Objectives        To determine the effect of sacral nerve stimulation (SNS) on the gut-liver axis after spinal cord injury (SCI).          Methods         Intestinal dysfunction model was established in rabbits after SCI by Fehlings method. The strength of stimulus (6

8 and 10 V) and frequency of (200

400 and 600 μs) were applied respectively

then the response was recorded and analyzed. The experimental group (EG group

n=18) included paraplegic rabbits that received electrical stimulation of the S3 nerve root. The paraplegic control group (CG group

n=18) and the normal control group (NG group

n=6) did not receive electrical stimulation. Under aseptic conditions

tissue samples of the small intestine

portal vein blood

and liver were collected at 24

48 and 72 h after SCI. The liver tissue was analyzed with bacterial cultures

blood sample was analyzed to measure endotoxin

and serum levels of ALT

AST

and GGT were detected. HE staining was used to study the morphology of liver tissue. Morphology

ultrastructure

and ZO-1 immunohistochemical assay of the small intestine was analyzed.         Results        After SCI

the main change specifically demonstrated on dyskinesia of single haustrum and distal colon. SNS preferably recovered the movement of denervation intestine and promoted the defecation. After stimulation

the pathologic changes of intestinal barrier was  alleviated

and the positive rates of the all cases in the liver were remarkably different from those in the CG group (12/18 vs 3/18

P0.01). Endotoxin levels in the EG at 72 h were significantly lower than the levels in the CG group (1.14±0.70 vs 0.07±0.05 EU/L

P0.01) at the same sampling time. The injury of liver was  correspondingly alleviated. The serum levels of ALT

AST

and GGT at 24

48 and 72 h were significantly higher in the CG and EG groups than in the NG group

but their levels at the 3 time points were reduced apparently in EG group than in the CG group (P0.05).         Conclusion         Electrical stimulus to sacral nerve roots is able to restore the denervation intestinal movement (mainly single haustrum and distal colon). The intestinal barrier function is improved and then probably reduces endotoxemia and bacterial translocation from intestine

and thus alleviates the liver injury. Therefore

the vicious cycle of the gut-liver axis is held back.