重症急性胰腺炎患者血清IL-6水平与内毒素移位及肠黏膜紧密连接蛋白表达关系的研究(英文)

Association of IL-6 in Serum with Endotoxin Translocation and Expression of Tight Junction Proteins in Colon from Patients with Severe Acute Pancreatitis

目的:大量研究表明重症急性胰腺炎(SAP)患者血清中高浓度IL-6和肠黏膜低表达的紧密连接蛋白可促进内毒素移位的发生。本文主要研究重症胰腺炎患者血清IL-6水平对内毒素移位和肠黏膜紧密连接蛋白表达的影响。方法:50例重症胰腺炎患者,其中12例在患病早期因结肠受累合并腹胀,对12例结肠受累患者应用结肠镜行结肠灌洗进行腹腔减压,同时取结肠黏膜进行活组织检查。所有病人在治疗的第3天,第7天,第10天,第14天抽取外周静脉血。40例健康志愿者作为对照组。应用ELISA方法检测血清IL-6水平,鲎试验(LAL)方法检测血清内毒素含量,应用免疫荧光和Western blotting方法检测肠黏膜紧密连接蛋白表达水平。结果:SAP患者血清IL-6和内毒素含量明显高于健康对照组,而结肠黏膜紧密连接蛋白表达低于对照组;在临床治疗过程中,早期SAP患者血清IL-6和内毒素水平高于晚期(P值均<0.05)。SAP早期血清高浓度的IL-6与结肠黏膜紧密连接蛋白的低表达具有相关性,差异有统计学意义(r=0.735,P<0.05)。结论:血清IL-6水平可作为早期评价重症急性胰腺炎严重程度的一项指标,IL-6水平与重症急性胰腺炎临床病程有相关性,可能导致肠道内毒素移位。

There is increasing evidence that severe acute pancreatitis （SAP） patients have high IL-6 levels in serum, and the low expression of tight junction proteins could increase endotoxin translocation （ET）. Thus, we sought to investigate the correlation of IL -6 level in serum with endotoxin translocation （ET） and expression of tight junction （T J） proteins in colon from severe acute pancreatitis pa- tients. Methods： 50 severe acute pancreatitis patients were set as study objects. 12 of 50 patients for clinical course in the first 3 days with colonic involvement presented with severe abdominal distention, they were treated with adopt colonic irrigation and decompression with colonoscopy, and colonic mucosal tissue were obtained at the same time. All blood samples of the patients were extracted from their pe- ripheral venous after treatment for the first ,3rd,7th,10th,14th day. 40 healthy individuals were set as control group. Serum IL-6 concen- trations were determined by enzyme-linked immunosorbent assay （ELISA）, levels of serum endotoxin were detected by limulus amebo- cyte lysate （LAL） assay, the expression of TJ proteins were determined by immunofluorescence and western blotting. Results： The levels of IL-6 and endotoxin in serum of SAP patients were higher than in healthy controls. However, the expressions of TJ proteins in SAP pa- tients were lower than those in healthy controls. Compared with the late stage clinical course of SAP patients, the early stage clinical course of SAP patients had a significantly higher levels ofendotoxin （P〈0.05） and IL-6 （P〈0.05） in serum. The lower expression of TJ proteins in colonic mucosa had significantly （r=0.735, P〈0.05） associated with the higher levels of IL-6 in serum within 3 days clinical course of SAP. Conclusions： In our research, we found that the high levels of IL-6 in serum had closely relationship with high levels of endotoxin in serum and low expression of tight junction proteins in colonic mucosa. The levels of IL-6 in serum, as an index to evaluate the severity of severe acute pancreatitis, is associated with the clinical course of severe acute pancreatitis, and may the reason ofendotox- in translocation.