Iiboshi Y, Nezu R, Cui L, Chen K, Khan J, Yoshida H, Sando K, Kamata S, Takagi Y, Okada A
Department of Pediatric Surgery, Osaka University Medical School, Japan.
JPEN J Parenter Enteral Nutr. 1996 Mar-Apr;20(2):98-104. doi: 10.1177/014860719602000298.
Although it has been reported that total parenteral nutrition induces an increased intestinal permeability and a decreased mucous gel layer covering the intestinal epithelium, the role of mucous gel on intestinal permeability has not been well understood. We examined the in vivo effects of N-acetyl cysteine (NAC) as mucolytic agent and colchicine as suppressant of the mucus production on the intestinal transmission of fluorescein isothiocyanate dextran 70,000 (FITC-dextran).
Rats were divided into four groups. In each group, FITC-dextran (750 mg/kg) with or without NAC (3000 mg/kg) was injected into the small intestinal lumen 3 hours after intraperitoneal injection of saline or colchicine (Col, 10 mg/kg). Thirty minutes after injection of FITC-dextran, blood samples were taken from portal vein to analyze plasma fluorescein concentration by fluorescence spectrometry. Samples of small intestine were sectioned in a cryostat for fluorescence microscopy, and the identical sections were stained by periodic acid-Schiff reaction.
Plasma FITC-dextran level in NAC group was higher than that in control group (p < .01), that in Col + NAC group was higher than that in Col group (p < .01) and that in Col + NAC group was higher than that in NAC group (p < .05). The spaces between villi were filled with mucous gel in the control and Col groups, whereas those were not entirely filled with mucous gel in NAC and Col + NAC groups. FITC-dextran and mucous gel showed complementary distribution in all rats. The villous interstitial edema was recognized in NAC group and the villi were disrupted in Col + NAC group.
These results suggest that intestinal permeability is possibly affected not only by the mucous gel covering the intestinal epithelium but also by mucus release from goblet cells of the small intestine.
尽管已有报道称全肠外营养会导致肠道通透性增加以及覆盖肠上皮的黏液凝胶层减少,但黏液凝胶对肠道通透性的作用尚未得到充分理解。我们研究了作为黏液溶解剂的N-乙酰半胱氨酸(NAC)和作为黏液分泌抑制剂的秋水仙碱对异硫氰酸荧光素葡聚糖70000(FITC-葡聚糖)肠道转运的体内作用。
将大鼠分为四组。每组在腹腔注射生理盐水或秋水仙碱(Col,10mg/kg)3小时后,将含或不含NAC(3000mg/kg)的FITC-葡聚糖(750mg/kg)注入小肠肠腔。注射FITC-葡聚糖30分钟后,从门静脉采集血样,通过荧光光谱法分析血浆荧光素浓度。将小肠样本在低温恒温器中切片用于荧光显微镜检查,相同切片进行过碘酸-希夫反应染色。
NAC组的血浆FITC-葡聚糖水平高于对照组(p <.01),Col + NAC组高于Col组(p <.01),且Col + NAC组高于NAC组(p <.05)。对照组和Col组绒毛之间的间隙充满黏液凝胶,而NAC组和Col + NAC组则未完全充满黏液凝胶。FITC-葡聚糖和黏液凝胶在所有大鼠中呈互补分布。NAC组可见绒毛间质水肿,Col + NAC组绒毛遭到破坏。
这些结果表明,肠道通透性可能不仅受覆盖肠上皮的黏液凝胶影响,还受小肠杯状细胞释放的黏液影响。