Investigating the protective effect of direct peritoneal resuscitation on intestinal barrier function in rat models of sepsis.

Abstract

Background: In sepsis, hypercytokinemia increases intestinal permeability, leading to bacterial translocation, which further exacerbates systemic inflammation and multiple organ dysfunction. This study investigates the impact of direct peritoneal resuscitation as an adjunctive treatment on intestinal barrier integrity in rat models of sepsis induced by severe intra-abdominal infection.

Methods: A cecal ligation and puncture procedure was performed on Sprague-Dawley rats to establish a sepsis model, with random allocation to the following resuscitation groups (n = 8): Sham, SP (sepsis), CR (conventional intravenous resuscitation), PLS (peritoneal lavage with normal saline), Lac-PDS (peritoneal lavage with 2.5% Glu-Lac-PDS), and Pyr-PDS (peritoneal lavage with 2.5% Glu-Pyr-PDS). The laboratory results, serum inflammatory cytokines, hematoxylin and eosin staining, transmission electron microscopy, intestinal tight junction protein and mucins expression levels, and serum D-lactate levels of rats in each group were observed. p <0.05 was regarded as statistically significant.

Results: After direct peritoneal resuscitation treatment, white blood cell and interleukin-10 were significantly increased; lactate, tumor necrosis factor α, and interleukin-6 were significantly decreased; liver and kidney functions were significantly improved; and intestinal pathological damage and subcellular changes were significantly reduced. The expressions of tight junction proteins and mucins were increased, and serum D-lactate was significantly reduced. The efficacy of the Pyr-PDS group was better than other treatment groups.

Conclusion: Direct peritoneal resuscitation adjunctive therapy improved overall condition and barrier function of intestine in rat models of sepsis induced by severe intra-abdominal infection. Pyr-PDS demonstrated greater efficacy than Lac-PDS in reducing inflammation and protecting intestinal barrier function.