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Department of Surgery, University of Cincinnati, and the Shriners Hospital for Children, Cincinnati, Ohio 45267-0558
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ABSTRACT |
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We examined the effect of endotoxemia in mice on protein and mRNA levels for the acute phase proteins complement C3 and serum amyloid A (SAA) in jejunal mucosa. Endotoxemia was induced in mice by the subcutaneous injection of 250 µg lipopolysaccharide per mouse. Control mice were injected with saline. C3 and SAA were measured by ELISA. Messenger RNA levels were determined by Northern blot analysis or competitive PCR. Immunohistochemistry was performed to determine in which cell type(s) C3 and SAA were present. Mucosal C3 and SAA protein and mRNA levels were increased in endotoxemic mice. Immunohistochemistry showed that C3 was present in both enterocytes and cells of the lamina propria, whereas SAA was seen mainly in lamina propria cells. Results suggest that endotoxemia stimulates production of C3 and SAA in small intestinal mucosa. The response may be regulated at the transcriptional level and probably reflects increased synthesis of the acute phase proteins in both enterocytes and cells of the lamina propria.
gut; enterocyte
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INTRODUCTION |
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IN PREVIOUS STUDIES from our laboratory (16, 30, 31), protein synthesis was increased in intestinal mucosa during sepsis and endotoxemia. Part of this response reflected increased cell turnover caused by loss of cells from the tips of the villi and stimulated enterocyte proliferation (28). In addition, the accelerated mucosal protein synthesis reflected increased biosynthesis in the individual enterocyte, as demonstrated by high protein synthesis rates in isolated enterocytes from septic rats (14).
The intestinal mucosa is the production site of a number of biologically important peptides and proteins, e.g., gut hormones. In recent studies, we found that the production by the enterocyte of the gut hormones vasoactive intestinal peptide and peptide YY was increased during sepsis (15, 33). Another group of proteins that participates significantly in the metabolic response to endotoxemia and sepsis is the acute phase proteins. Although the majority of the acute phase proteins are typically produced in the liver, there is recent evidence that some of the acute phase proteins may be synthesized at extrahepatic sites as well, including the intestinal mucosa. For example, inflammatory bowel disease has been shown to be associated with enhanced intestinal production of complements (1). Other studies have provided evidence that the enterocyte expresses several of the acute phase proteins (23).
The influence of sepsis and endotoxemia on mucosal acute phase proteins is not known. In the present study, we tested the hypothesis that endotoxemia in mice stimulates mucosal production of the acute phase proteins complement C3 and serum amyloid A (SAA). Complement C3 is an important acute phase protein involved in the local defense against invading bacteria (8), and its expression in the enterocyte was demonstrated recently (2, 3). SAA is one of the most abundant acute phase proteins in mice, being increased up to 1,000-fold in serum after stimulus (29). The role of SAA in the acute phase response is not fully understood, but there is evidence that it may play a role in enhancing the clearance of high-density lipoproteins (HDLs) (17). In a recent study, the expression of SAA mRNA was upregulated in intestine of endotoxemic mice but mucosal SAA protein levels were not measured in that report (6).
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MATERIALS AND METHODS |
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Animals and experimental design.
Male A/J mice (20-27 g) were purchased from Jackson Laboratory
(Bar Harbor, ME) and housed at a temperature of 22°C in a room with
a 12:12-h light-dark cycle for 1 wk before experiments. Endotoxemia was
induced by the subcutaneous injection of 250 µg/mouse of
lipopolysaccharide (Escherichia
coli 0111:B4; Calbiochem, LaJolla,
CA). Control mice were injected with corresponding volumes of sterile
saline. Food was withheld, but drinking water was provided after the
injection of endotoxin or saline. The dose of endotoxin used here was
based on a recent report in which we found that the subcutaneous
injection of the same amount of endotoxin in mice gave rise to a
maximal increase in total mucosal protein synthesis in the jejunum
(31). The endotoxin was injected subcutaneously rather than
intraperitoneally to avoid the influence of local metabolic changes
when intestinal mucosa was studied. Groups of mice were studied at
intervals up to 24 h after injection of endotoxin or saline. With mice
under pentobarbital sodium anesthesia (40 mg/kg ip), blood was
collected by heart puncture in heparinized tubes for determination of
plasma concentrations of C3 and SAA. We harvested the mucosa from a
10-cm segment of the jejunum by opening the intestine along the
antimesenteric border and by scraping the luminal side with a
microscope slide. The mucosa was immediately frozen in liquid nitrogen
and stored at
70°C until used for determination of mRNA
levels and concentrations of complement C3 and SAA. The left liver lobe
was excised, frozen in liquid nitrogen, and stored at
70°C
until analysis. In a separate series of experiments, the superior
mesenteric artery was catheterized and slowly perfused with 0.5-1
ml of saline before harvesting of the intestinal mucosa to minimize the
contribution of acute phase proteins from the blood to the acute phase
proteins that were measured in the tissue. The intestinal wall was
noted to blanch before mucosa was harvested. All experiments were
performed, and the animals were cared for according to the National
Research Council's "Guide for the Care and Use of Laboratory
Animals." The experimental protocol was approved by the University
of Cincinnati Institutional Animal Care and Use Committee.
Measurement of complement C3 and SAA. Plasma and tissue levels of complement C3 and SAA were measured by ELISA. For determination of complement C3 and SAA in mucosa and liver, tissue was ultrasonicated two times for 10 s in 1 ml of PBS containing 2 µg/ml each of the protease inhibitors leupeptin, aprotinin, pepstatin A, and antipain (Sigma, St. Louis, MO) and 2 mM phenylmethylsulfonyl fluoride (Sigma) and then centrifuged at 12,000 g at 4°C for 45 min. The supernatants were used for determination of complement C3 and SAA. Complement C3 was determined as described previously (13) using a goat anti-mouse C3 antibody (IgG fraction 55463; Cappel Research Products, Durham, NC). SAA was measured with a commercially available ELISA kit using a rat anti-human SAA antibody (Biosource International, Camarillo, CA). This antibody has a 100% cross-reactivity to mouse SAA according to the manufacturer. The lower limits of detection were 10 ng/ml for complement C3 and 0.23 µg/ml for SAA. One concern when measurements of C3 levels are performed is the specificity of the anti-C3 antibody, i.e., whether the antibody recognizes the cleavage products of C3 as well. In a control experiment using purified mouse C3 and purified human C3, C3a, C3b, and C3bi (purified mouse C3a, C3b, and C3bi are not commercially available), we found evidence that the anti-mouse C3 antibody used here recognizes C3, C3b, and C3bi but not C3a. Thus the results obtained with this antibody may reflect the presence both of C3 and of some of its cleavage products.
mRNA for complement C3 and SAA. Northern blot analysis and competitive PCR were used to determine the expression of mucosal and hepatic C3 and SAA mRNA. Mucosal samples were harvested as described in Measurement of complement C3 and SAA, and samples from two or three mice were pooled for each time point. Total RNA was extracted by the guanidinium thiocyanate-phenol-chloroform method (5) using a Stat-60 kit (Tel-Test B, Friendswood, TX).
For Northern blot analysis, RNA was denatured and separated by electrophoresis on a 1% agarose gel containing formaldehyde. The RNA was transferred from the gel to nylon membranes (Micron Separations, Westboro, MA) by capillary action in 2× saline sodium citrate (SSC) (1× SSC = 0.15 M NaCl and 15 mM sodium citrate) overnight. RNA was immobilized either by baking at 80°C for 2 h or by ultraviolet cross-linking. The blots were hybridized at 42°C for 4 h in 50% formaldehyde and 6× sodium chloride-sodium phosphate-EDTA (SSPE) (1× SSPE = 0.15 M NaCl, 10 mM NaH2PO4 and 1 M EDTA), 5× Denhardt's solution, 0.5% SDS, and 100 µg/ml salmon sperm DNA. cDNA probes for C3 and SAA were labeled by random priming with [32P]dATP or [32P]dCTP (Stratagene, LaJolla, CA). The blots were hybridized with the 32P-labeled cDNA probes at 42°C overnight. The blots were then washed two times in 1× SSC and 0.1% SDS and one time in 0.1× SSC and 0.1% SDS at room temperature and autoradiographed at
70°C. The blots were
stripped and rehybridized with an 18S oligonucleotide probe to control
for equal loading of RNA.
Competitive PCR was performed as described in detail previously (26).
In short, total RNA was extracted from mucosa as described in
mRNA
for
complement
C3
and
SAA. Dissolved total RNA samples were
reverse transcribed to cDNA using a Moloney murine leukemia virus
reverse transcriptase (M-MLV RT) (Promega, Madison, WI). Briefly, 5 µl of total RNA samples were added to 1 µM 3'-primer in 50 mM
Tris · HCl (pH 7.3) and heated to 90°C followed
by cooling to 37°C over 15 min. Reaction buffer, 75 mM KCl, 3 mM
MgCl2, 20 mM dithiothreitol, 50 U
RNasin, 35 U DNase, 250 µM dNTP, and 250 U M-MLV RT were then added,
and the samples were incubated at 37°C for 40 min, followed by
freezing at
70°C for at least 15 min to inactivate the
enzyme. The resulting cDNA samples were stored at
70°C until
used. Aliquots of the cDNA samples were then added to a cocktail
containing PCR buffer, gelatin, KCl, MgCl2, dNTP, C3 primers, and
Taq polymerase (Promega). A sequence of 385 nt in mouse complement C3 mRNA
(exons
4-7)
(7) was used to construct the C3 primers: 5'-sense 5'-CAC
CGC CAA GAA TGC CTA C-3' (nt 2684-2703) and
3'-antisense 5'-GAT CAG GTG TTT CAG CCG C-3' (nt
3049-3068). PCR was performed using a Perkin-Elmer DNA thermocycler by heating the samples to 95°C for 2 min, followed by
25 cycles of 95°C for 1 min, 62°C for 1 min, and 72°C for 2 min. The samples were kept at 60°C for 7 min and cooled to 4°C. Ten microliters of the PCR products were then separated by
electrophoresis at 100 V in a 1.5% agarose gel stained with ethidium
bromide. To quantify mRNA expression, a PCR MIMIC construction kit
(Clontech, Palo Alto, CA) was used to construct nonhomologous DNA
fragments using the mouse C3 gene-specific primers and composite
primers. An initial PCR amplification using the composite primers was
performed on the neutral DNA fragment that incorporated the C3
gene-specific primer sequence onto the neutral DNA. The yield of this
PCR MIMIC was calculated as the ratio between the optical densities at
260 and 280 nm and diluted to 100 attomol/µl. Competitive PCR was then performed by adding 2 µl of the cDNA samples to 2 µl of
different 10-fold dilutions of PCR MIMIC
(100-10
6 attomol), PCR
buffer, MgCl2, nucleotide
triphosphates (Gibco-BRL, Grand Island, NY), 5'- and 3'-C3
gene-specific primers, and Taq polymerase (Promega). The mixture was heated to 94°C for 45 s, to
50°C for 45 s, and to 72°C for 90 s. The samples were kept at
72°C for 7 min and cooled to 4°C. Five microliters of the PCR produces were separated by electrophoresis at 100 V in a 1.5% agarose
gel stained with ethidium bromide. Comparison between PCR MIMIC bands
(known concentrations) and C3 bands was made to determine the
concentration of C3 mRNA present using a video image system (BioMax ID
Image Analytic System; Eastman Kodak, Rochester, NY).
Immunohistochemistry.
Immunohistochemistry was performed to determine in which cell type(s)
of the mucosa complement C3 and SAA were present. With mice under
pentobarbital anesthesia, the lumen of the jejunum was flushed with
saline and a 0.5-cm segment was excised from the midportion of the
jejunum. The intestinal segment was immersed in OCT
embedding medium (Miles, Elkhart, IN) and then placed on a metal board
frozen in liquid nitrogen. The samples were stored at
70°C
until analysis.
20°C for 10 min. The sections were then blocked with 0.01%
avidin (no. A-9275, Sigma) and 0.1%
D-biotin (no. B-4501) for 15 min
each and further blocked with 5% BSA for 30 min at room temperature.
The primary antibodies, which were the same as used for the ELISA
assays described but diluted 1:100, were added to the sections, which
were then incubated for 2 h at 37°C. Biotin conjugated rabbit
anti-goat IgG (no. 39559, Cappel Research Products) and fluorescence
conjugated streptavidin (no. 1055097; Boehringer, Mannheim, Germany)
were diluted 1:2,000 and used consecutively for further detection of
C3. Goat anti-rat IgG conjugated with biotin (no. 55790, Cappel
Research Products) was used as secondary antibody for detection of SAA.
During staining, Tris-buffered saline (0.05 M, pH 7.6) was
used as the buffering system throughout and each step was followed by
washes. Negative controls were performed by omitting the primary
antibody. The sections were examined with a Nikon microphot-FXA (Nikon,
Melville, NY) equipped with an epifluorescence illumination system, and
photographs were observed on Ektachrome 400 ASA professional daylight
film. Note that when the anti-mouse C3 antibody was used,
immunohistochemistry may reflect the presence of C3 as well as its
cleavage products C3b and C3bi, as described in
Measurement
of
complement
C3
and
SAA.
Statistical analysis. Results are expressed as means ± SE. The Mann-Whitney rank sum was used for statistical analysis.
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RESULTS |
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Complement C3 levels in jejunal mucosa were increased by 50 and 86% 16 and 24 h after injection of endotoxin, respectively (Fig. 1A). Complement C3 concentrations in liver were five to six times higher than those in mucosa and were increased in endotoxemic mice at 8 h and through the rest of the experimental period (Fig. 1B). Plasma levels of C3 were increased 16 and 24 h after injection of endotoxin (Fig. 1C). Because the anti-mouse C3 antibody used in these experiments may recognize C3b and C3bi in addition to C3, the results may reflect the sum of C3 and its cleavage products C3b and C3bi. For clarity, results are described as C3 throughout the rest of the paper, but it is important to recognize this limitation of the study.
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Endotoxemia resulted in an approximately fourfold increase in mucosal SAA levels at 16 and 24 h (Fig. 2A). SAA concentrations were higher in liver than in mucosa and responded to endotoxemia in a similar way, with increased levels noted 16 and 24 h after injection of endotoxin (Fig. 2B). As expected (29), plasma concentrations of SAA were markedly elevated in endotoxemic mice, with a more than 20-fold increase noted at 16 h (Fig. 2C). Interestingly, plasma levels of SAA were increased already 4 and 8 h after injection of endotoxin, i.e., before the increase in mucosal and liver concentrations took place.
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Because it is possible that blood-borne acute phase proteins, deposited in the tissue, could have caused or at least contributed to the increased mucosal levels noted at 16 and 24 h in endotoxemic mice, a control experiment was performed in which the intestinal vasculature was perfused with saline before the mucosa was harvested. In this experiment, the basal C3 levels in the mucosa were somewhat lower than in mucosa of intestine that had not been perfused, probably reflecting in part removal of blood-borne C3 (Fig. 3A; compare with Fig. 1A). The difference in mucosal C3 levels between control and endotoxemic mice, however, persisted even after perfusion of the jejunal vasculature, and the relative increase in endotoxemic mice was even more pronounced in this experiment, being ~2.5- and 2-fold at 16 and 24 h, respectively (Fig. 3A). The endotoxin-stimulated levels of SAA were somewhat lower in mucosa of perfused intestine than in mucosa of intestine in which the vasculature had not been perfused with saline, whereas the basal levels of SAA were not reduced by the perfusion (Fig. 3B; compare with Fig. 2A).
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To examine whether the increased mucosal complement C3 and SAA levels during endotoxemia reflected an increased local production of the proteins, possibly regulated at the transcriptional level, we next measured mucosal levels of mRNA for C3 and SAA. When Northern blot analysis was performed, no signals for C3 or SAA mRNA were noticed in samples from saline-injected control mice. C3 mRNA was not detected on Northern blots in mucosal samples of endotoxemic mice but was present in liver tissue, with a faint band noticed at 2 h and a maximal response noticed 16 h after injection of endotoxin (Fig. 4). SAA mRNA was induced in jejunal mucosa of endotoxemic mice, with a weak signal noticed at 4 h after injection of endotoxin and a maximal response seen at 16 h (Fig. 5). In liver, the expression of SAA mRNA was induced already 2 h after injection of endotoxin and was sustained during the rest of the 24-h experimental period (Fig. 6). Note that in liver, two bands were present on Northern blots, similar to a recent report by de Beer et al. (6). The two mRNA bands reflect the fact that SAA is a multigene family; the heavier band (between 18S and 28S) may correspond to SAA5, and the lighter mRNA (below 18S) may correspond to SAA2 (6). In jejunal mucosa, only one band for SAA mRNA was seen (Fig. 5) and, on the basis of previous reports (6, 18), this band may represent mRNAs for SAA1-3.
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Because the absence of a clear mucosal signal for C3 mRNA on the Northern blots could be due to insufficient amounts of C3 mRNA in the mucosa, we performed PCR on RNA extracted from jejunal mucosa. Results from that experiment showed that mRNA for complement C3 was detectable in jejunal mucosa of both control and endotoxemic mice. To test whether endotoxemia resulted in increased C3 mRNA levels, competitive PCR was performed. Results from that experiment revealed an ~100% increase in mucosal C3 mRNA levels 4 h after induction of endotoxemia and a five- to sixfold increase at later time points (Fig. 7A). Because of the high sensitivity of PCR, one concern was that the signal for C3 mRNA noticed in mucosa may reflect "contamination" by nonmucosal cells. A control experiment was therefore performed in which mucosa was harvested after perfusion of the intestinal vasculature at different time points after saline or endotoxin injection. Competitive PCR showed an almost identical response to endotoxin as the one seen in the experiment in which the vasculature was not perfused (Fig. 7B; compare with Fig. 7A). Also, the basal levels of C3 mRNA were similar in the two experiments, suggesting that the C3 mRNA levels reflected local tissue mRNA rather than mRNA in circulating cells.
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Although the results described suggest that mucosal levels of C3 and SAA are increased during endotoxemia and that the increased protein levels may reflect transcriptional upregulation of the protein, the cellular origin of the proteins is not known. To test in which cell type(s) of the mucosa complement C3 and SAA were present, we performed immunohistochemical studies. C3 was present in both enterocytes and cells of the lamina propria (Fig. 8), whereas SAA was expressed mainly in cells of the lamina propria (Fig. 9). In endotoxemic mice, SAA was detected in the intestinal lumen (Fig. 9C). Evidence of mucosal injury was seen in the endotoxemic mice, with disruption of the epithelial layer and desquamation of cells into the intestinal lumen (Fig. 8, C and D and Fig. 9, C and D).
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DISCUSSION |
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In the present study, endotoxemia in mice was associated with increased concentrations of the acute phase proteins complement C3 and SAA in jejunal mucosa. Because C3 and SAA mRNAs were upregulated by endotoxin and immunohistochemistry indicated that the proteins were expressed in both enterocytes and nonepithelial mucosal cells, results are consistent with the concept that the local production of C3 and SAA may be increased in mucosa of small intestine during endotoxemia. The results are important because they support the role of the intestinal mucosa in the metabolic response to sepsis and endotoxemia and provide further evidence that the gut is an active participant in the inflammatory response to these conditions.
One major concern when the present results were interpreted was whether the mucosal levels of C3 and SAA represented local production of the proteins or merely a deposition or contamination of blood-borne proteins. Although circulating C3 and SAA probably contributed to the mucosal levels, several lines of evidence suggest that local production of the proteins took place in the mucosa. 1) When the vasculature of the jejunum was perfused with saline, the difference in mucosal C3 and SAA levels between control and endotoxemic mice persisted; 2) the increased mRNA levels for C3 and SAA, in particular the persistent increase in C3 mRNA after perfusion of the intestinal vasculature, strongly support a local production of the proteins; 3) when immunohistochemistry was applied, results showed that C3 was present in enterocytes and other mucosal cells and SAA was present in nonepithelial mucosal cells; and 4) there is evidence that enterocytes can synthesize several acute phase proteins, including C3 and SAA (2, 3, 23, 24, 27). Thus the increased mucosal levels of complement C3 and SAA may at least in part reflect increased local production of the proteins during endotoxemia.
To our knowledge, this is the first report of increased mucosal production of C3 and SAA during endotoxemia. In a recent report, increased SAA mRNA levels were noticed in intestine of endotoxemic mice but SAA protein levels were not measured (6). In other studies, mucosal production of acute phase proteins was increased in inflammatory bowel disease (1, 11, 12). In previous experiments, Molmenti et al. (23) found evidence for an acute phase response in human intestinal epithelial cells. In recent experiments in our laboratory, complement C3 protein and mRNA were expressed in cultured Caco-2 cells, a human intestinal epithelial cell line (23). Thus the intestinal mucosa may be the production site of acute phase proteins, both in response to local inflammation, such as inflammatory bowel disease (1, 11, 12), and in response to systemic inflammation, such as endotoxemia (present results).
Although the present report and other studies (23, 27) suggest that acute phase proteins may be produced at extrahepatic sites, the liver is probably the major site of acute phase protein synthesis, at least from a quantitative standpoint. In the present study, the concentrations of C3 and SAA were four to five times higher in liver tissue than in mucosa, supporting the central role of the liver in the acute phase response (29). The present finding of elevated circulating levels of SAA in endotoxemic mice before liver and mucosal levels of SAA were increased was surprising and may suggest that other tissues as well are involved in the acute phase response. Alternatively, the breakdown, excretion, and/or tissue distribution of circulating SAA was influenced by endotoxin before changes in liver and mucosal levels occurred.
The influence of endotoxemia on mucosal complement C3 levels was examined in the present study because C3 may be particularly important in the mucosa. Complement C3 converges the classical and alternative pathways into a final common pathway in the complement cascade which participates in the local defense against invading microorganisms and may cause lysis of bacteria (8). SAA was studied because it is the major acute phase protein in mice (4, 10, 29). Although the exact biological role of SAA in the acute phase response is unidentified, SAA is an apoprotein of HDL and may influence the formation and clearance of HDL (17). It should be noted that murine SAA is encoded by multiple genes and that at least five members of the SAA family have been identified and labeled SAA1 through SAA5 (6, 18, 20). The SAA proteins are highly homologous proteins (32), and the antibody used in the present study for ELISA and immunohistochemistry did not discriminate between the different members of the SAA family. In consideration of previous reports of the expression of different members of the SAA family in various tissues (6, 18), our results most likely represented upregulated production of SAA1-3 in the intestinal mucosa and increased synthesis of SSA2 and SAA5 in liver.
It is not known from the present study if the increased mRNA levels for C3 and SAA in liver and jejunal mucosa during endotoxemia reflected increased mRNA stability or upregulated gene transcription. In previous reports, increased SAA mRNA levels in liver tissue of endotoxemic mice were associated with increased SAA gene transcription, although posttranscriptional stabilization probably contributed to the increased mRNA levels (18).
The mediators and cellular mechanisms of mucosal C3 and SAA production during endotoxemia are not known from the present study. In other reports, several proinflammatory cytokines stimulated acute phase protein synthesis in human intestinal epithelial cells (23). In recent experiments in our laboratory, tumor necrosis factor (TNF) and interleukin (IL)-1 increased the production of C3 in cultured Caco-2 cells (24). In the same studies, endotoxin added in vitro to the Caco-2 cells did not influence C3 production. Thus it is possible that the increased mucosal levels of complement C3 and SAA noted here in endotoxemic mice were regulated by cytokines rather than by a direct effect of endotoxin, although further experiments are needed to test that notion. Increased mucosal levels of TNF, IL-1, and IL-6 during endotoxemia, as reported elsewhere (21, 22, 25), suggest that these cytokines may regulate acute phase protein synthesis in cells of the intestinal mucosa in a paracrine or autocrine manner.
Perspectives
The present results support the concept that the intestinal mucosa is an active participant, rather than only a passive bystander, in the metabolic and inflammatory response to sepsis and endotoxemia. Although the majority of the acute phase proteins are probably produced in the liver, the observations in this study are important because they suggest that the intestinal mucosa may contribute to the acute phase response. It should be an important focus for future studies to determine the biological role of mucosal acute phase proteins. It is likely that they are most important for the local metabolic response in the intestinal mucosa. Because mucosal acute phase proteins may be secreted into the portal vein, it is also possible that they can regulate the hepatic response to sepsis and endotoxemia.| |
ACKNOWLEDGEMENTS |
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This study was supported in part by Grants 8510 and 8450 from Shriners of North America.
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FOOTNOTES |
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Address for reprint requests: P.-O. Hasselgren, Dept. of Surgery, Univ. of Cincinnati, 231 Bethesda Ave., M. L. 558, Cincinnati, OH 45267-0558.
Received 19 November 1997; accepted in final form 10 August 1998.
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