Surgically induced leukocytic infiltrates within the rat intestinal muscularis mediate postoperative ileus
Surgically induced leukocytic infiltrates within the rat intestinal muscularis mediate postoperative ileus
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DOI：
10.1053/gast.1999.0029900378
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发表时间：
1999-08-01
期刊：
影响因子：
29.4
通讯作者：
Bauer, AJ
中科院分区：
文献类型：
--
作者：
Kalff, JC;Carlos, TM;Bauer, AJ
背景与目的：术后肠梗阻是一个鲜为人知的常见问题。我们之前证明了空肠环状肌活动的抑制与小肠手术后白细胞大量外溢到肌层之间的关联。这项研究是为了在这些事件之间建立直接的因果关系。方法：采用逆转录聚合酶链反应和免疫组织化学检测和定位粘附分子p -选择素、细胞间粘附分子1 （ICAM-1）和淋巴细胞功能相关抗原1 （LFA-1）的表达。在对照组和未接受抗体治疗的动物（1A29、WT.1和WT.3）中，对白细胞浸润和离体空肠环状肌功能进行量化。结果：手术操作引起肌层内ICAM-1和p-选择素信使RNA的显著上调。肌层微血管内ICAM-1和p -选择素表达增加，浸润细胞上表达ICAM-1和LFA-1。粘附分子抗体可阻止单核细胞和中性粒细胞向肌层募集，并可避免空肠环状肌功能障碍。结论：数据表明，粘附分子抗体可防止手术诱导的肠肌收缩抑制，因此提示术后晚期肠梗阻是通过肠外肌层内的白细胞炎症反应介导的。
Background & Aims: Postoperative ileus is a poorly understood and common problem. We previously demonstrated an association between a suppression in jejunal circular muscle activity and a massive extravasation of leukocytes into the muscularis after surgical manipulation of the small bowel. This study was pursued to establish a direct causal link between these events. Methods: Reverse-transcription polymerase chain reaction and immunohistochemistry were used to detect and localize expression of adhesion molecules: P-selectin, intercellular adhesion molecule 1 (ICAM-1), and lymphocyte function-associated antigen 1 (LFA-1). Leukocyte infiltration and in vitro jejunal circular muscle function were quantified in controls and manipulated animals with and without antibody treatment (1A29, WT.1, and WT.3). Results: Surgical manipulation caused a significant up-regulation within the muscularis of ICAM-1 and P-selectin messenger RNA. ICAM-1 and P-selectin protein expression was increased within the muscularis microvasculature, and ICAM-1 and LFA-1 were expressed on infiltrating cells. Administration of adhesion molecule antibodies prevented the recruitment of monocytes and neutrophils into the muscularis and also averted jejunal circular muscle dysfunction. Conclusions: The data demonstrate that adhesion molecule antibodies prevent surgically induced suppression of intestinal muscle contractions and therefore suggests that late postoperative ileus is mediated through a leukocytic inflammatory response within the intestinal muscularis externa.