Disciplina de Cirurgia Pediátrica, Departamento de Cirurgia, Universidade Estadual de Campinas, SP, Brasil.
Braz J Med Biol Res. 2010 Feb;43(2):160-5. doi: 10.1590/s0100-879x2010005000005. Epub 2010 Jan 22.
Babies with gastroschisis have high morbidity, which is associated with inflammatory bowel injury caused by exposure to amniotic fluid. The objective of this study was to identify components of the inflammatory response in the intestine and liver in an experimental model of gastroschisis in rats. The model was surgically created at 18.5 days of gestation. The fetuses were exposed through a hysterotomy and an incision at the right of the umbilicus was made, exposing the fetal bowel. Then, the fetus was placed back into the uterus until term. The bowel in this model had macro- and microscopic characteristics similar to those observed in gastroschisis. The study was conducted on three groups of 20 fetuses each: gastroschisis, control, and sham fetuses. Fetal body, intestine and liver weights and intestine length were measured. IL-1beta, IL-6, IL-10, TNF-alpha, IFN-gamma and NF-kappaB levels were assessed by ELISA. Data were analyzed statistically by ANOVA followed by the Tukey post-test. Gastroschisis fetuses had a decreased intestine length (means +/- SD, 125 +/- 25 vs 216 +/- 13.9; P < 0.005) and increased intestine weight (0.29 +/- 0.05 vs 0.24 +/- 0.04; P < 0.005). Intestine length correlated with liver weight only in gastroschisis fetuses (Pearson's correlation coefficient, r = 0.518, P = 0.019). There were no significant differences in the concentrations of IL-1beta, TNF-alpha or IFN-gamma in the intestine, whereas the concentration of NF-kappaB was increased in both the intestine and liver of fetuses with gastroschisis. These results show that the inflammatory response in the liver and intestine of the rat model of gastroschisis is accompanied by an increase in the amount of NF-kappaB in the intestine and liver.
先天性腹壁缺损(先天性脐膨出)患儿发病率较高,其主要与暴露于羊水导致的炎症性肠损伤有关。本研究旨在建立大鼠先天性脐膨出模型,探讨其肠道和肝脏的炎症反应特点。模型于妊娠第 18.5 天行剖宫产术建立,经子宫切口暴露胎儿,于胎儿右侧脐旁作一切口,暴露胎儿肠管,然后将胎儿放回子宫至足月。该模型中胎儿肠管大体和镜下表现与临床所见相似。本研究共纳入 3 组各 20 只胎儿:先天性脐膨出组、对照组和假手术组。分别测量胎儿体质量、肠管和肝脏质量及肠管长度,采用 ELISA 法检测肠组织和肝脏中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)和核转录因子-κB(NF-κB)水平。数据采用方差分析和 Tukey 检验进行统计学分析。结果显示,与对照组和假手术组相比,先天性脐膨出组胎儿肠管长度明显缩短[(125±25)mm 比(216±13.9)mm,P<0.005],肠管质量明显增加[(0.29±0.05)g 比(0.24±0.04)g,P<0.005],且肠管长度与肝脏质量呈正相关(r=0.518,P=0.019)。三组胎儿肠组织和肝脏中 IL-1β、TNF-α和 IFN-γ水平差异均无统计学意义(P>0.05),但先天性脐膨出组胎儿肠组织和肝脏中 NF-κB 水平明显升高(P<0.05)。综上,先天性脐膨出大鼠模型中,肠组织和肝脏的炎症反应与 NF-κB 表达增加有关。