Liang Zhe, Xie Yan, Dominguez Jessica A, Breed Elise R, Yoseph Benyam P, Burd Eileen M, Farris Alton B, Davidson Nicholas O, Coopersmith Craig M
Emory Center for Critical Care and Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, United States of America.
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America.
PLoS One. 2014 Jul 10;9(7):e101828. doi: 10.1371/journal.pone.0101828. eCollection 2014.
Mice with conditional, intestine-specific deletion of microsomal triglyceride transfer protein (Mttp-IKO) exhibit a complete block in chylomicron assembly together with lipid malabsorption. Young (8-10 week) Mttp-IKO mice have improved survival when subjected to a murine model of Pseudomonas aeruginosa-induced sepsis. However, 80% of deaths in sepsis occur in patients over age 65. The purpose of this study was to determine whether age impacts outcome in Mttp-IKO mice subjected to sepsis.
Aged (20-24 months) Mttp-IKO mice and WT mice underwent intratracheal injection with P. aeruginosa. Mice were either sacrificed 24 hours post-operatively for mechanistic studies or followed seven days for survival.
In contrast to young septic Mttp-IKO mice, aged septic Mttp-IKO mice had a significantly higher mortality than aged septic WT mice (80% vs. 39%, p = 0.005). Aged septic Mttp-IKO mice exhibited increased gut epithelial apoptosis, increased jejunal Bax/Bcl-2 and Bax/Bcl-XL ratios yet simultaneously demonstrated increased crypt proliferation and villus length. Aged septic Mttp-IKO mice also manifested increased pulmonary myeloperoxidase levels, suggesting increased neutrophil infiltration, as well as decreased systemic TNFα compared to aged septic WT mice.
Blocking intestinal chylomicron secretion alters mortality following sepsis in an age-dependent manner. Increases in gut apoptosis and pulmonary neutrophil infiltration, and decreased systemic TNFα represent potential mechanisms for why intestine-specific Mttp deletion is beneficial in young septic mice but harmful in aged mice as each of these parameters are altered differently in young and aged septic WT and Mttp-IKO mice.
条件性肠道特异性微粒体甘油三酯转运蛋白缺失(Mttp - IKO)的小鼠在乳糜微粒组装过程中出现完全阻断,并伴有脂质吸收不良。年轻(8 - 10周)的Mttp - IKO小鼠在接受铜绿假单胞菌诱导的败血症小鼠模型时存活率有所提高。然而,80%的败血症死亡发生在65岁以上的患者中。本研究的目的是确定年龄是否会影响Mttp - IKO小鼠败血症的预后。
对老年(20 - 24个月)的Mttp - IKO小鼠和野生型(WT)小鼠进行气管内注射铜绿假单胞菌。术后24小时处死小鼠进行机制研究,或观察7天的存活率。
与年轻的败血症Mttp - IKO小鼠相比,老年败血症Mttp - IKO小鼠的死亡率显著高于老年败血症WT小鼠(80%对39%,p = 0.005)。老年败血症Mttp - IKO小鼠肠道上皮细胞凋亡增加,空肠Bax/Bcl - 2和Bax/Bcl - XL比值升高,但同时隐窝增殖和绒毛长度增加。与老年败血症WT小鼠相比,老年败血症Mttp - IKO小鼠还表现出肺髓过氧化物酶水平升高,提示中性粒细胞浸润增加,以及全身TNFα水平降低。
阻断肠道乳糜微粒分泌以年龄依赖的方式改变败血症后的死亡率。肠道凋亡增加、肺中性粒细胞浸润增加以及全身TNFα降低代表了肠道特异性Mttp缺失在年轻败血症小鼠中有益而在老年小鼠中有害的潜在机制,因为这些参数在年轻和老年败血症WT及Mttp - IKO小鼠中的变化各不相同。