Mason C M, Dobard E, Kolls J, Nelson S
Pulmonary/Critical Care Medicine, Louisiana State University Medical Center, New Orleans 70112, USA.
Alcohol Clin Exp Res. 1998 Nov;22(8):1640-5.
Bacterial translocation has been proposed to be important in the pathophysiology of sepsis, as well as to be a consequence of sepsis. To study the effect of alcohol on bacterial translocation from the gut, normal Sprague-Dawley rats were administered alcohol by gavage by two regimens: Acute (3.7 g/kg, one dose) or Subacute (1 of 2 doses, 2.4 or 3.7 g/kg/day once daily for 14 days). Mesenteric lymph node cultures were performed, and portal venous blood was assayed for endotoxin. Ileal and cecal permeability studies were performed in the Acute and Subacute groups using fluorescein isothiocyanate-labeled dextrans of either 4,000 or 70,000 kDa size. As an index of the effect of systemic endotoxin, tissues from mesenteric lymph nodes, liver, and intestinal Peyer's patches were assayed for the presence of mRNA for tumor necrosis factor. Additionally, because extrapulmonary sepsis has been shown to suppress pulmonary antibacterial defenses, animals in the Subacute group were challenged by aerosol inoculation with Pseudomonas aeruginosa to determine bacterial clearance and alveolar cellular responses. The results show that neither of the alcohol regimens resulted in bacterial growth from mesenteric lymph nodes or portal blood. Animals in the Subacute group had more endotoxin present in portal blood than did the Control group (92.9 pg/ml vs. 40.2 pg/ml; p < 0.02). None of the animals had demonstrable mRNA for tumor necrosis factor in any of the tissues assayed. There were no demonstrable increases in ileal or cecal permeability for either the small or large molecular weight dextran in either alcohol group. Furthermore, there was no delay in the clearance of P. aeruginosa from the lung in the Subacute group, but these animals recruited fewer neutrophils into the airspaces in response to this challenge than did the Control animals. Thus, alcohol intoxication does not result in bacterial translocation from the gut in this model. Despite higher levels of portal venous endotoxin in the animals in the Subacute alcohol group, no adverse systemic consequences of this phenomenon could be demonstrated.
细菌移位被认为在脓毒症的病理生理学中很重要，同时也是脓毒症的一个后果。为了研究酒精对肠道细菌移位的影响，将正常的Sprague-Dawley大鼠通过两种方案经口灌胃给予酒精：急性（3.7 g/kg，一剂）或亚急性（两剂中的一剂，2.4或3.7 g/kg/天，每天一次，共14天）。进行肠系膜淋巴结培养，并检测门静脉血中的内毒素。在急性和亚急性组中，使用4000或70000 kDa大小的异硫氰酸荧光素标记的葡聚糖进行回肠和盲肠通透性研究。作为全身内毒素作用的指标，检测肠系膜淋巴结、肝脏和肠道派尔集合淋巴结组织中肿瘤坏死因子mRNA的存在情况。此外，由于肺外脓毒症已被证明会抑制肺部抗菌防御，对亚急性组的动物进行铜绿假单胞菌气溶胶接种，以确定细菌清除率和肺泡细胞反应。结果表明，两种酒精方案均未导致肠系膜淋巴结或门静脉血中细菌生长。亚急性组动物门静脉血中的内毒素含量高于对照组（92.9 pg/ml对40.2 pg/ml；p<0.02）。在任何检测的组织中，没有动物显示出肿瘤坏死因子的可检测mRNA。两个酒精组中小分子或大分子葡聚糖的回肠或盲肠通透性均无明显增加。此外，亚急性组中铜绿假单胞菌从肺部清除没有延迟，但与对照动物相比，这些动物在应对这种挑战时向气腔募集的中性粒细胞较少。因此，在该模型中酒精中毒不会导致肠道细菌移位。尽管亚急性酒精组动物门静脉内毒素水平较高，但未证明该现象有不良的全身后果。
