de Boissieu D, Canarelli J P, Cordonnier C, Richard S, Léké A, Tarrade T, Postel J P, Dupont C
Hôpital Saint Vincent de Paul, Paris, France.
J Pediatr Surg. 1996 Dec;31(12):1675-9. doi: 10.1016/s0022-3468(96)90046-9.
The role of platelet activating factor (PAF), a potent ulcerogen mediator in the digestive tract, is thought to be important in the genesis of necrotizing enterocolitis. The aim of this study was to evaluate the role of PAF in the perpetuation and aggravation of gastrointestinal damage resulting from limited ischemia in the 2-day-old piglet using a natural PAF antagonist (BN 50727). Animals were separated into six groups: U4, controls; S, sham operated animals undergoing laparotomy; I4 and I9, ligation of the mesenteric vessels in the last ileal loop; IT4 and IT9, same procedure together with treatment with BN 50727 (50 mg/kg) orally before and after surgery and intraperitoneally during surgery. Animals were killed at day 4 in groups U4, S, I4 and IT4 and at day 9 in groups I9 and IT9, with histological studies and mediator measurements taken. Macroscopic and histological lesions of intestinal wall in groups I4, I9, IT4 and IT9 were similar to those of human neonatal necrotizing enterocolitis and did not vary according to the absence or the presence of BN 50727 treatment (P = .7, I4 v IT4 and P = .9, I9 v IT9). Peritoneal bands were significantly reduced in treated groups IT4 and IT9 as compared with untreated ones I4 and I9 (P = .003). Mucosal PAF levels in the terminal ileum were higher in group I4 than in groups U4 or I9. In the upper loop, mucosal PAF levels were comparable in all groups. An increase in stool PAF levels was observed only in group I9 (26.4 ng/g v 4.7 ng/g, I9 v U4 + S, P < .05), whereas values comparable to those observed in controls were detected in other groups (I4, 7.2 ng/g; IT4, 4.5 ng/g; IT9, 6.8 ng/g). Tumor necrosis factor alpha (TNF alpha) measurements did not exhibit any difference between groups. Using a PAF antagonist, the role of PAF in the aggravation of intestinal damage after ischemia was not remarkable because treatment did not induce any modifications of parietal intestinal lesions. PAF antagonists appeared to reduce significantly the local peritoneal consequences of local inflammation.
血小板活化因子(PAF)是消化道中一种强效的致溃疡介质,被认为在坏死性小肠结肠炎的发病机制中起重要作用。本研究的目的是使用天然PAF拮抗剂(BN 50727)评估PAF在2日龄仔猪因局部缺血导致的胃肠道损伤的持续和加重过程中的作用。将动物分为六组:U4组为对照组;S组为接受剖腹手术的假手术动物;I4组和I9组为结扎末段回肠肠袢的肠系膜血管;IT4组和IT9组在手术前后口服BN 50727(50 mg/kg)并在手术期间腹腔内注射,同时进行相同的手术操作。U4组、S组、I4组和IT4组在第4天处死动物,I9组和IT9组在第9天处死动物,并进行组织学研究和介质测量。I4组, I9组, IT4组和IT9组肠壁的宏观和组织学病变与人类新生儿坏死性小肠结肠炎相似,且不因是否使用BN 50727治疗而有所不同(I4组与IT4组比较,P = 0.7;I9组与IT9组比较,P = 0.9)。与未治疗的I4组和I9组相比,治疗组IT4组和IT9组的腹膜粘连明显减少(P = 0.003)。I4组末段回肠黏膜PAF水平高于U4组或I9组。在上段肠袢中,所有组的黏膜PAF水平相当。仅在I9组观察到粪便PAF水平升高(I9组与U4组+ S组比较,26.4 ng/g对4.7 ng/g,P < 0.05),而其他组(I4组,7.2 ng/g;IT4组,4.5 ng/g;IT9组,6.8 ng/g)检测到的值与对照组相当。各实验组肿瘤坏死因子α(TNFα)水平没有差异。使用PAF拮抗剂时,PAF在缺血后肠道损伤加重中的作用不显著,因为治疗未引起肠壁病变的任何改变。PAF拮抗剂似乎能显著减轻局部炎症的局部腹膜后果。