Vasilescu C, Herlea V, Buttenschoen K, Beger H G
Department General Surgery II and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
J Cell Mol Med. 2003 Oct-Dec;7(4):417-24. doi: 10.1111/j.1582-4934.2003.tb00244.x.
To test the hypothesis that endotoxin is absorbed from the gut into the circulation in rats with experimental acute pancreatitis we studied two different animal models. In the first model necrotizing pancreatitis was induced by the ligation of the distal bilio-pancreatic duct while in the second, experimental oedematous acute pancreatitis was induced by subcutaneous injections of caerulein. In both experiments, in the colon of rats with acute pancreatitis endotoxin from Salmonella abortus equi was injected. Endotoxin was detected by immunohistochemistry in peripheral organs with specific antibodies. The endotoxin was found only in rats with both acute pancreatitis and endotoxin injected into the colon and not in the control groups. The distribution of endotoxin in liver at 3 and 5 days was predominantly at hepatocytes level around terminal hepatic venules, while in lung a scattered diffuse pattern at the level of alveolar macrophages was identified. A positive staining was observed after 12 hours in the liver, lung, colon and mesenteric lymph nodes of rats with both caerulein pancreatitis and endotoxin injected into the colon. We conclude that the experimental acute pancreatitis leads to early endotoxin translocation from the gut lumen in the intestinal wall and consequent access of gut-derived endotoxin to the mesenteric lymph nodes, liver and lung.
为了验证实验性急性胰腺炎大鼠体内内毒素从肠道吸收入循环系统这一假说,我们研究了两种不同的动物模型。在第一个模型中,通过结扎远端胆胰管诱导坏死性胰腺炎,而在第二个模型中,通过皮下注射蛙皮素诱导实验性水肿性急性胰腺炎。在两个实验中,均向急性胰腺炎大鼠的结肠内注射马流产沙门氏菌的内毒素。用特异性抗体通过免疫组织化学在外周器官中检测内毒素。仅在急性胰腺炎且结肠内注射了内毒素的大鼠中发现了内毒素,对照组未发现。内毒素在第3天和第5天在肝脏中的分布主要位于终末肝静脉周围的肝细胞水平,而在肺中则在肺泡巨噬细胞水平呈现散在的弥漫性分布模式。在注射了蛙皮素诱导胰腺炎且结肠内注射了内毒素的大鼠的肝脏、肺、结肠和肠系膜淋巴结中,12小时后观察到阳性染色。我们得出结论,实验性急性胰腺炎导致内毒素从肠腔早期转移至肠壁,并进而使源自肠道的内毒素进入肠系膜淋巴结、肝脏和肺。