Resuscitation-induced gut edema and intestinal dysfunction.

BACKGROUND: Mesenteric venous hypertension and subsequent gut edema play a pivotal role in the development of intra-abdominal hypertension. Although gut edema is one cause of intra-abdominal hypertension, its impact on gut function is unknown. The purpose of this study was to create a model of acute hydrostatic gut edema and to evaluate its effect on gut motility and barrier function. METHODS: The first study, group A, evaluated the effect of gut edema on transit over time using 20 mL/kg 0.9% saline. The second study, group B, focused on the 12-hour time period using 80 mL/kg 0.9% saline. Rats were randomized to superior mesenteric vein partial occlusion (venous hypertension) or sham surgery. At 6, 12, and 24 hours, group A underwent intestinal transit and tissue water weight measurements. At 12 hours, group B underwent tissue water, transit, ileal permeability and resistance, lactate and myeloperoxidase activity, and mucosal injury measurements. RESULTS: Venous hypertension with fluid resuscitation caused acute hydrostatic gut edema, delayed intestinal transit, increased mucosal permeability to macromolecules, and decreased tissue resistance over time. Mucosal injury was minimal in mesenteric venous hypertension. CONCLUSION: Acute mesenteric venous hypertension and resuscitation-induced gut edema, in the absence of ischemia/reperfusion injury, is associated with delayed intestinal transit and altered gut barrier function.

Differential effects of prophylactic, concurrent and therapeutic lactoferrin treatment on LPS-induced inflammatory responses in mice.

Mice injected with endotoxin develop endotoxaemia and endotoxin-induced death, accompanied by the oxidative burst and overproduction of inflammatory mediators. Lactoferrin, an iron binding protein, provides a natural feedback mechanism to control the development of such metabolic imbalance and protects against deleterious effects of endotoxin. We investigated the effects of intraperitoneal administration of human lactoferrin on lipopolysaccharide (LPS)-induced release of tumour necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), interleukin 10 (IL-10) and nitric oxide (NO) in vivo. Lactoferrin was administered as a prophylactic, concurrent or therapeutic event relative to endotoxic shock by intravenous injection of LPS. Inflammatory mediators were measured in serum at 2, 6 and 18 h post-shock induction. Administration of lactoferrin 1 h before LPS resulted in a rather uniform inhibition of all mediators; TNF by 82%, IL-6 by 43%, IL-10 by 47% at 2 h following LPS injection,and reduction in NO (80%) at 6 h post-shock. Prophylactic administration of lactoferrin at 18 h prior to LPS injection resulted in similar decreases in TNF-alpha (95%) and in NO (62%), but no statistical reduction in IL-6 or IL-10. Similarly, when lactoferrin was administered as a therapeutic post-induction of endotoxic shock, significant reductions were apparent in TNF-alpha and NO in serum, but no significant effect was seen on IL-6 and IL-10. These results suggest that the mechanism of action for lactoferrin contains a component for differential regulation of cellular immune responses during in vivo models of sepsis.

Fish oil supplementation does not impair the gut immune response to Trichinella spiralis infection in rats.

BACKGROUND: Fish oil has been recommended as a source of omega-3 fatty acids for preterm infants and for therapy of some inflammatory diseases. METHODS: Because fish oil supplementation could downregulate the host's immune response, we studied the gut inflammatory response to an enteric infection in 72 rats assigned to three dietary groups with differing fatty acid profile: 1) fish oil, rich in eicosapentaenoic and docosahexaenoic acid; 2) olive oil, containing 71% monounsaturated fat; and 3) rat chow, containing 57% saturated fat. One half (n = 36) of the rats were infected with Trichinella spiralis larvae; the other half served as controls. The inflammatory response to initial infection (study 1), and type I hypersensitivity response to a subsequent parasite-derived antigenic challenge (study 2) were assessed. Jejunal inflammatory cell infiltrate, mean villus height, disaccharidase levels, changes in short-circuit current in response to glucose absorption, and chloride secretagogues (study 1) were measured 9 days after infection. Short-circuit current changes induced by chloride secretion were measured when the proximal jejunum was challenged with T. spiralis-derived antigen 40 days after infection (study 2). RESULTS: In study 1, jejunal tissue from infected animals had more eosinophilic infiltrate, lower disaccharidase levels, and less glucose absorptive and chloride secretory capacity than tissue from noninfected animals. In study 2, the jejunum of infected animals showed an antigen-induced chloride secretory response, whereas no response was obtained from jejunal tissue from noninfected animals. Type of diet did not affect the response in either study. CONCLUSION: Under the conditions of this experiment, fish oil supplementation did not interfere with the local intestinal inflammatory response after T. spiralis infection.

Nutritional support for adaptation to radiation-induced suppression of mucosal immunity in the intestine of the rat.

Appropriate enteral nutrition provided immediately after injury or trauma to the gastrointestinal tract may limit or reverse damage to the mucosal barrier. In this regard, diets containing amino acids, such as arginine and glutamine, or fish oil have been identified as beneficial. This report assesses the role of amino acids as "essential nutrients" in the repair of intestinal mucosa damaged by gamma radiation. Rats were used experimentally to test the hypothesis that the recovery of the immune responses in the intestinal mucosa, which are suppressed by radiation, can be improved by feeding an elemental amino acid diet, referred to hereafter as the diet, immediately after irradiation. The objective was to assess the impact of the diet on the expression of type I hypersensitivity or anaphylaxis in the jejunal mucosa. The local expression of this immunological response, which involves several radiosensitive cell types, was studied in rats immunized by oral infection with the nematode parasite, Trichinella spiralis. Rats that recover from infection become immunized and their small intestine undergoes anaphylaxis when subsequently challenged with parasite-derived antigen. This hypersensitivity response is expressed, in part, as Cl- secretion and can be observed in vitro or in vivo. When challenge is provided by a secondary inoculum of infective T. spiralis larvae, Cl- secretion is accompanied by fluid secretion and by the rapid expulsion of the parasite from the intestine. Immunized rats maintained on a stock diet and exposed to 7 Gy of total-abdominal irradiation from a cobalt-60 gamma-ray source failed to express antigen-induced Cl- secretion fully for up to 14 days postirradiation, and rejection of the parasite was suppressed for at least 30 days postirradiation. The suppression of immune responsiveness is associated with the disappearance of intestinal mucosal mast cells, which normally trigger the anaphylactic response. When rats are maintained on the diet after irradiation, the capacity to reject the parasite remains suppressed. However, the ability to express anaphylaxis-mediated Cl- secretion returns by 3 days postirradiation. The quick, diet-supported recovery of antigen-induced Cl- secretion occurs despite the continued absence of mast cells. Although the recovery of anaphylaxis-mediated responses suppressed by irradiation is only partial, our experimental results underscore the potential for enhancing the recovery process through nutritional support.

Progesterone modulation of anaphylactically induced ion transport in uterus and intestine.

The objective of this study was to investigate the role of progesterone in modulating electrophysiological responses to antigenic challenge that are reflective of immune functions in uterine and jejunal mucosae. In the rat-Trichinella spiralis, host-parasite system, an enteric infection with a microscopic nematode sensitizes both the jejunum and uterus. Electrophysiological correlates of local anaphylaxis or type I hypersensitivity were monitored in vitro throughout the estrus cycle and during pregnancy. The magnitude of the anaphylactic response was correlated with serum levels of progesterone. Functional immunity was measured directly in the intestine by assessing the development of acquired resistance to reinfection with T. spiralis. Results support the conclusion that high progesterone output, as occurs during metestrus and pregnancy, and exogenously administered hormone suppress uterine responsiveness. However, the reduced uterine sensitivity to challenge could be attributed to nonspecific physiological effects of progesterone rather than direct effects on immunological components involved in the transduction of the antigenic signal. The electrophysiological response to antigen in the intestine was relatively refractory to effects of progesterone. These observations add to our understanding of endocrine control of mucosal responses to antigenic challenge and underscore site selectively of hormonal action.

Intestinal anaphylaxis: radiation-induced suppression.

The gastrointestinal tract is highly sensitive to ionizing radiation. Some of the most radiosensitive cells in this system are mast cells and epithelium. This article describes experiments that test the hypothesis that irradiation suppresses mucosal immune responses in which mast cells and epithelium are involved. The hypothesis was tested by examining the impact of ionizing radiation on anaphylactically mediated Cl- secretion in jejunum of rats sensitized by Trichinella spiralis infection and challenged with antigen derived from the parasite. Antigen-induced Cl- secretion was measured electrophysiologically in vitro. Rats were immunized by inoculation with 3 x 10(3) T. spiralis larvae and, 30-50 days later, exposed to total abdominal irradiation from a cobalt-60 gamma source. Doses were 5, 7, and 9 Gy. At 1, 3, 5, 7, 14, and 21 days postirradiation (DPI), jejunal segments were assessed for immune responsiveness. (Duration of suppression to antigenic challenge was directly related to radiation dose). Recovery of response to antigenic challenge after irradiation with 5 Gy was complete by 5 DPI. At 7 Gy, responsiveness was totally suppressed from 1 to 5 DPI, was partially expressed from 5 to 14 DPI, and was completely restored by 21 DPI. A dose of 9 Gy completely suppressed immune responsiveness throughout the 21-day period. Full responsiveness of jejunum to exogenous Cl- secretagogues at 1-5 DPI indicates that the immunosuppressive effect of radiation was not due to a breakdown in the secretory process at the epithelium level.(ABSTRACT TRUNCATED AT 250 WORDS)

Structural and molecular changes in intestinal smooth muscle induced by Trichinella spiralis infection.

Infection with Trichinella spiralis in the rat causes altered intestinal motility and jejunal smooth muscle contractility by day 6 postinoculation. The purpose of this study was to determine structural and molecular changes in the smooth muscle that could account for the functional changes that have been reported. By day 6 postinoculation, there was an increase in thickness of both muscle layers of the jejunum. This increase in mass was accompanied by an increase in total protein content of the seromuscular tissues. When specific proteins were analyzed, increases in actin and myosin heavy chain contents were found. On the other hand, there was no increase in collagen content. Alterations in gene expression at the pretranslational level were determined by monitoring total RNA and the proportion of mRNA that codes for alpha-smooth muscle actin. There was an increase in both parameters in longitudinal muscle from the jejunum of infected animals. The increase appeared to be site selective because there were no increases in either parameter in longitudinal muscle of the distal intestine. These results indicate that pretranslational upregulation of gene expression for actin isoforms occurs in smooth muscle of the proximal but not distal intestine during the early enteric phase of infection with T. spiralis. Thus the altered smooth muscle contractility that has been reported in experimental trichinosis may be related in part to an increased expression of smooth muscle protein.

Immunoregulation of endometrial and jejunal epithelia sensitized by infection.

The hypothesis was tested that the uterus of the rat orally infected with the parasite Trichinella spiralis becomes hypersensitized and that subsequent antigenic challenge affects functions in the endometrial epithelium. Results of experiments comparing the immunological responsiveness of isolated rat uterus with that of the jejunum supports our hypothesis. Antigenic challenge of uterus mounted in Ussing-type chambers causes an elevation in transuterine short circuit current (Isc) of 6.4 +/- 0.8 microA/cm2. The transduction of the antigenic signal to elicit the electrophysiological response involves 5-hydroxytryptamine (5-HT) working through a nerve-independent pathway. The antigen-stimulated rise in Isc peaks approximately 3 min after challenge. The uterine response is blocked by diisothiocyanostilbene-2,2'-disulfonic acid, an inhibitor of bicarbonate-chloride exchange. The antigen-evoked change in jejunal Isc is biphasic, peaking at 1.5 and approximately 4.0 min after challenge, and is about 10-fold greater in magnitude than the Isc in the uterus. The transductive pathway in the jejunum involves 5-HT, histamine and prostaglandin acting partly through intrinsic nerves. The jejunal response to antigen is inhibited by diphenylamine-2-carboxylate, a chloride channel blocker. Changes in net ion transport which are primed by infection and evoked by antigen are apparently triggered by local anaphylaxis in both the uterus and jejunum.

Simulation of parasite-induced gut hypersensitivity: implications for vaccination.

Antigenic challenge of jejunum from rats infected with Trichinella spiralis evokes a biphasic pattern of epithelial Cl- secretion, as measured in vitro by electrophysiological methods. Peaks of secretion occur at approximately 1.5 and approximately 5.0 min post-challenge. Challenge of jejunum from hosts passively immunized with serum containing anti-Trichinella anaphylactic antibody evokes the late phase but not the early phase of Cl- secretion. Since the early phase is mediated by 5-hydroxytryptamine and histamine from mast cells, we hypothesized that the failure to express that phase was due to a decrease in mast cell-derived mediators secondary to a deficiency in mucosal mast cell numbers. The hypothesis was tested by correlating mast cell numbers with patterns of antigen-induced Cl- secretion using several immunization regimes. Rats actively immunized by infection produced anti-Trichinella IgE and had a mucosal mastocytosis. Rats passively sensitized with serum containing anti-Trichinella IgE had normal numbers of mast cells in their mucosa. Inducing mastocytosis in rats, by infecting them with Nippostrongylus brasiliensis prior to passive sensitization with anti-Trichinella serum, primed for the expression of a biphasic Cl- secretory response upon subsequent challenge with Trichinella antigen. Rats actively sensitized by injection with Trichinella antigen elicited an IgE response without mastocytosis and expressed only the late phase of antigen-induced Cl- secretion. Results (i) support our hypothesis, (ii) emphasize the importance of the cellular state of the mucosa in the functional expression of local anaphylaxis; and (iii) provide a physiological explanation for the general failure of vaccination and passive sensitization to induce functional immunity equivalent to that induced by natural infection.

Phosphatidylethanolamine methylation in intestinal brush border membranes from rats resistant to Trichinella spiralis.

Methylation of phospholipids is proposed as a mechanism to explain changes in properties of intestinal brush border membrane that coincide with development of immunity to the intraepithelial parasite, Trichinella spiralis. Methylation was measured by the incorporation of the [3H]methyl group from S-adenosyl-L-[3H]methyl methionine into phospholipids. At least two enzymatic components were detected that converted phosphatidylethanolamine to phosphatidylcholine. The first, designated methyltransferase I, catalyzed the formation of phosphatidylmonomethylethanolamine from phosphatidylethanolamine and had a low Km for S-adenosyl-L-methyl-methionine (5 microM). The second, designated methyltransferase II, which catalyzed the methylation of phosphatidylmonomethylethanolamine to phosphatidyldimethylethanolamine and phosphatidyldimethylethanolamine to phosphatidylcholine, had a high Km for S-adenosyl-L-methyl methionine (167 microM). Both enzymes had two pH optima, were most active at 37 degrees C and were Mg2+ dependent. A decrease in methylation activity was present in brush border membranes from rats immunized against T. spiralis. Although the synthesis of phosphatidylcholine was not significantly altered there was a substantial decrease in the formation of phosphatidylmonomethylethanolamine and phosphatidyldimethylethanolamine as compared with nonimmunized rats. Since phospholipid composition influences membrane fluidity and cell function, it is proposed that altered methylation activity may influence the characteristics of brush border membrane in the immune host.