{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:54:07Z","timestamp":1790031247840,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,10,24]],"date-time":"2018-10-24T00:00:00Z","timestamp":1540339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","award":["240787\/F20"],"award-info":[{"award-number":["240787\/F20"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>One important hypothesis in primary sclerosing cholangitis pathophysiology suggests that bacterial products from an inflamed leaky gut lead to biliary inflammation. We aimed to investigate whether circulating markers of bacterial translocation were associated with survival in a Norwegian primary sclerosing cholangitis cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum levels of zonulin, intestinal fatty acid binding protein, soluble CD14, lipopolysaccharide and lipopolysaccharide\u2010binding protein were measured in 166 primary sclerosing cholangitis patients and 100 healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lipopolysaccharide\u2010binding protein and soluble CD14 were elevated in primary sclerosing cholangitis compared with healthy controls (median 13\u00a0662 vs 12\u00a0339\u00a0ng\/mL, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.010 and 1657 vs 1196\u00a0ng\/mL, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, respectively). High soluble CD14 and lipopolysaccharide\u2010binding protein (values &gt;optimal cut\u2010off using receiver operating characteristics) were associated with reduced liver transplantation\u2013free survival (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005, respectively). The concentration of soluble CD14 was higher in patients with hepatobiliary cancer compared to other primary sclerosing cholangitis patients and healthy controls. Zonulin was lower in primary sclerosing cholangitis than controls, but when excluding primary sclerosing cholangitis patients with increased prothrombin time zonulin concentrations were similar in primary sclerosing cholangitis and healthy controls. Concomitant inflammatory bowel disease did not influence the results, while inflammatory bowel disease patients without primary sclerosing cholangitis (n\u00a0=\u00a040) had lower concentration of soluble CD14. In multivariable Cox regression, high soluble CD14 and high lipopolysaccharide\u2010binding protein were associated with transplantation\u2010free survival, independent from Mayo risk score (HR: 2.26 [95% CI: 1.15\u20104.43], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.018 and HR: 2.00 [95% CI: 1.17\u20103.43], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.011, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Primary sclerosing cholangitis patients show increased levels of circulating markers of bacterial translocation. High levels are associated with poor prognosis measured by transplantation\u2010free survival, indicating that ongoing gut leakage could have clinical impact in primary sclerosing cholangitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13979","type":"journal-article","created":{"date-parts":[[2018,9,30]],"date-time":"2018-09-30T12:33:07Z","timestamp":1538310787000},"page":"371-381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Circulating markers of gut barrier function associated with disease severity in primary sclerosing cholangitis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7094-5585","authenticated-orcid":false,"given":"Amandeep K.","family":"Dhillon","sequence":"first","affiliation":[{"name":"Norwegian PSC Center, Division of Surgery, Inflammatory Diseases and Transplantation Oslo University Hospital Rikshospitalet Oslo Norway"},{"name":"Institute of Clinical 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Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sissel","family":"\u00c5kra","sequence":"additional","affiliation":[{"name":"Center for Clinical Heart Research, Department of Cardiology Oslo University Hospital Ullev\u00e5l Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evaggelia","family":"Liaskou","sequence":"additional","affiliation":[{"name":"Centre for Liver Research, NIHR Birmingham Liver Biomedical Research Centre, Institute of Immunology &amp; Immunotherapy University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rn","family":"Moum","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Oslo Oslo Norway"},{"name":"Department of Gastroenterology, Division of Medicine Oslo University Hospital Ullev\u00e5l Oslo 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