BIOSYNTHESIS OF INTESTINAL MUCIN IN SHOCK - RELATIONSHIP TO TRYPTIC HEMORRHAGIC ENTERITIS AND PERMEABILITY TO CURARE
BIOSYNTHESIS OF INTESTINAL MUCIN IN SHOCK - RELATIONSHIP TO TRYPTIC HEMORRHAGIC ENTERITIS AND PERMEABILITY TO CURARE
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DOI：
10.1097/00000658-196607000-00002
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发表时间：
1966-01-01
影响因子：
9
通讯作者：
GURD, FN
中科院分区：
文献类型：
--
作者：
BOUNOUS, G;MCARDLE, AH;GURD, FN
关于所谓的粘液屏障的特异性及其对潜在有毒物质的细胞内渗透的保护作用的确切机制知之甚少，无论是通常存在于肠腔中还是非天然毒物。我们的研究表明，这种对非天然毒物的屏障是存在的，在等容性休克期间，这种屏障明显减少。犬休克后期肠粘膜的酶消化是整个肠表面粘膜防御屏障下降的另一个例子。这种“胰蛋白酶”出血性坏死的病原体在以前的研究中得到证实。在本研究中，肠粘膜粘液产生的停止已被证明在休克早期。活体活组织检查显示正常粘膜总是被一层连续的粘蛋白覆盖。粘蛋白的产生速度是这样的，即2 ~ 3小时的减少产生期反映为绒毛顶端的粘液被消失。最初胰蛋白酶出血性坏死出现的时间和部位似乎与。失去了粘蛋白的保护层。因此推测粘液产生的损失是使肠粘膜易于蛋白水解消化酶的可能致病因素。如果所观察到的粘液屏障对非生理性和生理性毒物的下降涉及肠腔中通常存在的其他毒素，则这些有毒物质进入血流的通道可能在确定休克后期的模式中起重要作用。
Little is known concerning the specificity of the so-called mucus barrier and the exact mechanism of its protective role against intra-cellular penetration of potentially toxic materials, whether normally present In the intestinal lumen or unnatural poisons. Our studies indicate that such a barrier against unnatural poisons exists and that during normovolemic shock it is markedly reduced. The enzymatic digestion of the intestinal mucosa seen late in shock in the dog is another example of the fall of the mucosal defense barrier throughout the whole intestinal surface. The etiologic agent of this "tryptic" hemorrhagic necrosis was demonstrated in a previous study. In the present study the cessation of mucus production by the intestinal mucosa has been demonstrated early in shock. In vivo biopsies have shown that the normal mucosa is always covered by a continuous coat of mucin. The rate of production of mucin is such that a 2 to 3 hr. period of decreased production is reflected by the disappearance of the mucus coat from the tips of the villi. The time and the site of appearance of the initial tryptic hemorrhagic necrosis seem to coincide with the. loss of the shield of mucin. It is thus postulated that the loss of mucus production is a possible pathogenetlc factor in rendering the intestinal mucosa accessible to proteolytlc digestive enzymes. Should the observed fall in the mucus barrier to both unphysiologic and physiologic poisons involve other toxins normally present In the intestinal lumen, passage into the blood stream of these noxious substances might play an important role In determining the pattern of the later stages of shock.