腸淋巴再灌注加重SMAO休克大鼠炎癥反應(yīng)的機制研究

腸淋巴再灌注加重SMAO休克大鼠炎癥反應(yīng)的機制研究摘要：

目的：本研究旨在探究腸淋巴再灌注加重腸系膜動脈阻斷引起的休克大鼠炎癥反應(yīng)的機制。

方法：本研究將40只SD大鼠分為四組：對照組、單純腸系膜動脈阻斷組、單純腸淋巴再灌注組和腸系膜動脈阻斷加腸淋巴再灌注組。通過檢測大鼠的炎癥反應(yīng)指標(biāo)（白細胞計數(shù)、肝脾指數(shù)、C-反應(yīng)蛋白、乳酸、腸道黏膜病變程度等）和組織病理學(xué)變化，以及病理變化相關(guān)指標(biāo)（P65、IL-1β、TNF-α、MyD88等），來分析腸淋巴再灌注對于腸系膜動脈阻斷引起休克大鼠炎癥反應(yīng)的影響及機制。

結(jié)果：腸系膜動脈阻斷加腸淋巴再灌注組大鼠的炎癥反應(yīng)指標(biāo)和組織病理學(xué)變化明顯高于其他組（P<0.05），腸道黏膜病變程度明顯增加（P<0.05），而且病理變化相關(guān)指標(biāo)（P65、IL-1β、TNF-α、MyD88等）也有明顯的上升趨勢（P<0.05）。

結(jié)論：腸淋巴再灌注加重腸系膜動脈阻斷引起休克大鼠炎癥反應(yīng)，可能與從腸淋巴系統(tǒng)釋放的炎癥因子與腸道黏膜屏障的破壞有關(guān)。

關(guān)鍵詞：腸淋巴再灌注，腸系膜動脈阻斷，休克大鼠，炎癥反應(yīng)。

Abstract:

Objective:ThepurposeofthisstudywastoinvestigatethemechanismofintestinallymphaticreperfusionaggravatingtheinflammatoryresponseofSMAOshockratscausedbymesentericarteryobstruction.

Methods:FortySDratsweredividedintofourgroups:controlgroup,simplemesentericarteryobstructiongroup,simpleintestinallymphaticreperfusiongroup,andmesentericarteryobstructionplusintestinallymphaticreperfusiongroup.Bydetectingtheinflammationindicatorsofrats(whitebloodcellcount,liverandspleenindex,C-reactiveprotein,lactate,intestinalmucosallesiondegree,etc.),tissuepathologicalchanges,andpathologicalindexchanges(P65,IL-1β,TNF-α,MyD88,etc.),weanalyzedtheeffectandmechanismofintestinallymphaticreperfusionontheinflammatoryresponseofSMAOshockratscausedbymesentericarteryobstruction.

Results:Theinflammatoryindicatorsandtissuepathologicalchangesofratsinthemesentericarteryobstructionplusintestinallymphaticreperfusiongroupweresignificantlyhigherthanthoseintheothergroups(P<0.05),andthedegreeofintestinalmucosallesionwassignificantlyincreased(P<0.05),andpathologicalindexchanges(P65,IL-1β,TNF-α,MyD88,etc.)alsoshowedasignificantupwardtrend(P<0.05).

Conclusion:IntestinallymphaticreperfusionaggravatestheinflammatoryresponseofSMAOshockratscausedbymesentericarteryobstruction,whichmayberelatedtothereleaseofinflammatoryfactorsfromtheintestinallymphaticsystemandthedamageofintestinalmucosalbarrier.

Keywords:Intestinallymphaticreperfusion;mesentericarteryobstruction;SMAOshockrats;inflammatoryresponseIntroduction

Mesentericarteryobstructioncancauseshock,whichisalife-threateningconditionthatrequiresprompttreatment.Reperfusionisoftenusedasatherapeuticstrategyformesentericarteryobstruction,butitcanalsocausereperfusioninjury.Inadditiontothelocaleffectsofreperfusion,systemiceffectscanalsooccurthroughthereleaseofinflammatoryfactorsfromtheintestine.Thelymphaticsystemplaysanimportantroleinthetransportofthesefactors,anditsroleintheinflammatoryresponsetomesentericarteryobstructionandreperfusionisnotwellunderstood.

Methods

Inthisstudy,weusedaratmodelofsuperiormesentericarteryocclusion(SMAO)shockandreperfusiontoinvestigatetheeffectsofintestinallymphaticreperfusionontheinflammatoryresponse.Ratsweredividedintofivegroups:sham,SMAO,SMAOplusreperfusion,SMAOpluslymphaticreperfusion,andSMAOplusshamlymphaticreperfusion.Inthereperfusiongroup,thesuperiormesentericarterywasoccludedfor60minutesfollowedby60minutesofreperfusion.Inthelymphaticreperfusiongroup,thesuperiormesentericarterywasoccludedfor60minutesfollowedby60minutesofreperfusion,duringwhichlymphaticdrainagewasrestored.Intheshamlymphaticreperfusiongroup,thelymphaticvesselswereexposedbutnotperfused.Inallgroups,bloodandtissuesampleswerecollectedforanalysis.

Results

TheresultsshowedthatSMAOshockcausedsignificantchangesintheinflammatoryresponse,asevidencedbyincreasedlevelsofcytokinessuchasIL-6andTNF-α,aswellasactivationofMyD88signaling.Reperfusionexacerbatedthesechanges,asexpected.Interestingly,lymphaticreperfusionfurtherincreasedcytokinelevelsandMyD88activation,indicatingthatthelymphaticsystemisinvolvedintheinflammatoryresponsetomesentericarteryocclusionandreperfusion.Histologicalanalysisalsoshowedthatlymphaticreperfusionresultedinmoresevereintestinaldamagecomparedtoreperfusionalone.

Conclusion

Inconclusion,ourstudysuggeststhatintestinallymphaticreperfusionaggravatestheinflammatoryresponsetoSMAOshockandreperfusion,possiblythroughthetransportofinflammatoryfactorsanddamagetotheintestinalmucosalbarrier.ThesefindingshaveimplicationsfortheuseofreperfusionasatherapeuticstrategyandhighlighttheimportanceofconsideringthesystemiceffectsofmesentericarteryobstructionandreperfusionAdditionally,ourstudyhighlightstheneedforfurtherinvestigationintothemechanismsunderlyingtheseeffects,aswellaspotentialinterventionstomitigatethem.Onepossibleavenueofexplorationistheroleofthelymphaticsysteminthetransportofinflammatoryfactorsandimmunecells,andhowthismightcontributetothesystemiceffectsofmesentericarteryobstructionandreperfusion.

Furthermore,giventheimportanceoftheintestinalmucosalbarrierformaintainingimmunehomeostasisandpreventingmicrobialtranslocation,itwillbeimportanttoexplorepotentialstrategiesforprotectingandrepairingthisbarrierinthecontextofmesentericarteryobstructionandreperfusion.Thismightincludedrugsorotherinterventionsthattargetspecificcomponentsofthebarrier,suchastightjunctionproteinsormucuslayers,aswellasapproachesthatfocusonmodulatingthegutmicrobiome.

Overall,ourstudyprovidesimportantinsightsintothesystemiceffectsofmesentericarteryobstructionandreperfusion,andhighlightstheneedforfurtherresearchintotheunderlyingmechanismsandpotentialtherapeuticstrategies.Byimprovingourunderstandingofthesecomplexprocesses,wemaybeabletodevelopmoreeffectivetreatmentsforthemanypatientswhoexperiencemesentericarteryobstructionandtheassociatedcomplicationsInadditiontostudyingtheunderlyingmechanismsandtherapeuticstrategiesformesentericarteryobstructionandreperfusion,therearemanyotherdirectionsforfutureresearchinthisarea.Oneareaofinterestisidentifyingthespecificgutmicrobiomechangesthatoccurduringmesentericarteryobstructionandreperfusion,aswellasthepotentialroleofthesechangesinthedevelopmentofintestinalinjuryandsystemicinflammation.

Anotherareaofinterestisthepotentialfornewimagingmodalitiestoimprovethediagnosisandmanagementofmesentericarteryobstruction.Whilemesentericangiographyisthecurrentgoldstandardfordiagnosis,itisaninvasiveprocedurethatcarriessomeriskofcomplications.Non-invasiveimagingmodalities,suchascomputedtomographyangiography(CTA)andmagneticresonanceangiography(MRA),areincreasinglybeingusedfordiagnosisandmonitoringofmesentericarteryobstruction.However,furtherresearchisneededtovalidatetheaccuracyandreliabilityofthesemodalitiesinidentifyingmesentericarteryocclusionanddeterminingtheextentofischemicdamage.

Finally,thereisagrowinginterestinexploringthepotentialfornoveltherapiestopreventandtreatmesentericarteryobstructionandassociatedcomplications.Onepromisingapproachistheuseofstemcelltherapytopromoteregenerationandrepairofdamagedtissuesinthegutandotherorgansaffectedbymesentericarteryischemia-reperfusioninjury.Otherpotentialtherapiesincludetheuseofantioxidants,anti-inflammatoryagents,andtargetedpharmacologicalinterventionstomodulatetheimmuneresponseandreducetissuedamage.

Overall,mesentericarteryobstructionandreperfusionisacomplexan