埼玉医科大学雑誌 第32巻 第2号別頁 (2005年4月) T61-T68頁 ◇論文(図表を含む全文)は,PDFファイルとなっています.

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Thesis
穿孔性腹膜炎におけるビリルビン酸化生成物(Biopyrrins)ならびにヘムオキシゲナーゼの動向 ―実験的ならびに臨床的検討―

菊地 政貴
埼玉医科大学外科学(消化器・一般外科部門 消化器・一般外科(II))
(指導 平山 廉三 教授)

医学博士 乙第971号 平成17年2月18日 (埼玉医科大学)


 Heme oxygenase(HO)-1, the rate-limiting enzyme in heme degradation, is induced by oxidative stress and its major final product, bilirubin, is a potent physiological antioxidant. Bilirubin oxidative metabolites are generated from bilirubin as a result of its scavenging action against reactive oxygen species (ROS). Thus, the production of Biopyrrins, oxidative metabolites of bilirubin, appears to reflect the degree of oxidative stress, and the level of urine Biopyrrins may be useful for evaluation of oxidative stress. The purpose of this study was to clarify the target organs for oxidative stress by acute abdomen, based on the change of urine Biopyrrins levels and HO-1. The levels of urine Biopyrrins and expression of HO-1 were determined from mice cecal ligation and puncture (CLP) model , the lipopolysaccharide injected intraperitoneally (LPS I.P.) and intravenously(LPS I.V.) models. The expression of HO-1 protein was shown at liver in CLP model, at spleen in LPS I.V. model, and at both of liver and spleen in LPS I.P. model. The level of urine Biopyrrins changed in accordance with the expression of HO-1 in all models. The level of urine Biopyrrins in 71 cases of acute abdomen was determined, and compared with the criteria of SIRS (systemic inflammatory response syndrome). In the perforated peritonitis cases, high level of urine Biopyrrins were shown despite of that these cases did not satisfy the criteria of SIRS. These results suggest that the level of urine Biopyrrins is a possible marker for continuous monitoring of clinical severity of perforated peritonitis cases.
Keywords: Biopyrrins, Bilirubin, Heme oxygenase, 活性酸素, 腹膜炎

(C) 2005 The Medical Society of Saitama Medical School