Plasmadiafiltration ameliorating gut mucosal barrier dysfunction and improving survival in porcine sepsis models.
Plasmadiafiltration ameliorating gut mucosal barrier dysfunction and improving survival in porcine sepsis models.
复制标题
血浆滤过改善猪脓毒症模型的肠粘膜屏障功能障碍并提高存活率
DOI：
10.1186/s40635-016-0105-2
复制
发表时间：
2016-12
影响因子：
3.5
通讯作者：
Hao CM
中科院分区：
文献类型：
--
作者：
Li MX;Liu JF;Lu JD;Zhu Y;Kuang DW;Xiang JB;Sun P;Wang W;Xue J;Gu Y;Hao CM
背景本研究旨在探讨血浆透析滤过（plasmadiafiltration，PDF）是否能更有效地清除关键的大分子炎症介质，从而改善肠黏膜屏障功能，延长存活时间。PDF组、高容量血液滤过（HVHF）组和对照组，分别接受8 h治疗。免疫组化法检测肠黏膜上皮细胞ZO-1和occludin的表达，TUNEL法检测肠系膜淋巴结凋亡蛋白caspase-3阳性淋巴细胞。采用有创腔检测法测量血流动力学参数。ELISA法检测肿瘤坏死因子α（TNFα）和高迁移率族蛋白1（HMGB 1）。结果PDF能上级逆转脓毒症相关的血流动力学损害和血清生化异常，与HVHF和对照组相比，其生存时间明显延长（p< 0.01）。PDF仅对过度的TNF-α和HMGB 1反应具有持续保护作用。在PDF动物中，ZO-1和沿着上皮的分布模式更为规则（p< 0.01）。结论PDF能有效清除TNFα和HMGB 1等重要炎症介质，减轻肠黏膜屏障炎症损伤和淋巴细胞凋亡，改善循环功能，延长生存期。
BackgroundThe object of this study is to explore whether the plasmadiafiltration (PDF) is more effective in improving the intestinal mucosal barrier function by removing more key large molecular inflammatory mediators and then prolonging the survival time.MethodsTotally, 24 porcine sepsis models induced by cecal ligation and puncture (CLP) operation were randomly divided into three groups: PDF group, high-volume hemofiltration (HVHF) group, and control group, and received 8 h treatment, respectively. The expression of ZO-1 and occludin in intestinal mucosal epithelial cells were detected by immunohistochemistry, and apoptotic protein caspase-3-positive lymphocytes were signed in mesenteric lymph nodes by TUNEL staining. The hemodynamic parameters were measured by invasive cavity detection. The tumor necrosis factor alpha (TNFα) and high-mobility group protein 1 (HMGB1) were tested by ELISA method. And then, the survival curves with all-cause death were compared with three groups.ResultsPDF led to a superior reversal of sepsis-related hemodynamic impairment and serum biochemistry abnormalities and resulted in longer survival time compared with HVHF and control (p< 0.01). Definitive protection from excessive TNF-α and HMGB1 response were only achieved by PDF. A more regular distribution pattern of ZO-1 and occludin along the epithelium was found in PDF animals (p< 0.01). The presence of apoptotic lymphocytes was significantly reduced in the PDF animals (p< 0.01).ConclusionsPDF can effectively eliminate more pivotal inflammatory mediators of TNFα and HMGB1 and reduce the inflammation damage of the intestinal mucosal barrier and apoptosis of lymphocyte then improve the circulation function and prolong the survival time.