{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:05:05Z","timestamp":1791234305839,"version":"4.1.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Bacterial infections are associated with the risk of variceal bleeding through complex pathophysiologic pathways.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The primary objective of the present case-control study was to investigate the role of bacterial translocation and intestinal barrier dysfunction in the pathogenesis of variceal bleeding. A secondary objective was to determine independent predictors of key outcomes in variceal bleeding, including bleeding-related mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty-four (<jats:italic>n<\/jats:italic> = 84) consecutive patients participated in the study, 41 patients with acute variceal bleeding and 43 patients with stable cirrhosis, and were followed up for 6 weeks. Peripheral blood samples were collected at patient admission and before any therapeutic intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Child-Pugh (CP) score (OR: 1.868; <jats:italic>p<\/jats:italic> = 0.044), IgM anti-endotoxin antibody levels (OR: 0.954; <jats:italic>p<\/jats:italic> = 0.016) and TGF-\u03b2 levels (OR: 0.377; <jats:italic>p<\/jats:italic> = 0.026) were found to be significant predictors of variceal bleeding. Regression analysis revealed that albumin (OR: 0.0311; <jats:italic>p<\/jats:italic> = 0.023), CRP (OR: 3.234; <jats:italic>p<\/jats:italic> = 0.034) and FABP2 levels (OR:1.000, <jats:italic>p<\/jats:italic> = 0.040), CP score (OR: 2.504; <jats:italic>p<\/jats:italic> = 0.016), CP creatinine score (OR: 2.366; <jats:italic>p<\/jats:italic> = 0.008), end-stage liver disease model (MELD), Na (OR: 1.283; <jats:italic>p<\/jats:italic> = 0.033), portal vein thrombosis (OR: 0.075; <jats:italic>p<\/jats:italic> = 0.008), hepatocellular carcinoma (OR: 0.060; <jats:italic>p<\/jats:italic> = 0.003) and encephalopathy (OR: 0.179; <jats:italic>p<\/jats:italic> = 0.045) were significantly associated with 6-week mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bacterial translocation and gut barrier impairment are directly related to the risk of variceal bleeding. Microbiota-modulating interventions and anti-endotoxin agents may be promising strategies to prevent variceal bleeding.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.836306","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T07:26:21Z","timestamp":1646292381000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Endotoxin Translocation and Gut Barrier Dysfunction Are Related to Variceal Bleeding in Patients With Liver Cirrhosis"],"prefix":"10.3389","volume":"9","author":[{"given":"Christos","family":"Triantos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kalafateli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stelios F.","family":"Assimakopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Karaivazoglou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Mantaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Aggeletopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota I.","family":"Spantidea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Tsiaoussis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Rodi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hariklia","family":"Kranidioti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Goukos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spilios","family":"Manolakopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charalambos","family":"Gogos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios N.","family":"Samonakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios L.","family":"Daikos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasia","family":"Mouzaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Thomopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1053\/j.gastro.2013.10.018","article-title":"A MELD-based model to determine risk of mortality among patients with acute variceal bleeding","volume":"146","author":"Reverter","year":"2014","journal-title":"Gastroenterology."},{"key":"B2","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1053\/j.gastro.2015.01.032","article-title":"Decreasing mortality among patients hospitalized with cirrhosis in the United States from 2002 through 2010","volume":"148","author":"Schmidt","year":"2015","journal-title":"Gastroenterology."},{"key":"B3","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.dld.2017.11.006","article-title":"A simplified prognostic model to predict mortality in patients with acute variceal bleeding","volume":"50","author":"Lee","year":"2018","journal-title":"Dig Liver Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1016\/j.jhep.2018.08.009","article-title":"Corrigendum to EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. 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