The novel strategy with synbiotics therapy in small bowel transplantation

【目的】本研究旨在阐明合生剂治疗大鼠小肠移植后急性排斥反应的有益作用、细菌易位和有机酸作为急性排斥反应生物标志物的改变。【材料与方法】行原位SBTx， 1.0ml部分合成抗生素口服，每日2次，连用10天。在第5天和第10天采集粪便，检测肠道菌群和有机酸浓度的变化。第10天处死大鼠，无菌取肝、脾、肠系膜淋巴结、腹水、血液等脏器培养，评价细菌易位程度。对移植物进行组织学检查以确定急性排斥反应。【结果】兼性厌氧菌的生长抑制作用合成抗生素治疗组的兼性厌氧菌如肠球菌、肠杆菌科和葡萄球菌的数量在第10天有下降的趋势。有机酸浓度：合成菌处理组总有机酸浓度和几乎所有菌种浓度均有升高的趋势，但两组间只有乙酸浓度在第10天有显著差异。两组供体肠系膜淋巴结及腹水细菌易位数差异有统计学意义。两组间急性排斥反应组织学评分均数±标准差无显著差异。【结论】本研究表明，合生药物治疗在维持大鼠SBTx肠道屏障完整和减少细菌易位方面发挥了关键作用。临床小肠移植采用合生学治疗是一种新颖而必要的治疗策略，可以获得更好的移植物功能和低感染并发症的发生率。

【Aim】The aim of this study was to elucidate the beneficial effects of synbiotics therapy for acute rejection, bacterial translocation and alteration of organic acid as biomarker for acute rejection after small bowel transplantation in rats.【Material and Method】Orthotopic SBTx was performed and a 1.0ml portion of synbiotics was administered orally twice a day for 10days. Feces were sampled to detect the change of intestinal flora and the concentration of organic acids at day 5 and 10. At day 10, rats were sacrificed and several organs including liver, spleen, mesenteric lymph nodes, ascites and blood were obtained aseptically and cultured to evaluate the degree of bacterial translocation. Histological examination of the intestinal grafts was performed to define the acute rejection.【Results】Inhibition of growth in facultive anaerobesAll the population levels of facultative anaerobes such as Enterococcus, Enterobacteriaceae and Staphylococcus in synbiotics treatment group had a tendency to decrease on day 10.Concentration of organic acidsThe concentration of total organic acid and almost all the species had a tendency to increase in synbiotics treatment group, but only the concentration of acetic acid had a significant difference on day 10 between two groups.Bacterial TranslocationThe number of bacterial translocation in the donors' mesenteric lymph node and ascites was significantly difference between two groups.Acute rejection of intestinal graftThe scoring mean ±SD of histological evaluation of acute rejection had no significant difference was seen between two groups.【Conclusion】This study indicates synbiotics therapy plays a key role for the preservation of an intact intestinal barrier and reduces bacterial translocation in SBTx in rats. Synbiotics management for clinical small bowel transplantation could be a novel and essential therapeutic strategy to get a better graft function with a low incidence of infectious complication.