Xue-Lian Liao,Qu-Zhen Danzeng,Wei Zhang,Chen-Shu Hou,Bin-Bin Xu,Jie Yang,Yan Kang.[J].中华创伤杂志英文版,2018,21(6):323-328
Role of using two-route ulinastatin injection to alleviate intestinal injury in septicrats
  
DOI:10.1016/j.cjtee.2018.05.002
KeyWord: SepsisUlinastatinIntestinesTrypsinElastase
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Author NameAffiliation
Xue-Lian Liao Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China 
Qu-Zhen Danzeng Department of Critical Care Medicine, Tibet Autonomous Region People's Hospital, Lhasa 850000, Tibet, China 
Wei Zhang Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, Guizhou Province, China 
Chen-Shu Hou Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China 
Bin-Bin Xu Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China 
Jie Yang Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China 
Yan Kang Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China 
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Abstract:
      Purpose: Early application of protease inhibitors through the intestinal lumen could increase survival following experimental shock by blocking the pancreatic digestive enzymes. Hence, it was hypothesized that two-route injection (intraintestinal þ intravenous) of ulinastatin (UTI), a broad-spectrum protease inhibitor, could better alleviate intestinal injury than single-route injection (either intravenous or intraintestinal). Methods: A sepsis model induced by lipopolysaccharide on rats was established. The rats were randomly divided into five groups: sham, sepsis, UTI intravenous injection (Uiv), UTI intraintestinal injection (Uii), and UTI intraintestinal þ intravenous injection (Uii þ Uiv) groups. The mucosal barrier function, enzymeblocking effect, levels of systemic inflammatory cytokines, and 5-day survival rate were compared among groups. The small intestinal villus height (VH), crypt depth (CD), and two components of mucosal barrier (E-cadherin and mucin-2) were measured to evaluate the mucosal barrier function. The levels of trypsin and neutrophil elastase (NE) in the intestine, serum, and vital organs were measured to determine the enzyme-blocking effect. Results: Compared with the single-route injection group (Uiv or Uii), the two-route injection (Uii þ Uiv) group displayed: (1) significantly higher levels of VH, VH/CD, E-cadherin, and mucin-2; (2) decreased trypsin and NE levels in intestine, plasma, and vital organs; (3) reduced systemic inflammatory cytokine levels; and (4) improved survival of septic rats. Conclusion: Two-route UTI injection was superior to single-route injection in terms of alleviating intestinal injury, which might be explained by extensive blockade of proteases through different ways.
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