Splenectomy Attenuates Severe Thermal Trauma-induced Intestinal Barrier Breakdown in Rats

作     者：柳向东 陈振勇 杨鹏 黄文广 蒋春舫 

作者机构：Department of Plastic Surgery Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University Department of General Surgery Union Hospital Tongji Medical College Huazhong University of Science and Technology 

出 版 物：《Journal of Huazhong University of Science and Technology(Medical Sciences)》 (华中科技大学学报（医学英德文版）)

年 卷 期：2015年第35卷第6期

页      面：868-873页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：supported by the Natural Science Foundation of Hubei Province(No.2010CDBO7804) 

主　　题：burn splenectomy endotoxin nuclear factor-κB tumor necrosis factor-alpha zonula oc-cludens protein- 1 occludin 

摘      要：Summary： The severe local thermal trauma activates a number of systemic inflammatory mediators, such as TNF-α, NF-κB, resulting in a disruption of gut barrier. The gastrointestinal tight junction （T J） is highly regulated by membrane-associated proteins including zonula occludens protein-1 （ZO-1） and oc- cludin, which can be modulated by inflammatory cytokines. As splenectomy has been shown to reduce secretion of cytokines, we hypothesized that （1） severe scald injury up-regulates TNF-α and NF-κB, meanwhile down-regulates expression of ZO-1 and occludin, leading to the increased intestinal perme- ability, and （2） splenectomy can prevent the burn-induced decrease in ZO-1 and occludin expression, resulting in improved intestinal barrier. Wistar rats undergoing a 30% total body surface area （TBSA） thermal trauma were randomized to receive an accessorial splenectomy meanwhile or not. Intestinal in- jury was assessed by histological morphological analysis, and serum endotoxin levels, TNF-α, NF-κB, ZO-1 and occludin levels were detected by Western blotting in the terminal ileum mucosal tissue. 30% TBSA bum caused a significant increase in serum endotoxin levels, but NF-κB, and TNF-α, and the av- erage intestinal villus height and mucosal thickness were decreased significantly. Burn injury could also markedly decrease the levels of ZO-1 and occludin in terminal ileum mucosal tissue （all P〈0.01）. Sple- nectomy at 7th day after burn significantly reversed the bum-induced breakdown of ZO-1 and occludin （all P〈0.01）. The results of this study suggest that severe thermal injury damages the intestinal mucosal barrier. Splenectomy may provide a therapeutic benefit in restoring bum-induced intestinal barrier by decreasing the release of inflammatory cytokines and recovering TJ proteins.