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We read with interest the recent review by Wiest et al 1 on spontaneous bacterial peritonitis (SBP), and would like to point out a new mechanism involved in the pathogenesis of this phenomenon. Cirrhotic patients have altered host-defence response mechanisms and increased susceptibility to bacterial infections, which seem to be related to alterations in the intestinal barrier and/or bacterial translocation from the mucosa to the mesenteric lymph nodes and the intestinal circulation. For this reason, a better understanding on the causes underlying this infection is important for effective future therapies. Both liver cirrhosis and lipopolyshaccaride (LPS)-induced sepsis have been associated with increased activity of endogenous cannabinoids.2 ,3 Our study aims to expand the knowledge on the relationship between Cannabinoid receptor 2 (CB2) receptors and SBP. We analysed the mRNA expression of CB2 in cirrhotic patients with or without SBP, with a mean age of 61±12 years. The aetiology of cirrhosis was alcohol-induced in 5 subjects, 3 with hepatitis B or C, 3 with both …
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