Schimpl G, Pabst M A, Feierl G, Kuesz A, Ozbey H, Takahashi S, Höllwarth M E
Department of Paediatric Surgery, University of Graz, Medical School, Austria.
Gut. 1999 Dec;45(6):904-10. doi: 10.1136/gut.45.6.904.
Bacterial translocation (BT) plays a major role in the pathophysiological process of spontaneous infections in portal hypertension (PH) and cholestatic jaundice. The major mechanisms promoting BT in experimental animal models are the disruption of the intestinal ecological equilibrium and disruption of the intestinal mucosal barrier. The enzymes xanthine dehydrogenase (XD) and xanthine oxidase (XO) are often implicated as a significant source of oxidants which have a major impact on the impairment of intestinal barrier function.
To investigate the incidence of BT in rats with PH and obstructive jaundice, and to evaluate the impact of XD and XO.
Animals were subjected to sham laparotomy (SL), PH by calibrated stenosis of the portal vein, and common bile duct ligation (CBDL). They were fed either a standard pellet diet or a tungsten supplemented molybdenum-free diet. Four weeks after the operative procedure, intestinal colonisation and BT to portal vein, vena cava, mesenteric lymph nodes, liver, and spleen were determined. Intestinal XD and XO activity were measured enzymatically and histochemically.
Significant (p<0.01) intestinal bacterial overgrowth was present in all PH and CBDL groups compared with the SL group. In normally fed animals after SL, BT occurred in 12%. In PH and after CBDL, the rate of BT increased significantly (p<0.05) to 28% and 54% respectively. In the jejunum of normally fed animals subjected to PH or CBDL, a significant increase in XO was observed (p<0.01). Animals fed a tungsten supplemented diet showed a significant attenuation of BT to 14% in PH and 22% after CBDL (p<0. 05). Tungsten treatment completely suppressed jejunal XD and XO activities.
Significant intestinal bacterial overgrowth, BT, and XD to XO conversion occurred in PH and after CBDL. XD and XO inactivation by a tungsten supplemented molybdenum-free diet significantly reduced the incidence of BT without affecting intestinal bacterial overgrowth. These data strongly support the hypothesis that increased XD to XO conversion may contribute to intestinal barrier failure in PH and after CBDL.
细菌移位(BT)在门静脉高压(PH)和胆汁淤积性黄疸的自发性感染病理生理过程中起主要作用。实验动物模型中促进BT的主要机制是肠道生态平衡的破坏和肠黏膜屏障的破坏。黄嘌呤脱氢酶(XD)和黄嘌呤氧化酶(XO)常被认为是氧化剂的重要来源,对肠屏障功能损害有重大影响。
研究PH和梗阻性黄疸大鼠的BT发生率,并评估XD和XO的影响。
动物接受假手术(SL)、通过门静脉校准狭窄造成PH以及胆总管结扎(CBDL)。给它们喂食标准颗粒饲料或补充钨的无钼饲料。手术操作四周后,测定肠道定植情况以及门静脉、腔静脉、肠系膜淋巴结、肝脏和脾脏的BT情况。通过酶法和组织化学法测量肠道XD和XO活性。
与SL组相比,所有PH组和CBDL组均出现显著(p<0.01)的肠道细菌过度生长。SL后正常喂食的动物中,BT发生率为12%。在PH组和CBDL组后,BT发生率显著增加(p<0.05),分别达到28%和54%。在接受PH或CBDL的正常喂食动物的空肠中,观察到XO显著增加(p<0.01)。喂食补充钨饲料的动物在PH组中BT发生率显著降低至14%,CBDL组后降至22%(p<0.05)。钨处理完全抑制了空肠XD和XO活性。
PH组和CBDL组后出现显著的肠道细菌过度生长、BT以及XD向XO的转化。补充钨的无钼饮食使XD和XO失活显著降低了BT发生率,而不影响肠道细菌过度生长。这些数据有力支持了以下假说:XD向XO转化增加可能导致PH组和CBDL组后肠屏障功能衰竭。