Muramyl dipeptide causes mitochondrial dysfunction and intestinal inflammatory cytokine responses in rats.

INTRODUCTION: Intestinal flora and the translocation of its products, such as muramyl dipeptide (MDP), are common causes of sepsis. MDP is a common activator of the intracellular pattern recognition receptor NOD2, and MDP translocation can cause inflammatory damage to the small intestine and systemic inflammatory responses in rats. Therefore, this study investigated the effects of MDP on the intestinal mucosa and distant organs during sepsis and the role of the NOD2/AMPK/LC3 pathway in MDP-induced mitochondrial dysfunction in the intestinal epithelium. METHODS: Fifty male Sprague Dawley rats were randomly divided into five treatment groups: lipopolysaccharide (LPS) only, 1.5 and 15 mg/kg MDP + LPS, and 1.5 and 15 mg/kg MDP + short-peptide enteral nutrition (SPEN) + LPS. The total caloric intake was the same per group. The rats were euthanized 24 hours after establishing the model, and peripheral blood and small intestinal mucosal and lung tissues were collected. RESULTS: Compared to the LPS group, both MDP + LPS groups had aggravated inflammatory damage to the intestinal mucosal and lung tissues, increased IL-6 and MDP production, increased NOD2 expression, decreased AMPK and LC3 expression, increased mitochondrial reactive oxygen species production, and decreased mitochondrial membrane potential. Compared to the MDP + LPS groups, the MDP + SPEN+LPS groups had decreased IL-6 and MDP production, increased AMPK and LC3 protein expression, and protected mitochondrial and organ functions. CONCLUSIONS: MDP translocation reduced mitochondrial autophagy by regulating the NOD2/AMPK/LC3 pathway, causing mitochondrial dysfunction. SPEN protected against MDP-induced impairment of intestinal epithelial mitochondrial function during sepsis.

Large ureteral fibroepithelial polyp lacking epithelium due to ischemic infarction.

We describe a woman with flank pain and hydronephrosis. Computed tomography (CT) urography and maximum intensity projection (MIP) reformatted images clearly showed that a long finger-like intraluminal filling defects mass in the left middle ureter. The pathologic biopsy by ureteroscopy revealed that the lesion mainly consists of benign fibrinoid necrosis. A large soft smooth, spindle-like, dark brown mass (approximately 13.5 cm in length) was identified in left middle ureter when open surgery was performed. The segment of the ureter part attached to the stalk of the polyp was excised, then a dismembered ureteroplasty was performed. Pathologic examination revealed that the total polyp was an ischemic infarction, characteristic of cellular swelling, tissue degeneration, fibrinoid necrosis, and thrombosis in its vessels. The surface of the polyp was hardly covered with urothelium, but fibroepithelial polyp was still diagnosed. There was no recurrence during the 3 years of follow-up.