The role of endotoxin in liver injury

Gastroenterology. 1975 Dec;69(6):1346-56.


Evidence is present that a common pathway for hepatic injury by a variety of agents may result from impairment of the liver's ability to detoxify bacterial endotoxins from the gastrointestinal tract. Many factors may structurally, metabolically, or hormonally alter the normal liver's ability to render innocuous the small amounts of lipopolysaccharide ordinarily presented to it. This impairment may accentuate existing hepatic damage by allowing toxic levels of endotoxin to develop in the liver tissue, and by allowing endotoxin entry into the systemic circulation, may also lead to extrahepatic effects. Studies are cited that: (1) support a role for intraintestinal endotoxin in the development of experimental cirrhosis. (2) demonstrate how liver injury alters endotoxin detoxification, (3) examine the role of intestinal production and absorption of bacterial lipopolysaccharides in liver disease, and (4) point to a role for endotoxemia in extrahepatic manifestations of liver injury as well. Studies are also reviewed that suggest possible mechanisms for modifying endotoxicity in hepatic damage.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Chemical and Drug Induced Liver Injury / etiology*
  • Chemical and Drug Induced Liver Injury / pathology
  • Choline Deficiency / complications
  • Disseminated Intravascular Coagulation / etiology
  • Endotoxins / adverse effects*
  • Endotoxins / metabolism
  • Estrogens / adverse effects
  • Fever / etiology
  • Heart / physiopathology
  • Humans
  • Immune Tolerance
  • Inactivation, Metabolic
  • Intestinal Absorption
  • Intestines / microbiology
  • Kidney Diseases / etiology
  • Lipopolysaccharides / adverse effects
  • Liver / drug effects*
  • Liver Cirrhosis / etiology
  • Mononuclear Phagocyte System / physiology
  • Steroids / therapeutic use


  • Endotoxins
  • Estrogens
  • Lipopolysaccharides
  • Steroids