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Differential changes in intestinal permeability following burn injury
W J Messick1, M Koruda, A Meyer
1Department of General Surgery, Carolinas Medical Center, Charlotte, NC 28232-2861.
The Journal of Trauma
|March 1, 1994
Summary
Burn injury increases gut permeability (GP) differently across jejunum, ileum, and colon. This size- and site-dependent increase in GP may persist post-burn, impacting sepsis risk.
Area of Science:
- Gastroenterology
- Surgical Research
- Immunology
Background:
- Increased gut permeability (GP) post-burn injury is linked to sepsis and multiple organ failure.
- Previous research identified only global changes in GP, lacking site-specific data.
Purpose of the Study:
- To investigate site-specific and size-dependent alterations in GP in the jejunum, ileum, and colon after burn injury.
- To determine the temporal profile of GP changes following burn injury.
Main Methods:
- Utilized two probes of different sizes: fluorescein isothiocyanate-dextran-3 (FDEX, 4387 Da) and horseradish peroxidase (HRP, 40,000 Da).
- Assessed GP in jejunum, ileum, and colon at 1, 2, and 4 days post-burn in an animal model.
Main Results:
- Burn injury significantly increased GP for both small (FDEX) and large (HRP) probes across all segments.
- GP was significantly higher for the smaller FDEX probe compared to HRP.
- Jejunal GP peaked at 24 hours, while ileal and colonic GP increased early and remained elevated at days 2 and 4.
Conclusions:
- Burn injury induces differential gut permeability that is dependent on the intestinal site and probe size.
- Elevated gut permeability persists beyond 24 hours post-burn, even with feeding.
- Understanding these specific changes is crucial for managing post-burn complications like sepsis.