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地塞米松可预防脂多糖诱导的大鼠回肠上皮屏障功能障碍。

Dexamethasone Prevents Lipopolysaccharide-Induced Epithelial Barrier Dysfunction in Rat Ileum.

机构信息

Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

出版信息

Shock. 2018 Mar;49(3):334-344. doi: 10.1097/SHK.0000000000000930.

Abstract

Inflammatory mediators have been postulated as elementary inducing factors to the disruption of the intestinal tight junctions (TJ) and consequently, gut permeability and bacterial translocation. Corticosteroids are considered the mainstay in the treatment of septic shock; however, the impact of this therapy on the intestinal epithelial barrier dysfunction during septic shock remains unknown. Our aims were to demonstrate the role of low dexamethasone (DEX) doses in modulation of the inflammatory response, as well as the expression and the arrangement of TJ proteins in endotoxemic rats. One hour before the endotoxemia induction by lipopolysaccharide (LPS) administration, rats were pretreated with DEX at two low-doses (0.1 and 1.0 mg/kg). The parameters assessed included intestinal permeability, bacterial translocation, cytokines production, histology injury, localization, and expression of TJ proteins. Endotoxemic rats displayed intestinal epithelial barrier dysfunction, characterized by increased permeability and bacterial translocation, TJ disruption (opening and changes to its constituent proteins expression) and hyperactivation of the inflammatory response. On the other hand, the pretreatment with DEX attenuated the systemic and mucosal production of inflammatory mediators and also reverted the LPS-induced ileal injuries, increasing the expression of occludin and claudin-1, but also reducing claudin-2. Moreover, the histological damages and the morphology of the TJ were preserved by the DEX administration, therefore reducing their LPS-induced opening. The present study sheds light on the fact that early DEX treatment breaks the vicious cycle of local gut inflammation and barrier dysfunction in endotoxemia, especially preserving an essential structure of this monolayer epithelium, the TJ.

摘要

炎症介质被认为是破坏肠道紧密连接(TJ)的基本诱导因素,进而导致肠道通透性和细菌易位。皮质类固醇被认为是治疗感染性休克的主要药物;然而,这种治疗方法对感染性休克期间肠道上皮屏障功能障碍的影响尚不清楚。我们的目的是证明低剂量地塞米松(DEX)在调节炎症反应以及调节内毒素血症大鼠 TJ 蛋白的表达和排列中的作用。在通过脂多糖(LPS)给药诱导内毒素血症前 1 小时,大鼠用两种低剂量(0.1 和 1.0mg/kg)的 DEX 预处理。评估的参数包括肠道通透性、细菌易位、细胞因子产生、组织学损伤、TJ 蛋白的定位和表达。内毒素血症大鼠表现出肠道上皮屏障功能障碍,其特征是通透性和细菌易位增加、TJ 破坏(开放和其组成蛋白表达改变)以及炎症反应过度激活。另一方面,DEX 预处理可减轻全身和黏膜炎症介质的产生,也可逆转 LPS 诱导的回肠损伤,增加闭合蛋白和紧密连接蛋白-1 的表达,但也降低紧密连接蛋白-2 的表达。此外,DEX 给药可保存 TJ 的组织学损伤和形态,从而减少 LPS 诱导的开放。本研究阐明了这样一个事实,即早期 DEX 治疗可打破内毒素血症中局部肠道炎症和屏障功能障碍的恶性循环,特别是保存了这种单层上皮的重要结构,即 TJ。

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