烧伤后肠黏膜免疫组织细胞增殖分化的特征性研究

背景肠道黏膜免疫屏障下降导致肠道条件致病菌移位,导致肠源性感染,影响患者机体及相应功能的恢复,但其下降机制尚不清楚.目的对烧伤后肠黏膜免疫组织潘氏结内淋巴细胞(PPL)膜I小转型以及肠固有层的淋巴细胞(LPL)体外增殖情况进行观察,为提高黏膜免疫屏障水平、预防肠源性感染、加快烧伤患者临床康复提供依据.设计完全随机对照的纵向性研究.地点和对象本实验在武装警察部队总医院烧伤科及中心实验室完成,对象为20只无特殊病原菌(SPF)小鼠.干预随机分为正常对照组(10只)和烧伤组(10只).烧伤组动物以20%全身体表面积(TBSA)Ⅲ度烧伤,于伤后3 d与对照组同时活杀.主要观察指标体内免疫组化染色观察肠固有层中IgA型浆细胞;免疫诱异部位(PP)中淋巴细胞表面IgA流式细胞计数;烧伤后效应部位肠固有层(LP)淋巴细胞体外增殖检测;肠组织中IL-6 ELISA测定.结果PP中淋巴细胞表面IgA阳性率烧伤后3 d低于正常对照组;烧伤后LP中IgA浆细胞数明显少于伤前的水平;烧伤后动物的LP中淋巴细胞体外增殖明显下降;烧伤后3 d肠组织中IL-6水平与正常对照组无显著差别.结论烧伤抑制肠黏膜免疫组织淋巴细胞的增殖、分化,导致黏膜免疫屏障水平降低.

Study of the characteristics of the proliferation and differentiation of intestinal mucous membranous immunocytes after burn

BACKGROUND: The descent of intestinal mucous membranous immune barrier will cause the translocation of opportunistic pathogen, which will lead to enterogenous infection that will affect the rehabilitation of patients' organisms and relevant functions, but the mechanism is still not well estubli shed.OBJECTIVE: To observe the transition of mIg, A in peyer patch lymphocytes (PPL) and the conditions of proliferations in vitro of lamina properia lymphocytes (LPL) in intestinal mucous membranous immune tissues after burn,in order to increase mucous membranous immune barriers, to prevent enterogenous infections and to provide a clinical gist in speeding up rehabilitations in burn patients.DESIGN: A random control vertical study.SETTING and PARTICIPANTS: This study was completed in the Central Laboratory and Department of Burn Surgery, General Hospital of Chinese People' s Armed Police Forces. Subjects were 20 SPF mice.INTERVENTION: The mice were randomly grouped into control group ( n = 10) and burn group( n = 10). Mice in burn group were burnt with 20%of total body surface area(TBSA) in Ⅲ degree burn and executed after 3-day of injury together with the mice in control group.MAIN OUTCOME MEASURE: IgA plasmocytes in intestinal lamina propria(LP) were observed by in vivo immunohistochemical staining; IgA on the surface of lymphocytes in PP were counted by flow cytometry; in vitro proliferations of LP lymphocytes were assayed after burn; IL-6 in intestinal tissue was assayed by ELISA.RESULTS: The positive rate of Ig A in PP after 3-day of bum was lower than that of control group; the numbers of IgA plasmocytes in LP after burn were significantly less than the level before burn; in vitro proliferation of the lymphocytes in LP was distinctly decreased after burn; the level of IL-6 in intestinal tissue had no significant difference compared with that of control group.CONCLUSION: Burn inhibits the proliferation and differentiation of lymphocytes in intestinal mucous membranous immune tissues, which will lead to the depression of mucous membranous immune barrier.