Early tranexamic acid administration: A protective effect on gut barrier function following ischemia/reperfusion injury

The Journal of Trauma and Acute Care Surgery
Mark E DiebelJohn R Whittaker

Abstract

The mucus barrier is a critical component of the gut barrier and may be disrupted by pancreatic enzymes following trauma/hemorrhagic shock (T/HS). Luminal strategies against pancreatic enzyme activation or contact with the intestine are protective of the mucus layer and gut barrier integrity following T/HS. There is increasing evidence the use of tranexamic acid (TA) attenuates inflammatory responses in cardiac surgery and is readily absorbed from the gut. We therefore postulated that systemic administration of TA would attenuate mucus degradation and gut barrier failure following T/HS. This was studied in an in vitro model. Confluent monolayers of HT29-MTX (mucus-producing clone) and Caco-2 cocultures were exposed to 90 minutes of hypoxia followed by reoxygenation (H/R), luminal trypsin (5 μM), or both treatment groups. In a subset of experiments, TA (40 μM or 150 μM) was added to the basal chamber (systemic side) of intestinal cell cultures immediately following the hypoxic period. Mucus barrier function was indexed by rheologic measurement of both mucus thickness and viscosity (G', dyne/cm) and oxidant stress. Intestinal cell barrier integrity was indexed by transepithelial electrical resistance, permeability to fluorescein ...Continue Reading

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Citations

Jun 18, 2016·Current Opinion in Critical Care·Jayshil J PatelRobert G Martindale
Apr 20, 2017·The Journal of Trauma and Acute Care Surgery·Marco Henry SantamariaErik B Kistler
Oct 19, 2017·International Journal of Molecular Medicine·Qing-Tao MengZhong-Yuan Xia
Sep 6, 2020·Pharmaceutical Research·Larissa Gomes Dos ReisDaniela Traini
Jan 8, 2021·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·T W ClementsA W Kirkpatrick

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