Department of Surgery, Ernst-Moritz-Arndt-Universität, Greifswald, Germany.
Eur J Gastroenterol Hepatol. 2010 Sep;22(9):1039-49. doi: 10.1097/MEG.0b013e32833847db.
OBJECTIVE: During abdominal sepsis, the activation of hepatic Kupffer cells (KC) and its consequences are of central interest. This study evaluates the impact of selective KC depletion on hepatic microcirculation, cytokine release, and systemic alterations in the colon ascendens stent peritonitis (CASP), a model of polymicrobial abdominal sepsis. METHODS: For KC depletion clodronate liposomes were injected 24 h before CASP surgery in female C57BL/6N mice. Three and 12 h after CASP, in-vivo fluorescence microscopy of the liver was performed. Analysis of hepatocellular apoptosis was conducted by immunohistochemistry. In addition, levels of tumor necrosis factor (TNF), IL-6, and IL-10 in the liver, lungs, spleen, and plasma were determined, and bacteriology and survival analysis were performed. RESULTS: CASP led to significant sinusoidal perfusion failure, increased leukocyte recruitment, hepatocellular apoptosis and increased levels of TNF, IL-6, and IL-10 in the liver and plasma. KC depletion before CASP significantly reduced leukocyte recruitment to the liver and hepatocellular apoptosis. IL-10 secretion decreased dramatically in the liver and plasma of KC-depleted septic mice. In contrast, TNF levels were clearly elevated after clodronate treatment. In the lung and spleen, a compensatory upregulation of IL-10 could be detected after KC depletion. Clodronate treatment resulted in a significant reduction in survival. CONCLUSION: The results indicate that KC depletion is locally protective in polymicrobial abdominal sepsis, as it reduces hepatic inflammation and apoptosis. These effects could be observed in the presence of clearly elevated TNF levels. However, the lack of IL-10 in KC-depleted mice resulted in a detrimental systemic proinflammation.
目的:在腹腔感染时,肝枯否细胞(KC)的激活及其后果是研究的重点。本研究评估了选择性 KC 耗竭对结肠升支支架腹膜炎(CASP)模型中肝微循环、细胞因子释放和全身改变的影响,该模型为多微生物性腹腔感染。
方法:在 CASP 手术前 24 小时,给雌性 C57BL/6N 小鼠注射氯膦酸脂质体以耗竭 KC。在 CASP 后 3 和 12 小时,进行肝脏的体内荧光显微镜检查。通过免疫组织化学分析肝细胞凋亡。此外,还测定了肝、肺、脾和血浆中肿瘤坏死因子(TNF)、IL-6 和 IL-10 的水平,并进行了细菌学和生存分析。
结果:CASP 导致明显的肝窦灌注衰竭、白细胞募集增加、肝细胞凋亡和 TNF、IL-6 和 IL-10 在肝和血浆中的水平增加。在 CASP 前耗竭 KC 可显著减少白细胞向肝脏的募集和肝细胞凋亡。KC 耗竭的感染小鼠的肝和血浆中 IL-10 分泌明显减少。相反,在用氯膦酸处理后,TNF 水平明显升高。在肺和脾中,在 KC 耗竭后可检测到 IL-10 的代偿性上调。氯膦酸处理导致存活率显著降低。
结论:这些结果表明,在多微生物性腹腔感染中,KC 耗竭具有局部保护作用,可减少肝炎症和凋亡。在 TNF 水平明显升高的情况下可以观察到这些作用。然而,在 KC 耗竭的小鼠中缺乏 IL-10 导致了有害的全身促炎反应。
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