Basic Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2015; 21(45): 12800-12813
Published online Dec 7, 2015. doi: 10.3748/wjg.v21.i45.12800
Biliary tract external drainage protects against intestinal barrier injury in hemorrhagic shock rats
Lu Wang, Bing Zhao, Ying Chen, Li Ma, Er-Zhen Chen, En-Qiang Mao
Lu Wang, Bing Zhao, Ying Chen, Li Ma, Er-Zhen Chen, En-Qiang Mao, Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Author contributions: Chen EZ and Mao EQ contributed equally to this work; Wang L, Chen EZ and Mao EQ wrote the paper; Wang L, Zhao B and Chen Y participated in the surgical procedure; Wang L designed the protocol and performed enzyme-linked immunosorbent assay and immunohistochemistry; Wang L and Ma L performed the statistical analysis; Zhao B and Chen Y carried out the Western blotting; Zhao B and Ma L performed the histologic analysis; Chen EZ and Mao EQ conceived and designed the study.
Supported by National Natural Science Foundation of China, No. 81171789.
Institutional review board statement: This study has been reviewed and approved by Institutional Review Board of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Institutional animal care and use committee statement: All procedures involving animals were reviewed and approved by the Institutional Animal Care and Use Committee of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China [IACUC protocol number: SYXK (Shanghai) 2011-0113].
Conflict-of-interest statement: We declare no conflicts of interest regarding this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: En-Qiang Mao, MD, PhD, Professor of Medicine, Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road Number Two, Shanghai 200025, China. maoeq@yeah.net
Telephone: +86-21-64370045 Fax: +86-21-64370045
Received: June 4, 2015
Peer-review started: June 6, 2015
First decision: July 10, 2015
Revised: July 20, 2015
Accepted: September 15, 2015
Article in press: September 15, 2015
Published online: December 7, 2015
Abstract

AIM: To investigate the effects of biliary tract external drainage (BTED) on intestinal barrier injury in rats with hemorrhagic shock (HS).

METHODS: BTED was performed via cannula insertion into the bile duct of rats. HS was induced by drawing blood from the femoral artery at a rate of 1 mL/min until a mean arterial pressure (MAP) of 40 ± 5 mmHg was achieved. That MAP was maintained for 60 min. A total of 99 Sprague-Dawley rats were randomized into a sham group, an HS group and an HS + BTED group. Nine rats in the sham group were sacrificed 0.5 h after surgery. Nine rats in each of the HS and HS + BTED groups were sacrificed 0.5 h, 1 h, 2 h, 4 h and 6 h after resuscitation. Plasma tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and lipopolysaccharide (LPS) levels were analyzed using enzyme-linked immunosorbent assay. Plasma D-lactate levels were analyzed using colorimetry. The expression levels of occludin and claudin-1 in the ileum were analyzed using Western blot and immunohistochemistry. Histology of the ileum was evaluated by hematoxylin and eosin staining.

RESULTS: Plasma TNF-α levels in the HS + BTED group decreased significantly compared with the HS group at 1 h and 6 h after resuscitation (P < 0.05). Plasma IL-6 levels in the HS + BTED group decreased significantly compared with the HS group at 0.5 h, 1 h and 2 h after resuscitation (P < 0.05). Plasma D-lactate and LPS levels in the HS + BTED group decreased significantly compared with the HS group at 6 h after resuscitation (P < 0.05). The expression levels of occludin in the HS + BTED group increased significantly compared with the HS group at 4 h and 6 h after resuscitation (P < 0.05). The expression levels of claudin-1 in the HS + BTED group increased significantly compared with the HS group at 6 h after resuscitation (P < 0.05). Phenomena of putrescence and desquamation of epithelial cells in the ileal mucosa were attenuated in the HS + BTED group. Ileal histopathologic scores in the HS + BTED group decreased significantly compared with the HS group at 2 h, 4 h and 6 h after resuscitation (P < 0.05).

CONCLUSION: BTED protects against intestinal barrier injury in HS rats.

Keywords: Hemorrhagic shock, Biliary tract external drainage, Occludin, Claudin-1, D-lactate

Core tip: Our previous studies demonstrated that biliary tract external drainage decreased proinflammatory cytokine production and relieved tissue damage in rat models of hemorrhagic shock. In this research, we found that biliary tract external drainage increased the expression levels of occludin and claudin-1 and decreased plasma D-lactate and lipopolysaccharide levels under hemorrhagic shock conditions. These results demonstrate that biliary tract external drainage protects against intestinal barrier injury in hemorrhagic shock rats.