A New Mechanism of Serum Creatine Phosphokinase Elevation in Strangulated Small Bowel Obstruction: An Experimental Rat Model

Abstract

An experimental rat model was used to investigate the mechanisms of serum creatine phosphokinase (CPK) elevation in strangulated small bowel obstruction. Two models were used: a strangulated ileus model with the bowel lumen and blood flow obstructed simultaneously, and a control ileus model with only the bowel lumen occluded. The experiments demonstrated that CPK was released into the blood when the mesenteric blood flow was restored, and that CPK was released into the intestinal lumen in the strangulated ileus model but not the control ileus model. CPK activity in the mucosal layer of the strangulated ileus model was significantly decreased compared with that in the control ileus model. Purified CPK injected into the intestinal lumen was absorbed by the healthy intestine. These results suggest a new mechanism of serum CPK elevation in strangulated small bowel obstruction in which serum CPK is elevated with a significant decrease in mucosal CPK. Strangulated bowel content including mucosal CPK may be reabsorbed by the healthy distal intestine when bowel obstruction is incomplete.

Biochemical constituents of peritoneal fluid in cows

“…It has been shown experimentally in dogs (Thompson and others 1990), rabbits (Liao and others 1995, Cağlayan and others 2002) and rats (Mukai and others 1995) that intestinal ischaemia and reperfusion have an influence on the activities of ALP, aspartate amino transferase, CK and LDH in peripheral blood. Increased activities of ALP in serum have also been described in cattle with abomasal volvulus (Constable and others 1991).…”

“…In rats, Mukai and others (1995) assumed that increases in peripheral CK activities were due to leakage from smooth muscle layers of experimentally strangulated intestine. In horses, Grosche and others (2006) described higher CK activities in blood and peritoneal fluid as indicators of intestinal ischaemia due to strangulation obstruction.…”

Effect of large colon ischemia and reperfusion on concentrations of calprotectin and other clinicopathologic variables in jugular and colonic venous blood in horses

“…36 In addition, necrosis of colonic mucosal cells or intravascular cells might have caused an increase in CK activities in colonic venous blood samples af- Figure 3-Absolute concentration (A) and concentration expressed as a percentage relative to preischemic control values (B) of calprotectin in jugular (black bars) and colonic (white bars) venous blood samples obtained from horses (n = 6) before induction of ischemia of a segment of the large colon (control), 1 hour after induction of large colon ischemia (1hI), and 1, 2, and ter 1 hour of colon ischemia of horses in the present study. 37,38 Although most gastrointestinal tract CK is found in the seromuscular layer of the intestines, 39 it is also found in the cytoplasm of intestinal epithelial and endothelial cells. 40 This enzyme has been detected in physiologically normal small and large intestines of dogs, 39 and release of CK into circulation is detected within the first 3 hours after colon ischemia in dogs and rabbits.…”

Spezifische Parameter im Blut und Bauchpunktat zur Ermittlung des Schweregrades von intestinaler Ischämie bei Kolikpferden

“…Eine Möglichkeit für den frühzeitigen Nachweis vonEntzündungen stellen dieKriterien vonLight et al (35) dar.Mit deren Hilfe wurdeamBeispiel des Pleurapunktats beim Menschen ein Exsudatdurch eine LDH-Aktivität von>200 U/l(ca. zwei Drittel der physiologischen Aktivität im Serum) sowiee in Punktat-Serum-Ve rhältnis fürTotalproteinvon >0,5 und fürLDH von>0,6 definiert (35).Inzahlreichen In-vivo-Untersuchungen am Tiermodell konntedarüber hinaus nachgewiesen werden,dass sowohl Abweichungen der Enzymaktivitäten vonLDH, AP,AST,CK, Xanthinoxidase sowieder Phosphat-oder Laktatwerte im BP und/oder Serumeinen Hinweisauf intestinale Schädigungen geben können (8,34,45,54,58,63).AussagekräftigeParameter zum Nachweis abdominaler entzündlicher Ve ränderungen beimM enschen waren nebenden klassischen ParameternAlbumin und Totalprotein auch LDH,Cholesterin,Glukose, Laktat undder pH-Wertinder Peritonealflüssigkeit (3,14).Beim Kolikpferdhat die Untersuchung des BP eine große diagnostischeB edeutung ( 37).I nv erschiedenen Studien erwiesensich Totalprotein (37), Phosphat (2), AP (56) und Laktat (32,42) im BP bei Pferden mit hochgradigen intestinalen Ve ränderungen alsprognostisch bedeutende Parameter.…”

“…Die Untersuchungen erstreckten sich auf 26 Kolikpferde (11 Stuten, 11 Wallache,vier Hengste; Durchschnittsalter: 13,6 Jahre) und acht gesunde, klinikeigene Pferde (fünf Stuten, zwei Wallache, ein Hengst; Durchschnittsalter: 12,3 Jahre).Von den Kolikpferdenhatten 14Tiere eine Dislocatio coli (rechts-oder linksdorsale Ve rlagerung, Retroflexio coli,T orsio coli partialis) und 12 Pferde eine Dünndarmstrangulation (Hernia inguinalis, mesenterialis, omentalis,Vo lvulus). DieBestimmungder Aktivität speziellerintrazellulärerEnzyme wieLDH, AP und CK im Serumw aren in Studien beimV ersuchstier (45,54,63) hilfreicheKriterien fürdie Bestätigungvon Gewebe-und Organschäden, so auchvon intestinalen Ve ränderungen. Dabei wurdeangenommen,dass diese intrazellulären Enzyme ausd er geschädigten Darmwand in das Darmlumen und von dortdurch Resorption über noch durchbluteteDarmabschnitte in das periphere Gefäßsystemgelangen (45).…”