title: Effects of pyruvate-enriched peritoneal dialysis solution on intestinal barrier in peritoneal resuscitation from hemorrhagic shock in rats.
abstract: BACKGROUND
  To investigate protective effects of pyruvate-enriched peritoneal dialysis solution (P-PDS), compared with lactate-PDS (L-PDS), on the intestinal mucosal barrier in peritoneal resuscitation (PR) from severe hemorrhagic shock (HS) in rats.
  
  
  METHODS
  Fifty male SD rats were randomly divided into five groups (n = 10): group sham, group control (HS without fluid resuscitation), group intravenous resuscitation (IVR) (HS with IVR only), group L-PDS (HS with i.v. infusion plus PR with L-PDS), and group P-PDS (HS with i.v. infusion plus PR with P-PDS). HS was induced by hemorrhage with mean arterial pressure 40 mm Hg for 60 min. In three groups with fluid rehydration, IVR included shed blood and dl-lactate Ringer solution equal to two times the volume of shed blood during 60 min; in two groups with PR, 20 mL of L-PDS, or P-PDS were infused when i.v. infusion started after HS into the peritoneal cavity in 20 min, respectively. Blood samples were taken for determinations of pH, base excess, PaCO2, PaO2, and D-LA 60 min post fluid resuscitation. After rats were sacrificed, a segment of intestine was harvested for the detection of expressions of intestinal barrier proteins: zonula occludens-1 (ZO-1) and phosphorylated vasodilator-stimulated phosphoprotein (p-VASP) by Western blot and immunohistochemistry. Intestinal morphologic alterations were also observed.
  
  
  RESULTS
  Blood pH, base excess, and PaO2 were higher, whereas PaCO2 and D-LA were lower in group P-PDS than in other three HS groups (P < 0.05 and P < 0.01, respectively). Severe acidosis was nearly corrected in group P-PDS. Intestinal barrier proteins ZO-1 and p-VASP were significantly preserved in group P-PDS than in group L-PDS (P < 0.05) although they were improved in group L-PDS in comparison with other two HS groups (P < 0.05 or P < 0.01). Expressions of barrier proteins by Western blotting in group P-PDS were reversed to normal. The score of intestinal epithelial damage index was reduced in group L-PDS, compared with other two HS groups (P < 0.05), however, it was significantly lower in group P-PDS than in group L-PDS (P < 0.05).
  
  
  CONCLUSIONS
  Pyruvate was superior to lactate in PDS in the correction of severe acidosis with PR. P-PDS was more preservative of expressions of intestinal ZO-1 and p-VASP and mucosal barrier function, compared with L-PDS in PR from severe HS in rats.
authors.affiliation: Department of Emergency Medicine, Zhongshan Hospital, Dalian University, Dalian, China. Electronic address: dllxg@126.com.
authors.forename: Xiao-Guang
authors.initials: XG
authors.lastname: Lu
authors.affiliation: College (Institute) of Integrative Medicine, Dalian Medical University, Dalian, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Kang
authors.affiliation: Fresenius Medical Care, Dialysis Centers at Chicago, Rolling Meadows, Illinois; Shanghai Sandai Pharmaceutical R & D Co., Pudong, Shanghai, China. Electronic address: fqzh60130@yahoo.com.
authors.forename: Fang-Qiang
authors.initials: FQ
authors.lastname: Zhou
authors.affiliation: Department of Emergency Medicine, Zhongshan Hospital, Dalian University, Dalian, China.
authors.forename: Xiao-Zhou
authors.initials: XZ
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Zhongshan Hospital, Dalian University, Dalian, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Guo
authors.affiliation: Department of Emergency Medicine, Zhongshan Hospital, Dalian University, Dalian, China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Fan
authors.affiliation: Graduate School of Zunyi Medical University, Zunyi, China.
authors.forename: Zheng-Kai
authors.initials: ZK
authors.lastname: Liang
authors.affiliation: Department of Emergency Medicine, Zhongshan Hospital, Dalian University, Dalian, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yu
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D015815:Cell Adhesion Molecules / Q000378:metabolism; D015314:Dialysis Solutions / Q000494:pharmacology*; D004195:Disease Models, Animal; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000502:physiology; D019344:Lactic Acid / Q000494:pharmacology; D008297:Male; D008840:Microfilament Proteins / Q000378:metabolism; D010530:Peritoneal Dialysis / Q000379:methods*; D010750:Phosphoproteins / Q000378:metabolism; D010766:Phosphorylation / Q000187:drug effects / Q000502:physiology; D019289:Pyruvic Acid / Q000494:pharmacology*; D017207:Rats, Sprague-Dawley; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D062826:Zonula Occludens-1 Protein / Q000378:metabolism; D000098662:Vasodilator-Stimulated Phosphoprotein
chemical_list: D015815:Cell Adhesion Molecules; D015314:Dialysis Solutions; D008840:Microfilament Proteins; D010750:Phosphoproteins; C569044:Tjp1 protein, rat; D062826:Zonula Occludens-1 Protein; D000098662:Vasodilator-Stimulated Phosphoprotein; D019344:Lactic Acid; D019289:Pyruvic Acid
keywords: Dialysis solution; Hemorrhagic shock; Intestinal mucosal barrier; Peritoneal resuscitation; Phosphorylation; Pyruvate; Vasodilator-stimulated phosphoprotein