Gut ischemia-reperfusion affects gut mucosal immunity: A possible mechanism for infectious complications after severe surgical insults
Gut ischemia-reperfusion affects gut mucosal immunity: A possible mechanism for infectious complications after severe surgical insults
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DOI：
10.1097/01.ccm.0000196207.86570.16
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发表时间：
2006-01-01
影响因子：
8.8
通讯作者：
Hiraide, H
中科院分区：
文献类型：
--
作者：
Fukatsu, K;Sakamoto, S;Hiraide, H
目的：探讨肠缺血再灌注(I/R)对肠道相关淋巴组织(GALT)质量和功能的影响。设计：前瞻性随机对照研究。地点：研究室。对象：雄性肿瘤研究所小鼠。干预：90只小鼠随机分为3组：I/R组(肠缺血60min)、假手术组(仅开腹)和对照组(不手术)。在实验的第1、2、4、7和10天，处死小鼠，从小肠的Peyer斑块、上皮内间隙和固有层(LP)中采集淋巴细胞。测量和主要结果：肠道I/R显著减少Peyer补片、上皮内间隙和LP中的淋巴细胞数量。GALT效应部位，即上皮内间隙和LP的数量显著减少，但LP的数量迅速恢复。Peyer斑块中细胞数量的变化是微妙但持久的。与假手术组或对照组相比，肠I/R组Peyer斑块中的B细胞数量减少，上皮内间隙的α-βT细胞受体(TCR)+、γ-βTCR+、CD8+和B细胞数量减少，LP内的γ-βTCR+、CD8+和B细胞数量减少。I/R组与假手术组比较，呼吸道免疫球蛋白A水平差异无统计学意义。肠I/R组肠粘膜免疫球蛋白A在术后第1天开始升高，第2天后与假手术组比较差异无统计学意义。结论：肠I/R后肠粘膜免疫球蛋白A水平维持不变，但GALT细胞数量明显减少，淋巴细胞表型发生改变。这些改变可能与严重手术侮辱后感染并发症导致的发病率增加有关。
Objective: To examine influences of gut ischemia/reperfusion (I/R) on gut-associated lymphoid tissue (GALT) mass and function.Design: Prospective, randomized controlled study.Setting: Research laboratory.Subjects: Male Institute of Cancer Research mice.Interventions: Ninety mice were randomized to three groups: I/R (60-min gut ischemia), sham (laparotomy only), and control (no operation). On days 1, 2, 4, 7, and 10, mice were killed to harvest lymphocytes from Peyer patches, the intraepithelial space, and the lamina propria (LP) of the small intestine. Respiratory tract and small intestinal washings were also obtained.Measurements and Main Results: Gut I/R significantly reduced lymphocyte numbers in Peyer patches, the intraepithelial space, and the LP. The reduction was prominent in GALT effector sites, that is, the intraepithelial space and LP, but numbers recovered quickly in LP. Changes in cell numbers in Peyer patches, GALT inductive sites, were subtle but persistent. Gut I/R reduced B cell numbers in Peyer patches; alpha beta T cell receptor (TCR)+, gamma delta TCR+, CD8+, and B cell numbers in the intraepithelial space; and gamma delta TCR+, CD8+, and B cell numbers in the LP, in comparison with the sham or control group. There were no significant differences in respiratory tract immunoglobulin A levels between the I/R and sham groups. Intestinal immunoglobulin A was elevated on day 1 in the I/R group, with no significant difference after day 2 in comparison with the sham group.Conclusions: Despite the maintained mucosal immunoglobulin A level, gut I/R markedly reduces GALT cell numbers, with changes in lymphocyte phenotypes. These alterations may be associated with increased morbidity due to infectious complications after severe surgical insults.