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Cited by 26Trauma, Hemostasis, Coagulopathy, ResuscitationAbdominal vascular conditions and treatmentsSepsis Diagnosis and Treatment

The anatomic sites of disruption of the mucus layer directly correlate with areas of trauma/hemorrhagic shock-induced gut injury

Lu, Qi, Xu, Da-Zhong, Sharpe, Susan, Doucet, Danielle, Pisarenko, Vadim, Lee, Marlon, Deitch, Edwin A.·2011·Journal of Trauma: Injury, Infection & Critical Care
DOI 10.1097/ta.0b013e3181e1221b
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Abstract

BACKGROUND: The intestinal mucus layer is an important but understudied component of the intestinal barrier. Consequently, we tested the hypothesis that the anatomic sites of loss of the mucus layer would directly correlate with sites of intestinal villous injury after trauma-hemorrhagic shock (T/HS) and may, therefore, serve as loci of gut barrier failure. Consequently, to investigate this hypothesis, we used Carnoy's fixative solution to prepare fixed tissue blocks where both the gut morphology and the mucus layer could be assessed on the same tissues slides. METHODS: Male Sprague-Dawley rats were subjected to a laparotomy (trauma) and 90 minutes of sham shock (T/SS) or 35 mm Hg × 90 minutes of actual shock (T/HS). Three hours after resuscitation, the rats were killed, and samples of the terminal ileum were processed by fixation in Carnoy's solution. Gut injury was evaluated by determining the percentage of villi injured. The status of the intestinal mucus layer was quantified by determining the percentage of the villi covered by the mucus and the mucus thickness. RESULTS: Histologic analysis of gut injury showed that the incidence of gut injury was ∼10-fold higher in the T/HS than the T/SS rats (T/SS=2.5% ± 0.5% vs. T/HS=22.4% ± 0.5% of injured villi; p<0.01). The T/SS rats had 98% of their ileal mucosa covered with a mucus layer, and this was decreased after T/HS to 63% ± 3% (T/HS vs. T/SS; p<0.001). Furthermore, loss of the mucus layer was found to directly correlate with villous injury with a regression coefficient of r=0.94 (p<0.001). CONCLUSION: This study shows that T/HS significantly reduces the intestinal mucus layer and causes villous injury and that a correlation exists between specific anatomic sites of T/HS-induced loss of the mucus layer and gut injury.

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  • In critical illness, bile salt production drops, IgA production is impaired, and the dense mucosal barrier of secreted antimicrobial peptides is lost.

    “bile salt production drops,17 IgA production is impaired,31 and the dense mucosal barrier of secreted antimicrobial peptides is lost.”

    From The microbiome and critical illness (2016) · cites this paper as [25]

  • In many critically ill patients, the dense intestinal mucus layer is thinned, disrupted, or absent.

    “in many critically ill patients, the dense intestinal mucus layer is thinned, disrupted, or absent.”

    From The microbiome and critical illness (2016) · cites this paper as [25]

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Authors
Lu, Q., Xu, D.-Z., Sharpe, S., Doucet, D., Pisarenko, V., Lee, M., & Deitch, E. A.
Affiliations
Rutgers New Jersey Medical School (US)
ORCID
Venue
Journal of Trauma: Injury, Infection & Critical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-03
Volume
70
Issue
3
Pages
630-635
ISSN
0022-5282 (ISSN-L)
DOI
10.1097/ta.0b013e3181e1221b
OpenAlex
W2084533450
Cited by
26
References
25
Citations by year
2026: 1 · 2024: 2 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 3 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 1
FWCI
1.24
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Public Health Service (T32 069330)
  • National Institute of General Medical Sciences (GM 059841-09, R01GM059841)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
intestinal mucus layer, trauma-hemorrhagic shock, terminal ileum, mucus thickness
MeSH terms
Analysis of Variance, Animals, Ileum, Immunoenzyme Techniques, Intestinal Mucosa, Laparotomy, Male, Mucus, Shock, Hemorrhagic, Shock, Traumatic, Linear Models, Rats, Sprague-Dawley, Rats

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