Intra-abdominal sepsis: an immunocytochemical study of the small intestine mucosa.

Abstract

Studies on this immunological component in critically ill patients are limited by ethical and therapeutic constraints; however, suitable tissues may be obtained from patients whose condition necessitates surgical removal of part of the small bowel. A series of such specimens was retrieved for the present study. Tissues from near the excision margins considered viable by the surgeons and judged to be relatively remote from the primary intraabdominal damage by the pathologists-were selected for immunohistochemical studies. Methods PATIENTS AND TISSUESBlocks from the small intestines of 17 patients were taken from the files of the Department of Pathology, Aberdeen Royal Infirmary, Scotland (12 patients: six males, aged 54-78; six females, aged 34-79), and the Department of Surgery, Universidade Federal de Pernambuco, Recife, Brazil (five patients: one male, aged 39; four females, aged 57-79). All of the Aberdeen cases had presented with an acute abdomen; 11 had infarction of the small bowel attributed to a variety of thrombotic or mechanical causes. The Recife cases met the same criteria for selection. One Aberdeen case had a perforated ulcer. Controls were normal small intestine from two transplant donors. Tissues had been fixed in 10% neutral buffered formalin and processed to paraffin wax. Sections of 4 ztm were cut onto 3-aminopropyltriethoxysilane-subbed slides and dried at 60°C for 30 minutes. IMMUNOHISTOLOGYSections were first dewaxed in xylene and endogenous peroxidase blocked using 1.5% hydrogen peroxide in methanol. Optimal unmasking of antigens other than IgM was obtained by placing sections in 10 mM citrate buffer, pH 6.0, in an 800 W microwave oven operated on full power for 20 minutes, maintaining the level of buffer at 600 ml. Sections were left in hot buffer on the bench for a further 20 minutes prior to transferring to Tris buffered saline (TBS). IgM was exposed by digestion in 0.1% trypsin in 0.1% calcium chloride at 37°C, pH 7.8, for 30 minutes, followed by five-minute washes in running water (once) and TBS (twice).Murine monoclonal antibodies against IgM

Beneficial role of endogenous immunoglobulin subclasses and isotypes in septic shock

“…Consequently, low levels of this immunoglobulin could preclude bacterial clearance. Coutinho et al [15] reported noticeable reductions in numbers of IgA and IgM plasma cells in intestinal tissues from patients with intra-abdominal sepsis. The association between immunoglobulins levels with survival was not dependent on hemodilution, as supported in the multivariate analysis.…”

Human Serum from Patients with Septic Shock Activates Transcription Factors STAT1, IRF1, and NF-κB and Induces Apoptosis in Human Cardiac Myocytes

“…Lightfoot et al (71) have recently shown that major burn trauma to rats is associated with an almost 100-fold increase in cardiac myocyte apoptosis. Human studies of septic shock have suggested increased apoptosis primarily in cells of the immune system, although the phenomenon has also been noted in intestinal epithelial cells (73)(74)(75).…”

Effects of restraint stress on NALT structure and nasal IgA levels

“…One report showed that restraint stress does not reduce the number of IgA-producing cells in intestinal lamina propria of mice [12]. The other studies comparing the number of IgA + cells in intestinal and respiratory mucosa used stress protocols related to exercise or sickness, and are therefore difficult to compare to the current contribution [64,65].…”