小鼠溃疡性结肠炎模型的建立及病理组织学比较

目的建立乙酸,右旋葡聚糖硫酸钠（dextran sodium sulfate,DSS）,幽门螺杆菌（Helicobacter pyliri）小鼠溃疡性结肠炎（ulcerative colitis）动物模型,通过病理学对比观察,选择最佳的小鼠溃疡性结肠炎动物模型。方法将40只清洁级BALB/c小鼠随机分为4组,实验组中Ⅰ组采用乙酸刺激法诱发溃疡性结肠炎,Ⅱ组采用饮用3.5%DSS溶液诱发结肠炎,Ⅲ组采用幽门螺杆菌感染小鼠诱发溃疡性结肠炎,对照组饮用蒸馏水。观察小鼠每日的体重,大便性状和隐血情况,以及结肠大体形态和组织病理学改变。结果乙酸,右旋葡聚糖硫酸钠均可引起小鼠疡性结肠炎。结论 DSS诱发的小鼠溃疡性结肠炎是一种较理想的UC动物模型,可作为研究UC发病机制和药物治疗较理想的工具。     

携带IL-10基因的双歧杆菌对溃疡性结肠炎小鼠肠道屏障功能的影响

目的 观察表达IL-10基因的双歧杆菌对溃疡性结肠炎（UC）小鼠肠道屏障功能的影响,进一步探讨转基因双歧杆菌治疗UC的相关机制。方法 25只小鼠分为空白对照组、结肠炎组（UC-blank组）、双歧杆菌治疗组（UC-bacteria组）、空质粒双歧杆菌治疗组（UC-pBBAD/X-bacteria组）和表达IL-10基因双歧杆菌治疗组（UC-BL-hIL-10-bacteria组）,每组5只。采用5% DSS诱导建立UC小鼠模型,利用前期研究已成功筛选出的可稳定表达hIL-10蛋白的BL-hIL-10菌株对小鼠进行治疗。采用HE染色评估小鼠结肠炎症情况;采用荧光定量PCR检测小鼠结肠组织Claudin1、2、4、5、7和8的表达水平;计算小鼠DAI。结果 （1）BL-hIL-10菌株可以降低UC小鼠DAI,减轻UC小鼠结肠组织炎症程度。（2）BL-hIL-10菌株能下调UC小鼠结肠组织Claudin2表达水平,同时能够上调Claudin1、4、5、7和8的表达水平。（3）UC-BL-hIL-10-bacteria组UC小鼠的治疗效果明显优于UC-bacteria组和UC-pBBAD/X-bacteria组。结论 BL-hIL-10菌株能改善UC小鼠结肠黏膜的通透性,其机制可能与其能上调Claudin1、4、5、7和8的表达水平,同时降低Claudin-2的表达水平有关。     

Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis.

A diagnosis of idiopathic ulcerative colitis was made in a previously healthy 9-year-old boy. Symptoms persisted despite therapy with sulfasalazine, 50 mg/kg daily, but they eventually responded to treatment with parenteral nutrition and prednisone, 40 mg daily. Metronidazole was also given to eradicate persistent Dientamoeba fragilis from the stools. The symptoms resolved over 3 weeks, and the daily dose of prednisone was tapered. On two subsequent occasions a challenge with sulfasalazine caused an immediate recurrence of loose, blood-streaked stools and of nonspecific histologic features of ulcerative colitis, which resolved when the sulfasalazine was discontinued.     

低聚果糖对溃疡性结肠炎模型小鼠肠黏膜屏障影响的研究

目的 探讨低聚果糖对溃疡性结肠炎（UC）模型小鼠肠黏膜屏障的调节作用及可能机制。方法 小鼠随机分成3组：正常对照（NC）组、模型（MD）组和低聚果糖（FOS）组,采用葡聚糖硫酸钠制作UC小鼠模型。造模7 d同时给予干预治疗,停用造模药物并后续治疗7 d。采用细菌定量测定法检测肠道菌群,放射免疫法检测肠黏膜sIgA,ELISA法检测小鼠肠黏膜IL-10、TNF-α和IL-6水平。结果 模型组小鼠存在肠道菌群失调（t=2.088,2.036,2.203,2.109,P<0.05）,其TNF-α、IL-6水平高于正常对照组（t=1.734,1.801,P<0.05）,肠黏膜sIgA、IL-10低于正常对照组（t=1.820,1.806,P<0.05）;低聚果糖组肠道菌群失调状况较模型组有所改善,其TNF-α、IL-6水平低于正常对照组（t=1.980,1.816,1.936,1.920,1.969,1.893,P<0.05）,肠黏膜sIgA、IL-10高于正常对照组（t=1.801,1.796,P<0.05）。结论 低聚果糖可改善溃疡性结肠炎模型小鼠肠道菌群屏障功能,可以提高肠黏膜sIgA和抗炎细胞因子IL-10的水平并降低致炎细胞因子TNF-α和IL-6的水平,通过调节肠道过度的免疫反应,使免疫屏障功能得到一定恢复。     

Smoking and ulcerative colitis.

In a case-control study of smoking and ulcerative colitis patients with the disease were much less likely to smoke than community controls matched for age and sex. The difference was substantial, with an estimated relative risk of 3.8 for non-smoking on current habits, was even larger (6.2) when habits at onset of the disease were examined, and was mainly accounted for by 42 of 55 patients who had given up smoking a mean of eight years before onset. The association could not be explained by confounding by social class. These findings suggest that smoking directly or indirectly confers protection against ulcerative colitis.     

Mast cells in ulcerative colitis

The changes in the number and ultrastruture of mast cells were studied in 37 colonoscopical biopsies from patients with ulcerative colitis. Changes in the active stage of the disease and during remission were compared. Cell counts were performed on semithin sections stained with Giemsa after osmium tetroxide fixation. This method overcome the uncertain staining found after formalin fixation. Accumulation of mast cells accompanied by intense degranulation was found to be significant in the active stage of the disease. Two forms of degranulation were observed: discharge of the individual granules and protrusion and detachment of the cytoplasmic processes containing granules. The latter was a sign of rapid degranulation, as described earlier in animal experiments. Mast cells were closely associated with capillary blood vessels, Schwann cells, neural fibres, myofibroblasts and collagenous fibres, and were also present between epithelial cells. It is assumed that close topographic contact may also imply a functional correlation.     

Intestinal bacteria and ulcerative colitis

Convincing evidence from both animal models and the study of patients with ulcerative colitis (UC) implicates the intestinal microflora in the initiation and maintenance of the inflammatory processes in this condition. Despite this, no specific pathogen has been identified as causal and the disease is widely believed to occur as the result of a genetically determined, but abnormal immune response to commensal bacteria. When compared with healthy people, UC patients have increased levels of mucosal IgG directed against the normal microflora. Studies of mucosal bacterial populations in UC indicate that there may be increased numbers of organisms, but reduced counts of "protective" bacteria such as lactobacilli and bifidobacteria. In animal models of colitis, antibiotics, particularly metronidazole, clindamycin, ciprofloxacin and the combination of vancomycin/impinemem protect against UC, especially if given before the onset of inflammation. These antibiotics target anaerobes and some Gram-positive organisms such as enterococci. However, antibiotic use in more than a dozen randomised control trials has been very disappointing, probably because we do not know which species to target, when to give the antibiotics, for how long and in what combinations. Surprisingly, therefore, there is a consistent benefit in the small number of studies reported of probiotics to manage UC and pouchitis. There is scope for more work in this area focussing on the mucosal microflora, its interactions with the gut immune system, its metabolic properties and the potential ways of modifying it.     

Distinguishing ulcerative colitis from autoimmunity

Lymphoid hyperplasia, autoimmunity, and compromised intestinal intraepithelial lymphocyte development in colitis-free gnotobiotic IL-2-deficient miceContractor, N.V. et al. (1998)J. Immunol. 160, 385–394