ABSTRACT
This study was carried out on 25 selected patients with chronic liver diseases. All of them were subjected to complete medical examination, ultrasonography, endoscopy, liver function tests, prothrombin time and platelet count. The 25 patients were classified into Child A [5], Child B [7] and Child C [13]. The endotoxin level and antilipid A antibodies were assayed in the plasma and serum of the 25 patients and 10 healthy subjects. It was found that the endotoxin level and the antilipid A antibody response were significantly higher in child B and C than child A groups [P < 0.05 and P < 0.01]. The child group classification and the liver pattern correlated significantly with the endotoxin level and the antilipid A titre [P < 0.05 and P < 0.001]. Also the platelet count was significantly lower in child B and C than child A group [P < 0.05], the prothrombin time was prolonged in child B group but was significantly prolonged in child C group [P < 0.01]. The groups of patients classified as child B and C their plasma and serum were reassayed for the endotoxin level and antilipid A antibodies after receiving Neomycin therapy for decontamination of the bowel and minimization of the endotoxin production. Both the endotoxin level and the antilipid A antibody response decreased, the platelet count increased, the prothrombin time was shortened in both groups but in case of group C it was significantly shortened [P < 0.05]. The biochemical profile did not correlate neither with the endotoxin level nor the antilipid A antibody response. But after Neomycin administration the biochemical profile in group C improved. We concluded that Neomycin may be taken as a prophylactic precaution in severe liver affection, since it may help preventing the excessive accumulation of endotoxin and thus restores the liver function resulting into a delay in the progression of the liver disease. Also the antilipid A antibody assay may he used as an indication for increased in endotoxin level