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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 …
Contributors VR Carried out the main part of the experimental work and designed most of the experiments. JML participated in the experimental procedures with human samples. JR contributed in the cell experimental culture designs and procedures, GC participated in the data analysis. MN kindly provided the human serum samples. GFV aided with the molecular experiments. MMR gave conceptual advice and revised the manuscript. WJ directed the research and wrote the manuscript.
Funding This work was supported by grants from Dirección General de Investigación Científica y Técnica (SAF09-08839) and from the Agència de Gestió d'Ajuts Universitaris i de Recerca (SGR 2009/1496). CIBERehd is funded by the Instituto de Salud Carlos III (Spain).
Competing interests None.
Patient consent Obtained.
Ethics approval The study was performed according to the criteria of the Investigation and Ethics Committee of the Hospital Clínic Universitari.
Provenance and peer review Not commissioned; externally peer reviewed.
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