Department of Anesthesiology, General Hospital of Shenyang Commend, Shenyang, 110840, China.
Dig Dis Sci. 2013 Jun;58(6):1528-36. doi: 10.1007/s10620-012-2546-0. Epub 2013 Jan 19.
Cardiopulmonary bypass (CPB) is commonly applied to support circulation during heart surgery but frequently causes adverse effects.
The purpose of this study was to examine the potential of probiotics to improve small intestinal mucosa barrier function after CPB.
Twenty-four adult male SD rats were randomly divided into sham-operated (S), CPB-operated (CPB), and probiotic-fed (Y) groups. Diamine oxidase (DAO) activity and concentrations of D-lactic acid, endotoxin, TNFα, and IL-6 were measured in portal vein blood. IgA concentrations were determined in plasma and the small intestine. Vena cava blood and tissue samples were used to monitor bacterial growth. Intestinal epithelial ultrastructure was analyzed by transmission electron microscopy (TEM). Occludin and ZO-1 expression levels in the intestinal epithelium were detected by western blotting and immunohistochemistry, respectively.
D-lactic acid, endotoxin, TNFα and IL-6 levels, DAO activity, and bacterial translocation rate were increased (P < 0.05) in CPB and Y compared to the S group. The above indices were relatively lower (P < 0.05) in Y than in CPB. Plasma and small intestinal IgA levels were significantly lower (P < 0.05) in CPB, while in Y they were significantly increased (P < 0.05) but lower than in S (P < 0.05). These results were confirmed by TEM. Consistently, occludin and ZO-1 expression levels were significantly higher in Y than in CPB (P < 0.05) but still lower compared to S (P < 0.05).
Pre-administration of probiotics can improve, to some extent, intestinal barrier function after CPB in rats, and this effect is likely related to inhibition of the CPB-induced inflammatory response, improvement in local intestinal immune function, and increased expression of intestinal epithelial tight junction proteins.
体外循环(CPB)常用于心脏手术期间支持循环,但经常引起不良反应。
本研究旨在探讨益生菌改善 CPB 后小肠黏膜屏障功能的潜力。
将 24 只成年雄性 SD 大鼠随机分为假手术(S)、CPB 手术(CPB)和益生菌喂养(Y)组。测量门静脉血中二胺氧化酶(DAO)活性和 D-乳酸、内毒素、TNFα 和 IL-6 浓度。测定血浆和小肠中的 IgA 浓度。监测腔静脉血和组织样本中的细菌生长情况。通过透射电子显微镜(TEM)分析肠上皮超微结构。通过 Western 印迹和免疫组织化学分别检测肠上皮中闭合蛋白和 ZO-1 的表达水平。
CPB 和 Y 组的 D-乳酸、内毒素、TNFα 和 IL-6 水平、DAO 活性和细菌易位率均升高(P<0.05),与 S 组相比。Y 组上述指标均低于 CPB 组(P<0.05)。CPB 组血浆和小肠 IgA 水平明显降低(P<0.05),而 Y 组则明显升高(P<0.05),但仍低于 S 组(P<0.05)。TEM 结果证实了这一点。同样,Y 组的闭合蛋白和 ZO-1 表达水平明显高于 CPB 组(P<0.05),但仍低于 S 组(P<0.05)。
CPB 前给予益生菌可在一定程度上改善大鼠 CPB 后肠道屏障功能,这种作用可能与抑制 CPB 诱导的炎症反应、改善局部肠道免疫功能以及增加肠上皮紧密连接蛋白表达有关。