Ding J W, Andersson R, Soltesz V L, Pärsson H, Johansson K, Wang W, Bengmark S
Department of Surgery, Lund University Hospital, Sweden.
J Hepatol. 1994 Jun;20(6):720-8. doi: 10.1016/s0168-8278(05)80141-2.
Obstructive jaundice is frequently associated with septic complications and enteric bacteria have been isolated from both the infectious focus and bile in jaundiced patients. The present study aimed to evaluate bacterial translocation and the influence of a macrophage-stimulant (muramyl tripeptide phosphatidylethanolamine) on bacterial translocation in obstructive jaundice. Male Sprague-Dawley rats were subjected to sham operation (n = 10) or common bile-duct ligation and transection (n = 35). Two weeks later, jaundiced animals received either physiological saline (n = 15), muramyl tripeptide phosphatidylethanolamine liposomes (n = 10) or placebo (empty) liposomes (n = 10) orally, while sham-operated rats received physiological saline, 48 h prior to evaluation of enteric bacterial translocation. Blood, bile and caecal contents were collected and cultured aerobically and anaerobically, as were tissue samples from the liver, spleen and mesenteric lymph nodes. Positive mesenteric lymph node cultures in animals with jaundice + saline (7/15; 47%) and jaundice + placebo liposomes (4/10; 40%) significantly differed (p < 0.05) from sham-operated animals (1/10; 10%) and muramyl tripeptide phosphatidylethanolamine treated animals (0/10). Caecal counts (CFU/g) of Escherichia coli, Lactobacilli and aerobic and microaerobic bacteria did not differ statistically among the groups, although the number of E. coli tended to be higher in jaundiced animals. Thus, liposomal muramyl tripeptide phosphatidylethanolamine inhibits bacterial translocation, probably by activating mucosal macrophages and enhancing reticuloendothelial system function in rats with biliary obstruction.
梗阻性黄疸常伴有脓毒症并发症，且在黄疸患者的感染病灶和胆汁中均分离出了肠道细菌。本研究旨在评估细菌移位情况以及一种巨噬细胞刺激剂（胞壁酰三肽磷脂酰乙醇胺）对梗阻性黄疸中细菌移位的影响。将雄性Sprague-Dawley大鼠分为假手术组（n = 10）或胆总管结扎并横断组（n = 35）。两周后，黄疸动物口服生理盐水（n = 15）、胞壁酰三肽磷脂酰乙醇胺脂质体（n = 10）或安慰剂（空）脂质体（n = 10），而假手术大鼠在评估肠道细菌移位前48小时接受生理盐水。采集血液、胆汁和盲肠内容物进行需氧和厌氧培养，同时采集肝脏、脾脏和肠系膜淋巴结的组织样本进行培养。黄疸 + 生理盐水组（7/15；47%）和黄疸 + 安慰剂脂质体组（4/10；40%）动物的肠系膜淋巴结培养阳性率与假手术组动物（1/10；10%）和胞壁酰三肽磷脂酰乙醇胺治疗组动物（0/10）相比有显著差异（p < 0.05）。各组间大肠杆菌、乳酸杆菌以及需氧和微需氧菌的盲肠计数（CFU/g）无统计学差异，尽管黄疸动物中大肠杆菌的数量有升高趋势。因此，脂质体胞壁酰三肽磷脂酰乙醇胺可能通过激活黏膜巨噬细胞和增强胆道梗阻大鼠的网状内皮系统功能来抑制细菌移位。
