The gut origin of bacterial pancreatic infection during acute experimental pancreatitis in rats.
BACKGROUND
Infections are frequent complications and determine clinical course and outcome in severe pancreatitis. A novel animal model was used to assess minimal transit time of bacterial translocation (BT) across the gut mucosa in vivo using green fluorescent protein-transfected Escherichia coli and intravital video microscopy.


METHODS
Three hours after induction of acute pancreatitis by i.p. injection of 40 microg/kg cerulein, 0.5 ml of a suspension of green fluorescent protein-transfected E. coli were injected into the lumen of a small bowel reservoir formed by ligature in anesthetized Wistar rats. Translocation of E. coli was assessed by intravital microscopy. Animals were sacrificed 5 h after induction of pancreatitis.


RESULTS
BT across the mucosa and into the muscularis propria took a mean +/- SD of 36.4 +/- 8 min and 80.9 +/- 9.5 min, respectively, in sham animals. Pancreatitis resulted in a significantly shorter minimal transit time across the mucosa (16.4 +/- 4.9 min, p = 0.007) and into the muscularis propria (47.7 +/- 2.5 min, p = 0.001). E. coli were detected on frozen cross-sections and on bacteriological examination of pancreatic tissue in animals with acute pancreatitis but not in controls.


CONCLUSIONS
Intravital microscopy of fluorescent bacteria is a new approach towards studying BT in vivo. Minimal transit time of BT serves as a novel functional aspect of mucosal barrier function during acute pancreatitis. The observation of fluorescent bacteria translocating from the small bowel lumen into the pancreas provides substantial experimental proof for the gut-origin-hypothesis of infectious complications in pancreatitis.
Samel
Stephan
S
Department of Surgery, University Hospital Mannheim, Germany. stephan.samel@chir.ma.uni-heidelberg.de
Lanig
Sybille
S
Lux
Alexander
A
Keese
Michael
M
Gretz
Norbert
N
Nichterlein
Thomas
T
Sturm
Jörg
J
Löhr
Matthias
M
Post
Stefan
S
D000208:Acute Disease; D000818:Animals; D002108:Ceruletide; D004195:Disease Models, Animal; D004926:Escherichia coli / Q000302:isolation & purification*; D007082:Ileum / Q000382:microbiology*; D007413:Intestinal Mucosa / Q000382:microbiology*; D008297:Male; D018715:Microscopy, Video; D009130:Muscle, Smooth / Q000382:microbiology; D009336:Necrosis; D010195:Pancreatitis / Q000139:chemically induced / Q000382:microbiology* / Q000473:pathology; D051381:Rats; D017208:Rats, Wistar
D002108:Ceruletide