title: Effect of biliary tract external drainage on cytokine expression and histomorphology of intestine, liver, and lung in rats with hemorrhagic shock.
abstract: OBJECTIVE
  To investigate the protective effect of biliary tract external drainage on cytokine expression and pathomorphism of intestine, liver, and lung in rats with hemorrhagic shock.
  
  
  METHODS
  Randomized, control animal study.
  
  
  METHODS
  This study was conducted at The Institution Digestive Surgery Research Laboratory of Shanghai Jiao Tong University.
  
  
  METHODS
  Sprague-Dawley rats.
  
  
  METHODS
  Biliary tract external drainage was performed by inserting a cannula into the bile duct. Hemorrhagic shock was induced by drawing blood from the carotid artery.
  
  
  RESULTS
  Twenty-four Sprague-Dawley rats were randomized to three equal groups of eight: sham shock; hemorrhagic shock; and hemorrhagic shock plus bile duct drainage. The messenger RNA expression of tumor necrosis factor-alpha, interleukin-6 in the intestine, liver, and lung tissue from the three groups were analyzed by reverse transcription-polymerase chain reaction. Tumor necrosis factor-alpha was analyzed in the bile of the rats by enzyme-linked immunosorbent assay. Histology of intestine, liver, and lung was performed in all groups by hematoxylin and eosin staining. The messenger RNA expression of tumor necrosis factor-alpha was significantly increased in the hemorrhagic shock group compared with the sham shock group (intestine 0.54 +/- 0.07 vs. 0.37 +/- 0.05, liver 1.01 +/- 0.06 vs. 0.56 +/- 0.07, lung 0.94 +/- 0.07 vs. 0.62 +/- 0.06). The messenger RNA expression of interleukin-6 was also significantly increased in the hemorrhagic shock group compared with the sham shock group (intestine 0.89 +/- 0.12 vs. 0.50 +/- 0.09, liver 1.07 +/- 0.10 vs. 0.57 +/- 0.12, lung 1.09 +/- 0.09 vs. 0.67 +/- 0.06). Biliary tract external drainage reduced significantly the messenger RNA expression of tumor necrosis factor-alpha (intestine 0.43 +/- 0.06 vs. 0.54 +/- 0.07, liver 0.74 +/- 0.18 vs. 1.01 +/- 0.06, lung 0.87 +/- 0.15 vs. 0.94 +/- 0.07) and interleukin-6 (intestine 0.60 +/- 0.11 vs. 0.89 +/- 0.12, liver 0.71 +/- 0.16 vs. 1.07 +/- 0.10, lung 0.88 +/- 0.25 vs. 1.09 +/- 0.09). The concentration of tumor necrosis factor-alpha in bile was significantly higher in the hemorrhagic shock group compared with the sham shock group (31.22 +/- 6.44 ng/mL vs. 15.49 +/- 3.64 ng/mL, p < .01). The histologic observation of the intestine, liver, and lung showed that the biliary tract external drainage significantly attenuate the putrescence and exfoliation of intestinal villi, denaturation and putrescence of hepatocytes, edema, and inflammatory cells infiltration of lung.
  
  
  CONCLUSIONS
  Biliary tract external drainage decreases the messenger RNA expression of tumor necrosis factor-alpha, interleukin-6 and attenuate the tissue injury of the intestine, liver, and lung in rats model of hemorrhagic shock. The gut-liver axis was implicated to play a crucial role in hemorrhagic shock-induced multiple organ dysfunction syndrome.
authors.affiliation: Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. liuyjun3@mail.sysu.edu.cn
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Liu
authors.forename: En-Qiang
authors.initials: EQ
authors.lastname: Mao
authors.forename: Bin
authors.initials: B
authors.lastname: Ouyang
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Yao-Qing
authors.initials: YQ
authors.lastname: Tang
authors.forename: Shun-Wei
authors.initials: SW
authors.lastname: Huang
authors.forename: Xiang-Dong
authors.initials: XD
authors.lastname: Guan
mesh_terms: D000818:Animals; D001646:Bile / Q000502:physiology*; D004322:Drainage; D004764:Enterohepatic Circulation / Q000235:genetics / Q000502:physiology; D015870:Gene Expression; D015850:Interleukin-6 / Q000097:blood* / Q000235:genetics; D007413:Intestinal Mucosa / Q000473:pathology*; D007511:Ischemia / Q000235:genetics / Q000503:physiopathology; D008099:Liver / Q000473:pathology*; D008168:Lung / Q000473:pathology*; D008297:Male; D009102:Multiple Organ Failure / Q000235:genetics / Q000473:pathology; D009336:Necrosis; D012333:RNA, Messenger / Q000235:genetics; D051381:Rats; D017207:Rats, Sprague-Dawley; D012771:Shock, Hemorrhagic / Q000235:genetics* / Q000473:pathology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood* / Q000235:genetics
chemical_list: D015850:Interleukin-6; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha