Uchiyama Takashi, Delude Russell L, Fink Mitchell P
Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Intensive Care Med. 2003 Nov;29(11):2050-8. doi: 10.1007/s00134-003-1966-x. Epub 2003 Sep 3.
We previously showed that infusing rats with a solution of ethyl pyruvate ameliorates intestinal mucosal injury after mesenteric ischemia and reperfusion. Ethyl pyruvate also has been shown to inhibit the expression of various pro-inflammatory cytokines in several animal models of critical illness, but dose-response relationships have not been investigated.
Anesthetized C57BL/6 mice were subjected to 60 min of mesenteric ischemia followed by 60 min of reperfusion. After 55 min of ischemia, groups of mice were treated with normal saline or graded bolus doses of ethyl pyruvate dissolved in a calcium-containing balanced salt solution. Some animals (i.e., those in the sham group) were subjected to the anesthetic, but not mesenteric ischemia/reperfusion. Gut mucosal permeability was assessed using an everted gut sac technique.
University research laboratory.
Mesenteric ischemia/reperfusion significantly increased ileal mucosal permeability to the hydrophilic macromolecule, fluorescein isothiocyanate dextran (molecular mass 4,000 Da). Whereas the lowest dose of ethyl pyruvate evaluated (17 mg/kg) had no effect on gut mucosal permeability, the two highest doses tested (50 and 150 mg/kg) significantly ameliorated the development of ischemia/reperfusion-induced mucosal hyperpermeability to about the same extent. The two highest doses of ethyl pyruvate also significantly ameliorated deficits in ileal serosal and mucosal and hepatic surface microvascular perfusion induced by mesenteric ischemia/reperfusion. Ethyl pyruvate inhibited post-ischemia/reperfusion hepatic NF-kappaB activation and TNF mRNA expression in a dose-dependent fashion.
Doses of ethyl pyruvate equal to or greater than 50 mg/kg ameliorate inflammation, microvascular hypoperfusion and gut mucosal damage induced by mesenteric ischemia/reperfusion in mice.
我们之前的研究表明,给大鼠输注丙酮酸乙酯溶液可改善肠系膜缺血再灌注后的肠黏膜损伤。在几种危重病动物模型中,丙酮酸乙酯也已被证明能抑制多种促炎细胞因子的表达,但尚未对剂量反应关系进行研究。
将麻醉后的C57BL/6小鼠进行60分钟的肠系膜缺血,随后再灌注60分钟。在缺血55分钟后,给小鼠组分别注射生理盐水或溶解于含钙平衡盐溶液中的不同剂量丙酮酸乙酯推注。一些动物(即假手术组)接受麻醉,但不进行肠系膜缺血/再灌注。使用外翻肠囊技术评估肠道黏膜通透性。
大学研究实验室。
肠系膜缺血/再灌注显著增加了回肠黏膜对亲水性大分子异硫氰酸荧光素葡聚糖(分子量4000Da)的通透性。虽然所评估的最低剂量丙酮酸乙酯(17mg/kg)对肠道黏膜通透性没有影响,但测试的两个最高剂量(50和150mg/kg)在很大程度上显著改善了缺血/再灌注诱导的黏膜高通透性的发展。两个最高剂量的丙酮酸乙酯也显著改善了肠系膜缺血/再灌注引起的回肠浆膜、黏膜和肝表面微血管灌注不足。丙酮酸乙酯以剂量依赖的方式抑制缺血/再灌注后肝脏NF-κB的激活和TNF mRNA的表达。
剂量等于或大于50mg/kg的丙酮酸乙酯可改善小鼠肠系膜缺血/再灌注诱导的炎症、微血管灌注不足和肠道黏膜损伤。