Abstract
Background. We have previously shown minimal evidence of neutrophil infiltration during early
reperfusion of porcine ischemic ileum. However, we noted marked neutrophil infiltration
6 to 18 hours after ischemia during mucosal repair. We postulated such neutrophil
infiltration would disrupt restituting epithelium. Methods. Pigs were pretreated with anti-CD11/CD18 monoclonal antibody, superoxide dismutase-polyethylene
glycol, or saline solution before inducing 1 hour of ischemia. Pigs recovered for
up to 18 hours, after which mucosal repair was assessed. Results. One hour of ischemia induced loss of 19 ± 7% of the villous epithelial surface area.
Epithelial restitution covered the mucosal defect within 2 hours, although full recovery
of mucosal barrier function required 6 hours. By 18 hours, a significant decrease
in transepithelial electrical resistance and increase in transmucosal mannitol flux
was noted despite the continued presence of complete epithelial coverage. Accumulation
of neutrophils within restituting epithelium was noted on histologic examination,
associated with electron-microscopic evidence of widened paracellular spaces. Pretreatment
with anti-CD11/CD18 monoclonal antibody and superoxide dismutase-polyethylene glycol
significantly reduced neutrophil infiltration and normalized transepithelial electrical
resistance and mannitol fluxes. Conclusions. Mucosal inflammation during epithelial repair resulted in increased paracellular
permeability as neutrophils traversed restituted epithelium. Blocking neutrophil adhesion
or scavenging superoxide prevented mucosal dysfunction in recovering tissue. (Surgery
2002;132:461-70.)
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Article info
Publication history
Accepted:
March 29,
2002
Footnotes
*Supported by the United States Department of Agriculture (NRI#9802537) and the National Institutes of Diabetes and Digestive and Kidney Diseases (DK-53284).
**Reprint requests: Anthony T. Blikslager, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough St, Raleigh, NC 27606.
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
