The Protective Effect Of Applying LBP Antibody In Early Stage On Gut Mucosa Damage Of Obstructive Jaundice Rats

Obstructive jaundice is a common disease with high mortality and incidence of surgery complications in hepatobiliary surgery department,the possible reasons are renal dysfunction, malnutri- tion,hyperbilirubinemia and especially the mutiple organs failure caused by gut bacteria translocation,endotoxemia and gram negetive sepsis.Now the intestine mucose damage is the focus of researchers.The mean endotoxin concentration in plasma of severe septic shock patients is only 0.3 ng/ml,but in vitro experiment such concentration can not stimulate cell response,inflammatory factors are released only when hundreds times of endotoxin concentration was given.LBP can markedly magnify the effect of LPS,and LPS at pg/ml's level can produce plenty of inflammatory factors which can induce severe damage to cells.So it is concluded that there is a positive feedback ring between endotoxin,LBP and inflammatory factors.An effective block of LBP to LPS could decrease the mortality and complications.This experiment is to apply LBP antibody in early stage to block the positive feedback,then investigate gut funct- ion,and to offer theoretical basis to prevent gut dysfunction during the perioperative period of obstructive jaundice.Objective:To investigate the change of intestine mucosa,endotoxin (ET),tumor necrosis factor-α(TNF-α),nitrogin monoside(NO),and bacteria translocation of obstructive jaundice rats and estimate the effect of applying LBP(LPS binding protein,LBP) antibody in early stage.Methods:54 healthy male Wistar rats,weight 240-300g,were randomly divided into 3 groups:A group:sham operation and normal saline (NS);B group:common bile duct(CBD)ligation and NS;C group:CBD ligation and LBP antibody,18 rats in each group.The rats of A and B group were given NS and C group LBP antibody(50μg/Kg) from the 1st post operative day through tail vein.The specimens were collected (6 rats in each group) on 5th,10th,15th postoperative day respectively Then the rats were executed. Subsequently the intestine mucosa and bacteria translocation rate were investigate, and plasma ET,TNF-α, NO were detected.Results:1. Microscope results:The pathological section of intestinal mucosa and submucous were all normal on the 5th,10th,15th postoperative days in A group.The pathological section of B group showed some inflammatory cells infiltrating on the 5th postoperative day. Intestinal mucous membrane atrophied,villus intestinalis swell,the amount of caliciform cells decreased,the centrial lacteal dilated and the vessels became congestive on the 10th postoperative day,and the results as described above became more serious and endothelial cells'defluxion, lymph cells infiltrating,some lymph cells acc- umulated were also shown on the 15th postoperative day.The pathological section was normal on 5th postoperative day in C group.The amount of caliciform cells decreased,the centrial lacteal dilated slightly and the vessels became congestive and dilated notably on the 10th postoperative day in C group. Intestinal mucous membrane atrophied,villus intestinalis swell,the amount of caliciform cells decreased,the centriallacteal dilated and the vessels became congestive and dilated notably on the 15th postoperative day.2. ET:There were no changes in A group(P>0.05);significantly increased in B group(P<0.05) and correlated with postoperative time (P<0.05);it was increased on the 5th and 10th postoperative day in C group,there was no significant difference between B and C group on 5th postoperative day(P<0.05),but it was diffentent on the 10th postoperative day(P<0.01).The plasma ET was markedly increased on the 15th postoperative day than 10th(P<0.01),but the level of C group was significantly lower than B group(P<0.01).3. TNF-α:There was no distinct changes in A group(P>0.05); significantly increased in B group(P<0.05) and correlated with postoperative time(P<0.05);it was increased on the 5th and 10th postoperative day in C group,there was no significant difference between B and C group on 5th postoperative day(P<0.05),but it was different on the 10th postoperative day(P<0.01).The plasma TNF-αwas markedly increased on the 15th postoperative day than 10th (P<0.01),but the level of C group was significantly lower than B group(P<0.01).There was a positive correlation between ET and TNF-α.4. NO: No changes in A group(P>0.05);significantly increased in B group(P<0.05) and correlated with postoperative time(P<0.05);it was increased in C group(P<0.05),there was no significant difference between B and C group (P>0.01)on 5th and 10th postoperative day.The level of C group was significantly lower than B group(P<0.01) on the 15th postoperative day.5. Translocated bacteria cultured in lung tissue:The positive rate of B and Cgroup on 10th and 15th day was significantly increased. Compared with B group,the bacteria translocation positive rate of C group is lower(P<0.05).Conclusions:1. Intestine mucosa damage occurred in obstructive jaundice rats.2. There was an interaction between intestine mucosa damage and endotoxemia in obstructive jaundice rats.3. There was a correlation between intestine mucosa damage and excessive release of inflammatory factors such as TNF-αin obstructive jaundice rats.4. The concentration of NO was significantly increased in obstructive jaundice rats,and a high concentration of NO aggravated intestine mucosa damage.5. Apllying LBP antibody in early stage could effectively inhibit intestine mucosa damage caused by excessive inflammatory respones.