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1 Division of Gastroenterology,
Reactive oxygen metabolites (ROMs) contribute to
the pathophysiology of intestinal inflammation. Our aim was to
ascertain the involvement of ROMs in experimental ileitis in rats
produced by toxin A of Clostridium
difficile. Intraluminal toxin A caused a significant
increase in hydroxyl radical and hydrogen peroxide production by ileal
microsomes starting 1 h following toxin exposure and peaking at
2-3 h, and this was inhibited by pretreatment with DMSO, a ROM
scavenger, or superoxide dismutase (SOD), which inactivates ROMs. In
contrast, mucosal xanthine oxidase increased only slightly after toxin
A exposure, and allopurinol, an inhibitor of xanthine oxidase, had no
effect on toxin A-associated intestinal responses. Induction of
neutropenia resulted in reduction of toxin-mediated free radical
formation, fluid secretion, and permeability. The enterotoxic effects
of C. difficile toxin A were
associated with increased ROM release in ileal tissues, and the ROM
inhibitors DMSO and SOD inhibited these effects. This suggests that
ROMs released during toxin A enteritis are released primarily from neutrophils invading the inflamed bowel segment.
superoxide radicals; hydroxyl radicals; intestinal inflammation; intestinal secretion; enterotoxins
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