Univ. of Florida, College of Health and Human Performance, Dept. of Applied Physiology & Kinesiology, Gainesville, FL 32611, USA.
Am J Physiol Regul Integr Comp Physiol. 2012 Apr;302(7):R845-53. doi: 10.1152/ajpregu.00595.2011. Epub 2012 Jan 11.
Loss of the intestinal barrier is critical to the clinical course of heat illness, but the underlying mechanisms are still poorly understood. We tested the hypothesis that conditions characteristic of mild heatstroke in mice are associated with injury to the epithelial lining of the intestinal tract and comprise a critical component of barrier dysfunction. Anesthetized mice were gavaged with 4 kDa FITC-dextran (FD-4) and exposed to increasing core temperatures, briefly reaching 42.4°C, followed by 30 min recovery. Arterial samples were collected to measure FD-4 concentration in plasma (in vivo gastrointestinal permeability). The small intestines were then removed to measure histological evidence of injury. Hyperthermia resulted in a ≈2.5-fold elevation in plasma FD-4 and was always associated with significant histological evidence of injury to the epithelial lining compared with matched controls, particularly in the duodenum. When isolated intestinal segments from control animals were exposed to ≥41.5°C, marked increases in permeability were observed within 60 min. These changes were associated with release of lactate dehydrogenase, evidence of protein oxidation via carbonyl formation and histological damage. Coincubation with N-acetylcysteine protected in vitro permeability during hyperthermia and reduced histological damage and protein oxidation. Chelation of intracellular Ca(2+) to block tight junction opening during 41.5°C exposure failed to reduce the permeability of in vitro segments. The results demonstrate that hyperthermia exposure in mouse intestine, at temperatures at or below those necessary to induce mild heatstroke, cause rapid and substantial injury to the intestinal lining that may be attributed, in part, to oxidative stress.
肠道屏障的丧失对热病的临床病程至关重要,但潜在机制仍知之甚少。我们检验了这样一个假设,即小鼠轻度中暑的特征性条件与肠道上皮衬里的损伤有关,并且构成了屏障功能障碍的关键组成部分。麻醉小鼠用 4 kDa FITC-右旋糖酐(FD-4)灌胃,并暴露于逐渐升高的核心温度下,短暂达到 42.4°C,然后恢复 30 分钟。采集动脉样本以测量血浆中 FD-4 的浓度(体内胃肠道通透性)。然后取出小肠测量上皮衬里损伤的组织学证据。体温过高导致血浆 FD-4 升高约 2.5 倍,与匹配的对照相比,总是与上皮衬里明显的损伤组织学证据相关,尤其是在十二指肠。当从对照动物分离的肠段暴露于≥41.5°C 时,在 60 分钟内观察到通透性的显著增加。这些变化与乳酸脱氢酶的释放、羰基形成导致的蛋白质氧化的证据以及组织学损伤有关。在高热条件下,与 N-乙酰半胱氨酸共孵育可保护体外通透性,并减少组织学损伤和蛋白质氧化。在 41.5°C 暴露期间螯合细胞内 Ca(2+)以阻止紧密连接开放,未能降低体外节段的通透性。结果表明,在温度等于或低于引起轻度中暑所需温度的情况下,暴露于小鼠肠道的高温会迅速导致肠道衬里的严重损伤,这可能部分归因于氧化应激。