The role of erlotinib in the acute lung injury and the expression of surfactant protein A北大核心CSCD

Objective: To investigate the role of erlotinib in the expression of surfactant protein A (SP-A) in LPS-induced acute lung injury (ALI) of mice model. Methods: C57BL/6 mice were randomly (random number) divided into control group (n=6), ER group (n=6), LPS group (n=6), and ER+LPS group (n=6). In the LPS group, 2 mg/kg LPS was instilled into trachea of mice to induce lung injury. In control group, normal saline was instilled into trachea of mice instead. In the ER+LPS group and ER group, 100 mg/kg of erlotinib was instilled into stomach of mice, and one hour later. 2 mg/kg LPS was instilled into trachea of mice in ER+PLS group to induce lung injury. Twenty-four hours later, bronchoalveolar lavage fluid (BALF) and lung tissue of mice in four groups were collected. HE staining were used for evaluating pathological changes of lung injury. Lung wet/dry weight ratio, protein concentrations and total cell numbers in the BALF were measured to determine the degree of pulmonary edema. Immunohistochemical staining and Western Blot were used for testing the protein expression of SP-A, Data of multiple groups were analyzed by one way variance (ANOVA) and inter-group comparisons were made by the least significant difference (LSD) tests. Results: There was no significant difference in lung injury score (LIS) between control group (0.056±0.008) and ER (0.064±0.037) group, The LIS in LPS group (0.846±0.047) was higher than that in control group, however the LIS in ER+LPS group (0.279±0.020) was significant lower than that in LPS group (P < 0.05). Lung wet/dry weight, SP-A concentration and total cell numbers in the bronchoalveolar lavage fluid revealed that the degree of pulmonary edema in LPS group was higher than that in control group, and this pulmonary edema was reversed by erlotinib treatment. Immunohistochemical staining and Western blot showed that the expression of SP-A in LPS group was decreased compared with control group, but it was recovered after erlotinib treatment (P < 0.05). Conclusions: Erlotinib could protect the LPS-induced ALI, and it may be related to the regulation of SP-A. © 2018 Chinese Medical Association. All rights reserved.     

多器官功能障碍综合征大鼠肺组织血栓调节蛋白和基质金属蛋白酶-9的表达

Objective To determine the expressions of thrombomodulin (TM) and matrix metalloproteinase-9(MMP-9) in the lung of rats with multiple organ dysfunction syndrome (MODS) and to investigate the mechanism of lung injury in MODS. Method Forty adult mule Sprague-Dawley (SD) rats were randomly divided into two groups,namely the normal control group and the MODS model group. The rats of model group were further divided into four subgroups as per different intervals (6 h, 12 h, 24 h and 48 h) ,and there were 8 rats in each groups. The animal models of MODS were estabhshed by two hits,the left eyeball of each model rat was removed to bleed to 2 mL/100g,and four hours later, lipopolysaccharide (LPS 5 mg/kg) was injected into intraperitoneal cavity of model rats. The same volume of saline was injected intraperitoneally into rats of control group instead of LPS. All rats were sacrificed at various intervals. The histological changes in lung tissue were observed by naked eye and light microscope. The expressions of TM and MMP-9 proteins were deteceted by using immunohistechemistry. One-way ANOVA was used for comparison among multiple group. Results (1)There were no histopathological changes in lung of rats of control group, and the lung injury was serious in MODS rots. (2) Compared with the rots of con-trol group, the expression of TM in lung tissue of MODS rats increased 6 hours after LPS, reached peak 12 hours later(P <0.01),and then decreased during 24～48 period.There was no significant difference in expression of TM between two groups 48 hours later. Compared with control group, the expressions of MMP-9 in lung tissue of MODS rats didn't significantly increase 6 ～ 48 hours after LPS (P < 0.01). Conclusions There are endothelium damage and extracellular matrix damage found in the lung tissue of rats at the early phase of MODS. TM and MMP-9 are good biomarkers of endothelium and extracellular matrix damage, and they can be used for diagnosing and es-timating the severity of injury lungs at the early phase of MODS.     

Change of alveolar epithelial type Ⅱ cells and pulmonary surfactant protein A in young rats with acute lung injury

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.     

Change of alveolar epithelial type Ⅱ cells and pulmonary surfactant protein A in young rats with acute lung injury

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.     

Change of alveolar epithelial type Ⅱ cells and pulmonary surfactant protein A in young rats with acute lung injury

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.     

Change of alveolar epithelial type Ⅱ cells and pulmonary surfactant protein A in young rats with acute lung injury

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.     

Change of alveolar epithelial type Ⅱ cells and pulmonary surfactant protein A in young rats with acute lung injury

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.     

Change of alveolar epithelial type Ⅱ cells and pulmonary surfactant protein A in young rats with acute lung injury

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.     

Change of alveolar epithelial type Ⅱ cells and pulmonary surfactant protein A in young rats with acute lung injury

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.     

Change of alveolar epithelial type Ⅱ cells and pulmonary surfactant protein A in young rats with acute lung injury

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.     

痰热清注射液对急性肺损伤大鼠肺内炎症因子的影响

目的 研究痰热清注射液对内毒素性急性肺损伤(ALI)大鼠肺内炎症因子的影响。方法 清洁级健康SD雄性大鼠56只,随机（随机数字法）分为空白组、模型组、干预组。模型组、干预组分别给予内毒素(LPS)尾静脉注射,1h后,干预组给予痰热清注射液尾静脉注射。三组分别选取2,4,6h三个观察点,取支气管肺泡灌洗液(BALF)放射免疫法检测TNF-α,IL-1β,IL-8的含量及Wright-Giermsa染色计中性粒细胞的比例(ωPMN),并观察肺组织病理学变化及测湿干质量比值(W/D)。采用SPSS 17.0统计软件,以P＜0.05为差异具有统计学意义。结果2,4,6h三个观察点,模型组BALF中TNF-α,IL-1β,IL-8的含量及ωPMN较空白组明显升高(P＜0.05或P＜0.01),肺组织W/D明显增加(P＜0.01),且病理损伤程度明显重于空白组。干预组BALF中TNF-α,IL-1β,IL-8的含量及ωPMN较模型组明显降低(P＜0.05或P＜0.01),肺组织W/D明显减少(P＜0.01)且病理损伤程度明显轻于模型组。结论 痰热清注射液能抑制内毒素性急性肺损伤肺内炎症因子水平,减轻急性肺损伤程度。     

硫化氢逆转脂多糖诱导大鼠肺动脉低反应性以及与一氧化碳的关系

目的 观察整体水平应用硫化氢(H2S)后脂多糖(LPS)诱导的离体肺动脉对H2S舒张反应的变化及其与一氧化碳(CO)的关系.方法 将48只大鼠按照随机数字表法分为对照组[给予生理盐水(NS)]、LPS组、H2S供体硫氢化钠(NaHS)+LPS组和NaHS+NS组4组,每组12只.采用经大鼠气管内滴注LPS(0.8 ml/kg)染毒;NaHS±+LPS组和NaHS±NS组滴注LPS或NS之前10 min和之后2 h腹腔注射NaHS各0.5 ml(28 μmol/kg).各组取6只大鼠于染毒后12 h制备肺动脉环(PARs),采用离体血管环张力测定技术检测用血红素氧合酶-1(HO-1)抑制剂锌原卟啉Ⅸ(ZnPPⅨ)孵育前后PARs对累积浓度NaHS的舒张反应变化;各组另取6只大鼠于染毒后12 h检测出肺血(EPB)和入肺血(APB)中碳氧血红蛋白(COHb)含量,以其差值反映肺循环CO生成的水平.结果 与对照组相比,滴注LPS后PARs对NaHS的最大舒张反应百分比明显降低[(75.72±7.22)%比(96.40±4.40)%,P＜0.01＝;用ZnPPⅨ孵育PARs后,LPS诱导的PARs对NaHS舒张反应进一步降低[(62.91±8.22)%比(75.72±7.22)%,P＜0.01＝.腹腔注射NaHS可明显逆转LPS诱导的PARs对NaHS的低反应性,PARs对NaHS的最大舒张反应百分比明显升高[(94.65±8.45)%比(75.72±7.22)%,P＜0.01＝;但用ZnPPⅨ孵育PARs后,PARs对NaHS的舒张反应较孵育前显著下降[(83.75±9.76)%比(94.65±8.45)%,P＜0.01＝.NaHS+NS组中PARs对NaHS的舒张反应与对照组相比无明显差异,且在ZnPPⅨ孵育前后也无明显变化.COHb检测结果显示,与对照组相比,滴注LPS后APB和EPB中COHb水平的差值明显增高[(3.12±0.48)%比(2.12±0.32)%,P＜0.05＝;腹腔注射NaHS后,COHb水平的差值[(4.03±0.56)%]较LPS组进一步升高(P＜0.01＝.结论 腹腔注射H2S可以改善LPS诱导的离体肺动脉对H2S的低反应性,其机制可能与增强肺动脉HO-1/CO体系有关.

Abstract：

Objective To explore the effect of hydrogen sulfide (H2S) on abnormal pulmonary artery reactivity induced by lipopolysaccharide (LPS) and its relationship with carbon monoxide (CO). Methods Forty-eight rats were divided into four groups randomly according to table of random number: control group (normal saline, NS), LPS group, a donor of H2S sodium hydrosulfide (NaHS)+LPS group, and NaHS+NS group (n=12 in each group). Rats were given LPS by intratracheal instillation (0. 8 ml/kg). 0. 5 ml of NaHS (28 μmol/kg) was injected intraperitoneally 10 minutes before LPS or NS instillation and 2 hours after LPS or NS instillation in NaHS+LPS and NaHS+NS groups. Twelve hours after instillation of LPS, 6 rats from each group were sacrificed. The pulmonary artery rings (PARs) were prepared and the changes in cumulative relaxation response of PARs to NaHS were detected before and after incubation with an inhibitor of heme oxygenase-1 (HO-1) zinc protoporphyrin Ⅸ (ZnPP Ⅸ ) using isolated vascular ring tension detecting technique. Twelve hours after LPS instillation, the remaining 6 rats in each group were sacrificed, and the contents of carboxyhemoglobin (COHb) in efferent pulmonary blood (EPB) and afferent pulmonary blood (APB) were measured, and the difference between the contents of COHb in EPB and that of APB was calculated to represent content of CO from pulmonary circulation. Results In the present study, compared with control group, after the instillation of LPS the percentage of relaxation response of PARs to NaHS was significantly declined [(75. 72±7. 22)% vs. (96. 40±4. 40)%, P＜0. 01]. After being incubated with ZnPP Ⅸ, the decreased relaxation response of PARs to NaHS induced by LPS was further depressed [(62. 91 ±8. 22) % vs. ( 75. 72 ± 7. 22) %, P ＜ 0. 01]. Administration of NaHS intraperitoneally reversed the hyporesponsiveness of PARs to NaHS, the percentage of relaxation response of PARs to NaHS was significantly increased [(94.65± 8.45)% vs. (75.72 ± 7.22)%, P＜0.01]. However ZnPP Ⅸ also attenuated the effect [(83. 75 ± 9. 76)% vs. (94. 65 ± 8. 45)%, P ＜ 0. 01]. NO significant changes were observed between NaHS+NS group and control group, also between the results before and after ZnPP Ⅸincubation. Compared with control group, the difference between the contents of COHb in EPB and that of APB increased after instillation of LPS [(3. 12±0. 48)% vs. (2. 12±0. 32)%, P＜0. 05], which further increased after intraperitoneal administration of NaHS [(4.03 ± 0. 56) %, P ＜ 0. 01]. Conclusion The results suggested that intraperitoneal administration of H2S could reverse hyporesponsiveness of PARs to H2S induced by LPS, and the result might be related to an intensification of HO-1/CO system in pulmonary artery tissue.     

普通肝素雾化吸入对内毒素性肺损伤大鼠肺泡局部凝血及炎症反应的影响

目的 观察内毒素诱导急性肺损伤(ALI)大鼠雾化吸入普通肝素(UFH)后的肺部局部效应,探讨其对肺泡内凝血、纤溶和炎症反应的作用.方法 87只雄性Wistar大鼠按随机数字表法分为假损伤组、模型组、肝素治疗组(HT组)和肝素预防组(HP组).静脉注射(静注)内毒素脂多糖(LPS)制备ALI模型.HP组和HT组分别于注射LPS前后给予UFH雾化吸入,模型组和假损伤组则雾化吸入生理盐水.各组分别于静注LPS后6、12和24 h处死大鼠进行肺泡灌洗,采用酶联免疫吸附法测定支气管肺泡灌洗液(BALF)中凝血酶-抗凝血酶复合物(TAT)、组织型纤溶酶原激活物(t-PA)、尿激酶型纤溶酶原激活物(u-PA)、纤溶酶原激活物抑制剂-1(PAI-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平.结果 损伤后6 h,模型组BALF中TAT浓度(μg/L:3.346±0.585)最高,其次是HT组(2.764±0.100),HP组(2.564±0.216)最低(均P＜0.05);HP组t-PA(μg/L:3.037±0.524)最高,HT组(2.494±0.191)其次,模型组(1.716±0.125)最低(均P＜0.05);HP组u-PA(μg/L)高于模型组(0.411±0.118比0.303±0.049,P＜0.05);HP组PAI-1(μg/L)明显低于HT组和模型组(2.296±0.246比2.597±0.425、2.834±0.198,均P＜0.05),直至12 h时HP组仍低于HT组(1.273±0.441比1.817±0.252,P＜0.05);HT组和HP组TNF-α(ng/L)显著低于模型组(68.154±3.915、36.990±6.539比77.001±4.485),且HP组低于HT组(均P＜0.05),至12 h HP组(15.287±4.754)仍最低,与HT组和模型组(26.756±5.336、23.674±4.398)比较差异有统计学意义(均P＜0.05).模型组、HT组和HP组各时间点IL-6水平均无明显差异.结论 内毒素性ALI大鼠雾化吸入UFH后起到了抑制局部凝血、减弱纤溶抑制、促进纤溶、降低炎症反应的作用,预防性吸人UFH比治疗性吸入效果更显著,最佳效应时间在注射后6 h.

Abstract：

Objective To observe the local changes in alveoli in intravenous endotoxin-induced acute lung injury (ALI) rat model after inhalation of aerosolized unfractioned heparin(UFH), and to observe its effects on coagulability, fibrinolysis and inflammatory response. Methods Eighty-seven male Wistar rats were divided into groups according to table of random number: sham, model, heparin therapy (HT) and heparin prophylaxis(HP). Endotoxin-induced ALI model was reproduced by intravenous administration of lipopolysaccharide (LPS). Rats in Hp and HT groups received aerosolized UFH before and after injection with LPS respectively, while rats in both sham and model groups inhaled aerosolized normal saline. Rats in each group were respectively sacrificed at 6, 12 and 24 hours after intravenous administration of LPS, and bronchoalveolar lavage fluid (BALF) was collected. Enzyme-linked immunosorbent assay was used to measure the level of thrombin-antithrombin (TAT), tissue-type plasminogen activator (t-PA),urokinase-type plasminogen activator (u-PA), plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor- (TNF-α), interleukin-6 (IL-6) in BALF. Results At.6 hours after injury, the level of TAT (μg/L) in model group (3.346±0. 585) was highest, that in HT group (22. 764±0. 100) was higher, and that in HP group (2. 564±0. 2216) was lowest in BALF (all P＜0. 05). The t-PA(μg/L) concentration in HP group (3.037±0. 5224) was highest, that in HT group (22. 494±0. 191) was higher, and that in model group (1. 716±0. 1225) was lowest (all P＜0. 05). Compared with model group, u-PA (μg/L) level in HP group dramatically enhanced (0. 411±0. 118 vs. 0. 303±0. 049, P＜0. 05). The concentration of PAI-1 (μg/L) in HP group was significantly lower than that of HT and model groups (22. 2296 ± 0. 2246 vs. 22.597±0. 4225,2.834±0.198, both P＜0. 05). In HP group, it was still lower than that in HT group at 12 hours (1.2273±0. 441 vs. 1. 817±0. 252, P＜0. 05). TNF-α(ng/L) levels in HT and HP groups were markedly lower compared with model group (68. 154±3. 915, 36. 990±6. 539 vs. 77. 001±4. 485) at 6 hours, and the level in HP group was lower than that in HT group (all P＜0. 05). TNF-α concentration in HP group was still the lowest at 122 hours (15.2287±4. 754), and there was significant difference compared with HT and model groups (26. 756±5. 336, 23. 674±4. 398, both P＜0. 05). The levels of IL-6 were not distinctively different among model, HT and HP groups at various time-points. Conclusion It was proved that inhalation of aerosolized UFH resulted in lowering local coagulability, alleviating fibrinolytic depression, improving fibrinolysis, and attenuating inflammation in endotoxin-induced ALI rat model. More prominent results will be obtained when it was use as a prophylactic measure. The optimal time of usage is 6 hours after endotoxin injection.     

NG-硝基-L-精氨酸对脂多糖诱导大鼠肺损伤时肺表面活性物质和细胞凋亡的影响

目的 探讨NG-硝基-L-精氨酸(L-NA)对内毒素性肺损伤大鼠肺表面活性物质(PS)和细胞凋亡的影响.方法 雄性SD大鼠24只,按随机数字表法均分为对照组、模型组、L-NA治疗组.模型组、L-NA治疗组舌下静脉注射脂多糖(LPS)复制内毒素性肺损伤模型;对照组给予等量生理盐水.L-NA治疗组于注射LPS 3 h后给予L-NA 20 mg/kg;对照组和模型组给予等量生理盐水.6 h后处死动物,取肺组织,用原位杂交法测定肺组织表面活性物质相关蛋白A(SP-A)mRNA表达;用流式细胞术检测肺组织细胞凋亡率;用蛋白质免疫印迹法(Western blotting)检测天冬氨酸特异性半胱氨酸蛋白酶3(caspase-3)蛋白表达;用免疫组化法测定Bcl-2和Bax蛋白表达.结果 与对照组比较,模型组SP-A mRNA表达[吸光度(A)值]明显下降(0.071±0.017比0.113±0.021),细胞凋亡率[(25.04±4.57)%比(11.37±3.08)%]、caspase-3蛋白表达(A值:298.64±37.11比110.24±14.35)、Bax蛋白表达(A值:0.145±0.011比0.076±0.010)明显升高,Bcl-2蛋白表达(A值:0.064±0.011比0.073±0.009)和Bcl-2/Bax比值(0.447±0.086比0.976±0.157)明显下降(均P<0.01).与模型组比较,L-NA治疗组SP-A mRNA表达(A值:0.085±0.015)和Bcl-2蛋白表达(A值:0.070±0.087)明显增强(P<0.01和P<0.05),但细胞凋亡率[(20.67±1.35)%]、caspase-3蛋白表达(A值:268.75±42.56)、Bax蛋白表达(A值:0.142±0.012)和Bcl-2/Bax比值(0.498±0.069)均无明显变化(均P>0.05).结论 L-NA不通过抑制肺细胞凋亡来减轻内毒素性肺损伤的程度,对调节凋亡相关基因caspase-3和Bax也无明显影响;而是可通过增强PS表达减轻内毒素性肺损伤.     

硫化氢/胱硫醚-γ-裂解酶在内毒素性急性肺损伤发生中的作用

目的 探讨硫化氢/胱硫醚-γ-裂解酶(H2S/CSE)体系在内毒素所致大鼠急性肺损伤(ALI)中的作用并初探其机制.方法 将64只SD大鼠随机分为对照组、ALl组(经气管内滴注脂多糖(LPS)复制ALI模型]、硫氢化钠(NaHS)组和炔丙基甘氨酸(PPG)组,各组再分为给药后4 h和8 h亚组,每个亚组8只.于各时间点处死动物,光镜下观察肺组织病理学改变;化学法检测血浆H2S、一氧化氮(NO)和一氧化碳(CO)含量、肺组织丙二醛(MDA)含量、髓过氧化物酶(MPO)、CSE、诱生型一氧化氮合酶(iNOS)和血红素加氧酶(HO)活性;放射免疫法检测肺组织P-选择素含量,用免疫组化法检测肺组织iNOS、HO-1的蛋白表达.结果 气管内滴注LPS可引起肺组织明显的病理学改变;肺组织MDA含量、MPO活性和P-选择素水平升高,血浆iNOS、HO活性和肺组织iNOS、HO-1蛋白表达增强,血浆NO、CO含量增加,血浆H2S含量和肺组织CSE活性下降(P<0.05或P<0.01).预先给予NaHS可显著减轻内毒素所致上述指标的改变;而预先给予PPG可加重内毒素所致肺损伤,使肺组织MDA含量、MPO活性、P-选择素水平,血浆NO含量,肺组织iNOS活性和iNOS蛋白表达进一步增加,但对血浆CO含量、肺组织HO活性和HO-1蛋白表达无明显影响.结论 H2S/CSE体系的下调在内毒素所致大鼠ALI的发病学中有一定作用,内、外源性H2S具有抗内毒素所致ALI的作用,该作用可能与其抗氧化效应、减轻中性粒细胞所致肺过度的炎症反应以及下调NO/iNOS体系、上调CO/HO-1体系有一定关系.     

前列腺素E1对猪肺损伤的保护效应研究

目的 应用肺损伤模型全面研究前列腺素E1脂微球制剂(1ipo-PGEl)对肺损伤的保护效应.方法 应用静脉输注内毒素加大容量控制通气法制备猪肺损伤模型.将16头猪随机均分为给药组及对照组.置人肺动脉导管,监测动脉、混合静脉血气分析;测定基础值及给予内毒素后2、3、4和5 h的血液动力学及肺气体交换参数.用气道阻塞技术描记两组动物的静态压力-容积(P-V)曲线,并利用S形曲线回归公式拟合,P-V曲线以进一步确定和比较其呼吸力学参数.用酶联免疫吸附法(ELISA)检测血清肿瘤坏死因子-α(TNF-α)及白细胞介素-8(IL-8)浓度.结果 实验期间对照组平均动脉压(MAP)及心排血指数(CI)均明显下降(P 均<0.05),给药组血流动力学较稳定.除基础测定外,给药组在各监测时间点所有氧合指标[包括动脉血氧分压(PaO2、氧合指数(PaO2/FiO2)、肺-动脉血氧分压差(A-aDO2)和肺内分流率(Qs/Qt)]的改善均显著优于对照组(P均相似文献   

急性肺损伤幼鼠肺泡Ⅱ型上皮细胞和肺表面活性蛋白A的变化

目的 探索急性肺损伤(ALI)时肺泡Ⅱ型上皮细胞(AEC-Ⅱ)和肺表面活性蛋白A(SP-A)的变化规律.方法 110只SD幼鼠(雄性53只,雌性57只)随机分为对照组、ALI组(每组分6个亚组).ALI组腹腔注射脂多糖(LP3,4 mg/ks),对照组注射生理盐水.于注射后6,12,24,36,48,72 h每组处死8只幼鼠并取材.透射电镜下观察各组AEC-Ⅱ超微结构的变化.采用半定量RT-PCR法测量各组肺组织SP-A mRNA的表达,用Western blot法测量肺组织SP-A含量.采用SPSS 12.0统计软件包进行方差分析和方差齐性检验.结果 注射LPS 24 h后,AEC-Ⅱ表面微绒毛消失.24 h和48 h时AEC-Ⅱ中板层小体(LB)出现暂时性数馈增加.48 h时LB呈特征性"指环状"绕核排列和巨大的空泡样LB.72 h时LB数目显著减少,可见破碎和残余的LB.SP-A从24 h至48 h表达显著增强(P<0.01),于36 h达最高值(6.94±0.80,P<0.01),72 h 下降至最低点(3.87 ±0.50,P<0.01).结论 ALI时AEC-Ⅱ形态变化与肺组织SP-A含量变化是时间依赖性的.AEC-Ⅱ损伤早期伴有肺组织SP-A的代偿性增加.AEC-Ⅱ损伤加重时LB出现特征性变化,可能与SP-A的代偿有关.ALI晚期,AEC-Ⅱ的严重损伤与SP-A的下降密切相关.     

经中心静脉途径注入腺病毒转载的核转录因子-κB抑制因子基因治疗大鼠感染性急性肺损伤

目的 观察经中心静脉途径注入腺病毒转载的核转录因子-kB(NF-kB)抑制因子(IkB)基因对感染性急性肺损伤(ALI)的治疗作用。方法 按随机数字表法将30只SD大鼠分为假手术组、ALI模型组、IkB治疗组,每组10只。IkB治疗组经中心静脉注入滴度为1×109 pfu腺病毒转载的IkB基因1 ml,假手术组和模型组注人生理盐水1 ml;然后模型组和IκB治疗组经尾静脉注入脂多糖(LPS,5 mg/kg)1ml复制ALI模型,假手术组则注入生理盐水1 ml。观察7d后大鼠的动脉血气分析,肺湿/干重(W/D)比值,血浆肿瘤坏死因子-α (TNF-α)、白细胞介素-6(IL-6)含量,肺组织NF-κBp65蛋白表达及光镜下肺组织病理改变,并计算肺损伤评分。结果 模型组死亡1只大鼠,其余大鼠均存活。3组间pH值、动脉血二氧化碳分压(PaCO2)比较无明显差异;动脉血氧分压(PaO2)假手术组最高,模型组最低。模型组血浆TNF-α (μg/L)、IL-6(ng/L)含量明显高于假手术组(TNF-α：5.20±1.09比3.01±0.46;IL-6:540.28±100.78比214.45±61.37,均P＜0.05);IkB治疗组血浆TNF-α和IL-6含量明显低于模型组(TNF-α.3.70±0.96比5.20±1.09;IL-6:356.49±60.58比540.28±100.78,均P＜0.05),其中TNF-α含量已恢复至假手术组水平。肺W/D比值：假手术组最低(4.49±0.36),模型组最高(5.78±0.43),IκB治疗组居中(5.33±0.38);肺损伤评分（分）：假手术组最低（0.17±0.41）,模型组最高(2.29±0.76),IκB治疗组居中（1.57±0.53）;肺NF-κB免疫组化评分（分）：假手术组最低(1.00±0.89),模型组最高(9.43±1.13),IκB治疗组居中(4.00±1.15);上述指标3组间两两比较差异均有统计学意义(均P＜0.05)。结论 经中心静脉途径注入腺病毒转载的IκB基因,可降低ALI大鼠血中炎症因子TNF-α、II-6含量,抑制NF-κB活化,减少肺水含量和肺泡塌陷以及肺实变,从而减轻肺损伤。     

山莨菪碱对急性肺损伤时肺泡巨噬细胞分泌细胞因子的干预探讨

目的观察山莨菪碱(654-2)对急性肺损伤(ALI)大鼠肺泡巨噬细胞(AM)分泌肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的影响,探讨其对ALI治疗作用的可能机制。方法复制ALI大鼠模型。实验动物随机分为ALI模型组、654-2治疗组、对照组,进行各组大鼠动脉血气、肺湿／干(W／D）值测定及肺组织病理学光镜检查。分离培养各组大鼠肺泡巨噬细胞,采用生物活性法进行AM上清液TNF-α、IL-6测定。结果654-2治疗组大鼠AM分泌TNF-α［（38．98±4.51)KU/L］和IL-6［（20．82±6.3)kU/L］的水平明显低于ALI组［TNF-α为(68.27±9.13)kU/L,P＜0.001;IL-6为(33.84±9.02)kU/L,P＜0.01］,并能使血气改善(P＜0.05)、W／D值下降(P＜0.05),肺组织损伤程度减轻。结论654-2对ALI大鼠肺泡巨噬细胞过度活化、分泌TNF-α、IL-6具有显著抑制作用,在一定程度上防止ALI的发生和发展。     

内毒素致急性肺损伤大鼠肺组织信号转导和转录激活因子1的调控作用

目的 探讨信号转导和转录激活因子1(STAT1)在内毒素致急性肺损伤(ALI)大鼠肺组织中的表达及其调控作用.方法 静脉注射内毒素脂多糖(LPS)制备大鼠ALI模型.将动物随机分为对照组、LPS组、地塞米松(DEX)干预组;DEX干预组灌胃DEX 0.135 mg/kg,对照组和LPS组分别灌胃等量生理盐水,连用5 d后LPS组和DEX干预组经尾静脉注射LPS 5 mg/kg,对照组以生理盐水1 ml替代.于致伤后1、2、4、8、16 h各处死6只大鼠,取肺组织,用蛋白质免疫印迹法(Western blotting)测定STAT1表达的动态变化,光镜下观察肺组织病理学改变.结果 与对照组比较,LPS组STAT1的活化从1 h开始增高,4 h达高峰,然后逐渐下降;2、4、8 h时STAT1表达显著升高(P均<0.01);DEX干预组STAT1表达趋势同LPS组,但2、4、8 h时STAT1表达显著低于LPS组(P均<0.05).结论 内毒素致ALI中存在STAT1异常表达;STAT1参与了肺组织炎症的形成.