Kısa Bağırsak Sendromunda Karaciğerde Ultrastrüktürel Değişiklikler ve Cd14 Ekspresyonu

Abstract

Amaç: Sıçanlarda kısa bağırsak sendromunun (KBS) total parenteral beslenmeden (TPB) bağımsız karaciğer üzerindeki ultrastrüktürel ve biyokimyasal değişiklikler ve CD14 mRNA ekspresyonu üzerindeki etkilerinin araştırılması amaçlandı.Gereç ve Yöntemler: Erkek 180-220 g ağırlığındaki (n=37) Wistar Albino sıçan sham (n=16), KBS (n=21) grubu olmak üzere rastgele iki gruba ayrıldı. Sham grubunda ileoçekal valvin 15 cm proksimalinden bağırsak ayrıldı ve tekrar anastomoz edildi. KBS grubunda ise bağırsakların %75’i çıkarıldı. Tüm hayvanlara eş besleme yapıldı. CD14 mRNA ekspresyonu semikantitatif olarak RT- PCR ile değerlendirildi. Eş zamanlı olarak karaciğer fonksiyon testleri ölçüldü ve karaciğerdeki ultrastrüktürel değişiklikler incelendi.Bulgular: Karaciğer fonksiyon testlerinde istatistiksel olarak anlamlı fark saptanmadı. Karaciğerin histolojik incelenmesinde inflamasyon, fibroz ve steatoz açısından anlamlı fark bulunmamakla beraber Kolestaz KBS grubunda daha belirgindi (p<0,05). Elektron mikroskobide belirgin ultrastrüktürel değişiklikler izlendi; microvillus kanalikül uzunluğu, luminal granüler materyal varlığı ve kanalikül uzunluğunun arttığı görüldü (p<0,05). Karaciğer CD14 mRNA ekspresyonu KBS grupta anlamlı olarak arttı (p<0,05).Ultrastrüktürel değişiklikler ile CD14 mRNA ekspresyonu arasındaki korelasyon belirgin olarak gözlendi (p<0,05).Sonuç: TPN’den bağımsız KBS modelinde kolestaz ultrastrüktürel olarak gösterildi. KBS grubunda artmış CD14 mRNA ekspresyonu, portal venöz endotoksemi nedeniyle bu değişikliklerin oluşabileceğini desteklemektedir.

Keywords

• Kolestaz, Endotoksemi, Karaciğer yetmezliği, PCR, Kısa bağırsak sendromu

Ultrastructural Changes and CD14 Expression in the Liver in the Short Bowel Syndrome

Abstract

Objective: Our aim was to explore the effects of short bowel syndrome (SBS) on CD14 mRNA expression in the liver and examine ultrastructural and biochemical changes in a rat model of total parenteral nutrition (TPN) independent SBS.Material and Methods: Male Wistar Albino rats, weighing 180 to 220 g (n=37) were randomly divided into two groups as sham operated (n=16) and short bowel syndrome (n=21). Division and re-anastomosis of the bowel 15 cm proximal to the ileocecal junction was performed in sham operated animals. 75% of the small intestine was resected in the short bowel syndrome group. All animals were pair-fed. CD14 mRNA expression was evaluated semiquantitatively via RTPCR. Concomitantly, liver function test were performed and ultrastructural changes in the liver were evaluated.Results: There was no statistical significant difference regarding liver function tests. There were no significant differences for inflammation, fibrosis and steatosis on histological examination of liver. Cholestasis was more prominent in the SBS group (p<0.05). There were marked ultrastructural changes on electron microscopy. Microvilli canaliculus length, presence of luminal granular biliary material and luminal length of canaliculus were increased in the SBS group (p<0.05). CD14 expression was significantly increased in the liver in the SBS group (p<0.05). The correlation between the ultrastructural changes and CD14 mRNA expression was also prominent (p<0.05)Conclusion: Cholestasis was demonstrated ultrastructurally in this rat model of TPN independent SBS. Increased expression of CD14 mRNA in the SBS group supports that these changes might occur because of portal venous endotoxemia

Keywords

• Cholestasis, Endotoxemia, Hepatic failure, PCR, Short bowel syndrome

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