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Oral administered nonabsorbable antibiotics prevent endotoxemia in primates following intestinal ischemia
P Gathiram1, M T Wells, J G Brock-Utne
1Department of Physiology, University of Durban-Westville, South Africa.
Abstract:
Plasma lipopolysaccharide (LPS) concentrations have been found to increase during a temporary occlusion of the superior mesenteric artery (SMA). We have attempted to show, by a prophylactic oral administration of a nonabsorbable antibiotic to monkeys subjected to an SMA occlusion shock, that the increased LPS is intestinal in origin. A total of eight monkeys were subjected to a temporary occlusion of the SMA. Four monkeys received prophylactic oral administration of a nonabsorbable antibiotic, while the rest acted as controls. The plasma LPS concentrations before occlusion in the control and the kanamycin group were 0.069 +/- 0.006 and 0.092 +/- 0.005 ng/ml, respectively. At the end of the 1-hr occlusion period the plasma LPS concentration in the controls increased to 0.09 +/- 0.009 ng/ml (P less than 0.1) and peaked to 0.378 +/- 0.103 ng/ml (P less than .001) within 20 min of reperfusion. Thereafter, the plasma LPS concentration returned slowly to baseline. In the kanamycin group the plasma LPS concentration remained at baseline throughout both the occlusion and reperfusion periods. These data suggest that the origin of the increased plasma LPS concentration seen following temporary occlusion of the SMA is from the gut, and is information of possible importance in patients about to undergo intestinal surgery.
Insights
Temporary superior mesenteric artery (SMA) occlusion increases plasma lipopolysaccharide (LPS). Prophylactic antibiotics prevented this rise, indicating LPS originates from the gut, crucial for intestinal surgery patients.
Area of Science:
- Gastroenterology
- Surgical Research
- Immunology
Background:
- Plasma lipopolysaccharide (LPS) levels elevate during superior mesenteric artery (SMA) occlusion.
- The intestinal origin of this LPS increase requires elucidation.
Purpose of the Study:
- To determine if the gut is the source of increased plasma LPS following temporary SMA occlusion.
- To assess the efficacy of prophylactic nonabsorbable antibiotics in mitigating LPS elevation.
Main Methods:
- Eight monkeys underwent temporary SMA occlusion.
- Four monkeys received prophylactic oral kanamycin; four served as controls.
- Plasma LPS concentrations were measured before, during, and after occlusion/reperfusion.
Main Results:
- Control group showed a significant increase in plasma LPS post-occlusion and reperfusion (P < .001).
- Kanamycin group maintained baseline LPS levels throughout the experiment.
- Antibiotic prophylaxis prevented LPS elevation.
Conclusions:
- The gut is the primary source of increased plasma LPS after temporary SMA occlusion.
- This finding is significant for managing patients undergoing intestinal surgery.
- Nonabsorbable antibiotics may mitigate LPS-related complications.