革兰氏阴性菌分泌内毒素,脂多糖(LPS),在东南亚肝胆管结石和慢性胆道炎症的形成和复发中起重要作用。我们旨在阐明局部抗生素冲洗对慢性增生性胆管炎(CPC)和肝胆管结石的抗炎作用和机制。
将大肠杆菌注射到兔胆管中以诱导CPC。兔分为假手术(SO),聚维酮碘,甲硝唑加氯己定,氧氟沙星,呋喃西林,Neosporin®G.U.,和CPC团体。建立CPC后进行局部灌溉28天。残留的大肠杆菌和LPS,MCP-1、CD14、COX-2、VEGF的表达,IL-6,NF-κB,TNF-α,Fas,TGF-β1,α-SMA,胶原蛋白-I,β-葡糖醛酸酶,PKC,C-myc,在胆管组织中评估粘蛋白5AC。
残留的大肠杆菌和LPS,MCP-1、CD14、COX-2、IL-6、NF-κB的表达,TNF-α,Fas,TGF-β1,α-SMA,β-葡糖醛酸酶,PKC,C-myc,和SO中的粘蛋白5AC,聚维酮碘,甲硝唑加氯己定,氧氟沙星,和Neosporin®G.U.组明显低于呋喃西林和CPC组(P<0.05)。在SO中VEGF和I型胶原水平,聚维酮碘,甲硝唑加氯己定,氧氟沙星组明显低于呋喃西林组,Neosporin®G.U.,和CPC组(P<0.05)。
LPS影响大肠杆菌引起的慢性增生性胆管炎和肝胆管结石复发的病理生理。局部抗生素冲洗可以通过减少LPS诱导的促炎和促纤维化细胞因子的释放来预防慢性增生性胆管炎和结石的形成。聚维酮碘,甲硝唑加氯己定,和氧氟沙星比新孢菌素®G.U.和呋喃西林更有效。
The gram-negative bacteria secreted endotoxin, Lipopolysaccharide (LPS), plays important roles in the formation and recurrence of hepatolithiasis and chronic biliary inflammation in patients of Southeast Asia. We aimed to elucidate the anti-inflammatory effect and mechanism of local antibiotics irrigation on chronic proliferative cholangitis (CPC) and hepatolithiasis.
Escherichia coli was injected into rabbit bile ducts to induce CPC. Rabbits were divided into sham operation (SO), povidone-iodine, Metronidazole plus chlorhexidine, ofloxacin, furacillin, Neosporin® G.U., and CPC groups. Local irrigation was performed for 28 days after CPC was established. Residual E. coli and LPS, and the expression of MCP-1, CD14, COX-2, VEGF, IL-6, NF-κB, TNF-α, Fas, TGF-β1, α-SMA, Collagen-I, β-glucuronidase, PKC, C-myc, and Mucin 5AC were assessed in bile duct tissues.
The residual E. coli and LPS, and expression of MCP-1, CD14, COX-2, IL-6, NF-κB, TNF-α, Fas, TGF-β1, α-SMA, β-glucuronidase, PKC, C-myc, and Mucin 5AC in the SO, povidone-iodine, Metronidazole plus chlorhexidine, ofloxacin, and Neosporin® G.U. groups were significantly lower than those in the furacillin and CPC groups (P<0.05). VEGF and Collagen-I levels in the SO, povidone-iodine, metronidazole plus chlorhexidine, and ofloxacin groups were significantly lower than those in the furacillin, Neosporin® G.U., and CPC groups (P<0.05).
LPS affects the pathophysiology of E. coli caused chronic proliferative cholangitis and hepatolithiasis recurrence. Local antibiotics irrigation could prevent chronic proliferative cholangitis and stones formation by decreasing LPS-induced proinflammatory and profibrotic cytokines release. Povidone iodine, metronidazole plus chlorhexidine, and ofloxacin were more effective than Neosporin® G.U. and furacillin.