The isolated perfused liver response to a 'second hit' of portal endotoxin during severe acute pancreatitis

Studies Related to the Involvement of EsA in Improving Intestinal Inflammation in Acute Pancreatitis via the NF-κB Pathway

Background

Acute pancreatitis (AP) is a clinically frequent acute abdominal condition, which refers to an inflammatory response syndrome of edema, bleeding, and even necrosis caused by abnormal activation of the pancreas's own digestive enzymes. Intestinal damage can occur early in the course of AP and is manifested by impaired intestinal mucosal barrier function, and inflammatory reactions of the intestinal mucosa, among other factors. It can cause translocation of intestinal bacteria and endotoxins, further aggravating the condition of AP. Therefore, actively protecting the intestinal mucosal barrier, controlling the progression of intestinal inflammation, and improving intestinal dynamics in the early stages of AP play an important role in enhancing the prognosis of AP.

Methods

The viability and apoptosis of RAW264.7 cells treated with Esculentoside A (EsA) and/or lipopolysaccharide were detected using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and flow cytometry, respectively. The expression of apoptosis-related proteins and NF-κB signaling pathway-related proteins were detected by western blot (WB). An enzyme-linked immunosorbent assay was used to measure TNF-α and IL-6 secretion.

Results

In vitro experiments demonstrated that EsA not only promoted the apoptosis of inflammatory cells but also reduced the secretion of TNF-α and IL-6 in a dose-dependent manner. Additionally, it inhibited the activation of the NF-κB signaling pathway by decreasing the expression of phosphorylated-p65(p-p65) and elevating the expression of IκBα. Similarly, in vivo experiments using a rat AP model showed that EsA inhibited the expression of p-p65 elevating the expression of IκBα in the intestinal tissues of the rat AP model and promoting the apoptosis of inflammatory cells in the intestinal mucosa in vivo experiments, while improving the pathological outcome of the pancreatic and intestinal tissues.

Conclusion

Our results suggest that EsA can reduce intestinal inflammation in the rat AP model and that EsA may be a candidate for treating intestinal inflammation in AP and further arresting AP progression.

Computational Hypothesis: How Intra-Hepatic Functional Heterogeneity May Influence the Cascading Progression of Free Fatty Acid-Induced Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common type of chronic liver disease in developed nations, affecting around 25% of the population. Elucidating the factors causing NAFLD in individual patients to progress in different rates and to different degrees of severity, is a matter of active medical research. Here, we aim to provide evidence that the intra-hepatic heterogeneity of rheological, metabolic and tissue-regenerating capacities plays a central role in disease progression. We developed a generic mathematical model that constitutes the liver as ensemble of small liver units differing in their capacities to metabolize potentially cytotoxic free fatty acids (FFAs) and to repair FFA-induced cell damage. Transition from simple steatosis to more severe forms of NAFLD is described as self-amplifying process of cascading liver failure, which, to stop, depends essentially on the distribution of functional capacities across the liver. Model simulations provided the following insights: (1) A persistently high plasma level of FFAs is sufficient to drive the liver through different stages of NAFLD; (2) Presence of NAFLD amplifies the deleterious impact of additional tissue-damaging hits; and (3) Coexistence of non-steatotic and highly steatotic regions is indicative for the later occurrence of severe NAFLD stages.

Sham Feeding with Chewing Gum in Early Stage of Acute Pancreatitis: A Randomized Clinical Trial

Background

The correlation between sham feeding and acute pancreatitis (AP) has only been examined in limited studies. We aimed to investigate the efficacy and safety of sham feeding in the early stage of AP.

Material/Methods

A randomized controlled clinical trial was performed. Equal groups of AP patients were recruited. Patients in the sham feeding group received chewing gum 4 times a day after admission. All patients in the trial received standard treatment consistent with the guidelines for AP. The primary outcomes were mortality, length of stay (LOS), and medical expenses. Secondary outcomes were the incidence of complications and other adverse events, return of gastrointestinal function, the details of enteral nutrition and intra-abdominal pressure.

Results

From May 2014 to December 2015, a total of 204 patients were recruited. The LOS and hospital costs in the sham feeding group were reduced, although mortality was equivalent between groups. The return of gastrointestinal function occurred earlier in the sham feeding group, with no complications related to gum chewing.

Conclusions

Sham feeding with chewing gum is safe and efficacious in the early stage of AP.

Effect and Mechanism of Portal Blood Stasis Removal on Intestinal Endotoxemia and Hepatic Ischemia Reperfusion Injury

OBJECTIVE

We used a rabbit model of hepatic ischemia reperfusion in situ to observe the change of portal venous endotoxin level before reperfusion, and the effect of portal blood stasis removal on intestinal endotoxemia and hepatic ischemia reperfusion injury. The purpose was to find an ideal method for portal blood stasis removal and provide the experimental proof for clinical application of hepatectomy.

METHODS AND MATERIALS

To investigate the effect of portal blood stasis removal on intestinal endotoxemia and hepatic ischemia reperfusion injury, a rabbit hepatic ischemia reperfusion injury model was established and treated with removal of portal blood stasis before the portal blood circulation was resumed. Serum endotoxin content, alanine aminotransferase (ALT), hyaluronic acid (HA), and content of malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), superoxide dismutase (SOD) and activation of nuclear factor-κB (NF-κB) in liver tissue were examined respectively.

RESULTS

In portal blood stasis the level of serum endotoxin significantly decreased with each 2.5 mL blood removal (P < .01), subsequently reaching a minima at the 7.5 mL blood removal (P > .05). Removing portal blood stasis ameliorated endotoxemia and hepatic ischemia reperfusion injury as shown by ALT, HA, MDA, SOD, TNF-α, IL-6, and activation of NF-κB compared to no removal. The first 5 mL portal blood stasis contains high volume of endotoxin which may be responsible for hepatic reperfusion injury.

CONCLUSION

Removal of portal blood stasis before the resume of splanchnic circulation may ameliorate intestinal endotoxemia and hepatic ischemia reperfusion injury.

Kynurenine-3-monooxygenase inhibition prevents multiple organ failure in rodent models of acute pancreatitis

Acute pancreatitis (AP) is a common and devastating inflammatory condition of the pancreas that is considered to be a paradigm of sterile inflammation leading to systemic multiple organ dysfunction syndrome (MODS) and death. Acute mortality from AP-MODS exceeds 20% (ref. 3), and the lifespans of those who survive the initial episode are typically shorter than those of the general population. There are no specific therapies available to protect individuals from AP-MODS. Here we show that kynurenine-3-monooxygenase (KMO), a key enzyme of tryptophan metabolism, is central to the pathogenesis of AP-MODS. We created a mouse strain that is deficient for Kmo (encoding KMO) and that has a robust biochemical phenotype that protects against extrapancreatic tissue injury to the lung, kidney and liver in experimental AP-MODS. A medicinal chemistry strategy based on modifications of the kynurenine substrate led to the discovery of the oxazolidinone GSK180 as a potent and specific inhibitor of KMO. The binding mode of the inhibitor in the active site was confirmed by X-ray co-crystallography at 3.2 Å resolution. Treatment with GSK180 resulted in rapid changes in the levels of kynurenine pathway metabolites in vivo, and it afforded therapeutic protection against MODS in a rat model of AP. Our findings establish KMO inhibition as a novel therapeutic strategy in the treatment of AP-MODS, and they open up a new area for drug discovery in critical illness.

Protective effect of curcumin on intestinal mucosal barrier in rats with obstructive jaundice

AIM: To investigate the protective action of curcumin on small intestinal mucosal barrier in rats with obstructive jaundice.

METHODS: Thirty-six male SD rats were randomly divided into a sham operated group (SO), an obstructive jaundice group (OJ) and a curcumin treatment group (Cur). Using a light microscope, small intestinal tissue morphological changes were observed, the intestinal villus height and mucosal thickness were measured, the levels of plasma endotoxin were determined by limulus reagent method, the levels of serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by radioimmunoassay, intestinal diamine oxidase (DAO) activity was determined by spectrophotometric method, and the expression of nuclear factor kappa B (NF-κB) and intercellular adhesion molecule-1 (ICAM-1) was detected by immunohistochemical method.

RESULTS: In the OJ group, intestinal villi were disordered, sparse and showed fracture and edema, and intestinal mucosal atrophy, epithelial cell necrosis and shedding, and inflammatory cell infiltration were observed. Intestinal mucosal changes in the Cur group were significantly reduced compared with the OJ group: intestinal villi were neatly arranged, intestinal mucosa was thickened, villous edema was mild, there was no obvious epithelial cell loss, and inflammatory cell infiltration was reduced. Compared with the SO group, the levels of endotoxin, TNF-α and IL-6 in the OJ group were significantly increased (P < 0.01), and the intestinal DAO activity, intestinal villus height and mucosal thickness were significantly decreased (P < 0.01). Compared with the OJ group, the levels of endotoxin, TNF-α and IL-6 in the Cur group were significantly decreased (P < 0.05 or 0.01), and the intestinal DAO activity, intestinal villus height and mucosal thickness were significantly increased (P < 0.05). Compared with the SO group, the expression of NF-κB and ICAM-1 in the OJ group was significantly up-regulated (P < 0.01); however, the expression of NF-κB and ICAM-1 in the Cur group was significantly down-regulated compared with the OJ group (P < 0.05 or 0.01).

CONCLUSION: Curcumin protects against intestinal mucosal barrier injury in rats with obstructive jaundice possibly by inhibiting expression of NF-κB, TNF-α, IL-6 and ICAM-1.

Relationship between expression of triggering receptor-1 on myeloid cells in intestinal tissue and intestinal barrier dysfunction in severe acute pancreatitis

BACKGROUND

Triggering receptor expressed on myeloid cells-1 (TREM-1) in the intestine was upregulated and correlated with disease activity in inflammatory bowel diseases. Membrane-bound TREM-1 protein is increased in the pancreas, liver and kidneys of patients with severe acute pancreatitis (SAP), suggesting that TREM-1 may act as an important mediator of inflammation and subsequent extra-pancreatic organ injury. This study aimed to investigate the relationship between the expression of TREM-1 in intestinal tissue and intestinal barrier dysfunction in SAP.

METHODS

Sixty-four male Wistar rats were randomly divided into a sham operation group (SO group, n=32) and a SAP group (n=32). A SAP model was established by retrograde injection of 5% sodium deoxycholate into the bile-pancreatic duct. Specimens were taken from blood and intestinal tissue 2, 6, 12, and 48 hours after operation respectively. The levels of D-lactate, diamine oxidase (DAO) and endotoxin in serum were measured using an improved spectro-photometric method. The expression levels of TREM-1, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) mRNA in terminal ileum were detected by real-time reverse transcription-polymerase chain reaction (RT-PCR). Specimens of the distal ileum were taken to determine pathological changes by a validated histology score.

RESULTS

The serum levels of D-lactate, DAO and endotoxin were significantly increased in each subgroup of SAP compared with the SO group (P<0.01, P<0.05). The expression levels of TREM-1, IL-1β and TNF-α mRNA in the terminal ileum in each subgroup of SAP were significantly higher than those in the SO group (P<0.01, P<0.05). The expression level of TREM-1mRNA was positively correlated with IL-1β and TNF-α mRNA (r=0.956, P=0.044; r=0.986, P=0.015), but the correlation was not found between IL-1β mRNA and TNF-α mRNA (P=0.133). Compared to the SO group, the pathological changes were aggravated significantly in the SAP group.

CONCLUSIONS

The expression level of TREM-1 in intestinal tissue of rats with SAP was elevated, leading to the release of inflammatory mediators and intestinal mucosal injury. This finding indicates that TREM-l might play an important role in the development of intestinal barrier dysfunction in rats with SAP.

TREM-1 Promotes Pancreatitis-Associated Intestinal Barrier Dysfunction

Severe acute pancreatitis (SAP) can cause intestinal barrier dysfunction (IBD), which significantly increases the disease severity and risk of mortality. We hypothesized that the innate immunity- and inflammatory-related protein-triggering receptor expressed on myeloid cells-1 (TREM-1) contributes to this complication of SAP. Thus, we investigated the effect of TREM-1 pathway modulation on a rat model of pancreatitis-associated IBD. In this study we sought to clarify the role of TREM-1 in the pathophysiology of intestinal barrier dysfunction in SAP. Specifically, we evaluated levels of serum TREM-1 and membrane-bound TREM-1 in the intestine and pancreas from an animal model of experimentally induced SAP. TREM-1 pathway blockade by LP17 treatment may suppress pancreatitis-associated IBD and ameliorate the damage to the intestinal mucosa barrier.

Morphological and apoptotic changes in the intestinal mucosa and lung parenchyma after ischaemic/reperfusion injury of the jejunum

Ischaemic/reperfusion (IR) injury of the small intestine may lead to the development of multiple organ failure. Little is known about the morphological changes occurring in the organs during the subacute course of this syndrome. The objective of this study was to observe histopathological features and the role of apoptosis in the jejunal mucosa and lung parenchyma after intestinal IR injury in a long-term experiment. Wistar rats (n = 36) were divided into 4 experimental groups (IR(10), IR(20), IR(30), S). Groups IR(10), IR(20) and IR(30) (each n = 10) were subjected to 1-hour ischaemia of the cranial mesenteric artery followed by 10, 20 or 30 days of reperfusion, respectively. The control group S (n = 6) was not subjected to ischaemia. The jejunal mucosa remained intact after all periods of reperfusion. Apoptotic cells were found particularly in the lamina propria, with the most significant difference observed in the IR(30) group (P < 0.01). The lung parenchyma had lower regenerative capacity, which was confirmed by a high index of histological damage after 30 days of reperfusion (P < 0.01) and by the presence of an increased number of apoptotic cells, especially in the pulmonary interstitium. The number of apoptotic cells was ten times higher than in the control group (P < 0.001).

Study of the protective effects of dexamethasone on ileum mucosa injury in rats with severe acute pancreatitis

OBJECTIVES

To study the protecting effects of dexamethasone on ileum mucosa injury of rats with severe acute pancreatitis (SAP).

METHODS

The SAP rats were prepared by improved Aho's methods. The plasma endotoxin and inflammatory mediators in serum were determined. The rat mortality, pathological changes of terminal ileum, nuclear factor kappa B (NF-kappaB), apoptotic indexes, and apoptotic related protein expression were observed.

RESULTS

The plasma endotoxin, inflammatory mediators, and NF-kappaB protein expression as well as pathological scores of the treatment group of ileum mucosa were lower than those of the model group at different time points. P selectin in model group significantly exceeded the dexamethasone treatment group at 3 and 6 hours (P < 0.01, P < 0.05). Caspase-3 protein expression in dexamethasone treatment group significantly exceeded the model group at 3 and 6 hours (P < 0.05), and apoptotic indexes were higher than those of the model group at 6 hours (P < 0.05), but Bax protein has shown no marked difference among groups.

CONCLUSIONS

Dexamethasone can reduce the endotoxin level and inflammatory mediators and down-regulate NF-kappaB protein expression of ileum mucosa, and ileum mucosa epithelial cell apoptosis induction was involved as well. The tissue microarrays technique is of advantage in SAP study.

Differential preservation of lipopolysaccharide-induced chemokine/cytokine expression during experimental pancreatitis-associated organ failure in rats shows a regulatory expressed phenotype

BACKGROUND

Altered lipopolysaccharide (LPS)-responsiveness is a key feature of acute pancreatitis (AP)-associated multiple organ failure (AP-MOF) in rats and humans.

AIM

To determine the differential expression of 16 cytokines and chemokines in response to delayed LPS administration in established experimental AP-MOF in rats.

METHODS

In a cubic factorial group design (12 groups, n = 6 rats/group), 0, 6 and 30 microg/kg Escherichia coli 0111:B4 LPS was administered intra-arterially, 18 h into experimental AP-MOF or sham laparotomy. AP was induced by intraductal glycodeoxycholic acid and intravenous caerulein. Central venous serum concentrations of 16 cytokines and chemokines were measured by Searchlight multiplex ELISA.

RESULTS

Four patterns were observed: (1) TNF-alpha, IL-1alpha, IL-1beta, IL-6, IFN-gamma, MCP-1, MIP-2alpha, MIP-3alpha, fractalkine and RANTES showed a diminished LPS response in AP versus sham (p < 0.001, ANOVA); (2) IL-2, IL-4 and GM-CSF levels were undetectable; (3) CINC-2alpha and GRO/KC showed little or no difference between AP and controls, and (4) IL-10 concentrations after 0 and 6 microg/kg, but not 30 microg/kg LPS injection were significantly higher in AP than controls (p < 0.001, ANOVA).

CONCLUSION

Experimental AP-MOF in rats results in differential preservation of the cytokine and chemokine response to LPS challenge, with a predominantly regulatory expressed phenotype.

Tryptophan catabolites in mesenteric lymph may contribute to pancreatitis-associated organ failure

Background

Multiple organ failure (MOF) is the key determinant of mortality in acute pancreatitis (AP). Mesenteric lymph cytotoxicity contributes to organ failure in experimental models of systemic inflammation. The aim of this study was to evaluate the mesenteric lymph pathway and the lymph injury proteome in experimental AP-associated MOF, and to test the hypothesis that immunoregulatory tryptophan catabolites contribute to mesenteric lymph cytotoxicity.

Methods

Using an experimental model of AP in rats, the humoral component of mesenteric lymph in AP was compared with that from sham-operated control animals, using in vitro and in vivo cytotoxicity assays, high-throughput proteomics and high-performance liquid chromatography. The experimental findings were corroborated in a cohort of 34 patients with AP.

Results

Compared with biologically inactive lymph from sham-operated rats, mesenteric lymph in AP became cytotoxic 3 h after induction. Hierarchical clustering of lymph proteomic mass spectra predicted the biological behaviour of lymph. Levels of the immunoregulatory tryptophan catabolite, 3-hydroxykynurenine, were increased in cytotoxic lymph and re-created cytotoxicity in vitro. In humans with AP, plasma kynurenine concentrations correlated in real time with MOF scores and preceded a requirement for mechanical ventilation and haemodialysis.

Conclusion

These results support the concept that mesenteric lymph-borne kynurenines may contribute to pancreatitis-associated MOF.

Protective effect of propofol on intestinal mucosa in rats with gut ischemia-reperfusion

AIM: To investigate the effect of propofol on intestinal mucosa in rats with gut ischemia-reperfusion (I/R).

METHODS: Ninety-six Wistar rats were randomized into 3 groups: sham operation (SO) group, control group (I/R + saline) and treatment (I/R + propofol) group. Propofol (0.1 mg/kg) was injected into gut immediately after superior mesenteric artery occlusion in the treatment group. The pathological changes in intestinal mucosa were assessed by Chiu's scores. The contents of diamine oxidase (DAO) and tumor necrosis factor-α (TNF-α) in gut tissues were determined. All measurements were done 0, 30, 60, 120 and 240 min after reperfusion.

RESULTS: Pathological changes were observed both in the control group and in the treatment group, but those in the latter were lighter. In comparison with the control group, the TNF-α content was decreased dramatically in the treatment group, and the decrease was the most significant at 60 min (9.52 ± 2.82 vs 12.08 ± 3.64, P < 0.01); the content of DAO in the treatment group was decreased obviously, and a significant decrease also occurred at 60 min (2.34 ± 0.42 vs 0.98 ± 0.49, P < 0.01).

CONCLUSION: Enteral administration of propofol can protect intestinal mucosa against I/R injury in rats.

Expression of Toll-like receptor 2 in distal ileum of rats with acute necrotizing pancreatitis and its significance

AIM: To investigate the expression of Toll-like receptor 2 (TLR2) in distal ileum of rats with acute necrotizing pancreatitis(ANP) and its significance.

METHODS: Sixty SD rats were randomly divided into ANP group (n = 40) and sham-operation group (n = 20). TLR2 mRNA expression in distal ileum of rats was detected by real-time PCR, and its protein expression was determined by immunohistochemistry and Western blot.

RESULTS: The expression levels of TLR2 mRNA and its protein were significantly higher in the ANP group than in the sham-operation group. Western blot showed that the TLR2 mRNA expression level was correlated with the pathological scores (r = 0.42, P < 0.01) and permeability (r = 0.41, P < 0.011) of intestinal mucosa. Immunohistochemistry displayed that the TLR2 protein expression was rather high on ileum mucosa surface, in T and B lymphocytes, histoleucocytes and eosinocytes of lamina propria, arteries and veins of submucosa, longitudinal and circular muscular layers of the ANP group.

CONCLUSION: Expression of TLR2 is increased in the distal ileum of rats with ANP. Its overexpression may correlate with intestinal mucosa injury and development of enterogenic infection.

Mechanism of acute pancreatitis complicated with injury of intestinal mucosa barrier

Acute pancreatitis (AP) is a common acute abdomen in clinic with a rapid onset and dangerous pathogenetic condition. AP can cause an injury of intestinal mucosa barrier, leading to translocation of bacteria or endotoxin through multiple routes, bacterial translocation (BT), gut-origin endotoxaemia, and secondary infection of pancreatic tissue, and then cause systemic inflammatory response syndrome (SIRS) or multiple organ dysfunction syndrome (MODS), which are important factors influencing AP's severity and mortality. Meanwhile, the injury of intestinal mucosa barrier plays a key role in AP's process. Therefore, it is clinically important to study the relationship between the injury of intestinal mucosa barrier and AP. In addition, many factors such as microcirculation disturbance, ischemic reperfusion injury, excessive release of inflammatory mediators and apoptosis may also play important roles in the damage of intestinal mucosa barrier. In this review, we summarize studies on mechanisms of AP.

Effects of propofol on apoptosis of intestinal epithelial cells in rats with gut ischemia-reperfusion injury

AIM: To investigate the effects of propofol on apoptosis of intestinal epithelial cells in rats with gut ischemia-reperfusion (I/R) injury.

METHODS: Ninety-six Wistar rats were randomly divided into three groups: sham operation, control (I/R + saline) and propofol (I/R + propofol) groups. Propofol (0.1 mg/kg) was injected into the guts of rats in the I/R + propofol group immediately after the superiormesentericartery (SMA) was clipped. The rate of apoptosis of intestinal epithelial cells was determined using the TdT-mediated d-UTP-biotin nick end-labeling (TUNEL) method. The expression of Caspase-3 and bcl-2 proteins in intestinal epithelial cells was examined by immunohistochemistry. Pathological changes in gut epithelial cells were assessed by Chiu's scores. Measurements were taken at 0, 30, 60, 120 and 240 min after reperfusion.

RESULTS: The rate of apoptosis of intestinal epithelial cells (P < 0.01) and the levels of Caspase-3 protein were significantly lower in the I/R + propofol group than that in the control group at 0, 30, 60, 120 and 240 min after reperfusion (104.4 ± 5.3 vs 146.4 ± 7.6; 97.4 ± 6.2 vs 130.4 ± 7.4; 134.4 ± 5.1 vs 170.4 ± 8.1; 125.4 ± 6.2 vs 160.4 ± 9.5; and 101 ± 5.8 vs 120.4 ± 8.2, respectively, all P < 0.01), whereas the levels of bcl-2 protein increased dramatically (13.34 ± 4.12 vs 6.72 ± 2.59; 14.96 ± 4.85 vs 8.24 ± 3.13; 15.29 ± 5.28 vs 9.63 ± 2.89; 10.39 ± 3.61 vs 9.63 ± 2.89; 10.39 ± 3.61 vs 5.96 ± 1.93; 11.08 ± 4.83 vs 6.87 ± 2.43, respectively, all P < 0.01). Pathological injures were seen to have been alleviated.

CONCLUSION: Enteral administration of propofol reduces apoptosis of intestinal epithelial cells in rats with gut ischemia-reperfusion injury.

Protective effects of carbachol on intestinal epithelial cells against oxidative injury

AIM: To study the effects of carbachol on the H₂O₂-oxidative injury of intestinal epithelial cells (IEC).

METHODS: IEC were cultured with the presence of H₂O₂in vitro to induce the oxidative injury. IEC were divided into 3 groups: control group, H₂O₂ (2.5 mmol/L) group and carbachol (100 μmol/L) group. The viability of IEC was measured by MTT assay. The level of lactate dehydrogenase (LDH) in culture media and the malondialdehyde (MDA) content in IEC were measured.

RESULTS: In compared with those in control group, LDH level (7.40 ± 2.10 vs 0.81 ± 0.12, P < 0.01) and MDA content in H₂O₂ group were significantly elevated, and the viability of IEC was obviously decreased (37.25% ± 0.80% vs 100% ± 0.13%, P < 0.01). However, in carbachol group, LDH level (4.64 ± 1.31 vs 7.40 ± 2.10, P < 0.01) and MDA content were lower while IEC viability was obviously higher than those in H₂O₂ group (78.70% ± 2.80% vs 37.25% ± 0.80%, P < 0.01).

CONCLUSION: Carbachol can protect rat IEC from the oxidative injury.

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