Introduction

Bacterial translocation (BT) can be defined as the passage of bacterial flora from the intestinal lumen to mesenteric lymph nodes (MLNs) or other extra-intestinal sites (Manuela Merli, 2015). Several studies have demonstrated the importance of BT in cirrhosis and it’s role in the pathogenesis of spontaneous bacterial peritonitis (SBP) (Runyon BA, 1994). Although the mechanisms driving the translocation of the gut flora in cirrhosis are not fully understood, recent evidence suggests that translocation of bacteria and bacterial products, such as endotoxin from the intestinal lumen into the systemic circulation, is a key factor in the pathogenesis of chronic liver diseases and the development of complications in cirrhosis (Kirsten E. Pijls et al 2013). In addition to changes in the intestinal flora and the immune system, dysfunction of the intestinal epithelial barrier may also contribute to BT (Kirsten E. Pijls et al, 2013). This review discusses the multiple mechanisms involved in the process of BT, with an emphasis on alterations in intestinal flora and mucosal barrier function (Reiner Wiest et al, 2014).

Introduction

Compartments involved in pathological bacterial translocation

GALT

MLN

MECHANICAL COMPONENTS

SECRETARY COMPONENTS

MUCUS

IGA ANTIBODIES

BACTERIAL OVER-GROWTH