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Intestinal Mucosal TLR4 Signal Involves in Bacterial Translocation in a Rat Model of Cardiopulmonary Resuscitation

CHANG Rui-ming1,JIANG Jun1,FU Yue1,LI Li1,WEN Li-qiang1,CHANG Jian-xing1(1.Department of Emergency Medcine,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China)  
【Objective】 To investigate whether intestinal expression of Toll-like receptor 4(TLR4) signaling was involved in bacterial translocation and mediated sepsis generation in a rat model of cardiopulmonary resuscitation(CPR).【Methods】 Through the establishment of rat model of CPR,the experimental animals were set CPR-6 hour group(CPR-6h) and CPR-48 hour group(CPR-48h) as the early and late stages after the establishment of spontaneous circulation,then observed two-stage intestinal TLR4 expression and MAPKs(pERK,pJNK,and pp38MAPK) expression of intracellular signaling proteins by using Western blot,detected bacterial translocation by bacterial culture of mesenteric lymph nodes(MLNs) and liver tissue,determinated intestinal epithelial damage by observing cell junction widening or opening ratio.【Results】 In the CPR-6h group,TLR4,pERK,pJNK,and pp38MAPK protein expression were significantly increased(P 0.05,compared with sham control),and a low percentage of cell junction widening or opening ratio(2.01%) and a small quantity of colonies of colony-forming unit per gram(cfu/g) were observed in the mesenteric lymph nodes(MLNs) and liver tissue.However,in the CPR-48h group,except for pERK,TLR4,pJNK,and pp38MAPK protein were decreased,which were compared with those in the CPR-6h group(P 0.05).However,the percentage of cell junction widening or opening ratio was much higher than that in the CPR-6h and sham groups(8.4%,P 0.001).Moreover,the bacterial colonies of mesenteric lymph nodes and liver tissue were(14 300 ± 2 750)cfu/g and(4 400 ± 623)cfu/g,which were remarkably increased when compared to CPR-6h groups [(3 700 ± 1 090)cfu/g and(9 800 ± 850)cfu/g,P 0.001].【Conclusion】 The lower expression of intestinal mucosal TLR4 signal was observed during the late stage of CPR,which suggested that intestinal mucosal cells may reduce its ability to sense and identify bacteria,which resulted in bacterial translocation.
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