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Vol. 299, Issue 2, 442-448, November 2001
Section of Gastroenterology and Nutrition, Division of Digestive
Diseases, Departments of Internal Medicine (A.K., S.C., A.B., S.J.,
J.Z.F.), Pharmacology (A.K., A.B.), Physiology and Molecular Biophysics
(A.K.), and Pathology (S.J.), Rush Presbyterian St. Lukes Medical
Center, Chicago, Illinois; and Department of Pathology (E.W.H., S.Y.),
Loyola University Medical Center, Maywood, Illinois
Only 30% of alcoholics develop liver disease (ALD) suggesting that
additional factors are needed. Endotoxin is one such factor, but its
etiology is unclear. Since the gut is the main source of endotoxin, we
sought to determine whether an increase in intestinal permeability
(leaky gut) is required for alcohol-induced endotoxemia and liver
injury and whether the gut leakiness is preventable. For 10 weeks, rats
received by gavage increasing alcohol doses (to 8 g/kg/day) and either
oats (10 g/kg) or chow b.i.d. Intestinal permeability was then assessed
by urinary excretion of lactulose and mannitol. Liver injury was
evaluated histologically, biochemically (liver fat content), and by
serum aminotransferase. Alcohol caused gut leakiness that was
associated with both endotoxemia and liver injury. Oats prevented these
changes. We conclude that chronic gavage of alcohol in rats is a simple
experimental model that mimics key aspects of ALD, including
endotoxemia and liver injury, and can be useful to study possible
mechanisms of endotoxemia in ALD. Since preventing the gut leakiness by
oats also prevented the endotoxemia and ameliorated liver damage in
rat, our results suggest that alcohol-induced gut leakiness 1) may
cause alcohol-induced endotoxemia and liver injury and 2) may be the
critical cofactor in the 30% of alcoholics who develop ALD. Further
studies are needed to determine whether ALD in humans can be prevented
by preventing alcohol-induced gut leakiness, studies that should lead
to the development of useful therapeutic agents for the prevention of
ALD.
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