Polistena Andrea, Johnson Louis Banka, Ohiami-Masseron Salomé, Wittgren Lena, Bäck Sven, Thornberg Charlotte, Gadaleanu Virgil, Adawi Diya, Jeppsson Bengt
Department of Surgery, Malmö University Hospital, Lund University, Malmö, Sweden.
BMC Surg. 2008 Jan 3;8:1. doi: 10.1186/1471-2482-8-1.
Preoperative radiotherapy of the pelvic abdomen presents with complications mostly affecting the small bowel. The aim of this study was to define the features of early radiation-induced injury on small bowel.
54 mice were divided into two groups (36 irradiated and 18 sham irradiated). Animals were placed on a special frame and (in the radiated group) the exteriorized segment of ileum was subjected to a single absorbed dose of 19 or 38 Gy radiation using 6 MV high energy photons. Specimens were collected for histology, immunohistochemistry (IHC) and ELISA analysis after 2, 24 and 48 hours. Venous blood was collected for systemic leucocyte count in a Burker chamber.
Histology demonstrated progressive infiltration of inflammatory cells with cryptitis and increased apoptosis. MIP-2 (macrophage inflammatory protein) concentration was significantly increased in irradiated animals up to 48 hours. No significant differences were observed in IL-10 (interleukin) and TNF-alpha (tumour necrosis factor) levels. IHC with CD45 showed a significant increase at 2 hours of infiltrating leucocytes and lymphocytes after irradiation followed by progressive decrease with time. Caspase-3 expression increased significantly in a dose dependent trend in both irradiated groups up to 48 hours.
Acute small bowel injury caused by local irradiation is characterised by increased apoptosis of crypt epithelial cells and by lymphocyte infiltration of the underlying tissue. The severity of histological changes tends to be dose dependent and may affect the course of tissue damage.
盆腔腹部术前放疗会出现多种并发症，其中大多数影响小肠。本研究的目的是明确小肠早期放射性损伤的特征。
将54只小鼠分为两组（36只接受照射，18只假照射）。将动物置于特殊框架上，（在照射组）使用6兆伏高能光子对回肠外置段给予19或38戈瑞的单次吸收剂量辐射。在2、24和48小时后收集标本进行组织学、免疫组织化学（IHC）和酶联免疫吸附测定（ELISA）分析。采集静脉血，在伯克血细胞计数板中进行全身白细胞计数。
组织学显示炎症细胞进行性浸润伴隐窝炎和凋亡增加。照射动物体内巨噬细胞炎性蛋白 - 2（MIP - 2）浓度在48小时内显著升高。白细胞介素 - 10（IL - 10）和肿瘤坏死因子 - α（TNF - α）水平未观察到显著差异。CD45免疫组织化学显示照射后2小时浸润白细胞和淋巴细胞显著增加，随后随时间逐渐减少。在两个照射组中，半胱天冬酶 - 3表达在48小时内呈剂量依赖性显著增加。
局部照射引起的急性小肠损伤的特征是隐窝上皮细胞凋亡增加以及下层组织淋巴细胞浸润。组织学变化的严重程度往往呈剂量依赖性，可能影响组织损伤的进程。
