory response. 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