Leng Yuxin, Yi Min, Fan Jie, Bai Yu, Ge Qinggang, Yao Gaiqi
Department of Intensive Care Unit, Peking University Third Hospital, North Garden Road, No. 49, Haidian District, Beijing 100191, People's Republic of China.
Sci Rep. 2016 Mar 16;6:22814. doi: 10.1038/srep22814.
Intra-abdominal hypertension (IAH) is a common and serious complication in critically ill patients for which there is no well-defined treatment strategy. Here, we explored the effect of IAH on multiple intestinal barriers and discussed whether the alteration in microflora provides clues to guide the rational therapeutic treatment of intestinal barriers during IAH. Using a rat model, we analysed the expression of tight junction proteins (TJs), mucins, chemotactic factors, and Toll-like receptor 4 (TLR4) by immunohistochemistry. We also analysed the microflora populations using 16S rRNA sequencing. We found that, in addition to enhanced permeability, acute IAH (20 mmHg for 90 min) resulted in significant disturbances to mucosal barriers. Dysbiosis of the intestinal microbiota was also induced, as represented by decreased Firmicutes (relative abundance), increased Proteobacteria and migration of Bacteroidetes from the colon to the jejunum. At the genus level, Lactobacillus species and Peptostreptococcaceae incertae sedis were decreased, whereas levels of lactococci remained unchanged. Our findings outline the characteristics of IAH-induced barrier changes, indicating that intestinal barriers might be treated to alleviate IAH, and the microflora may be an especially relevant target.
腹腔内高压（IAH）是危重症患者常见且严重的并发症，目前尚无明确的治疗策略。在此，我们探讨了IAH对多种肠道屏障的影响，并讨论了微生物群的改变是否能为指导IAH期间肠道屏障的合理治疗提供线索。我们使用大鼠模型，通过免疫组织化学分析紧密连接蛋白（TJ）、黏蛋白、趋化因子和Toll样受体4（TLR4）的表达。我们还使用16S rRNA测序分析微生物群种群。我们发现，除通透性增强外，急性IAH（20 mmHg，持续90分钟）还导致黏膜屏障显著紊乱。肠道微生物群也发生了失调，表现为厚壁菌门（相对丰度）减少、变形菌门增加以及拟杆菌属从结肠迁移至空肠。在属水平上，乳酸杆菌属和不确定的消化链球菌科减少，而乳球菌水平保持不变。我们的研究结果概述了IAH诱导的屏障变化特征，表明可通过治疗肠道屏障来缓解IAH，而微生物群可能是一个特别相关的靶点。
