Deitch E A, Specian R D, Berg R D
Department of Surgery, Louisiana State University Medical Center, Shreveport 71130-3932.
Crit Care Med. 1991 Jun;19(6):785-91. doi: 10.1097/00003246-199106000-00010.
Previously, we documented that nonlethal doses of endotoxin injure the intestinal mucosal barrier and promote bacterial translocation from the gut to systemic organs. The current study was performed to determine the role of cytokines and complement activation in the pathogenesis of endotoxin-induced mucosal injury and bacterial translocation, as well as to quantify the magnitude of endotoxin-induced intestinal mucosal permeability.
The frequency of endotoxin-induced bacterial translocation was similar between normal outbred (88%), complement deficient (67%), and macrophage-hyporesponsive (55%) mice, indicating that neither complement nor macrophage activation is necessary for endotoxin-induced bacterial translocation to occur. As early as 2 hrs after endotoxin challenge, there was evidence of a greater than two-fold increase in ileal (p = .008) but not jejunal (p = .11) permeability as measured by the clearance of 51Cr EDTA. Both the increase in endotoxin-induced ileal permeability and the occurrence of bacterial translocation were largely prevented by pretreatment with allopurinol, a competitive inhibitor of xanthine oxidase.
These results suggest that endotoxin-induced bacterial translocation, mucosal injury, and ileal permeability are mediated via activation of xanthine oxidase, and not through complement activation or the liberation of macrophage products.
此前,我们记录到非致死剂量的内毒素会损伤肠道黏膜屏障,并促进细菌从肠道向全身器官的移位。进行本研究以确定细胞因子和补体激活在内毒素诱导的黏膜损伤及细菌移位发病机制中的作用,以及量化内毒素诱导的肠道黏膜通透性的程度。
正常远交系小鼠(88%)、补体缺陷小鼠(67%)和巨噬细胞低反应性小鼠(55%)中,内毒素诱导的细菌移位频率相似,表明补体激活和巨噬细胞激活均不是内毒素诱导细菌移位发生所必需的。在内毒素攻击后2小时,通过51Cr EDTA清除率测定发现,回肠通透性(p = 0.008)有超过两倍的增加,但空肠通透性(p = 0.11)没有增加。用黄嘌呤氧化酶竞争性抑制剂别嘌呤醇预处理,在很大程度上可预防内毒素诱导的回肠通透性增加和细菌移位的发生。
这些结果表明,内毒素诱导的细菌移位、黏膜损伤和回肠通透性是通过黄嘌呤氧化酶激活介导的,而非通过补体激活或巨噬细胞产物的释放介导。