Detection of intestinal bacterial translocation in subclinical ischemia-reperfusion using the polymerase chain reaction technique

Microbial Translocation and Perinatal Asphyxia/Hypoxia: A Systematic Review

The microbiome is vital for the proper function of the gastrointestinal tract (GIT) and the maintenance of overall wellbeing. Gut ischemia may lead to disruption of the intestinal mucosal barrier, resulting in bacterial translocation. In this systematic review, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, we constructed a search query using the PICOT (Patient, Intervention, Comparison, Outcome, Time) framework. Eligible studies reported in PubMed, up to April 2021 were selected, from which, 57 publications’ data were included. According to these, escape of intraluminal potentially harmful factors into the systemic circulation and their transmission to distant organs and tissues, in utero, at birth, or immediately after, can be caused by reduced blood oxygenation. Various factors are involved in this situation. The GIT is a target organ, with high sensitivity to ischemia–hypoxia, and even short periods of ischemia may cause significant local tissue damage. Fetal hypoxia and perinatal asphyxia reduce bowel motility, especially in preterm neonates. Despite the fact that microbiome arouse the interest of scientists in recent decades, the pathophysiologic patterns which mediate in perinatal hypoxia/asphyxia conditions and gut function have not yet been well understood.

Escherichia coli translocation in experimental short bowel syndrome: probiotic supplementation and detection by polymerase chain reaction

BACKGROUND

After massive bowel resection, bacterial overgrowth is frequent and favors the occurrence of Gram-negative intestinal bacterial translocation (BT). Probiotics have been recommended in several diseases and may also have beneficial effects on BT. Conversely, polymerase chain reaction (PCR) technique has shown better sensitivity than conventional methods in bacterial detection and has not been investigated in experimental models of short bowel syndrome and BT.

OBJECTIVE

To test the hypothesis that Bifidobacterium lactis (BL) administration decreases Escherichia coli bacterial translocation (ECBT) in experimental short bowel syndrome and to confirm the better sensitivity of PCR technique to detect ECBT.

METHODS

Forty-eight adult Wistar rats, orally fed with standard rat chow and tap water ad libitum, were maintained in individual metabolic cages for 10 days and divided into three groups: Control group (n = 15): non-manipulated animals. RES group (n = 15): 80% gut resection. 1 ml of sterile water was administered daily after orogastric intubation. RES-PRO group (n = 18): same resection as RES group and daily administration of 7.8 × 10(9) BL (CFU). At the end of the study, portal blood, peripheral blood and mesenteric lymph node (MLN) samples were recovered and cultured. Also, genomic DNA from E. coli was detected by PCR technique.

RESULTS

In conventional culture there was no ECBT in control animals whereas 73% of RES and 33% of RES-PRO animals showed it. PCR detected ECBT in 47, 87 and 33%, respectively, showing higher sensitivity.

[The influence of sepsis as a complication after trauma on immune response to injury]

INTRODUCTION

Mortality rate in trauma complicated with sepsis is exceeding 50%. Outcome is not determined only by infection or trauma, but also by the intensity of immuno-inflammatory response.

OBJECTIVE

The aim of this study was to determine the influence of sepsis on the immuno-inflammatory response, in the group of 35 traumatized men, of which in 25 cases trauma was complicated with sepsis.

METHODS

Cytokines were measured by ELISA test in plasma. Blood samples were drown on the first, third and fifth day after ICU admission.

RESULTS

Proinflammatory cytokine IL-8 was 230-fold higher in trauma + sepsis group (1148.48 vs. 5.05 pg/ml; p < 0.01), and antiinflammatory cytokine IL-ra was 4-fold higher (1138.3 vs. 310.05 pg/ml; p < 0.01), whereas IL-12 and IL-4 showed no significant difference between the groups.

CONCLUSION

We concluded that sepsis, as a complication after trauma, drastically enhances immuno-inflammatory response to insult, as indicated by IL-8 and IL-ra, but not IL-12 and IL-4.

Acute pancreatitis, bacterial translocation, and different octreotide regimens: an experimental study

PURPOSE

To determine the effect of octreotide, octreotide with zinc, levamisole, and misoprostol on the bacterial translocation that develops in rats with acute pancreatitis (AP).

METHODS

A total of 36 rats were divided into six groups, each consisting of six rats. Only laparotomy was performed on the first group. Acute pancreatitis was performed on the second group. Octreotide was given to the third, fourth, fifth, and sixth groups. Octreotide, octreotide with zinc, levamisole, and misoprostol were given to groups III, IV, V, VI, respectively. Rats were euthanized 48 h after the occurrence of AP. Blood and mesenteric lymph node samples were collected for polymerase chain reaction (PCR). Pancreatic tissue and terminal ileum were obtained for histopathological examinations.

RESULTS

The severity of pancreatitis and mucosal damage of the terminal ileum was higher in group II than groups I, III, IV, V, and VI, histopathologically (P < 0.05). There wasn't a significant difference with respect to OA with Zn or L or M and OA group (P > 0.05). A significant difference was found in PCR positivity in blood and mesenteric lymph node between groups I and II (P < 0.05).

CONCLUSIONS

In AP, administering octreotide alone significantly prevented the bacterial translocation by preventing mucosal damage. The zinc, levamisole, or misoprostol with octreotide did not influence the results.

The pathological effect of Helicobacter pylori infection on liver tissues in mice

Helicobacter pylori infection is associated with chronic gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. Some reports also suggest that it causes extragastric disease, including hepatitis. In this study, the pathological changes in the liver and gall bladder in H. pylori-colonized C57BL/6 mice were investigated. Twenty mice were inoculated orally with H. pylori strain SS1, and ten controls were injected with phosphate-buffered saline. Gastric colonization with H. pylori was assessed at 2 months after inoculation. Mice were examined at 8 months by histopathology, culture for H. pylori, and PCR for specific H. pylori genes. All C57BL/6 mice infected with H. pylori for 8 months developed severe gastric mucosal inflammation. Three mice showed mild-to-moderate multifocal hepatitis. The gall bladder mucosa of one H. pylori-infected mouse showed thickening of the mucous membrane with mild submucosal lymphocytic infiltration. H. pylori was observed morphologically in four liver specimens and six gall bladders from infected mice by immunohistochemistry. Specific H. pylori genes were also detected in six liver samples from infected mice, six samples of bile, and two blood samples by nested PCR. Thus, H. pylori inoculated orally may reach the hepatobiliary system and cause inflammation as an independent aetiological factor. The pathway to the liver may be via the blood or the biliary system.

Mutation, selection, and functional repair in formyl peptide receptor genes: a view on the selection processes occurring in this gene subfamily

Formyl peptides (FPs) released by some bacteria are powerful chemoattractants and activators of granulocytes, monocytes, and macrophages, acting through the members of a subfamily of specific seven-transmembrane G-protein-coupled formyl peptide receptors (FPRs), which are expressed only in mammals. Upon stimulation, granulocytes chemotactically move towards sites of maximal FP concentration, and release different bactericidal lytic enzymes and reactive oxygen species (ROI). In some instances, such as ischemia/reperfusion, the proinflammatory mediators released by the injured tissues and the intestinal bacteria and endotoxins, which may permeate across the damaged mucosal barrier, prime the inflowing granulocytes for an enhanced ROI production, resulting in severe damage to the host tissues. In this investigation 16 representative FPR and FPR-like mRNAs were selected to study the pattern of mutation/conservation of the individual nucleotides (nt) in the coding sequences. Mutations occur in 56.7%, 46.4%, and 87.5 % of cases in the first, second, and third nt, respectively, of the coding triplets. A probabilistic analysis demonstrated a significant nonrandom linkage between mutations in the first and second nt. Furthermore, the triplets that are variously double-mutated in the first two nt code, on average, for more hydrophobic amino acids (AA) in the transmembrane segments and more hydrophilic AA in the external and intracytoplasmic segments, thus preserving the general structure of the receptor. The authors hypothesize that when in one of the first two nt a mutation leading to a nonfunctioning protein product occurred, the mutated gene was eventually eliminated; however, a second mutation occurring in the other previously unmutated nt may have led to a protein product that is compatible with functional activity, although mutated in one (noncritical) AA. Such double mutations effecting a "functional repair" have thus survived and are retained among the extant sequences. Moreover, the combined mutation of all three nt in coding triplets occurs with a significantly higher than random frequency and this finding may be interpreted in a similar way.

Review article: bacterial translocation in the critically ill--evidence and methods of prevention

BACKGROUND

Delayed sepsis, systemic inflammatory response syndrome (SIRS) and multiorgan failure remain major causes of morbidity and mortality on intensive care units. One factor thought to be important in the aetiology of SIRS is failure of the intestinal barrier resulting in bacterial translocation and subsequent sepsis.

AIM

This review summarizes the current knowledge about bacterial translocation and methods to prevent it.

METHODS

Relevant studies during 1966-2006 were identified from a literature search. Factors, which detrimentally affect intestinal barrier function, are discussed, as are methods that may attenuate bacterial translocation in the critically ill patient.

RESULTS

Methodological problems in confirming bacterial translocation have restricted investigations to patients undergoing laparotomy. There are only limited data available relating to specific interventions that might preserve intestinal barrier function or limit bacterial translocation in the intensive care setting. These can be categorized broadly into pre-epithelial, epithelial and post-epithelial interventions.

CONCLUSIONS

A better understanding of factors that influence translocation could result in the implementation of interventions which contribute to improved patient outcomes. Glutamine supplementation, targeted nutritional intervention, maintaining splanchnic flow, the judicious use of antibiotics and directed selective gut decontamination regimens hold some promise of limiting bacterial translocation. Further research is required.

Genetics of postoperative complications following thoracic surgery

The field of complex trait-gene interaction research has expanded exponentially in recent years, and new insights into the ways patients respond to surgical stimuli have arisen from this body of work. From a physiological systems perspective, thoracic surgical procedures (thoracotomy in particular) represent a massive input stimulus, and it is, therefore, not surprising that approximately 30% of these patients experience an adverse postoperative event. The best risk prediction models have typically explained about 60% to 70% of the risk, leaving a large residual component unaccounted for. It is quite possible that there is a genetic (heritable) component to this residual risk. This article explores some of the concepts underlying gene-disease interactions, the preliminary work that has been done to date in this area, and finally discusses some of the more important methodological issues involved in complex trait association study design.

Detection ofHelicobacter pyloriDNA in peripheral blood from patients with peptic ulcer or gastritis

Cases of Helicobacter bacteremia have been reported from time to time. Helicobacter pylori is the most important representative of Helicobacterium, yet whether it can result in bacteremia has rarely been studied. In this study, we examined H. pylori DNA in peripheral blood and gastric mucosa of patients with peptic ulcer or chronic gastritis by polymerase chain reaction (PCR). We found H. pylori DNA in 15 of 20 gastric samples, and 9 of these specimens were positive for H. pylori culture. H. pylori DNA amplified by PCR was positive in the peripheral blood of three patients, who all had duodenal ulcers. Gastric biopsy specimens from these three patients were all positive for H. pylori genes and H. pylori was isolated from these specimens. After the 16S rRNA gene sequences of three specimens from the same patient were obtained, we found that they were identical, which suggested that they are the same strain. Our findings suggest that H. pylori exists not only in gastric mucosa but also in peripheral blood, and it is possible that H. pylori can result in bacteremia.

Triggers of inflammation after renal ischemia/reperfusion

Renal ischemia/reperfusion (I/R) is a common cause of acute renal failure (ARF). Ischemic ARF is associated with tubulointerstitial inflammation, and studies using animal models have demonstrated that the inflammatory response to I/R exacerbates the resultant renal injury. Ischemic ARF involves complement activation, the generation of cytokines and chemokines within the kidney, and infiltration of the kidney by leukocytes. Recent work has revealed some of the events and signals that trigger the inflammatory response to aseptic, hypoxic injury of the kidney. In many ways, the inflammatory reaction to this injury resembles that seen during ascending urinary infection, and it may represent a general response of the tubular epithelial cells (TECs) to stress or injury. A greater understanding of the signals that trigger the inflammatory response may permit the development of effective therapies to ameliorate ischemic ARF.

Mechanism of delayed resuscitation in promoting loss of intestinal mucous membrane barrier function after rats scalding

AIM: To investigate the effect of delayed resuscitation on intestinal mucous membrane barrier function and its relationship with neutrophil infiltration of local tissue after rats scalding.

METHODS: Rats with 40% full-thickness scald burn were randomly divided into two group: immediately resuscitation group (IR group) and delayed resuscitation group (DR group). The content of D-lactate, diamine oxidase (DAO) in plasma and myeloperoxidase (MPO), superoxide dismutase (SOD) and malondialdehyde (MDA) in intestinal mucous tissue were determined at different time points after burn. Apoptosis of mucous epithelial cells were identified by terminal deoxynucletidyl-transferase mediated dUTP-biotin nick end labeling (TUNEL) histochemical methods.

RESULTS: The contents of D-lactate in plasma in DR group were much higher than those of IR group (P < 0.01 or 0.05), MPO activity in intestinal mucous tissue of DR group were dramatically increased accompanying with decrease of SOD activity and increase of MDA contents. Herein, we found a close correlation between the contents of D-lactate and activity of MPO. Meanwhile, we also found an increase of the activity of DAO in plasma and number of TUNEL positive staining epithelial cells in DR group.

CONCLUSION: Delayed resuscitation promotes the loss of intestinal mucous membrane barrier function due to the increase of both cell necrosis and cell apoptosis, which may be related to increased neutrophil infiltration in local tissue.

Intestinal failure: Pathophysiological elements and clinical diseases

There are two main functions of gastrointestinal tract, digestion and absorption, and barrier function. The latter has an important defensive effect, which keeps the body away from the invading and damaging of bacteria and endotoxin. It maintains the systemic homeostasis. Intestinal dysfunction would happen when body suffers from diseases or harmful stimulations. The lesser dysfunction of GI tract manifests only disorder of digestion and absorption, whereas the more serious intestinal disorders would harm the intestinal protective mechanism, or intestinal barrier function, and bacterial/endotoxin translocation, of intestinal failure (IF) would ensue. This review disscussed the theory of the intestinal failure, aiming at attracting recognition and valuable comments by clinicians.