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London Health Sciences Centre Research, and the Departments of Medical Biophysics and Medicine, University of Western Ontario, London, Ontario, Canada N6A 4G5
Our major objective was to investigate whether
injury to the mucosa of the small intestine occurred in a normotensive
model of sepsis and whether such injury was associated with
microvascular perfusion deficits. Using fluorescence intravital
microscopy, we show direct evidence of cell injury within the mucosa
(pneumonia 12.4 ± 2.6 cells/field, sham 2.2 ± 0.7 cells/field), whereas use of
51Cr-labeled EDTA showed evidence
of increased mucosal permeability (pneumonia 1.90 ± 0.67 ml · min
1 · 100 g
1; sham
0.24 ± 0.04 ml · min
1 · 100 g
1), 48 h following induction of pneumonia. Despite such
injury the capillary density in the ileal mucosa and submucosa of
pneumonic rats (1,027 ± 77 and 1,717 ± 86 mm2) was not significantly
different compared with sham (998 ± 63 and 1,812 ± 101 mm2). However, a modest albeit
significant decrease in capillary perfusion was measured in the
muscularis layer of pneumonia (11.0 ± 1.3 mm) compared with sham
(13.9 ± 0.63 mm) and appeared to be associated with leukocyte
entrapment. Pretreatment using low doses of endotoxin to induce
endotoxin tolerance not only increased muscularis capillary density but
reduced the number of leukocytes trapped within the microvasculature,
decreased myeloperoxidase activity within the ileum in pneumonic rats,
and prevented mucosal injury. In conclusion, we have shown that
pneumonia results in remote injury to the mucosa of the ileum and that
such injury was not associated with concurrent mucosal perfusion deficits.
microcirculation; leukocyte; intravital microscopy; small intestine
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