Markers of bacterial translocation in end-stage liver disease

Table 1 Biological markers for assessment of bacterial translocation in liver cirrhosis

	Origin	Comments	Ref.
Bacterial DNA	Bacteria	Pros: Long half-life, association with cytokine production, hemodynamic changes and prognosis	Bellot et al[20], Francés et al[31], El-Naggar et al[32], González-Navajas et al[33], Zapater et al[34], Jun et al[35], Fagan et al[36]
		Cons: Variable rates of detection (maybe depending on methodology used), lower prevalence in outpatients	Rincón et al[39], Sersté et al[40], Feng et al[41], Fujita et al[42], Vlachogiannakos et al[43], Mortensen et al[44], Mortensen et al[45], Appenrodt et al[46]
LPS	Gram (-) bacteria	Pros: Correlation with TNF-α, stage of cirrhosis, prognostic value for severity of liver damage	Hanck et al[52], Lin et al[54], Chan et al[55]
		Cons: Short half-life, variation of detection rates	Bellot et al[5], Fukui et al[53], Kaser et al[56], Stadlbauer et al[57]
LBP	Acute phase protein triggered by LPS	Pros: Long half-life, correlation with TNF-RI, TNF-α, IL-6, and hyperdynamic circulation	Albillos et al[19], Albillos et al[59]
		Cons: Low detection rates, elevated in systemic infection from Gram (-) bacteria	Albillos et al[19], Albillos et al[59]
sCD14	Monocytes, liver	Pros: Prognostic marker of disease progression in HBV/HCV/HIV, NAFLD and alcoholic liver disease, correlation with liver fibrosis, easily measured	Landmann et al[61], Tuomisto et al[62], Sandler et al[63], Balagopal et al[64], French et al[65], Ogawa et al[66], Campos et al[67]
Calprotectin	Neutrophils	Pros: Easily measured, fecal levels associated with stage of liver disease, SBP and HE, ratio of ascites calprotectin/total protein may be better	Gundling et al[77], Lutz et al[81]
		Cons: Plasma levels do no distinguish cirrhotic patients from healthy controls, weak association with alcoholic liver disease	Homann et al[75], Homann et al[76], Montalto et al[78]
Procalcitonin	Neutrophils, liver, thyroid	Pros: Ascitic levels may differentiate between cirrhotic subgroups	Attar et al[97]
		Cons: No correlation with HE, conflicting results depending on etiology of liver disease	Spahr et al[92], Elefsiniotis et al[94], Rahimkhani et al[95], Villarreal et al[96]
ANCAs (IgA)	Neutrophils	Pros: Associated with ascites and advanced cirrhosis, predicts time to the first infectious complication	Papp et al[99]
		Cons: Single study

LPS: Lipopolysaccharides; HE: Hepatic encephalopathy; SBP: Spontaneous bacterial peritonitis; LBP: Lipopolysaccharide binding protein; ANCA: Anti-neutrophil cytoplasmic antibodies; TNF-α: Tumor necrosis factor-alpha; IL: Interleukin; HCV: Hepatitis C virus; HBV: Hepatitis B virus; HIV: Human immunodeficiency virus; NAFLD: Non-alcoholic fatty liver disease.