Abstract
Background: The lack of an early, sensitive marker for intestinal ischemia has led to delay in
diagnosis and worsened outcome for patients with acute onset of this condition. Our
preliminary studies revealed that guinea pig cytosolic β-glucosidase (CBG) is expressed
predominantly in the small intestine, with lower levels in the liver and pancreas
and undetectable levels in other organs. Cytosolic β-glucosidase was investigated
as a serum marker of small intestinal ischemia in a guinea pig model. Methods: Guinea pigs underwent anesthesia, sham laparotomy, 30 minutes of mesenteric ischemia
followed by 6 hours of reperfusion, 6 hours of sustained mesenteric ischemia, or closed-loop
small bowel obstruction. Serum samples were assayed for CBG activity. At the conclusion
of the ischemia/reperfusion experiments, small bowel samples were assayed for residual
enzyme activity, and paraffin sections were graded for the severity of histologic
injury. Results: Serum CBG activity rose rapidly after intestinal ischemia with and without reperfusion.
Peak enzyme activities were elevated 23-fold for reperfused animals (P < .001) by 4 hours. For nonreperfused animals, peak serum CBG activities reached
29-fold above baseline and were significantly higher than the CBG activities of reperfused
animals at 4 hours (P < .01) and at 6 hours (P < .05). Mucosal injury ranged from undetectable to moderate and corresponded in severity
with both peak serum enzyme activity and decreased residual activity in the small
bowel. In animals subjected to closed-loop obstruction, there was a mean increase
of serum CBG of 9.2-fold from 4 to 6 hours after establishment of obstruction (P < .05). Conclusions: In the guinea pig model, CBG is a sensitive marker of ischemic injury caused by arterial
occlusion or closed-loop obstruction of the small bowel. (Surgery 1999;125:202-10.)
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References
- Ischemic disorders of the intestines.Curr Probl Surg. 1978; 15: 1-85
- Mesenteric infarction.Am J Surg. 1977; 133: 188-193
- The surgical management of acute occlusion of the superior mesenteric artery.Ann Surg. 1978; 188: 721-731
- The spectrum of mesenteric infarction.Am J Surg. 1970; 119: 233-239
- Mesenteric vascular disease.Am J Surg. 1980; 139: 188-192
- Acute mesenteric infarction.Am Surg. 1976; 42: 562-567
- Pathology of intestinal ischemia.Surg Clin North Am. 1992; 72: 43-63
- Initial results from an aggressive roentgenological and surgical approach to acute mesenteric ischemia.Surgery. 1977; 82: 848-855
- Aggressive approach to acute mesenteric ischemia.Surg Clin North Am. 1992; 72: 157-182
- Diagnostic tests for intestinal ischemia.Surg Clin North Am. 1992; 72: 85-105
- A new provocative test for chronic mesenteric ischemia.Am J Gastroenterol. 1991; 86: 888-891
- Determination of tissue O2 tensions by hollow visceral tonometers: effect of breathing enriched O2 mixtures.J Clin Invest. 1964; 43: 193-200
- Radiology in intestinal ischemia: angiographic diagnosis and management.Surg Clin North Am. 1992; 72: 125-141
- Acute mesenteric ischemia: the continuing difficulty in early diagnosis.Postgrad Med J. 1993; 69: 48-51
- Primary structure of the cytosolic β-glucosidase of guinea pig liver.Biochem J. 1996; 319: 829-837
- Exolytic hydrolysis of toxic plant glucosides by guinea pig liver cytosolic β-glucosidase.J Biol Chem. 1991; 267: 14027-14032
- Purification and characterization of a cytosolic broad-specificity β-glucosidase from human liver.J Biol Chem. 1981; 256: 13004-13013
- Hydrolysis of a naturally occurring β-glucoside by a broad-specificity β-glucosidase from liver.Biochem J. 1986; 237: 469-476
- The mammalian cytosolic broad-specificity β-glucosidase.in: β-Glucosidases: biochemistry and molecular biology. American Chemical Society, Washington1993: 83-112
- Plasma lysosomal enzymes after liver transplantation in the pig.Enzyme. 1991; 45: 145-154
- Glycohydrolases as markers of hepatic ischemia-reperfusion injury and recovery.Hepatology. 1996; 24: 157-162
- A safe and fast-acting surgical anesthetic for use in the guinea pig.J Appl Physiol. 1975; 38: 538-539
- Differentiation of β-glucocerebrosidase from β-glucosidase in human tissues using sodium taurocholate.Arch Biochem Biophys. 1975; 175: 569-582
- A model of intestinal ischemia in the neonatal rat utilizing superior mesenteric artery occlusion and intraluminal PAF.J Surg Res. 1995; 58: 724-727
- Current management of small-bowel obstruction.Adv Surg. 1997; 31: 1-34
- Simultaneous liver and lung injury following gut ischemia is mediated by xanthine oxidase.J Trauma. 1992; 32: 723-728
- Gut ischemia/reperfusion-induced liver dysfunction occurs despite sustained oxygen consumption.J Surg Res. 1992; 52: 432-436
- Hepatocellular oxidant stress following intestinal ischemia/reperfusion injury.J Surg Res. 1991; 51: 467-471
- Leukocyte adhesion and hepatic microvacular responses to intestinal ischemia/reperfusion in rats.Gastroenterology. 1996; 111: 666-673
- Heat shock protein 70 messenger RNA reflects the severity of ischemia/reperfusion injury in the perfused rat liver.Crit Care Med. 1997; 25: 324-329
- Induction of kidney heme oxygenase-1 (HSP32) mRNA and protein by ischemia/reperfusion: possible role of heme as both promoter of tissue damage and regulator of HSP32.J Pharmacol Exp Ther. 1993; 264: 457-462
- Effect of ischemia on protein synthesis in the septic liver.Surg Gynecol Obstet. 1991; 172: 441-448
- Human small intestinal β-galactosidases.Biochem J. 1969; 114: 351-359
- Intestinal β-galactosidases.J Clin Invest. 1969; 48: 716-728
- Amygdalin (Laetrile) and prunasin β-glucosidases: distribution in germ-free rat and in human tumor tissue.Proc Natl Acad Sci USA. 1981; 78: 6513-6516
- A β-glucosidase in feline kidney that hydrolyzes amygdalin (Laetrile).Arch Biochem Biophys. 1980; 201: 363-368
- Enzymatic and metabolic changes in the peripheral serum after superior mesenteric artery ligation in dogs.Ital J Surg Sci. 1983; 13: 269-273
- Intestinal alkaline phosphatase and base deficit in mesenteric occlusion.J Surg Res. 1976; 20: 243-246
- Serum lactate dehydrogenase in the diagnosis of the acute surgical abdomen.Surgery. 1958; 44: 43-51
- Intestinal fatty acid-binding protein in serum and urine reflects early ischemic injury to the small bowel.Surgery. 1993; 113: 545-551
- Intestinal fatty acid-binding protein is a useful marker for mesenteric infarction in humans.Gastroenterology. 1996; 110: 339-343
Article info
Publication history
Accepted:
September 11,
1998
Footnotes
☆Supported by dedicated health research funds of the University of New Mexico Health Sciences Center.
☆☆Reprint requests: Don Morris, MD, Department of Surgery, UNM Health Sciences Center, ACC 2nd Floor, 2211 Lomas Blvd NE, Albuquerque, NM 87131-5431.
Identification
Copyright
© 1999 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
