Chen Chien-Ting, Chu Chi-Jen, Wang Teh-Fang, Lu Rei-Hwa, Lee Fa-Yauh, Chang Full-Young, Lin Han-Chieh, Chan Che-Chang, Wang Sun-Sang, Huang Hui-Chun, Lee Shou-Dong
Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
J Gastroenterol Hepatol. 2005 Mar;20(3):450-5. doi: 10.1111/j.1440-1746.2004.03550.x.
Endotoxin has been proposed to participate in the development of hepatic encephalopathy. However, there is no published data concerning the effects of endotoxin neutralization on the degree of hepatic encephalopathy. The present study investigated the effect of chronic intraperitoneal injection of polymyxin B, a neutralizing antagonist of endotoxin, on hepatic encephalopathy in rats with thioacetamide (TAA)-induced fulminant hepatic failure.
Male Sprague-Dawley rats weighing 300-350 g were used. Fulminant hepatic failure was induced by intraperitoneal injection of TAA (350 mg/kg/day) for 3 days. Two series of rats were designed to compare the effects of low dose (0.1 mg) or high dose (0.2 mg) intraperitoneal polymyxin B administration versus normal saline (NS) on hepatic encephalopathy. The injection was twice daily started from 2 days prior to TAA administration and lasted for 5 days. Severity of encephalopathy was assessed by the counts of motor activity in an Opto-Varimex animal activity meter. Plasma levels of endotoxin and tumor necrosis factor-alpha (an index of liver injury) were measured by Limulus assay and the ELISA method, respectively.
Neutralization of endotoxin by either low dose or high dose polymyxin B administration did not significantly alleviate the degree of hepatic encephalopathy, as represented by the counts of motor activities (P > 0.05). Plasma levels of endotoxin and tumor necrosis factor-alpha were comparable between rats treated with polymyxin B or NS (P > 0.05).
Our findings do not support the notion that endotoxin plays a major role in the pathogenesis of hepatic encephalopathy in rats with TAA-induced fulminant hepatic failure.
内毒素被认为参与了肝性脑病的发生发展。然而,关于内毒素中和对肝性脑病程度影响的公开数据尚无报道。本研究探讨了腹腔内慢性注射多粘菌素B(一种内毒素中和拮抗剂)对硫代乙酰胺(TAA)诱导的暴发性肝衰竭大鼠肝性脑病的影响。
选用体重300 - 350 g的雄性Sprague-Dawley大鼠。通过腹腔注射TAA(350 mg/kg/天),连续3天诱导暴发性肝衰竭。设计两组大鼠,比较腹腔注射低剂量(0.1 mg)或高剂量(0.2 mg)多粘菌素B与生理盐水(NS)对肝性脑病的影响。从给予TAA前2天开始,每天注射2次,持续5天。通过Opto-Varimex动物活动仪中运动活动计数评估脑病严重程度。分别采用鲎试剂法和ELISA法测定血浆内毒素水平和肿瘤坏死因子-α(肝损伤指标)。
低剂量或高剂量多粘菌素B给药对内毒素的中和作用均未显著减轻以运动活动计数表示的肝性脑病程度(P > 0.05)。多粘菌素B治疗组和NS治疗组大鼠的血浆内毒素水平和肿瘤坏死因子-α水平相当(P > 0.05)。
我们的研究结果不支持内毒素在TAA诱导的暴发性肝衰竭大鼠肝性脑病发病机制中起主要作用这一观点。