The Effect Of Low-protein Diet And Starvation On TF And PAI-1 In Sepsis Rats

Objective:To investigate the effects of protein malnutrition and energy malnutrition on inflammatory and coagulation in sepsis rats.METHODS: 108 SD rats were randomly divided into 3 groups,36 in each group.The normal feeding group received a free diet(27 g/d,18% protein feed),and protein malnutrition group received a low protein diet(27 g/d,5% protein feed),energy malnutrition group received 66.7%restricted diet(9g/d,18% protein feed),after 4 weeks of continuous feeding,20 rats in each group were randomly selected for cecal ligation and perforation(CLP),and the survival rate was compared.The remaining 16 rats in each group were randomly divided into 2 subgroups,which were blank group and CLP group.Blank group was sacrificed after 4 weeks of continuous feeding and CLP group was sacrificed 8h after surgery,blood,spleen and liver were taken,the proportions of spleen CD3+,CD4+,CD8+ T cells and M1 macrophages,and liver tissue factor(TF)and plasminogen activatior inhibitior 1(PAI-1)mRNA,as well as serum IL-6,IL-10 levels were detected.RESULTS: The body weight,thymus and spleen weight of protein malnutrition group and energy malnutrition group were significantly lower than those of normal feeding group.In the blank group,plasma IL-6 levels and spleen CD3+ and CD3+CD4+ T lymphocyte ratios were higher in rats with energy-malnutrition than in normal feeding and protein-malnutrition rats.The proportion of M1 macrophages in spleen was more than that in normal feeding and protein-malnutrition rats.Survival curve analysis showed that the postoperative seven-day mortality rate in the energy-malnutrition group was100%,which was significantly higher than that in the normal feeding group(65%)and the protein-malnutrition group(55%).After CLP,the levels of TF,PAI-1 and plasma IL-6with energy malnutrition were higher than those of normal nutrition and protein-malnutrition rats and the proportion of M1 macrophages was lower than that of normal nutrition rats.There were no significant differences in liver TF,PAI-1 and plasma IL-10 between protein-malnutrition and normal feeding rats.The levels of plasma IL-6and M1 macrophages of protein-malnutrition rats were lower than those of normal feeding rats.There was a significant positive correlation between liver TF and PAI-1mRNA and plasma IL-6 concentration(r= 0.6443,r = 0.5735,P<0.05).Conclusion: TF and PAI-1 in energy-deficient sepsis rats are significantly higher than those in normal feeding and protein malnutrition groups,and positively correlated with IL-6.Long-term sustained stress(hunger)leads to sustained chronic inflammatory state,and increased immune mobilization,stimulation of inflammatory cytokine release and coagulation system activation in sepsis.Inflammatory factor release without sustained stress in protein malnutrition was significantly reduced.