实验性急性肺损伤肺组织中细胞间粘附分子的表达及大黄对其影响

目的:主要探讨肺组织中细胞间粘附分子-1(ICAM-1mRNA)表达与急性肺损伤(ALI)的关系和大黄对其影响。方法:注射脂多糖(LPS)复制ALI动物模型并分为LPS组、对照组、大黄+LPS组、地塞米松+LPS组。观察病理形态和ALI生物学标志并测定肺组织中ICAM-1mRNA的表达。结果:肺血管内皮细胞ICAM-1mRNA表达在LPS组显著高于对照组(P＜0.01),而大黄+LPS和地塞米松+LPS组显著弱于LPS组(P＜0.05,P＜0.01)。肺湿/干重比,肺泡灌洗液中性粒细胞比、蛋白含量以及肺血管壁通透性、肺泡通透指数也显著小于LPS组。结论:在ALI肺组织中ICAM-1mRNA表达增强参与了ALI发病的作用,大黄可使ICAM-1mRNA的表达减弱从而使肺组织损伤减轻。     

金纳多对内毒素诱导小鼠急性肺损伤保护作用机制的初步研究

目的：初步探讨银杏叶提取物金纳多（Ginaton）对内毒素（lipopolysaccharide, LPS）诱导小鼠的急性肺损伤(acute lung injury, ALI)保护作用的可能机制。方法：于小鼠腹腔注射LPS（10 mg/kg）复制ALI动物模型。将小鼠随机分为对照组、LPS组、Ginaton组和Ginaton＋LPS组。观察各组肺组织病理学改变,测量肺湿/干重比,支气管肺泡灌洗液蛋白含量及乳酸脱氢酶（lactate dehydrogenase, LDH）活性,测量丙二醛（malondialdehyde, MDA）、一氧化氮合酶（nitric oxide synthase, iNOS）和髓过氧化物（myeloperoxidase,MPO),免疫组织化学方法检测血红素加氧酶（heme oxygenase HO-1）及iNOS蛋白表达。结果： 金纳多可有效减轻LPS所致肺组织病理学变化,并降低肺湿/干重比和肺泡灌洗液中蛋白含量,降低肺泡灌洗液中LDH活性、肺组织MPO和iNOS活性,同时MDA和NO含量下降。免疫组织化学结果显示,LPS组iNOS表达上升（P＜0.01）,而血红素加氧酶（HO-1）蛋白表达未见明显变化;而预先给予Ginaton可显著提高HO-1的表达,降低iNOS的表达（P＜0.01）。结论：Ginaton可减轻LPS所致急性肺组织损伤,其机制可能与诱导HO-1的表达,下调iNOS的表达和活性有关。     

过氧化物酶增殖体激活受体-β在大鼠急性肺损伤中的作用

目的探讨过氧化物酶增殖体激活受体-β（PPARβ-）在急性肺损伤（ALI）发生发展中可能的作用,以期从新的视角揭示ALI/ARDS的发病机理,并为ALI/ARDS的防治提供理论基础。方法采用颈静脉注射脂多糖（LPS）的方法复制大鼠ALI模型,随机分为对照组和LPS组。半定量RT-PCR方法测定肺组织中PPARβ-mRNA的表达水平;免疫组织化学染色法测定肺组织PPARβ-蛋白表达水平;同时测定动脉血气分析、肺组织湿/干（W/D）比值、肺组织MPO活性、光镜观察肺组织病理变化。结果LPS组大鼠PaO2显著降低（P〈0.01）,肺组织W/D比值、肺组织髓过氧化物酶（MPO）活性以及肺组织的病理积分均显著升高（P〈0.05）。免疫组化显示对照组大鼠肺组织可表达PPARβ-蛋白,主要位于肺泡上皮细胞及肺间质细胞;与对照组相比,LPS组大鼠肺组织PPARβ-蛋白的表达均显著升高（P〈0.05）,分布在肺泡上皮细胞及炎性细胞。RT-PCR结果显示对照组肺组织表达一定量的PPARβ-mRNA,与对照组比较,LPS组大鼠肺组织PPARβ-mRNA的表达量显著升高（P〈0.05）。结论正常大鼠肺泡上皮细胞及间质细胞存在PPARβ-,在ALI形成过程中PPARβ-蛋白和mRNA表达均显著增加,提示PPARβ-可能与ALI的炎症反应相关。     

腺苷A2A受体激动剂CGS21680对脂多糖诱导的小鼠急性肺损伤的保护作用

 目的：探讨腺苷A2A受体激动剂对脂多糖(LPS)诱导的急性肺损伤（ALI）小鼠的作用。方法：采用LPS（10 mg/kg）气管内注射6 h后的ALI小鼠模型。实验动物随机分为生理盐水对照组、ALI组、CGS21680治疗组和CGS21680对照组。测定各组6 h后肺湿重/干重比值（W/D）。比色法测定各组肺组织中髓过氧化物酶(MPO)活性。Western blotting分析各组肺组织中细胞间黏附分子1（ICAM-1）和血管细胞黏附分子1（VCAM-1）的表达。酶联免疫吸附法（ELISA）检测各组小鼠血清中单核细胞趋化蛋白1（MCP-1）的浓度。观察各组肺组织病理改变。结果：ALI组肺W/D、MPO活性、ICAM-1及VCAM-1表达和MCP-1浓度均较对照组显著升高。CGS21680治疗组前述各项指标较ALI组有显著下降。CGS21680组较对照组各项指标无显著差异。肺组织病理显示,ALI组可见肺间质明显充血水肿,大量炎症细胞浸润,部分肺泡腔内可见红细胞。CGS21680治疗组可显著改善肺组织的病理变化。结论：腺苷A2A受体激动剂CGS21680可明显减轻LPS诱导的ALI小鼠肺组织的炎症反应及肺组织水肿,提示腺苷A2A受体激动剂在急性肺损伤中具有保护作用。     

黑木耳多糖对内毒素诱导急性肺损伤大鼠肺组织的保护作用

目的:探讨黑木耳多糖对LPS诱导急性肺损伤大鼠肺组织的保护作用及其机制。方法:将健康SD大鼠随机分为对照组、LPS组、地塞米松组以及黑木耳多糖低、中、高浓度组,根据分组,分别给予生理盐水或不同浓度黑木耳多糖预防性灌胃7 d,第8天腹腔注射生理盐水或LPS(8 mg/kg),地塞米松组在给予LPS后腹腔注射地塞米松(3 mg/kg)。造模12 h后于腹主动脉取血,并制肺组织匀浆和肺泡灌洗液。检测支气管肺泡灌洗液中蛋白含量、肺湿/干重比、髓过氧化物酶(MPO)、总抗氧化能力(T-AOC)、总超氧化物歧化酶(T-SOD)、一氧化氮合酶(NOS)、丙二醛(MDA)等指标,做组织切片HE染色并进行肺损伤评分。结果:应用黑木耳多糖干预后,急性肺损伤大鼠支气管肺泡灌洗液中蛋白含量明显下降,肺湿/干重比值降低;大鼠肺组织中MPO、NOS活性及MDA含量较LPS组降低,T-AOC含量和T-SOD活性较之升高;肺组织病理改变减轻,肺损伤指数下降。结论:黑木耳多糖具有保护LPS损伤大鼠肺组织的作用,其机制可能与其抗氧化作用有关。     

银杏叶提取物对脂多糖诱导大鼠急性肺损伤的保护作用

探讨银杏叶提取物（GBE）对脂多糖（LPS）诱导大鼠急性肺损伤（ALI0的保护作用。给大鼠静脉LPS复制ALI动物模型。首先动态观察ALI的形成过程，注LPS后2h已形成明显的ALI。另批大鼠随机分成：对照组（静注生理盐水），LPS组（静注LPS，5mg/kg体重），CBE＋LPS组（注LPS前三天开始每天灌胃给GBE一次，按黄酮甙8mg/kg体重计算，当日在给LPS前h再给一次GBE），每组6只大鼠。注LPS或盐水后2h收集标本，进行测定。发现：注LPS后肺湿／干重量比，肺泡灌洗液中蛋白含量及肺血管通透指数均升高（均P＜0．01）；血中乳酸（LD），一氧化氮（NO），内皮素－1（ET－1），肿瘤坏死因子－α（TNF－α）含量及血乳酸脱氢酶（LDH）活性，均有显著升高（P＜0．01，P＜0．001）。而肺组织细胞膜Na^ -K^ ATPase活性显著下降（P＜0．01）。预先给予GBE可显著缓解上述变化（P＜0．05，P＜0．01）。提示GBE在防治肺的急性炎症性疾病中有一定的应用前景。     

肺血管内皮细胞在大鼠急性肺损伤发生中的作用

目的:观察肺血管内皮细胞受损在大鼠急性肺损伤发病中的作用及地塞米松的影响。方法:给Wistar大鼠静脉注射脂多糖(LPS5mg/kgBW)复制急性肺损伤模型。采用ELISA、放射免疫、原位杂交等多种方法测定肺组织ICAM-1mRNA表达、iNOS活性、血中TNF-α、NO₂^-/NO₃^-、ACE含量及肺血管通透性、肺泡灌洗液中细胞数、蛋白含量等的变化。结果:注射LPS后,肺血管ICAM-1mRNA表达增加,从1h开始至24h达高峰。肺组织匀浆iNOS活性升高、肺血管通透性升高、肺泡灌洗液中中性粒细胞数量增加,巨噬细胞数量减少、蛋白含量增加,血中TNF-α、NO₂^-/NO₃^-含量升高而ACE含量下降等变化多在注LPS后2h明显。预先给予地塞米松对上述多种指标的变化有明显缓解作用。结论:提示LPS通过损伤肺血管内皮细胞导致急性肺损伤,地塞米松对其有一定保护作用。     

内源性H2S对LPS所致大鼠急性肺损伤时肺动脉高压的影响及其与一氧化氮的相互作用

目的： 探讨硫化氢（H2S）对脂多糖（LPS）所致急性肺损伤时肺动脉高压（PAH）的影响及H2S/胱硫醚-γ-裂解酶（CSE）体系和一氧化氮（NO）/一氧化氮合酶（NOS）体系在其发生机制中的相互作用。 方法： 将72只大鼠随机分为生理盐水（NS）对照组、LPS组、LPS+L-NAME组、LPS+PPG组，检测给药后2、4、6、8 h的平均肺动脉压（mPAP），以及4、8 h血浆H2S、NO含量和iNOS、cNOS活性、肺组织NO含量和iNOS、cNOS、CSE活性，免疫组化法测定肺组织iNOS蛋白表达，并结合肺光镜形态等指标综合评价肺损伤程度。 结果： LPS组各时点的mPAP显著高于对照组，给药后4、8 h，NO含量、iNOS活性和蛋白表达升高，cNOS活性及H2S含量、CSE活性降低，肺组织损伤较重。预先给予L-NAME可减轻LPS所致上述指标的改变。而预先给予PPG可加重LPS所致肺损伤，但对cNOS活性无明显影响。 结论： LPS使内源性H2S减少导致mPAP升高； H2S/CSE体系与NO/NOS体系共同参与LPS所致急性肺损伤时PAH形成的调控机制，在其中呈相互的负性调节作用。     

白藜芦醇通过激活SGK1上调急性肺损伤小鼠肺泡上皮钠离子通道的表达

目的探讨白藜芦醇(resveratrol)对急性肺损伤(ALI)小鼠肺泡上皮钠离子通道(ENaC)的作用及可能机制。方法将小鼠随机分为对照(control)组、LPS组、RES组和PP242组,每组6只。苏木精-伊红(HE)染色观察肺组织病理;BCA法测肺泡灌洗液(BALF)中蛋白含量,酶联免疫吸附实验(ELISA)检测炎性因子水平;流式细胞计量术检测BALF中性粒细胞比例;Western blot检测肺组织α-ENaC蛋白表达和SGK1磷酸化水平,实时荧光定量PCR(qPCR)检测肺组织α-ENaC mRNA转录水平。结果 1)与对照组相比,LPS组肺组织损伤明显,BALF中性粒细胞比例、蛋白含量和炎性因子水平明显升高(P0.05),肺组织α-ENaC表达和SGK1磷酸化水平显著下调(P0.05);2)与LPS组相比,RES组肺损伤明显减轻,BALF中性粒细胞比例、蛋白含量和炎性因子水平明显降低(P0.05),伴α-ENaC表达和SGK1磷酸化水平显著上调(P0.05);3)与RES组相比,PP242组肺损伤明显加重,BALF中性粒细胞比例、蛋白含量和炎性因子水平明显升高(P0.05),同时伴α-ENaC表达和SGK1磷酸化水平显著下调(P0.05)。结论 SGK1介导的α-ENaC上调机制参与了RES对ALI的保护作用。     

肠系膜淋巴管结扎对大鼠急性肺损伤的影响

目的：探讨结扎肠系膜淋巴管对失血-脂多糖（LPS）致大鼠急性肺损伤（ALI）的拮抗作用。方法：雄性Wistar大鼠45只，均分为结扎组、未结扎组、假手术组，以失血、LPS复制二次打击模型，结扎组行肠系膜淋巴管结扎术致肠淋巴液断流。在手术创伤后24 h，所有大鼠颈总动脉放血，进行血气分析；从左肺收集支气管肺泡灌洗液（BALF），观察WBC、NO及其合酶、SOD、MDA以及肺泡通透性指数等指标的水平；右肺制备10%组织匀浆，检测MPO、ATPase活性等指标；观察右肺后叶超微结构。结果：二次打击后，未结扎组动脉血PaCO2、BALF中细胞总数及PMN、NO2-/NO3-、NOS、MDA含量以及肺匀浆MPO活性、肺通透性指数均显著高于假手术组，动脉血pH、PaO2、BALF中SOD、肺匀浆ATPase活性显著低于假手术组（P<0.01，P<0.05）；结扎组大鼠BALF中细胞总数及PMN、MDA、NO2-/NO3-含量、肺通透性指数均显著高于假手术组，BALF中SOD活性显著低于假手术组（P<0.01，P<0.05）。但结扎组大鼠动脉血pH、PaO2、肺匀浆ATPase活性显著高于未结扎组，动脉血PaCO2、BALF中细胞总数及PMN、NO2-/NO3-、NOS、MDA含量、肺通透性指数及肺匀浆MPO显著低于未结扎组（P<0.01，P<0.05）；且肺血管内皮细胞损伤程度较未结扎组轻微。结论：肠系膜淋巴管结扎可减轻失血-LPS致大鼠的急性肺损伤。提示二次打击的肠系膜淋巴液在大鼠急性肺损伤的发病过程中发挥着重要作用。     

The role of aquaporin-1 (AQP1) expression in a murine model of lipopolysaccharide-induced acute lung injury

A murine model of lipopolysaccharide (LPS)-induced acute lung injury (ALI) was used to evaluate whether aquaporin-1 (AQP1) is involved in lung inflammation and lung edema formation. Swiss strain mice (n = 122) had LPS (5 mg/kg) instilled intratracheally (IT), and were then treated with either 0.9 % saline or dexamethasone (5 mg/kg/day). Mice were euthanized at 2 days and 7 days after treatment. Inflammatory cytokines (TNF-alpha, IL-6), protein concentration in bronchoalveolar lavage (BAL) fluid, lung wet-to-dry weight ratio, histology, immunohistochemistry, and AQP1 Western blot were performed. Lung wet-to-dry weight ratio and lung vascular permeability were also measured in the AQP1 knockout mice (n = 9) that received IT LPS (5 mg/kg) at 2 days. Intratracheal instillation of LPS produced a severe lung injury at 2 days, characterized by elevation of TNF-alpha, IL-6 in the BAL fluid, and by histological changes consistent with increased lung vascular permeability and neutrophil infiltration. AQP1-immunoreactivity in the pulmonary capillary endothelium was reduced at 2 days and 7 days. Administration of dexamethasone improved LPS-induced ALI and retained expression of AQP1. However, depletion of AQP1 did not affect lung edema formation, lung vascular permeability, or lung histology. The results suggest that although AQP1 expression is decreased after lung injury, depletion of AQP1 does not alter lung inflammation and lung edema induced by LPS.     

NF-κB在大鼠急性肺损伤模型肺组织中的表达及N-乙酰半胱氨酸的影响

目的 :检测NF κB在LPS诱导的急性肺损伤 (ALI)肺组织中的表达 ,以及N 乙酰半胱氨酸 (NAC)对ALI的抑制作用。方法 :采用免疫组化染色 (ABC法 )和Westernblot,检测NF κB在急性肺损伤大鼠气道和肺组织中的表达 ,以及NAC干预后活性NF κB表达的变化。结果 :正常对照组大鼠气道黏膜上皮和肺间质中 ,仅见少量散在的NF κB核阳性细胞 ;而LPS诱导ALI后 ,气道黏膜、肺间质、肺泡腔及血管内皮细胞中NF κB核阳性的细胞明显增多 (P <0 .0 1)。NF κB核阳性反应细胞主要为气道黏膜上皮细胞、浸润的炎症细胞、肺泡上皮细胞和血管内皮细胞。NAC治疗组NF κB核阳性细胞较LPS诱导的ALI组及对照组均明显减少 (P <0 .0 1)。Westernblot的结果显示 ,LPS诱导的ALI后不同时间点 ,NF κB的表达不同 ,于急性肺损伤 3h达高峰。各时间点NF κB的表达均较正常对照组高。结论 :LPS诱发的大鼠急性肺损伤的气道和肺组织内NF κB的表达增加 ,肺组织内的多数细胞参与了NF κB的激活。NAC可通过抑制NF κB的激活减轻急性肺损伤的炎症程度     

Human epidermal growth factor receptor signaling in acute lung injury

Acute lung injury (ALI) is a syndrome marked by increased permeability across the pulmonary epithelium resulting in pulmonary edema. Recent evidence suggests that members of the human epidermal growth factor receptor (HER) family are activated in alveolar epithelial cells during ALI and regulate alveolar epithelial barrier function. These tyrosine kinase receptors, which also participate in the pathophysiology of pulmonary epithelial malignancies, regulate cell growth, differentiation, and migration as well as cell-cell adhesion, all processes that influence epithelial injury and repair. In this review we outline mechanisms of epithelial injury and repair in ALI, activation patterns of this receptor family in pulmonary epithelial cells as a consequence injury, how receptor activation alters alveolar permeability, and the possible intracellular signaling pathways involved. Finally, we propose a theoretical model for how HER-mediated modulation of alveolar permeability might affect lung injury and repair. Understanding how these receptors signal has direct therapeutic implications in lung injury and other diseases characterized by altered epithelial barrier function.     

Integrin alphavbeta5 regulates lung vascular permeability and pulmonary endothelial barrier function

Increased lung vascular permeability is an important contributor to respiratory failure in acute lung injury (ALI). We found that a function-blocking antibody against the integrin alphavbeta5 prevented development of lung vascular permeability in two different models of ALI: ischemia-reperfusion in rats (mediated by vascular endothelial growth factor [VEGF]) and ventilation-induced lung injury (VILI) in mice (mediated, at least in part, by transforming growth factor-beta [TGF-beta]). Knockout mice homozygous for a null mutation of the integrin beta5 subunit were also protected from lung vascular permeability in VILI. In pulmonary endothelial cells, both the genetic absence and blocking of alphavbeta5 prevented increases in monolayer permeability induced by VEGF, TGF-beta, and thrombin. Furthermore, actin stress fiber formation induced by each of these agonists was attenuated by blocking alphavbeta5, suggesting that alphavbeta5 regulates induced pulmonary endothelial permeability by facilitating interactions with the actin cytoskeleton. These results identify integrin alphavbeta5 as a central regulator of increased pulmonary vascular permeability and a potentially attractive therapeutic target in ALI.     

Heat shock protein 90 inhibitors protect and restore pulmonary endothelial barrier function

Heat shock protein 90 (hsp90) inhibitors inactivate and/or degrade various client proteins, including many involved in inflammation. Increased vascular permeability is a hallmark of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Thus, we tested the hypothesis that hsp90 inhibitors may prevent and/or restore endothelial cell (EC) permeability after injury. Exposure of confluent bovine pulmonary arterial endothelial cell (BPAEC) monolayer to TGF-beta1, thrombin, bacterial lipopolysaccharide (LPS), or vascular endothelial growth factor (VEGF) increased BPAEC permeability, as revealed by decreased transendothelial electrical resistance (TER). Treatment of injured endothelium with hsp90 inhibitors completely restored TER of BPAEC. Similarly, preincubation of BPAEC with hsp90 inhibitors prevented the decline in TER induced by the exposure to thrombin, LPS, VEGF, or TGF-beta1. In addition, hsp90 inhibitors restored the EC barrier function after PMA or nocodazole-induced hyperpermeability. These effects of the hsp90 inhibitors were associated with the restoration of TGF-beta1- or nocodazole-induced decrease in VE-cadherin and beta-catenin expression at EC junctions. The protective effect of hsp90 inhibitors on TGF-beta1-induced hyperpermeability was critically dependent upon preservation of F-actin cytoskeleton and was associated with the inhibition of agonist-induced myosin light chain (MLC) and myosin phosphatase target subunit 1 (MYPT1) phosphorylation, F-actin stress fibers formation, microtubule disassembly, increase in hsp27 phosphorylation, and association of hsp90 with hsp27, but independent of p38MAPK activity. We conclude that hsp90 inhibitors exert barrier protective effects on BPAEC, at least in part, via inhibition of hsp27-mediated, agonist-induced cytoskeletal rearrangement, and therefore may have useful therapeutic value in ALI, ARDS, and other pulmonary inflammatory disease.     

Protection of LPS-induced murine acute lung injury by sphingosine-1-phosphate lyase suppression

A defining feature of acute lung injury (ALI) is the increased lung vascular permeability and alveolar flooding, which leads to associated morbidity and mortality. Specific therapies to alleviate the unremitting vascular leak in ALI are not currently clinically available; however, our prior studies indicate a protective role for sphingosine-1-phosphate (S1P) in animal models of ALI with reductions in lung edema. As S1P levels are tightly regulated by synthesis and degradation, we tested the hypothesis that inhibition of S1P lyase (S1PL), the enzyme that irreversibly degrades S1P via cleavage, could ameliorate ALI. Intratracheal instillation of LPS to mice enhanced S1PL expression, decreased S1P levels in lung tissue, and induced lung inflammation and injury. LPS challenge of wild-type mice receiving 2-acetyl-4(5)-[1(R),2(S),3(R),4-tetrahydroxybutyl]-imidazole to inhibit S1PL or S1PL(+/-) mice resulted in increased S1P levels in lung tissue and bronchoalveolar lavage fluids and reduced lung injury and inflammation. Moreover, down-regulation of S1PL expression by short interfering RNA (siRNA) in primary human lung microvascular endothelial cells increased S1P levels, and attenuated LPS-mediated phosphorylation of p38 mitogen-activated protein kinase and I-κB, IL-6 secretion, and endothelial barrier disruption via Rac1 activation. These results identify a novel role for intracellularly generated S1P in protection against ALI and suggest S1PL as a potential therapeutic target.     

DADLE对大鼠急性全脑缺血再灌注继发肺损伤的作用

 目的：通过建立大鼠急性全脑缺血再灌注模型,观察肺组织超氧化物歧化酶（SOD）活性、丙二醛（MDA）含量及肺组织光镜、电镜病理变化,探讨δ阿片受体激动剂DADLE对急性肺损伤的保护作用。方法：SD大鼠30只随机分为假手术（sham）组、模型（I/R）组和DADLE处理组。采用改良的二血管阻断加低血压法建立全脑缺血再灌注模型。DADLE处理组（n=10）于再灌注前经左侧颈静脉注射DADLE 5 mg/kg,再灌注120 min后,取肺组织,光镜、电镜观察其病理学改变及检测肺组织SOD活性、MDA含量。右侧股动脉取血测定氧分压,计算氧合指数。结果：I/R组与 sham组比较,肺脏表现为肺泡间隔增宽,毛细血管扩张充血,肺胞腔内及血管周围中性粒细胞浸润,Ⅱ型上皮细胞表面微绒毛明显减少,肺胞腔及气管腔均有浆液渗出,大鼠肺组织SOD活性降低和MDA含量升高。DADLE处理组与I/R组比较肺脏充血减轻,肺组织损伤程度明显减轻,中性粒细胞浸润有所减少,SOD活性升高和MDA含量降低。DADLE处理组动脉血氧分压和氧合指数有升高趋势,与I/R组比较差异有统计学意义。结论：大鼠急性全脑缺血再灌注模型对肺有不同程度的损伤,DADLE可减轻急性肺损伤,对肺组织提供一定的保护作用。