Xiong Wei, Xu Shiyuan, Li Hongyue, Liang Kunhui
Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Anesthesiology, Zhongshan Hospital, Xiamen University, Xiamen, China.
Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
J Surg Res. 2016 Jan;200(1):250-9. doi: 10.1016/j.jss.2015.06.068. Epub 2015 Jul 7.
Hypothermia can ameliorate ischemia-reperfusion-induced intestinal injury; however, whether the therapeutic mechanism of hypothermia on hemorrhagic shock, a severe condition of ischemia-reperfusion, is associated with mitochondrial protection in enterocytes is rarely reported. We aimed to evaluate the effects of hypothermia on mitochondria after shock-induced intestinal injury.
A severe hemorrhagic shock model was constructed in Sprague-Dawley rats at induced hypothermic (32°C or 34°C) or normothermic temperatures (37°C), followed by resuscitation with whole shed blood and Ringer lactate (15 mg/kg body weight). After 2 h, 24 rats were killed and their intestinal tissue was collected; the remaining animals were returned to the normothermic environment to observe the survival time.
There was severe mitochondrial dysfunction in the normothermia group, as well as increased oxidative stress and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling apoptotic index. As expected, hypothermia treatment decreased mitochondrial permeability transition pore opening and restored the mitochondrial membrane potential and intracellular adenosine triphosphate content. Furthermore, hypothermia elevated mitochondrial-reduced glutathione and decreased mitochondrial malondialdehyde; consistent with the restored mitochondrial function, intestinal cell apoptosis and intestinal histopathologic injury were attenuated, the systemic inflammatory response was mitigated, and survival time was significantly prolonged. Additionally, moderate-induced hypothermia (32°C) had better therapeutic effects than mild hypothermia (34°C).
The results suggest that moderate hypothermia resuscitation is an effective treatment for shock-induced intestinal injury, and its therapeutic mechanism may be related to mitochondrial protection.
低温可减轻缺血-再灌注诱导的肠道损伤;然而,低温对失血性休克(一种严重的缺血-再灌注状态)的治疗机制是否与肠上皮细胞中的线粒体保护相关,鲜有报道。我们旨在评估低温对休克诱导的肠道损伤后线粒体的影响。
在诱导低温(32°C或34°C)或正常体温(37°C)条件下,在Sprague-Dawley大鼠中构建严重失血性休克模型,随后用全血和乳酸林格液(15mg/kg体重)进行复苏。2小时后,处死24只大鼠并收集其肠道组织;其余动物返回正常体温环境观察生存时间。
正常体温组存在严重的线粒体功能障碍,以及氧化应激增加和末端脱氧核苷酸转移酶介导的dUTP缺口末端标记凋亡指数升高。正如预期的那样,低温治疗降低了线粒体通透性转换孔的开放,恢复了线粒体膜电位和细胞内三磷酸腺苷含量。此外,低温提高了线粒体还原型谷胱甘肽水平,降低了线粒体丙二醛水平;与恢复的线粒体功能一致,肠细胞凋亡和肠道组织病理学损伤减轻,全身炎症反应减轻,生存时间显著延长。此外,中度低温诱导(32°C)比轻度低温(34°C)具有更好的治疗效果。
结果表明,中度低温复苏是治疗休克诱导的肠道损伤的有效方法,其治疗机制可能与线粒体保护有关。