Autogenous fecal peritonitis in Wistar rats with permanent bilateral carotid occlusion: morbidity, mortality and microbiological response

PURPOSE: To investigate morbidity, mortality and microbiological response to fecal peritonitis induced in Wistar rats with permanent bilateral carotid ligation (PBCL). METHODS: Fecal peritonitis was induced in 30 rats, with 10 animals in each group: Group1 - normal young animals; Group2 - normal mature animals; and Group3 - rats with PBCL after four months postoperative follow-up. Peritonitis was induced with 10% stool suspension. Morbidity and mortality were evaluated. The survival animals after seven days were euthanized for tests. For microbiological studies blood were collected from the carotids and right ventricle; and fragments of lung and peritoneum. RESULTS: The morbidity and mortality of young animals were significantly lower than in mature animals with and without PBCL. There was no difference in morbidity and mortality among mature rats with and without PBCL. The diversity of microorganisms producing septicemia was similar to native micro biota of the large bowel. CONCLUSIONS: The immune response was more efficient in young animals, represented by significant less morbidity and no natural mortality. PBLC did not affect morbidity and mortality in mature rats. The immune response to fecal peritonitis has age as an independent predictor.

Lymphocyte subsets and cytokines in ascitic fluid of decompensated cirrhotic patients with and without spontaneous ascites infection

Background: Spontaneous bacterial peritonitis [SBP] is a frequently encountered and important complication of decompensated liver cirrhosis. The immune system plays an important role in the development or eradication of this infection. A number of compositional and functional alterations in immune system cells have been demonstrated in cirrhotic patients: however, there is a lack of knowledge about this issue in ascitic infections

Aim of the study: The aim of the present study was to evaluate lymphocyte subsets and levels of some ascitic and lymphocytic intracytoplasmic cytokines in decompensated cirrhotic patients with or without spontaneous bacterial peritonitis which may help to understand the role of immune system in pathogenesis of SBP and consequently introduction of new therapeutic modalities

Subjects and methods: This case-control study included 50 decompensated cirrhotic patients [37 male. 13 female] from gastroenterology and hepatology unit of internal medicine department; Assiut university hospital with different etiologies. Patients with ascitic polymorphonuclear leukocyte count >/=250/mm[3] and/or positive ascitic bacterial cultures were classified as the 'patients group' [n=25, mean +/- SD of age was 57.84 +/- 6.66 years]. Patients with ascitic poly morphonuclear leukocyte count <250/mm[3] and/or negative ascitic bacterial cultures were classified as the controls group [n=25, mean +/- SD of age was 60.36 +/- 6.51years]. Comparison was made between the patients and controls groups for the following parameters: ascites leukocyte counts and differentiations; ascitic fluid protein; albumin levels and serum-ascites albumin gradients; flow cytometric detection of ascitic lymphocyte subsets [CD3, CD4. CD8, CD4/CD8 ratio. CD19, CD45] and ascitic cytokine TNF-alpha

Results: Ascitic total protein and albumin levels were significantly decreased in patients group. The C4, CD19. CD45 and CD4/CD8 ratio were significantly decreased in the patients group. Furthermore, ascites CD3, CD8 and TNF-alpha levels were significantly elevated in this group. The incidence of renal impairment, gastrointestinal bleeding and hepatic encephalopathy was higher in patients group and there was a significant correlation between TNF-alpha and renal impairment in this group

Conclusion: These results suggest that a cytotoxic, especially Th1, immune response predominates in ascites infections. It also demonstrates that TNF-alpha might he involved in the pathogenesis of ascites infections

Evaluation of peritoneal reinfection after fecal peritonitis / Avaliação da reinfecção peritoneal após peritonite fecal

PURPOSE: To investigate the role of a previous abdominal infection on peritonitis. METHODS: Twenty-seven adult female Wistar rats were submitted to fecal peritonitis by an intraperitoneal injection of a solution of rat feces. The animals were divided into three groups (n = 9 each): Group 1 - control - intraperitoneal injection of an amount of fecal solution known to be lethal (10 ml/kg), Group 2 - reinfection - intraperitoneal injection of an amount of fecal solution known not to be lethal (2 ml/kg) followed by an injection of fecal solution (10 ml/kg) 30 days later, Group 3 - late reinfection - intraperitoneal injection of 2 ml/kg feces followed by an injection of 10 ml/kg four months later. RESULTS: All animals in Group 1 died within seven days after injection of the fecal solution. In contrast, in the pre-infected Group 2 only one animal died 24 hours after injection of the fecal solution (10 ml/kg). In Group 3, eight of the nine animals in each subgroup died over a period of seven days. The difference in survival time between groups 1, 2 and 3 was for p = 0.0042 (logrank test). CONCLUSIONS: Milder peritoneal sepsis due to fecal infection raises the organic resistance to a new more intense fecal contamination occuring after a short period of time. However, this protection did not persist over a prolonged period of time.

OBJETIVO: Investigar o efeito de uma nova infecção peritoneal após realização de peritonite fecal prévia. MÉTODOS: Foram utilizados 27 ratos fêmea Wistar adultos submetidos à peritonite fecal com injeção intraperitoneal de uma solução de fezes de ratos. Os animais foram distribuidos em três grupos (n = 9): Grupo 1 - controle: injeção intraperitoneal de solução de fezes com uma quantidade sabidamente letal (10 ml/kg); Grupo 2 - reinfecção: injeção intraperitoneal de solução de fezes com uma quantidade sabidamente não letal (2 ml/kg) e, após 30 dias, injeção de solução de fezes (10 ml/kg); Grupo 3 - reinfecção tardia: injeção intraperitoneal de fezes a 2ml/kg e, após quatro meses, injeção de 10ml/kg. RESULTADOS: Todos os animais do Grupo 1 morreram dentro de sete dias após a injeção da solução de fezes. Em contraste, no grupo de reinfecção precoce Grupo 2 apenas um animal morreu 24 horas após a injecção da solução de fezes (10 ml / kg). No Grupo 3, oito dos nove animais morreram durante um período de sete dias. A diferença no tempo de sobrevivência entre os grupos 1, 2 e 3 foi de p = 0,0042 (teste de logrank). CONCLUSÕES: Uma sepse peritoneal menor por fezes eleva a resistência orgânica a nova contaminação fecal mais intensa que ocorra após um período curto. Contudo, essa defesa não persiste por tempo mais prolongado.

Changes in adrenal steroidogenesis in spontaneous bacterial peritonitis and sterile ascites

Adrenal androgens, particularly dehydroepiandrosterone [DHEA], may have important regulatory effects on the immune system in humans. This study measured the changes in adrenal steroidogenesis in 13 non-infected cirrhosis patients with sterile ascites and 13 patients with spontaneous bacterial peritonitis and the relation with circulating interleukin-6 [IL-6] levels. Comparisons were made with 10 healthy age-matched control subjects. The severity of bacterial peritonitis in liver cirrhosis was significantly associated with enhanced serum IL-6 and cortisol levels, and a decrease in serum DHEA sulfate in relation to serum IL-6 concentrations. Careful, long-term studies on DHEA administered to cirrhosis patients are needed to assess its safety in improving a number of pathological conditions that complicate liver cirrhosis

Effect of post-natal castration on sepsis mortality in rats

PURPOSE: To investigate the influence of castration in early periods of development on survival to experimental acute sepsis. METHODS: Four groups of 10 (ten) Wistar rats were used. The groups were comprised of males (M), females (F), males castrated on the fourth day of life (CM) and males castrated on the fourth day of life with testosterone replacement (CMR). Sepsis was induced by ligature and cecal perforation in adult life. RESULTS: The analysis of death within 24 hours following sepsis induction showed greater mortality between the M and the CMR groups as compared to the CM and F (p=0.0180) groups. Multiple correspondence analysis (MCA) indicates an association between the M and the CMR groups for death within 24 hours as well as a relationship between the F and the CM groups for the absence of death and death up to 24 hours following sepsis induction. Statistical analysis of the Kaplan-Meier survival curve through log-rank demonstrates a significant difference among the four groups (p=0.0055) and between the M and the F (p=0.0005) groups. CONCLUSION: Data suggest a better survival to sepsis within 24 hours for the F and CM groups, the presence or absence of testosterone in early periods of post-natal life being responsible for these findings.

OBJETIVO: Investigar a influência da castração em períodos precoces do desenvolvimento de ratos, na sobrevida a sepse aguda experimental quando adultos, desenvolveu-se este estudo. MÉTODOS: Utilizou-se quatro grupos de 10 ratos Wistar divididos entre machos (GM), fêmeas (GF), machos castrados no quarto dia de vida GMC) e machos castrados no quarto dia de vida com reposição de testosterona (GMCR). A sepse foi induzida por ligadura e perfuração cecal na vida adulta. RESULTADOS: A análise do óbito até 24 horas da indução da sepse mostrou maior mortalidade entre os GM e GMCR em relação aos grupos GMC e GF (p=0.0180). A análise de correspondência múltipla (ACM) indica uma associação entre si dos GM e GMCR para o óbito em 24 horas, assim como uma relação entre si dos GF e GMC para a ausência de óbito e o óbito até 24 horas. A análise estatística da curva de sobrevida de Kaplan-Meier pelo log-rank demonstra diferença significativa entre os quatro grupos (p=0,0055), e entre GM e GF (p=0,0005). CONCLUSÃO: Os dados sugerem uma maior sobrevida à sepse em 24 horas dos grupos GF e GMC, e a presença ou ausência de testosterona em períodos precoces da vida pós-natal seria responsável por este achado.

Prognostic value of analysis of serum and ascitic fluid levels of intercellular adhesion molecule-1 [ICAM-1] and vascular cell adhesion molecule-1 [VCAM-1] in patients with spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis [SBP] is a life-threatening complication in patients with liver cirrhosis. Renal failure or multiorgan insufficiency is considered to be the main causes of death in patients with SBP. The aim of this work was the evaluation of serum and ascitic fluid levels of intercellular adhesion molecule-1 [ICAM-1] and vascular cell adhesion molecule-1 [VCAM-1] in patients with spontaneous bacterial peritonitis. We prospectively studied 18 cirrhotic patients with SBP, 9 cirrhotic ascitic individuals without any evidence of infection as cirrhotic ascitic controls and 10 healthy controls. Serum and ascitic fluid levels of ICAM-1 and VCAM-1 were measured and compared. Serum levels of ICAM-1, and VCAM-1 were significantly increased in cirrhotic ascitic patients, either infected or non-infected, compared with healthy controls. SBP was associated with significantly elevated serum and ascitic levels of ICAM-1, and VCAM-1 compared with non-infected cirrhotic ascitic patients. There was also, a significant increase in serum and ascitic levels of ICAM-1, and VCAM-1 in patients with SBP who developed renal failure. A prognostic significance can be attributed to increased serum and ascitic levels of ICAM-1 and VCAM-1 in patients with SBP as regard development of renal failure

Modelo de peritonite experimental em camundongos esquistossomóticos / Model of experimental peritonitis in mice with schistosomiasis

Os autores estudaram, em um modelo experimental em camundongos, a formaçäo de um quadro de sepsis por peritonite difusa, após a inoculaçäo na cavidade peritoneal de uma soluçäo de Escherichia coli, acrescida de sulfato de bário e hemoglobina. Foram estudados 2 grupos de camundongos, formados de 20 camundongos normais (Grupo A) e o de 20 camundongos esquistossomóticos (Grupo B). Após 24 horas de evoluçäo realizou-se a necrópsia, identificando-se que no Grupo A 60// dos animais apresentaram peritonite difusa, enquanto que no Grupo B 90// dos casos evoluíram com peritonite. Este resultado foi estatisticamente significante (p < 0,05). Estes achados reforçam pesquisas clínicas que diagnosticaram uma maior susceptibilidade às infecçöes, dos pacientes esquistossomóticos

Immunotherapeutic modification of Escherichia coli peritonitis and bacteremia by Tinospora cordifolia.

We present here the protective effects of an Indian medicinal plant Tinospora cordifolia as compared to gentamicin in E. Coli induced peritonitis. Pretreatment with tinospora cordifolia or gentamicin reduced mortality in mice injected with 1 x 10(8) E. coli intraperitoneally from 100% in controls to 17.8% and 11.1% respectively. This was associated with significantly improved bacterial clearance as well as improved phagocytic and intracellular bactericidal capacities of neutrophils in the Tinospora cordifolia treated group. In the gentamicin treated mice although bacterial clearance was rapid, polymorph phagocytosis was depressed. Tinospora cordifolia did not possess in vitro bactericidal activity. The results demonstrate that a "prohost approach" may be beneficial in the therapy of peritonitis.