Effects of intestinal intervention on bacterial translocation in a rat model of acute liver failure in vivo.
OBJECTIVE
The study aimed to confirm bacterial translocation (BT) in rats with acute liver failure (ALF), to explore the correlation between the concentration of lipopolysaccharides and Toll-like receptor 4 (TLR4) expression, and further, to evaluate the curative effects of lactulose and montmorillonite (smecta) in this setting.


METHODS
D-Galactosamine was injected into the abdominal cavity of rats to induce ALF. Escherichia coli JM109 labeled with enhanced green fluorescent protein was administered to track BT. Simultaneously, the rats were given lactulose or smecta. Blood samples were collected for measuring liver function, cytokines, endotoxins, and TLR4 expression. Representative tissue specimens from the liver, spleen, and mesenteric lymph nodes were aseptically harvested for bacterial identification by agarose gel electrophoresis, laser scanning confocal microscopy, and flow cytometry.


RESULTS
BT occurred in ALF, accompanied by impaired liver function with increased cytokines, endotoxins, and TLR4 expression. After the treatment with lactulose or smecta, all these parameters decreased, including the relative quantity of translocated bacteria while albumin increased. Furthermore, compared with the lactulose treatment group, the parameters in the smecta treatment group improved. Moreover, in the group in which smecta was given for prophylaxis, there was greater improvement than with treatment.


CONCLUSIONS
Intestinal intervention with lactulose or smecta can ameliorate BT; moreover, smecta has a better effect than lactulose, and its preventive effect was also better than its therapeutic effect.
Yang
Jie
J
Department of Infectious Diseases, Tangdu Hospital, Xi'an, PR China.
Nie
Qing-He
QH
Wang
An-Hui
AH
Huang
Xiao-Feng
XF
Liu
Qing-Quan
QQ
Li
Yun-Ming
YM
D000818:Animals; D018988:Bacterial Translocation / Q000187:drug effects*; D001546:Bentonite / Q000494:pharmacology*; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D004587:Electrophoresis, Agar Gel; D004731:Endotoxins / Q000097:blood; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000378:metabolism; D005434:Flow Cytometry; D005688:Galactosamine; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D049452:Green Fluorescent Proteins / Q000096:biosynthesis / Q000235:genetics; D007422:Intestines / Q000187:drug effects* / Q000276:immunology / Q000382:microbiology; D007792:Lactulose / Q000494:pharmacology*; D008099:Liver / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D017114:Liver Failure, Acute / Q000139:chemically induced / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D008198:Lymph Nodes / Q000187:drug effects / Q000382:microbiology; D008297:Male; D018613:Microscopy, Confocal; D051381:Rats; D017207:Rats, Sprague-Dawley; D017640:Silicates / Q000494:pharmacology*; D013154:Spleen / Q000187:drug effects / Q000382:microbiology; D051197:Toll-Like Receptor 4 / Q000097:blood
D016207:Cytokines; D004731:Endotoxins; D005765:Gastrointestinal Agents; D017640:Silicates; C495347:Tlr4 protein, rat; D051197:Toll-Like Receptor 4; C485184:enhanced green fluorescent protein; C016752:smecta; D001546:Bentonite; D049452:Green Fluorescent Proteins; D007792:Lactulose; D005688:Galactosamine