Circulation and mucosal injury

摘要

This review is concerned with major aspects of research on small bowel circulation. Of the hundreds of papers published in the past year dealing with intestinal vascular physiology, pathophysiology, and more clinical reports, only a small proportion fit into the scope of this section. The subtopics reviewed here include experimental intestinal ischemia-reperfusion injury (IRI), lung damage during IRI, immature gut ischemia, and neuroendocrine regulators of the mesenteric circulation. The importance of neutrophil adhesion, accumulation, and migration in IRI remains a popular object of laboratory investigation. The beneficial effects of local adenosine, prostaglandins, and nitric oxide in IRI have also been explored. Comparisons have been made of local neutrophil behavior versus that of recruited neutrophils in IRI. Plasma versus interstitial responses to lipid peroxidative systems have been delineated. The effect of IRI in the bowel on lung microcirculatory function has been investigated and pulmonary inflammatory responses show events that differ from intestinal counterparts. Similarly, neonatal bowel ischemia exhibits a unique pathophysiology. The range of endogenous mediators of intestinal circulatory change is growing and appears to encompass multiple neurotransmitters, paracrine, and endocrine agents. The breadth of investigative activity and the novelty of recent insights reflect the advances of research in an exciting arena.