National Taiwan University College of Medicine, Taipei, Taiwan.
BMC Gastroenterol. 2010 Apr 20;10:39. doi: 10.1186/1471-230X-10-39.
Bowel obstruction is a common cause of abdominal emergency, since the patients are at increased risk of septicemia resulting in high mortality rate. While the compartmentalized changes in enteric microfloral population and augmentation of bacterial translocation (BT) have already been reported using experimental obstruction models, alterations in epithelial permeability of the obstructed guts has not been studied in detail. Myosin light chain kinase (MLCK) is actively involved in the contraction of epithelial perijunctional actinomyosin ring and thereby increases paracellular permeability. In the current study we attempt to investigate the role of MLCK in epithelial barrier defects using a rat model of simple mechanical obstruction.
Wistar rats received intraperitoneal injection of ML-7 (a MLCK inhibitor) or vehicle at 24, 12 and 1 hrs before and 12 hrs after intestinal obstruction (IO). The distal small intestine was obstructed with a single ligature placed 10 cm proximal to the ileocecal junction in IO rats for 24 hrs. Sham-operated rats served as controls.
Mucosal injury, such as villous blunting and increased crypt/villus ratio, was observed in the distal small intestine of IO rats. Despite massive enterocyte shedding, intestinal villi were covered with a contiguous epithelial layer without cell apoptosis. Increased transmural macromolecular flux was noticed in the distal small intestine and the proximal colon after IO. The bacterial colony forming units in the spleen and liver of IO rats were significantly higher than those of sham controls. Addition of ML-7 ameliorated the IO-triggered epithelial MLC phosphorylation, mucosal injury and macromolecular flux, but not the level of BT.
The results suggest that IO-induced premature enterocytic sloughing and enhanced paracellular antigenic flux were mediated by epithelial MLCK activation. In addition, enteric bacteria may undergo transcytotic routes other than paracellular paths to cross the epithelium.
肠阻塞是腹部急症的常见原因,因为患者发生败血症的风险增加,导致死亡率高。虽然已经使用实验性阻塞模型报道了肠内微生物种群的分区变化和细菌易位(BT)的增加,但阻塞肠道上皮通透性的变化尚未详细研究。肌球蛋白轻链激酶(MLCK)积极参与上皮细胞旁周肌动球蛋白环的收缩,从而增加了细胞旁通透性。在本研究中,我们试图使用简单机械阻塞的大鼠模型来研究 MLCK 在肠上皮屏障缺陷中的作用。
Wistar 大鼠在肠阻塞(IO)前 24、12 和 1 小时以及 12 小时后腹腔内注射 ML-7(MLCK 抑制剂)或载体,IO 大鼠的回肠-盲肠交界处近端放置单个结扎线,将远端小肠阻塞 24 小时。假手术大鼠作为对照。
IO 大鼠的远端小肠观察到黏膜损伤,如绒毛变钝和隐窝/绒毛比增加。尽管有大量的肠上皮细胞脱落,但肠绒毛仍被连续的上皮层覆盖,没有细胞凋亡。IO 后,远端小肠和近端结肠的跨壁大分子通量增加。IO 大鼠的脾和肝中的细菌菌落形成单位明显高于 sham 对照组。添加 ML-7 可改善 IO 引发的上皮 MLC 磷酸化、黏膜损伤和大分子通量,但不能改善 BT 水平。
结果表明,IO 诱导的过早肠上皮细胞脱落和增强的细胞旁抗原通量是由上皮 MLCK 激活介导的。此外,肠内细菌可能通过细胞旁途径以外的转胞吞途径穿过上皮细胞。