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| Xue-Lian Liao,Qu-Zhen Danzeng,Wei Zhang,Chen-Shu Hou,Bin-Bin Xu,Jie Yang,Yan Kang.[J].Chin J Traumatol,2018,21(6):323-328. 10.1016/j.cjtee.2018.05.002 |
| Role of using two-route ulinastatin injection to alleviate intestinal injury in septicrats |
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| DOI：10.1016/j.cjtee.2018.05.002 |
| KeyWord: SepsisUlinastatinIntestinesTrypsinElastase |
| FundProject: |
| Author Name | Affiliation | | Xue-Lian Liao | Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China | | Qu-Zhen Danzeng | Department of Critical Care Medicine, Tibet Autonomous Region People's Hospital, Lhasa 850000, Tibet, China | | Wei Zhang | Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, Guizhou Province, China | | Chen-Shu Hou | Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China | | Bin-Bin Xu | Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China | | Jie Yang | Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China | | Yan Kang | Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China |
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| Abstract: |
| Purpose: Early application of protease inhibitors through the intestinal lumen could increase survival following experimental shock by blocking the pancreatic digestive enzymes. Hence, it was hypothesized that two-route injection (intraintestinal þ intravenous) of ulinastatin (UTI), a broad-spectrum protease
inhibitor, could better alleviate intestinal injury than single-route injection (either intravenous or intraintestinal).
Methods: A sepsis model induced by lipopolysaccharide on rats was established. The rats were randomly divided into five groups: sham, sepsis, UTI intravenous injection (Uiv), UTI intraintestinal injection (Uii), and UTI intraintestinal þ intravenous injection (Uii þ Uiv) groups. The mucosal barrier function, enzymeblocking effect, levels of systemic inflammatory cytokines, and 5-day survival rate were compared among groups. The small intestinal villus height (VH), crypt depth (CD), and two components of mucosal barrier (E-cadherin and mucin-2) were measured to evaluate the mucosal barrier function. The levels of trypsin and neutrophil elastase (NE) in the intestine, serum, and vital organs were measured to determine the enzyme-blocking effect.
Results: Compared with the single-route injection group (Uiv or Uii), the two-route injection (Uii þ Uiv) group displayed: (1) significantly higher levels of VH, VH/CD, E-cadherin, and mucin-2; (2) decreased trypsin and NE levels in intestine, plasma, and vital organs; (3) reduced systemic inflammatory cytokine
levels; and (4) improved survival of septic rats.
Conclusion: Two-route UTI injection was superior to single-route injection in terms of alleviating intestinal injury, which might be explained by extensive blockade of proteases through different ways. |
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