Effect of acute portal hypertension on gut mucosa.
OBJECTIVE
Patients with cirrhosis are predisposed to develop spontaneous bacteremias and peritonitis, mainly by enteric bacteria. Portal hypertension, by producing congestion and edema of the bowel wall, could increase the passage of bacteria from the intestinal lumen to regional lymph nodes to the systemic circulation or to both, a process termed bacterial translocation. The aim of this study was to investigate bacterial translocation, brush border enzyme activity and intestinal permeability of experimental acute portal hypertension.


METHODS
Twenty-six male Wistar rats were used for all experiments. Rats were studied two days after the induction of portal hypertension (n = 13). Control animals were also studied two days after sham operation (n = 13). Samples of mesenteric lymph nodes for standard bacteriological cultures and a fragment of ileum for histological examination and mucosal contents of protein, Alp were obtained. Moreover, we evaluated the intestinal permeability by using the phenolsulfonphthalein test.


RESULTS
Two days after surgery, a significantly greater properties of rats with acute portal hypertension (12 of 13, 92%) had positive mesenteric lymph node cultures compared with control group: sham operated (2 of 13, 15%). A significant increase in disappearance of phenol red from the luminal solution was observed in rats with acute portal hypertension. Brush border enzyme of Alp was also significantly decreased in acute portal hypertension, compared with in sham operated controls.


CONCLUSIONS
The results of our study suggested that acute portal hypertension may be a major factor in the development of spontaneous infections in cirrhosis.
Hashimoto
Naoki
N
Second Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka, Sayama, Osaka 589-8511, Japan.
Ohyanagi
Harumasa
H
D000469:Alkaline Phosphatase / Q000378:metabolism; D000818:Animals; D001284:Atrophy; D004195:Disease Models, Animal; D006975:Hypertension, Portal / Q000382:microbiology* / Q000503:physiopathology*; D007202:Indicators and Reagents / Q000493:pharmacokinetics; D007413:Intestinal Mucosa / Q000503:physiopathology*; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D010539:Permeability; D010637:Phenolsulfonphthalein / Q000493:pharmacokinetics; D011506:Proteins / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar
D007202:Indicators and Reagents; D011506:Proteins; D000469:Alkaline Phosphatase; D010637:Phenolsulfonphthalein