Pan S A, Okazaki Y, Takemoto T
Department of Internal Medicine, Taipei Medical College, Taiwan, ROC.
J Gastroenterol Hepatol. 1990 May-Jun;5(3):281-7. doi: 10.1111/j.1440-1746.1990.tb01630.x.
The present study investigated the defect of duodenal defence responsible for the tendency of recurrence of duodenal ulcer. Male Wistar rats were treated with cysteamine-HCl subcutaneously to induce duodenal ulcer, and bromodeoxyuridine (BrdU) was given intraperitoneally 1 h before laparotomy. Serial tissue sections and immunocytochemical staining of BrdU were done to study the cell kinetics during and after healing. Deep ulcers developed in the proximal part of the duodenum 24 h after cysteamine injection, and the ulcer was replaced by scar tissue 1 week later. BrdU-labelling index of normal duodenal mucosa in control rats was 30-34%. On the peripheral part of the regenerative mucosa, BrdU-labelling index increased from 1.5% to 26-27%, 1-4 weeks after injection and remained at this level thereafter. On the central part, except the most central area, the labelling index remained at 0% until 3 weeks, and was 15% 6 weeks after cysteamine treatment. It never achieved the level seen in control normal mucosa. The labelling rate of fibrous cells in scar tissue decreased from 28% to nearly 0% 1-4 weeks after the injection. It is concluded that both the ulcer scar and the regenerative mucosa do not achieve a mature state in the initial scarred stage; they need more time to reach a relatively mature condition. Moreover, the regenerative mucosa will be the weak, easily damaged part of the duodenum.
本研究调查了十二指肠防御功能缺陷与十二指肠溃疡复发倾向之间的关系。采用皮下注射半胱胺盐酸盐的方法诱导雄性Wistar大鼠发生十二指肠溃疡,并在剖腹手术前1小时腹腔注射溴脱氧尿苷(BrdU)。通过连续组织切片和BrdU免疫细胞化学染色来研究愈合过程中和愈合后的细胞动力学。注射半胱胺24小时后,十二指肠近端出现深度溃疡,1周后溃疡被瘢痕组织取代。对照大鼠正常十二指肠黏膜的BrdU标记指数为30% - 34%。在再生黏膜的周边部分,注射后1 - 4周,BrdU标记指数从1.5%增加到26% - 27%,此后维持在该水平。在中央部分,除最中央区域外,标记指数在3周前一直保持在0%,半胱胺处理6周后为15%。它从未达到对照正常黏膜的水平。注射后1 - 4周,瘢痕组织中纤维细胞的标记率从28%降至近0%。结论是,溃疡瘢痕和再生黏膜在初始瘢痕形成阶段均未达到成熟状态;它们需要更多时间才能达到相对成熟的状态。此外,再生黏膜将成为十二指肠脆弱且易受损的部分。