Reviewer's report
Title:Assessment of the transhepatic clearance of lipopolysaccarides in cirrhosis
before and after transjugular intrahepatic portosystemic stenting (TIPS).
Version: 1Date:12 July 2011
Reviewer: Daniel Douek
Reviewer's report:
This is an excellent, interesting and well-written study. Many in the field have
discussed performing such analyses and it is nice to see that this has finally been
done with important results as a consequence.
I have a few essential revisions for the authors which I think should be made:
1. The authors never explicitly state their definition of the transhepatic LPS
gradient and how it was calculated. Logically I presume it is the endotoxin
concentration in the portal vein minus the endotoxin concentration in the hepatic
vein.
2. The authors should mention that LBP is synthesized by the liver and how that
may affect the results.
3. L-arginine is also a substrate for arginase in “alternatively activated
macrophages,” leading to collagen production. It should be discussed.
4. The authors should label the y-axis in Figure 1B and 1C.
5. The authors should cite and discuss a recent paper in Gastroenterology on
microbial translocation in cirrhosis which is pertinent to their findings: "Sandler et
al., Host Response to Translocated Microbial Products Predicts Outcomes of
Patients with HBV or HCV infection. Gastroenterology, Online 2 July 2011"
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Reviewer's report
Title:Assessment of the transhepatic clearance of lipopolysaccarides in cirrhosis
before and after transjugular intrahepatic portosystemic stenting (TIPS).
Version: 1Date:12 July 2011
Reviewer: Daniel Douek
Reviewer's report:
This is an excellent, interesting and well-written study. Many in the field have
discussed performing such analyses and it is nice to see that this has finally been
done with important results as a consequence.
I have a few essential revisions for the authors which I think should be made:
1. The authors never explicitly state their definition of the transhepatic LPS
gradient and how it was calculated. Logically I presume it is the endotoxin
concentration in the portal vein minus the endotoxin concentration in the hepatic
vein.
2. The authors should mention that LBP is synthesized by the liver and how that
may affect the results.
3. L-arginine is also a substrate for arginase in “alternatively activated
macrophages,” leading to collagen production. It should be discussed.
4. The authors should label the y-axis in Figure 1B and 1C.
5. The authors should cite and discuss a recent paper in Gastroenterology on
microbial translocation in cirrhosis which is pertinent to their findings: "Sandler et
al., Host Response to Translocated Microbial Products Predicts Outcomes of
Patients with HBV or HCV infection. Gastroenterology, Online 2 July 2011"
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Please review this paper.
user
Reviewer's report
Title:Assessment of the transhepatic clearance of lipopolysaccarides in cirrhosis
before and after transjugular intrahepatic portosystemic stenting (TIPS).
Version: 1Date:12 July 2011
Reviewer: Daniel Douek
Reviewer's report:
This is an excellent, interesting and well-written study. Many in the field have
discussed performing such analyses and it is nice to see that this has finally been
done with important results as a consequence.
I have a few essential revisions for the authors which I think should be made:
1. The authors never explicitly state their definition of the transhepatic LPS
gradient and how it was calculated. Logically I presume it is the endotoxin
concentration in the portal vein minus the endotoxin concentration in the hepatic
vein.
2. The authors should mention that LBP is synthesized by the liver and how that
may affect the results.
3. L-arginine is also a substrate for arginase in “alternatively activated
macrophages,” leading to collagen production. It should be discussed.
4. The authors should label the y-axis in Figure 1B and 1C.
5. The authors should cite and discuss a recent paper in Gastroenterology on
microbial translocation in cirrhosis which is pertinent to their findings: "Sandler et
al., Host Response to Translocated Microbial Products Predicts Outcomes of
Patients with HBV or HCV infection. Gastroenterology, Online 2 July 2011"
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
assistant