İntestinal iskemik önkoşullamanın barsak histopatolojisi ve bakteriyel translokasyona etkisi

Amaç: İskemik ön koşulluma ilk defa kalpte tanımlanan ve son zamanlarda barsakta da etkisi saptanan bir fenomendir. Bu çalışmanın amacı intestinal iskemik ön koşullanmanın barsak morfolojisi ve bakteriyel translokasyona etkisini ve bu etkinin nitrik oksit yolağı ile ilişkisini belirlemektir. Yöntem: Ağırlıkları 250-300 gr. olan 24 adet Wistar-AIbino rat üç gruba ayrıldı. Kontrol grubuna (n=8) laparotomi yapıldı. l/R (n=8) grubunu laparotomi yapıldı ve superior mezenterik arter 30 dk. klempe edildi, iskemik ön koşullama grubundu (n=8) 10 dk.süre ile iskemi ve 10 dk. reperfüzyonu takiben 30 dk. iskemi uygulandı. 24 saat sonra tüm hayvanlardan intestinal hasarı ve bakteriyel tanslokasyonu değerlendirmek için steril şartlarda doku ve kan örnekleri alındı Bulgular: I/R grubundu izole edilen bakteri insidensi diğer gruplardan anlamlı olarak yüksek saptandı (p

The effects of intestinal ischemic preconditioning on the intestinal histopathology and bacterial translocation

The effects of intestinal ischemic preconditioning on the intestinal histopathology and bacterial translocation Aim: ischemic preconditioning (IPC) was first demonstrated in the heart but this protective effect has been also recently described in the intestine. The aim of this study was to determine the effects of intestinal ischemic preconditioning on the morphology of intestine and bacterial translocation. Method: 24 male Wistar rats weighting 250-300 gr. were randomized into three groups. A control group of rats (n = 8) were subjected to laparotomy. In an ischemic group (n=8), laparotomy was performed and the superior mesenteric artery was occluded by un atruumatic clamp for 30 min. In the preconditioned group (n=8), before the ischemia-reperfusion period (as in ischemic group), rats were subjected to initial 10 min of intestinal ischemia and 10 min of reperfusion. Twenty-four hours later, to evaluate whether the I / R induced intestinal injury and BT, tissue and blood samples were collected and liver, spleen, mesenteric lymph node specimens were obtained under sterile conditions for microbiological analysis. Samples of ileum were removed for histopathological evaluation. Results: In I / R group, the incidence of bacteria isolated from a mesenteric lymph nodes, spleen, liver and blood was significantly higher than other groups (p<0.05). 1PC prevented I/R induced BT and significantly reduced the I/R induced intestinal injury (p<0.05). Increased iNOS expression observed on the ileal specimens of the I/R group was found to be prevented by IPC. Conclusion: Our dutu suggest IPC as u key factor that reduces bacterial translocation and iNOS activation in intestinal I / R. This is the first study showing that intestinal IPC blocks the cascade of events that causes bacterial translocation and intestinal injury which may lead to sepsis.

Kaynakça

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