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. 2019 Feb;30(2):177-183.
doi: 10.5152/tjg.2018.17512.

Association between small intestinal bacterial overgrowth and toll-like receptor 4 in patients with pancreatic carcinoma and cholangiocarcinoma

Xiaoying Ma  1 , Heju Wang  1 , Peng Zhang  2 , Lin Xu  1 , Zibin Tian  2
Affiliations

Association between small intestinal bacterial overgrowth and toll-like receptor 4 in patients with pancreatic carcinoma and cholangiocarcinoma

Xiaoying Ma et al. Turk J Gastroenterol. 2019 Feb.

Abstract

Background/aims: Multiple factors have been linked to pathogenesis of pancreatic cancer and cholangiocarcinoma. Until now, few studies have investigated the role of small intestinal bacterial overgrowth (SIBO) and toll-like receptor 4 (TLR-4) signaling in these diseases. This study aimed to examine the relationship between the prevalence of SIBO and the TLR-4 expression in patients with pancreatic carcinoma and cholangiocarcinoma.

Materials and methods: A total of 90 human subjects suffering from pancreatic carcinoma (n=30), cholangiocarcinoma (n=30), and healthy controls (n=30) were enrolled in the study. A glucose hydrogen breath test (GHBT) was used to evaluate SIBO. The TLR4 protein expression was measured by immunohistochemistry (IHC).

Results: The positive rate of SIBO was 63.3% in the pancreatic cancer group and 46.7% in patients with cholangiocarcinoma, which was significantly greater than 13.3% in the healthy control group (p<0.05). An IHC analysis revealed that the TLR-4 protein expression in the SIBO-positive pancreatic carcinoma patients was significantly higher than that in the SIBO-negative patients (p<0.05), and the same result was in the cholangiocarcinoma subjects. In addition, a correlation analysis identified the positive relationship between the prevalence of SIBO and the TLR-4 protein expression in pancreatic carcinoma (r=0.489), and the same result was in the cholangiocarcinoma subjects.

Conclusion: Our findings indicate a high prevalence of SIBO in pancreatic carcinoma and cholangiocarcinoma, and SIBO displays a positive correlation with the TLR-4 expression, suggesting that SIBO could be a risk factor for the pathogenesis of pancreatic carcinoma and cholangiocarcinoma, in which the TLR4 signaling may be involved.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The expiratory hydrogen concentrations were contrasted between the groups of patients with pancreatic carcinoma, the patients with cholangiocarcinoma, and the control group. Both the basic value and post-prandial expiratory hydrogen concentrations were higher in patients with pancreatic carcinoma and cholangiocarcinoma, and these differences were statistically significant (p<0.05)
Figure 2. a–d
Figure 2. a–d
An immunohistochemical analysis of the TLR-4 protein expression in pancreatic carcinoma, cholangiocarcinoma, and their adjacent normal tissues: Expression of the TLR-4 protein in pancreatic carcinoma tissues (×100) (a); expression of the TLR-4 protein in paracarcinoma normal tissues (×100) (B); expression of the TLR-4 protein in cholangiocarcinoma tissues (×100) (c); expression of the TLR-4 protein in para-carcinoma normal tissues (×100) (d) TLR-4: toll-like receptor
See this image and copyright information in PMC

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