Cytokine regulation of gut ornithine decarboxylase gene expression and enzyme activity.

BACKGROUND. The enzyme ornithine decarboxylase (ODC) catalyzes the rate-limiting step in polyamine biosynthesis and is important for gut mucosal repair after systemic injury (e.g., burns); however, the mechanisms responsible for the injury-mediated induction of ODC are not known. The purpose of this study was to determine whether interleukin-1 (IL-1) or tumor necrosis factor (TNF), which are released immediately after injury, regulates gut mucosal ODC enzyme activity and gene expression. METHODS. In vivo: In experiment 1, 64 male BALB/c mice received either recombinant IL-1 beta (2 x 10(4) units/kg administered intraperitoneally) or saline solution. In experiment 2, 64 mice received either recombinant TNF-alpha (100 micrograms/kg administered intraperitoneally) or saline solution. We determined ODC enzyme activity and ODC mRNA levels in small intestine and kidneys at 2, 4, 12, and 24 hours after injection. In vitro: We also determined the ODC enzyme activity in intestinal epithelial crypt cells after either IL-1 beta or TNF-alpha treatment. RESULTS. IL-1, but not TNF, increased small intestinal ODC enzyme activity. In addition, IL-1 increased ODC enzyme activity in intestinal epithelial crypt cells at 5 and 6 hours after treatment. Both IL-1 and TNF increased small intestinal ODC mRNA levels. Neither agent affected ODC enzyme activity or ODC mRNA levels in the kidney. CONCLUSIONS. These results suggest that the cytokine-mediated induction of ODC in the small intestine is tissue specific, that the induction occurs at multiple cellular levels, and that ODC may play a vital role in the restoration of gut mucosa that occurs after injury.     

Cutaneous burn increases apoptosis in the gut epithelium of mice

Background: Gut mucosal homeostasis depends on a balance between cell proliferation and cell death. After cutaneous burn injury, gut mucosal weight has been shown to decrease. This decrease in weight was paradoxically associated with an increase in gut proliferative factors. For mucosal weight to decrease in the presence of increased proliferation, there must be an even greater increase in cell death. We postulate that cutaneous burn injury causes an increase in gut epithelial cell death primarily by apoptosis.Study Design: We produced a 30% full-thickness scald burn in the dorsum of anesthetized male C57BL6 mice and collected the proximal small bowel at 12, 24, 36, 48, and 60 hours after injury. Sham burned animals served as controls. Apoptosis and proliferation were measured by immunohistochemical assays (terminal deoxyuridine nick-end labeling for apoptosis and proliferative cell nuclear antigen assay for proliferation). Apoptosis was also measured by ELISA for cytoplasmic histone-associated DNA fragments. Mucosal height was determined on histologic sections. The two groups were compared at each time point using Wilcoxon two-sample test and t-test with Bonferroni’s correction where appropriate.Results: The percentage of apoptotic cells (number of cells stained by terminal deoxyuridine nick-end labeling per 100 villus cells) was significantly higher at 12, 24, and 48 hours after injury. This increase was corroborated by an increase in the ELISA at 12 hours. Proliferation as measured by immunostaining for proliferative cell nuclear antigen significantly increased at 12, 24, 48, and 60 hours. Mucosal height as a gross measure of mucosal atrophy was not different between the groups.Conclusions: We have shown an increase in apoptosis coupled with an increase in proliferation after a burn injury. These results imply an increase in cell turnover in the gut epithelial cells after a burn. Impaired bowel function has been demonstrated repeatedly after burn injury, and this increase in cell turnover may be related.     

严重烧伤后糖皮质激素受体变化在应激性胃粘膜损害中的作用

目的　探讨糖皮质激素受体变化在烧伤后应激性胃粘膜损害中的作用。　方法　观察大鼠严重烧伤后不同时相胃粘膜组织糖皮质激素受体的动态变化及胃粘膜损伤情况。　结果　伤后6h皮质醇含量明显升高 ,12h达高峰 (P <0 .0 5～ 0 .0 1) ,而胃粘膜细胞胞浆内糖皮质激素受体水平显著下降 (P <0 .0 5～ 0 .0 1) ,胃粘膜损伤指数于伤后 6、12、2 4、4 8h显著增加 (P <0 .0 5～ 0 .0 1)。　结论　严重烧伤后糖皮质激素受体减少是应激性胃粘膜损害的重要因素     

Gut epithelial apoptosis after severe burn: effects of gut hypoperfusion

BACKGROUND: Severe cutaneous burn causes transient mesenteric vasoconstriction and altered gut mucosal integrity. We recently showed that burn also increases gut epithelial cell death by apoptosis. The goal of this study was to determine whether changes in gut perfusion after burn contribute to burn-associated gut apoptosis. STUDY DESIGN: We first correlated superior mesenteric artery blood flow with measurement of gut perfusion at the tissue level by laser doppler in four nonburned rats before, during, and after arterial clamping to validate our measurements of gut perfusion. We then characterized gut perfusion sequentially over time after burn; gut perfusion was measured 3 cm from the ligament of Treitz before burn and hourly for 6 hours. A group of control rats underwent the exact same protocol without the burn to exclude effects of anesthesia and laparotomy on tissue perfusion (n = 4). We studied a third group of rats with hypoperfusion of the same duration and magnitude induced mechanically without burn (n = 7). Sections of the proximal gut from all three groups (control without burn, burn, and hypoperfusion without burn) were examined for epithelial apoptosis. RESULTS: Linear regression analysis demonstrated a strong correlation between superior mesenteric artery blood flow and intestinal tissue perfusion measured by laser doppler under both low and high flow conditions (r = 0.85). Laser doppler measurements of gut perfusion after burn showed deceased gut perfusion that was maximal at 2 hours postburn (p < 0.05), and that persisted for 4 hours (p < 0.05). By 6 hours, gut perfusion returned to baseline. Apoptosis increased significantly in the burn group (2.11 +/- 0.17%) compared with control (0.52 +/- 0.2%) and the mechanically decreased perfusion group (0.51 +/- .03) (p < 0.001). CONCLUSIONS: We conclude that burn-induced gut hypoperfusion is insufficient to cause burn-related increased gut epithelial apoptosis. We speculate that the signal for increased gut epithelial apoptosis is primarily related to proinflammatory mediators induced by the burn wound.     

烧伤后早期肠道营养保护肠粘膜的实验研究

我们以部分空肠段旷置——胃造口——烧伤(25%)家兔模型就烧伤早期肠道营养对肠粘膜的保护及其可能机制进行了探讨。39只家兔(2.0±0.5kg)随机分为三组即:正常对照组(不烧伤并自由进食)早期喂养组与烧伤对照组(致伤后30分钟内按75ml/kg·24小时经饲管分别持续泵入营养液和冷开水)。结果显示:烧伤对照组肠粘膜氧耗量、肠组织尿酸及丙二醛显著增加,肠粘膜下血流量显著减少。早期喂养组粘膜氧耗量接近正常,血流量高于烧伤及正常对照组,尿酸及回肠段丙二醛显著低于烧伤对照组。空肠旷置段与非旷置段的粘膜氧耗量及肠组织次黄嘌呤、黄嘌呤、丙二醛均无显著差异。所以,烧伤早期肠道营养对肠粘膜有保护作用,可降低肠粘膜氧耗量,改善粘膜下血流量,减轻再灌注损伤。喂养的食物除对粘膜的局部作用,可能还涉及由“食物作用”介导的整体性调节因素。     

烧伤后早期肠道营养保护肠粘膜的实验研究

我们以部分空肠段旷置──胃造口──烧伤（２５％）家兔模型就烧伤早期肠道营养对肠粘膜的保护及其可能机制进行了探讨。３９只家兔（２．０±０．５ｋｇ）随机分为三组即：正常对照组（不烧伤并自由进食）早期喂养组与烧伤对照组（致伤后３０分钟内按７５ｍｌ／ｋｇ·２４小时经饲管分别持续泵入营养液和冷开水）。结果显示：烧伤对照组肠粘膜氧耗量、肠组织尿酸及丙二醛显著增加，肠粘膜下血流量显著减少。早期喂养组粘膜氧耗量接近正常，血流量高于烧伤及正常对照组，尿酸及回肠段丙二醛显著低于烧伤对照组。空肠旷置段与非旷置段的粘膜氧耗量及肠组织次黄嘌呤、黄嘌呤、丙二醛均无显著差异。所以，烧伤早期肠道营养对肠粘膜有保护作用，可降低肠粘膜氧耗量，改善粘膜下血流量，减轻再灌注损伤。喂养的食物除对粘膜的局部作用，可能还涉及由＂食物作用＂介导的整体性调节因素     

严重烧伤大鼠肝脏p38丝裂原活化蛋白激酶对肿瘤坏死因子α表达的调控及其在肝损伤中的作用

目的观察大鼠严重烧伤后肝脏p38丝裂原活化蛋白激酶(MAPK)对肿瘤坏死因子(TNF)α表达的调控及其在肝损伤中的作用。方法将健康成年雄性SD大鼠随机分为假伤组;烧伤 SB203580组:30%TBSAⅢ度烫伤(以下称烧伤)后15min和12h静脉注射p38MAPK的特异性抑制剂SB203580(10mg/kg);烧伤对照组:同前致伤后给予等量等渗盐水,每组8只。测定3组大鼠伤后24h血清天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)活性的变化,并分别采用实时逆转录聚合酶链反应(RT-PCR)法和蛋白印迹(Western blot)法检测肝脏TNF-αmRNA及p38MAPK、磷酸化p38MAPK的表达水平。结果烧伤对照组大鼠血清AST和ALT活性及肝脏TNF-αmRNA的表达水平均显著高于假伤组(P<0.05或0.01);烧伤 SB203580组此3项指标均显著低于烧伤对照组(P<0.05或0.01),但与假伤组比较差异无统计学意义(P>0.05).3组大鼠肝脏p38MAPK表达水平比较,差异无统计学意义(P>0.05);其磷酸化p38MAPK表达水平之比———假伤组∶烧伤对照组∶烧伤 SB203580组为1.00∶3.90∶1.10,烧伤 SB203580组与假伤组比较,差异无统计学意义(P>0.05),与烧伤对照组比较明显偏低(P<0.01).结论大鼠严重烧伤后,肝脏中活化的p38MAPK促进了TNF-αmRNA的表达,并参与了肝损伤的发生。     

Increases in nup475 and c-jun are early molecular events that precede the adaptive hyperplastic response after small bowel resection.

OBJECTIVE: The authors determined whether increases of nup475 and c-jun gene expression occur after small bowel resection and whether these changes are specific to the gut. SUMMARY BACKGROUND DATA: Massive small bowel resection (SBR) is characterized by adaptive proliferation of the remaining gut mucosa; the molecular signals responsible for this adaptive hyperplasia are unknown. Increases in the "immediate-early genes" nup475 and c-jun are noted in some proliferating tissues; however, alterations in the expression of these genes have not been described in the gut after SBR. METHODS: Rats underwent either a 70% proximal SBR or intestinal transection with reanastomosis (SHAM) and were then killed over a time course (0.5, 2, and 24 hours). The ileum, duodenum, colon, and kidneys were removed and RNA was extracted for Northern hybridization. RESULTS: The authors found that steady-state mRNA levels of both nup475 and c-jun were increased 81% and 62%, respectively, in the ileal remnant at 2 hours in rats after SBR compared with the SHAM group. In addition, nup475 was increased 101% in the duodenum at 24 hours and 31% in the colon at 0.5 hours in rats after SBR. In contrast, neither gene was increased in the kidney. CONCLUSIONS: Increases in steady-state levels of nup475 and c-jun are limited to the gut after SBR, and the timing and magnitude of these changes differ, depending on the gut segment. Finally, the rapid and nutrient-independent increases of nup475 and c-jun suggest an important role for these genes as early molecular signals that participate in the adaptive hyperplasia occurring in the gut remnant after SBR.     

早期肠道喂养对烧伤大鼠肠道一氧化氮合酶的影响

OBJECTIVE: Our previous studies have proved that early enteral feeding could improve intestine blood flow after burn injury. But the mechanism was far from being clarified. This study was attempted to explore the effects of early enteral feeding on nitric oxide synthase (NOS) activity in burned rat small intestine and the relationship between the intestine mucosa blood flow (IMBF) and the activity of NOS. METHODS: The rats were randomly divided into three groups: burned control (B), burned and early enteral feeding (EF), and normal control (C). The activity of NOS including constitute NOS(cNOS) and inducible NOS(iNOS), and the IMBF were determined at postburn 0, 3, 6, 12, 24, 48 hours. RESULTS: It was found that cNOS activity and IMBF were decreased markedly postburn, and there was positive correlation between cNOS and IMBF (r = 0.97, P < 0.01). But the activity of iNOS, total NOS were increased significantly postburn, they had no correlation to the IMBF. In EF group cNOS activity and the IMBF were significantly higher, the iNOS was obviously lower than that of B group and there was no significant difference of total activity of NOS between two groups. CONCLUSION: Our results suggested that NOS which is catalyzed from cNOS may play main role in adjusting IMBF. By using early enteral feeding the activity of cNOS is increased and the ischemic state in small intestine is improved after burn injury.     

Bacterial translocation and its relationship to visceral blood flow, gut mucosal ornithine decarboxylase activity, and DNA in pigs

The relationship of bacterial translocation to gut blood flow and mucosal integrity was studied in pigs. Three groups of miniature pigs were studied: sham injured (controls) (n = 7), 50% mechanical reduction in blood flow to the superior mesenteric artery (SMA) and celiac artery (CA) (n = 6), and a 40% third-degree cutaneous flame burn (n = 9). Forty-eight hours after injury, animals were killed and organ samples obtained for analysis. Bacteria of the same biotype as that found in the intestinal lumen were present in the mesenteric lymph nodes (MLN) of 9 of 9 burned pigs and 5 of 6 pigs undergoing partial vascular occlusion. The DNA content and ornithine decarboxylase (ODC) activity were increased in the colon mucosa of animals from both the reduced-flow and burn-injured groups compared with control animals. Decreased blood flow to the gut may contribute to the development of bacterial translocation. In addition, intestinal regenerative capacity remains intact 48 hours after injury.     

烧伤早期家兔小肠细胞凋亡的研究

目的　探讨严重烧伤早期家兔小肠粘膜上皮细胞、淋巴细胞以及蚓状突淋巴细胞凋亡及其意义。　方法　采用日本大耳白兔 2 5只 ,随机分成 5组 :正常对照组、严重烧伤 3、6、12、2 4h组 ,每组均为 5只。各烧伤组制作成 30 %TBSAⅢ度烧伤动物模型 ,于伤后相应时相点对 5个部位的肠组织取材 ,行HE染色、电镜检查及用DNA切口末端标记技术 (TUNEL)行原位细胞凋亡检测 ,TUNEL切片作统计分析。　结果　HE染色烧伤组见较多凋亡细胞单个分散在小肠及蚓状突粘膜上皮层、粘膜固有层 (部分延伸到粘膜下层 )的淋巴小结和散在淋巴组织中 ;伤后 2 4h组有少数肠粘膜断裂 ;所有切片未见明显炎症及坏死现象。电镜显示凋亡小体形成。TUNEL法见大量呈蓝黑色的阳性细胞核 ,分布位置同HE染色。伤后 3h小肠及蚓状突细胞凋亡数较对照组已有明显增多 (P<0 .0 1) ,到 6和 12h显著升高达峰值 (P <0 .0 1) ,伤后 2 4h已下降接近 3h水平 ,但仍高于对照组 (P <0 .0 1) ;烧伤组家兔中段及远端小肠粘膜上皮细胞凋亡数均高于近端小肠 (P <0 .0 5 )。　结论　严重烧伤早期家兔小肠粘膜上皮细胞、淋巴细胞以及蚓状突淋巴细胞大量凋亡 ,中远端小肠粘膜上皮细胞凋亡较近端小肠显著 ,这些变化可能是烧伤后肠道细菌及内毒素移位的细胞学基础。     

The role of bifidobacteria in gut barrier function after thermal injury in rats

BACKGROUND: Early multiple organ dysfunction syndrome appears to be facilitated with bacterial translocation in severe burn injury, yet the mechanisms of bacterial translocation remain in dispute. The aim of this study was to characterize the potential role of intestinal bifidobacteria in the pathogenesis of gut-derived bacterial translocation after burns and to analyze the effects of bifidobacterial supplement on gut barrier function. METHODS: Wistar rats were randomly divided into burn group (Burn, n = 60), sham burn group (SB, n = 10) in experiment 1, and burn + saline group (BS, n = 30), burn + bifidobacteria group (BB, n = 30), and sham-burn + saline group (SS, n = 30) in experiment 2. Animals in BB group were fed bifidobacterial preparation (5 x 10(9) CFU/mL) after burns, 1.5 mL, twice daily. Animals in BS and SS were fed saline. Samples were taken on postburn days 1, 3, and 5. The incidence of bacterial translocation and counts of Bifidobacterium, fungi and Escherichia coli in gut mucosa, as well as the sIgA levels in mucus of the small intestine were determined. The positive sIgA expression in lamina propria and ileum mucosal injury were evaluated light microscopically by blinded examiners. RESULTS: The incidence of bacterial translocation was increased after burns, which was accompanied by significant decrease in number of bifidobacteria but significant increase in E. coli and fungi in gut mucosa, and elevation of levels of plasma endotoxin and IL-6 (p < 0.001). The incidence of bacterial translocation was markedly reduced after 3- and 5-day supplementation of bifidobacteria compared with control group (p < 0.05). The counts of mucosal bifidobacteria were increased by 4- to 40-fold, whereas E. coli and fungi were decreased by 2- to 30-fold and 10- to 150-fold, respectively, after bifidobacterial supplementation. The damage of mucosa tended to be less pronounced after 3-day bifidobacteria-supplemented formula compared with control group (grade 2 [0-6] versus grade 4 [3-6], p < 0.05). Moreover, the expression and release of sIgA was markedly augmented after 3-days of bifidobacteria-supplementation formula and it returned to normal range on postburn day 5. CONCLUSIONS: The decrease in counts and proportion of bifidobacteria to other flora in gut may play an important role in the development of bacterial translocation after thermal injury. Supplementation of exogenous bifidobacteria could improve gut barrier function, and attenuate bacterial/endotoxin translocation secondary to major burns.     

大鼠严重烧伤后肠绒毛的改变

目的观察大鼠烧伤后肠绒毛的改变,探讨其与发生肠源性感染的可能关系。方法选用Wistar大鼠50只,其中10只作为对照组,不作任何处理;余下40只作为烧伤组,造成30%TBSAⅢ度烫伤(以下称烧伤)后,经腹腔补充等渗盐水4ml/100g.观察对照组及烧伤组大鼠伤后8、12、24、48h回肠末端肠黏膜形态、中央乳糜管管径、小肠含水量百分比的变化。结果对照组大鼠肠绒毛形态正常;烧伤组伤后各时相点肠绒毛肿胀,肠黏膜细胞间出现宽大裂隙,局部有绒毛缺损。烧伤组大鼠伤后各时相点中央乳糜管持续扩大,其管径均明显大于对照组(P<0.01),同时管中存有大量的淋巴液。烧伤组大鼠伤后8、12h小肠含水量百分比分别为(70.5±2.2)%、(69.5±3.1)%,明显低于对照组(76.9±1.5)%(P<0.01),而伤后24、48h则与对照组相近(P>0.05).结论严重烧伤后大鼠肠绒毛的变化可能会促进肠道毒素和细菌的侵入,肠淋巴通道可能是肠源性感染的重要途径。烧伤后早期肠黏膜对肠道水分的回吸收过程是短暂加强的。     

Inhibition of ileal and colonic ornithine decarboxylase activity by alpha-difluoromethylornithine in rats: transient atrophic changes and loss of postresectional adaptive growth

To determine the role of putrescine synthesis in adaptive hyperplasia of the ileum and colon, DL-alpha-difluoromethylornithine (DFMO), an enzyme-activated, irreversible inhibitor of ornithine decarboxylase (ODC), the enzyme controlling putrescine biosynthesis, was fed to rats after excision of the proximal half of the small bowel. A rise in ODC activity (280% in the proximal ileum, 62% in the proximal colon) and a rise in putrescine content (220% in the proximal ileum, 250% in the proximal colon) normally accompanied characteristic cytochemical adaptive increases in the ileum and colon at day 6. Inclusion of 1% DFMO (2.1 gm/kg/day) in drinking water for 12 hours before operation and for 14 days thereafter decreased ODC activity by 85% to 96%, reduced levels of putrescine and spermidine and measurements of the adaptive response by 50% in the ileum, and abolished the adaptive response in the colon. During the first 10 days of DFMO feeding, villous atrophy and other hypoplastic changes occurred in control rats, but by 14 days of DFMO feeding atrophy and hypoplasia were no longer present. Although DFMO inhibits adaptive hyperplasia occurring in the ileum and colon of rats after resection of the proximal half of the small bowel, spontaneous recovery of villous atrophy occurs during further DFMO feeding and may protect the host during chemotherapy.     

Role of bombesin on gut mucosal growth.

OBJECTIVE: The authors examined the effects of exogenous bombesin (BBS) on gut mucosal growth in chow-fed rats and the mucosal regeneration after gut atrophy brought about by feeding an elemental diet and after intestinal injury produced by methotrexate (MTX). SUMMARY BACKGROUND DATA: Bombesin is one of many gastrointestinal peptides implicated in the regulation of gut mucosal growth. Although BBS is known to stimulate growth of normal pancreatic tissue, the trophic effect of BBS on gut mucosa is less clear and its exact role in gut mucosal regeneration and repair is not known. METHODS: Rats were fed a regular chow diet (control) or an elemental diet plus either saline or BBS (10 micrograms/kg). In another experiment, rats fed a chow diet and treated with saline or BBS were given MTX (20 micrograms/kg) or a single intraperitoneal injection. In all experiments, small and large bowel mucosa and pancreas were removed and analyzed for BBS-mediated proliferation. RESULTS: Bombesin produced significant mucosal proliferation of the small bowel at day 14, but not at day 7, in rats fed regular chow. In contrast, BBS treatment for 7 days produced significant proliferation in both the atrophic and injured gut mucosa of rats given elemental diet or MTX. CONCLUSIONS: Bombesin may be an important enterotrophic factor for normal mucosal proliferation and may be clinically beneficial as an agent to restore or maintain gut mucosa during periods of atrophy or injury.     

Neurotensin augments intestinal regeneration after small bowel resection in rats.

Massive small bowel resection (SBR) is characterized by increased proliferation of residual gut mucosa and pancreas. Neurotensin (NT), a gut tridecapeptide, stimulates growth of normal gut mucosa and pancreas. This study examined whether NT affected growth of the small intestine and the pancreas after either distal or proximal SBR. Male Fischer 344 rats were divided into four groups. Group 1 underwent ileal transection with reanastomosis (SHAM) and group 2 underwent 70% distal SBR. Group 3 underwent SHAM operation (jejunal transection), and group 4 underwent 70% proximal SBR. After operation, each group was further subdivided to receive either saline (control) or NT (300 micrograms/kg) subcutaneously in gelatin every 8 hours for 7 days. At death, the pancreas and proximal jejunum (from groups 1 and 2) or distal ileum (from groups 3 and 4) were removed, weighed, and analyzed for DNA, RNA, and protein content. Both proximal and distal SBR significantly increased mucosal growth in the remnant intestine; a more pronounced effect was noted with proximal SBR. Administration of NT significantly augmented the adaptive changes in both groups of rats by mechanisms involving increases in both cell size (hypertrophy) and cell number (hyperplasia). Pancreatic growth was stimulated by distal (but not proximal) SBR; NT did not augment this response. The authors conclude that NT augments intestinal growth after SBR by mechanisms involving an increase in overall mucosal cellularity. Administration of NT may be therapeutically useful to enhance mucosal regeneration during the early period of adaptive hyperplasia after SBR.     

烫伤大鼠肠粘膜前列腺素水平与前列腺素转移因子mRNA表达的变化

目的　探讨烫伤大鼠肠粘膜前列腺素E2 (PGE2 )、前列腺素I2 (PGI2 )、血栓素A2 (TXA2 )水平和前列腺素转移因子 (PGT)mRNA表达变化及其意义。　方法　以 30 %TBSAⅢ度烫伤大鼠为模型 ,以放射免疫法测定肠粘膜中PGE2 、PGI2 、TXA2 的含量 ,用原位杂交检测PGTmRNA表达。　结果　大鼠肠粘膜PGE2 、PGI2 水平在伤后 12h升高 ,随后明显降低 (P <0.0 5～ 0.0 1);TXA2 水平在伤后 2 4、4 8h明显高于正常水平 (P <0.0 5 );PGTmRNA表达在伤后有增加的趋势。　 结论　烫伤后肠粘膜PGE2 水平降低及TXA2 水平升高 ,可能是肠粘膜损伤的机制之一 ;PGT对伤后PGs水平具有调节作用     

Specific inhibition of iNOS decreases the intestinal mucosal peroxynitrite level and improves the barrier function after thermal injury

Failure of GI tract mucosa to act as a barrier against bacterial translocation (BT) has been proposed as a potential source of sepsis and subsequent multiple organ failure post thermal injury. Nitric oxide (NO) is an inorganic radical produced by NO synthase (NOS) from -arginine. Gut mucosal constitutive NOS (cNOS) provides protection for itself. In contrast to cNOS, inducible NOS (iNOS) releases far greater amounts of NO, promotes oxidative reactions and is responsible for tissue injury. Peroxynitrite formed by the rapid reaction between superoxide and NO, is a toxic substance that contributes to tissue injury in a number of biological systems. This study was designed to investigate the effect of iNOS specific inhibitor S-methylisothiourea (SMT) on the postburn intestinal mucosal barrier function and the possible mechanism of SMT's action. Female SPF Sprague–Dawley rats underwent 35% total body surface area (TBSA) or sham burn. Either SMT or the same volume of saline was given (5 mg/kg, i.p. q 12 h) for 2 days to assess the effect of iNOS inhibition. On postburn day 2, the intestinal mucosal cNOS and iNOS activity were assayed by using Griess' reagent, the mesenteric lymph node (MLN), spleen and liver were collected and cultured for BT assay and the cellular localization of nitrotyrosine, a marker for peroxynitrite activity, was examined by immunostaining. After thermal injury in rats, administration of SMT for 2 days decreased the intestinal mucosal iNOS activity/tNOS activity ratio and the BT incidence. Nitrotyrosine immunostaining of the intestinal mucosa showed a decrease in the SMT-treated group. These findings suggest that SMT, a specific inhibitor for iNOS improves the barrier function after burn by suppression of the intestinal mucosal iNOS activity. The decrease in NO production resulted in decreased formation of peroxynitrite and subsequently decreased damage of mucosal tissue.     

Reversal of the effect of albumin on gut barrier function in burn by the inhibition of inducible isoform of nitric oxide synthase

HYPOTHESIS: The use of albumin in the early resuscitation formula after major burn has been forbidden because of its damaging effect on the gut barrier function. We hypothesize that inhibition of the inducible isoform of nitric oxide synthase to stabilize endothelial permeability and to retain albumin in the vascular space will ameliorate the major trauma-induced gut barrier dysfunction. DESIGN, INTERVENTIONS, AND MAIN OUTCOME MEASURES: In experiment 1, specific pathogen-free rats undergoing 35% total body surface area burn or sham burn were given equal volumes (7.5 mL/kg) of isotonic sodium chloride solution or albumin from femoral veins for fluid resuscitation at 0, 4, or 8 hours after burn. In experiment 2, intraperitoneal S-methylisothiourea sulfate (7.5 mg/kg) was given immediately after burn to rats from different groups, as in experiment 1 (SMT groups). At 24 hours after burn, the intestinal mucosa was assayed for myeloperoxidase activity as an index for neutrophil sequestration, the distribution of fluorescein isothiocyanate-dextran across the lumen of small intestine was determined to evaluate the intestinal permeability, and bacterial translocation (BT) to the mesenteric lymph nodes (MLNs) and histological findings in the ileum were also examined. RESULTS: Compared with sham burn, burn induced significant increases in intestinal mucosa myeloperoxidase activity, intestinal permeability, BT to the MLNs, and villi sloughing in rats. Albumin administration at 0 or 4 hours after burn enhanced the increases in neutrophil sequestration, permeability, and villi sloughing compared with saline injection at the same times. In contrast, injection of albumin in the burn-SMT group did not aggravate these changes in intestinal myeloperoxidase activity, intestinal permeability, BT to the MLNs, and villi edema. Burn-SMT rats with albumin injections at 4 or 8 hours after burn showed significant 35% and 52% decreases, respectively, in intestinal permeability compared with burn-SMT-saline rats. Use of albumin at 8 hours after burn in combination with S-methylisothiourea significantly attenuated BT to the MLNs and reduced villi edema. CONCLUSIONS: Early albumin resuscitation aggravated the burn-induced gut damage. Albumin administration and inhibition of the inducible isoform of nitric oxide synthase in combination decreased burn-induced gut barrier dysfunction and reversed the damaging effect of albumin on gut barrier function and decreased BT.     

烧伤后肠黏膜细胞外基质与细胞凋亡关系的实验研究

目的　探讨烧伤后大鼠肠黏膜细胞凋亡与细胞外基质的关系。　方法　 30只Wistar大鼠随机分为烧伤后 6、12h,1、3、5d组及正常对照组 ,每组 5只。检测肠黏膜上皮细胞凋亡数、cas pases 3酶活性、细胞外基质成分 (层粘连蛋白、Ⅳ型胶原 )含量 ,并作相关分析。　 结果　烧伤后大鼠肠上皮凋亡细胞数、caspases 3的活性较正常对照组明显升高 (P <0.0 5或 0 .0 1) ,大鼠肠黏膜层粘连蛋白、Ⅳ型胶原含量较正常对照组下降 ( P <0.0 5或 0 .0 1)。直线相关分析结果 :烧伤后肠黏膜层粘连蛋白、Ⅳ型胶原含量变化与细胞凋亡数呈显著的负相关 (r =- 0.5 75, - 0.6 13,P <0 0 5 )。　 结论　烧伤后大鼠肠黏膜细胞凋亡增加 ,且与细胞外基质的变化相关。