Mikami Yukio, Dobschütz Ernst V, Sommer Olaf, Wellner Ulrich, Unno Michiaki, Hopt Ulrich, Keck Tobias
Department of General and Visceral Surgery, University Hospital Freiburg, Freiburg, Germany.
Surgery. 2009 Feb;145(2):147-56. doi: 10.1016/j.surg.2008.08.036. Epub 2008 Nov 28.
The role of polymorphonuclear neutrophil granulocytes (PMNs) and the PMN-derived protease, which is called matrix metalloproteinase-9 (MMP-9), for the gut barrier dysfunction in severe acute pancreatitis (SAP) has not yet been clarified. The aim of this study was to evaluate the effects of PMNs and MMP-9 on gut barrier dysfunction in rat SAP.
SAP was induced by the injection of 5% sodium taurocholate, and anti-rat PMN serum or BB-94 were administered 48 h and 24 h, respectively, before the induction of acute pancreatitis. Twenty-four hours after the induction of acute pancreatitis, the gut barrier dysfunction and the incidence of bacterial translocation (BT) and PMN transmigration were investigated by bacterial, histologic, and biochemical (MPO) analysis. Inhibition of MMP-9 was achieved by depletion of PMNs or inhibition of MMP-activity by a broad-spectrum MMP inhibitor and confirmed by zymography. In addition, reactive oxygen species were evaluated by spin trap assay.
The mucosal injury and the infiltration of PMNs into the gut tissue of rats with SAP were significantly increased in comparison with rats treated with anti-rat PMN serum or BB-94. The levels of MMP-9 and reactive oxygen species in the gut of rats with SAP were significantly higher than those of the rats treated with anti-rat PMN serum or BB-94. Pretreatment with anti-rat PMN serum or BB-94 reduced the incidence of BT in SAP.
The incidence of BT in SAP was prevented by the depletion of PMNs or less pronounced by the injection of the MMP inhibitor BB-94. PMNs play an important pathophysiologic role in the occurrence of BT, and MMP-9 is involved in both BT and PMN transmigration in rat SAP.
多形核中性粒细胞(PMNs)以及被称为基质金属蛋白酶-9(MMP-9)的PMN衍生蛋白酶在重症急性胰腺炎(SAP)肠道屏障功能障碍中所起的作用尚未明确。本研究旨在评估PMNs和MMP-9对大鼠SAP肠道屏障功能障碍的影响。
通过注射5%牛磺胆酸钠诱导SAP,分别在诱导急性胰腺炎前48小时和24小时给予抗大鼠PMN血清或BB-94。急性胰腺炎诱导24小时后,通过细菌学、组织学和生化(MPO)分析研究肠道屏障功能障碍、细菌移位(BT)发生率和PMN迁移情况。通过消耗PMNs或用广谱MMP抑制剂抑制MMP活性来实现对MMP-9的抑制,并通过酶谱法进行确认。此外,通过自旋捕获试验评估活性氧。
与用抗大鼠PMN血清或BB-94治疗的大鼠相比,SAP大鼠肠道组织的黏膜损伤和PMN浸润显著增加。SAP大鼠肠道中MMP-9和活性氧水平显著高于用抗大鼠PMN血清或BB-94治疗的大鼠。用抗大鼠PMN血清或BB-94预处理可降低SAP中BT的发生率。
消耗PMNs可预防SAP中BT的发生,注射MMP抑制剂BB-94则使其发生率降低程度较小。PMNs在BT的发生中起重要的病理生理作用,且MMP-9参与大鼠SAP中的BT和PMN迁移。