간경변증에서 세균감염의 병태생리 = Bacterial Infection in Cirrhosis: Pathogenesis

다국어 초록 (Multilingual Abstract)

Bacterial infection is common in chronic liver disease. Numerous mechanisms caused immune dysfunction include impairment of macrophage Fcγ-receptor-mediated clearance of bacteria, decreased neutrophil phagocytic activity, decreased complement system activity, increased shunting of blood, and increased intestinal permeability. Interestingly cirrhotic patients showed more excessive pro-inflammatory response than in those without. This bacterial induced ``cytokine storm`` cause excessive anti-inflammatory response syndrome. It contributes to sepsis related organ failure and immune dysfunction. The possible etiology of increased intestinal permeability in liver cirrhosis is known as intestinal hypomotility and small intestinal bacterial overgrowth. Although the exact mechanism by bacterial translocation develop in cirrhotic patients is unknown, increased intestinal permeability may promote bacterial translocation (BT). BT was defined as the invasion of indigenous intestinal bacteria through the gut mucosa into normal sterile tissue for example intestinal lymph node, peripheral blood, ascites, and etc. BT acts infection source of infectious disease in cirrhotic patients especially in spontaneous bacterial peritonitis.