Effects Of Da Cheng Qi Decoction On Mitochondrial Apoptotic Pathway And Expression Of NF-κB And COX-2Proteins Of Small Intestine Smooth Muscle In Rats With Multiple Organ Dysfunction Syndrome

Background: Multiple organ dysfunction syndrome (MODS) can be induced byserious damage, infection, major operation, hypoperfusion and shock, in acute illpatients. In MODS, more than two organs dysfunction simultaneously or successively.MODS is the main cause of death in patients undergoing acute abdominal surgery,with many causes, complex pathological mechanism, and high mortality rate. Undernormal condition, local inflammatory reaction is very necessary to the body withinfection or damaged tissue, playing protective effect by removing bacteria andrepairing damaged tissues. But if inflammation is abnormal amplification or out ofcontrol, inflammation will make cell death, tissue and organ dysfunction or injury,producing harmful effect to the body, and finally leading to the occurrence of MODS.Therefore, in essence, MODS is the result of uncontrolled inflammation, and infectionis the precipitating factor of the inflammatory response, and also the root cause ofMODS. In the current study view, the gastrointestinal tract is the key part of MODS.When the peristaltic function of gut with plenty of bacteria and endotoxin is damaged,bacteria and endotoxin translocate into the circulation, causing excessiveinflammatory response. These make systemic inflammatory response syndrome (SIRS) and MODS occur. Therefore, the gastrointestinal tract plays a very important role inMODS development. The gut is not only the target organ of MODS, but also theinitiating organ of MODS. The function of gut is an important prognosis index ofcritically ill patients. Protecting and promoting gastrointestinal motor functioneffectively is considered the key to prevent and treat MODS.Objective: To observe the expression and distribution of mitochondrial apoptosisrelated protein Bcl-2and Bax, and NF-κ B and COX-2proteins of the small intestinalsmooth muscle of MODS rats, and the intervention effects of Da Cheng QiDecoction (DCQD);to study the mechanism of gastrointestinal motility disordersunder MODS station, and also the effect of DCQD on MODS.Methods: One hundred healthy adult Wistar rats of clean grade, half male andhalf female, weight200-250g. Rats were randomly divided into three groups: controlgroup with20rats，MODS group with40rats, and DCQD group with40rats. Themodel of MODS was established according to previous experiments. Briefly, understerile condition, MODS and DCQD group rats were intraperitoneal injection of onemillilitre Escherichia coli suspension of8×108cfu/ml. Control group wereintraperitoneal injection of one milliliter physiological saline. The rats in DCQDgroup rats in the modeling of before two days were treated with DCQD orally, oneml/100g each time, twice a day. One day after injection, the proximal small intestinewas used in the experiment. To observe and detect of the expression and distributionof mitochondrial apoptosis related protein Bcl-2, Bax, and NF-κ B, COX-2proteins insmall intestinal smooth muscle tissue in rats using immunohistochemical staining.Results: Observation of mitochondrial apoptosis related protein Bcl-2and Bax:Compared with control group, the expressions of Bax in MODS group was increasedsignificantly (P<0.05), and Bcl-2was decreased significantly (P<0.05). Comparedwith MODS group, the expressions of Bax in DCQD group was reduced significantly(P<0.05), and Bax was decreased significantly (P<0.05).Observation of NF-κ B, COX-2proteins: Compared with control group, theexpressions of NF-κ B, COX-2proteins in MODS group was increased significantly(P<0.05). Compared with MODS group, the expressions of Bax in DCQD group was reduced significantly (P<0.05).Conclusions: Gastrointestinal obstruction symptom was serious in rats withMODS induced by bacterial peritonitis, and motility function was damaged. DCQTcould obviously alleviate gastrointestinal obstruction symptoms, promotegastrointestinal motor function recovery, thus reducing the mortality of rats in MODS.Under MODS condition, the expression of Bax proteins in small intestinalsmooth muscle of rats with MODS was significantly increased than the control group,and the expression of Bcl-2protein was significantly reduced. These mademitochondrial apoptotic pathway activate, leading apoptosis of small intestinalsmooth muscle, and resulting in gastrointestinal motility disorders. DCQD couldinhibit mitochondrial apoptotic pathways by increasing the expression of Bcl-2protein in small intestinal smooth muscle of rats with MODS, and decreasing theexpression of Bax protein, therefore could promote the recovery of gastrointestinalmotility.Gastrointestinal motility disorders in MODS might be associated the increasedexpression of NF-κ B and COX-2proteins in small intestinal smooth muscle of rats.DCQD could inhibit the inflammatory response and apoptosis signal pathway byreducing the expression of NF-κ B and COX-2proteins, to protect small intestinalsmooth muscle of rats with MODS, and promote gastrointestinal motility recovery.