In acute peritonitis, any surgical intervention leads to impaired immune protection with the development of postoperative purulent-septic complications, which increases several times the likelihood of death, especially in people with secondary immunodeficiency as a consequence diabetes mellitus. We aimed to study the dynamics of pro- and anti-inflammatory cytokine content in rat serum under experimental acute generalized peritonitis on the background of diabetes mellitus. Fifty-six white rats were used for the study. The determination of the serum cytokine profile was performed by enzyme-linked immunosorbent assay. When comparing the levels of interleukins between the study groups, a statistically significant increase in the level of proinflammatory cytokines was found in the group of diabetic animals during all experimental periods. In particular, the concentration of interleukin – 1β increased significantly by 94% on day 1 of observation, by 115% on day 3, and by 121% on day 7 compared to the control group. Similarly, a significant increase in TNF-α levels was observed in animals with diabetes. In this group, the most significant increase in the level of TNF-α was recorded on the seventh day of the experiment, and it increased by 3.4 times. Animals with acute peritonitis on the background of diabetes had a significantly increased concentration of anti-inflammatory cytokines in the serum of all study groups, which confirms their involvement in the pathogenesis of the disease under study.
Мета. Вивчити та оцінити морфологічні зміни в легенях тварин з експериментальним гострим поширеним перитонітом. Матеріали і методи. У цьому дослідженні використано 32 білих щури. Гострий перитоніт моделювали шляхом введення 0,5 мл 10% розчину захопленої фекальної суспензії в черевну порожнину досліджуваних тварин. Строки спостереження: 1-ша, 3-тя, 7-ма доби від початку моделювання перитоніту. Для гістологічного дослідження брали тканину легенів. Отримані шматочки органа фіксували в 10% розчині нейтрального формаліну, а потім фарбували гематоксиліном і еозином. Результати. Упродовж усього спостереження посилювалася ексудативно-запальна реакція судин, виникали дистелектаз, ділянки спадання та емфізематозного розширення альвеол, а також розширення та повнокров’я судин. Стінка бронхів потовщувалась переважно за рахунок клітинних інфільтратів, просвіти бронхіол були вільними від ексудату та клітинних елементів. Висновки. Під час гістологічного дослідження тканини легенів тварин із змодельованим гострим поширеним перитонітом у порівнянні з інтактними щурами на 1-шу добу експерименту було виявлено ділянки спадання та емфізематозного розширення альвеол. На 3-тю добу більшість судин мала широкі повнокровні просвіти, відбувався еритродіапедез як у периваскулярні простори, так і в просвіт окремих альвеол. На 7-му добу спостерігали значне розширення вен та кровонаповнення артерій.
The main cause of mortality in acute generalized peritonitis (AGP) is the development of multiple organ insufficiency. The intestine is the organ where the first changes develop in this pathology. The aim of the study – to research and evaluate the morphological changes in the small intestine wall of animals with experimental AGP. Materials and Methods. 32 white rats were used in this study. Acute peritonitis was modeled by introduction of 10 % fecal suspension in the dosage of 0.5 ml per 100 g of the animal's weight into the abdominal cavity of rats by puncture. The terms of observation: the 1st, 3rd and the 7th days from the beginning of the peritonitis modeling. For histological study the intestinal tissue was taken. The resulting pieces of the organ were fixed in a 10 % neutral formalin solution, which were then stained with hematoxylin and eosin. Results and Discussion. On the 3rd day of the experiment in animals with a modeled AGP, vascular changes were manifested first of all by the rounding (retraction) of endothelial cells or their desquamation and the appearance of defects, that allow plasma proteins and the formed elements of blood to leave circulation boundaries of the vascular bed. On the 7 th day in animals with a modeled AGP increased vascular permeability of the mucous membrane of the small intestine was accompanied by a significant edema of the stroma of the villi and by focal hemorrhages. Conclusion. Consequently, the distinct inflammatory changes in all terms of the injury were seen in the wall of the small intestine at the simulated AGP. The significant expansion of the capillaries and venules against the background of inflammatory infiltration in the stroma of the glandular component of the small intestine was noted on the 1st day from the beginning of the experiment. An increase in the height of intestinal villus and a crypt with retraction and desquamation of endothelial cells in the wall of vessels, which caused platelet adhesion in the areas of destruction was observed on the 3rd day. The areas of focal necrosis of the superficial epithelium, which were accompanied by multiple hemorrhages per diapedesis in the perivascular space of the mucous membrane, were seen in the wall of the small intestine of animals with a simulated AGP on the 7th day.
Introduction. The combined course of acute peritonitis and diabetes increasingly leads to the development of secondary immunodeficiencies, which contribute to an increase in the percentage of postoperative complications and fatalities, the emergence of complexity of treatment and diagnosis. The aim of the study – to learn the peculiarities of humoral link of the immune response in the organism of experimental animals during simulated acute common peritonitis on the background of diabetes mellitus compared with animals with experimental acute peritonitis alone. Reserch Methods. 56 white rats were used in this work. Diabetes mellitus was modeled by intraperitoneal administration of Srethosotocin from “Sigma” firm with the rate of 7 mg per 100 g of animal mass, acute peritonitis – insertion of 0.5 ml of 10 % of the captured fecal suspension into the abdominal cavity of the animals. The concentration of immunoglobulins in serum was determined. Observation time points: 1, 3, and 7 days from the beginning of the peritonitis modeling. Results and Discussion. Analyzing the results of studies, it can be stated that there were observed directed changes in the concentration of immunoglobulins in blood serum of rats of different groups. Thus, on the first day after simulating acute common peritonitis on the background of diabetes, the level of Ig G decreased by 1.5 times, Ig M – by 1.3 times and Ig A – by 1.4 times (p<0.05). On the seventh day of the experiment, levels of all classes of immunoglobulins were statistically significantly lower than those of the group with acute common peritonitis: Ig G level was lower by 21 %, Ig M and Ig A were lower by 17 % and 56 % respectively (p<0.05). The results of our studies indicate that the presence of diabetes in acute general peritonitis leads to a decrease in the resistance of the humoral level of the immune system with antigenic stimulation and secondary immunodeficiency states. Conclusion. In animals with acute peritonitis, protective mechanisms of the humoral immunity level are substantially reduced on the background of diabetes, which is confirmed by statistically significantly lower levels of immunoglobulins of classes A, M, G compared to a group of animals with a pattern of acute peritonitis. The revealed functional impairment of humoral immunity indicates an appreciable weakening of the organism's protection factors in acute peritonitis on the background of diabetes mellitus with the development of secondary immunodeficiency.
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