TY - JOUR
T1 - Selective intestinal decontamination in advanced chronic heart failure
T2 - A pilot trial
AU - Conraads, Viviane M.
AU - Jorens, Philippe G.
AU - De Clerck, Luc S.
AU - Van Saene, Hendrik K.
AU - Ieven, Margaretha M.
AU - Bosmans, Johan M.
AU - Schuerwegh, Annemie
AU - Bridts, Chris H.
AU - Wuyts, Floris
AU - Stevens, Wim J.
AU - Anker, Stefan D.
AU - Rauchhaus, Mathias
AU - Vrints, Christiaan J.
PY - 2004/6
Y1 - 2004/6
N2 - Background and aims: Endotoxin, derived from intestinal aerobic Gram-negative bacilli (AGNB), could be an important monocyte activator in chronic heart failure (CHF). The effect of selective decontamination of the digestive tract (SDD) on intracellular monocyte cytokine production, monocyte CD14 expression, circulating endotoxin and cytokines, and flow-mediated dilation (FMD) was studied in patients with severe CHF. Methods and results: Ten patients with CHF (NYHA class III-IV) were enrolled in a non-placebo controlled pilot trial involving the administration of SDD (polymyxin B, tobramycin) for 8 weeks. One patient was later excluded due to cardiac transplantation. Before treatment, after 4 and 8 weeks therapy, and 6 weeks post-treatment, monocyte CD14 expression, intracellular monocyte production of interleukin-1β [IL-1β], interleukin-6 [IL-6], tumour necrosis factor (TNF)-α with and without lipopolysaccharide (LPS) stimulation were measured. Concentrations of endotoxin and cytokines (IL-1β, IL-6, TNF-α) were also determined. AGNB in faeces, intestinal endotoxin and FMD were assessed at baseline, after 4 weeks of treatment and 6 weeks post-treatment. SDD eradicated intestinal AGNB (P
AB - Background and aims: Endotoxin, derived from intestinal aerobic Gram-negative bacilli (AGNB), could be an important monocyte activator in chronic heart failure (CHF). The effect of selective decontamination of the digestive tract (SDD) on intracellular monocyte cytokine production, monocyte CD14 expression, circulating endotoxin and cytokines, and flow-mediated dilation (FMD) was studied in patients with severe CHF. Methods and results: Ten patients with CHF (NYHA class III-IV) were enrolled in a non-placebo controlled pilot trial involving the administration of SDD (polymyxin B, tobramycin) for 8 weeks. One patient was later excluded due to cardiac transplantation. Before treatment, after 4 and 8 weeks therapy, and 6 weeks post-treatment, monocyte CD14 expression, intracellular monocyte production of interleukin-1β [IL-1β], interleukin-6 [IL-6], tumour necrosis factor (TNF)-α with and without lipopolysaccharide (LPS) stimulation were measured. Concentrations of endotoxin and cytokines (IL-1β, IL-6, TNF-α) were also determined. AGNB in faeces, intestinal endotoxin and FMD were assessed at baseline, after 4 weeks of treatment and 6 weeks post-treatment. SDD eradicated intestinal AGNB (P
KW - Chronic heart failure
KW - Endothelial dysfunction
KW - Endotoxin
KW - Inflammation
KW - Selective digestive decontamination
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U2 - 10.1016/j.ejheart.2003.12.004
DO - 10.1016/j.ejheart.2003.12.004
M3 - Article
C2 - 15182775
AN - SCOPUS:2942625803
VL - 6
SP - 483
EP - 491
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 4
ER -