大肠杆菌肺炎模型老龄大鼠的小肠分泌型IgA和肿瘤坏死因子的观测

目的：探讨老年肺炎时小肠损伤的发病机制。方法：复制大鼠大肠杆菌肺炎模型,分为青年对照组、青年模型组、老龄对照组和老龄模型组。观测肺脏和小肠组织病理改变及其组织含水量,肠内容物分泌型IgA（sIgA),IgA含量,血清和小肠组织肿瘤坏死因子（TNF）含量。结果：青年和老龄模型组肺和小肠组织损伤和含水量增高明显,其中老龄模型组大鼠肺组织损伤较青年模型组严重。青年模型组肠内容物sIgA含量的增高较青年对照组显著,老龄对照组sIgA高于青年对照组,老龄模型组sIgA低于老龄对照组。青年模型组和老龄模型组血清和小肠组织TNF的增高分别较青年对照组和老龄对照组显著,老龄模型组和血清和小肠组织TNF含量高于青年模型组。结论：TNF含量增多和sIgA含量变化与肺炎的肠道损伤发生发展有关密切关系,TNF增多及sIgA含量减少在老龄肺炎大鼠的变化更为显著。     

大肠杆菌肺炎老龄大鼠小肠组织自由基和前列腺素代谢变化

目的 研究老年肺炎的小肠损伤病理生理特点。方法 复制大肠杆菌肺炎模型,分为青年对照组和模型组、老龄对照组和模型组。主要观察肺脏和小肠组织病理改变和含水量,小肠组织6－Keto-PGF1α、TXB2、NO和MDA含量及SOD活性。结果 肺炎鼠的肺、小肠组织损伤明显和含水量增高,老龄大鼠组织损伤较青年大鼠严重。与青年对照组比较,青年 模型组SOD活性和6－Keto-PGF1α含量降低,TXB2、NO、MDA含量较高。老龄对照组NO含量降低和MDA含量增高较青年对照组显著。老龄模型组SOD活性、6－Keto-PGF1α含量的降低和NO、MDA、TXB2含量的增高较老龄对照组显著。与老龄模型组比较,青年模型组MDA、NO含量降低和SOD活性升高。结论 前列腺素及自由基介导的损伤参与肺炎的小肠组织损伤发生发展。由于增龄变化,肺炎老龄大鼠小肠自由基损伤青年大鼠尤为重要。     

肺炎双球菌肺炎老龄大鼠小肠组织自由基和前列腺素代谢变化

目的：研究老年肺炎的小肠损伤病理生理特点。方法：复制肺炎双球菌肺炎大鼠模型，分为青年和老龄对照组及模型组。主要观察肺脏和小肠组织含水量，小肠组织6-酮-前列腺素F1α(6-keto-PGF1α)、血栓素B2(TXB2)、一氧化氮(NO)、丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性。结果：肺炎大鼠的肺组织损伤明显，肺脏和小肠组织含水量增高。青年模型组和老龄模型组小肠组织6-keto-PGF1α含量、SOD活性的降低和TXB2、NO、MDA含量的增高均较青年对照组和老龄对照组显著。与青年对照组比较，老龄对照组SOD活性降低，MDA含量升高。老龄模型组SOD活性的降低和MDA含量的增高较青年模型组显著。结论：前列腺素及自由基介导的损伤参与肺炎小肠组织损伤的发生和发展。由于增龄变化，肺炎老龄大鼠小肠自由基损伤较青年大鼠尤为严重。     

肺炎克雷伯杆菌肺炎老龄大鼠心肌损伤中TNF-α IL-1及MIP-2表达的意义

目的从心肌组织肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、巨噬细胞炎症蛋白-2(MIP-2)的表达和MIP-2 mRNA表达变化揭示老年肺炎导致心肌损伤的病理机制。方法复制肺炎克雷伯杆菌肺炎模型,大鼠分为青龄对照组、青龄模型组、老龄对照组、老龄模型组。观察肺脏和心脏的普通病理改变及心肌组织的超微结构,计数外周血和肺泡灌洗液白细胞及中性粒细胞,采用免疫组织化学方法和原位杂交方法测定心肌组织TNF-α、IL-1、MIP-2蛋白表达和MIP-2 mRNA表达。结果老龄模型组的肺脏损伤、心肌损伤和肺脏细菌计数的增高较青龄模型组严重。青龄模型组和老龄模型组外周血和肺泡灌洗液白细胞和中性粒细胞分别高于青龄对照组和老龄对照组。青龄模型组和老龄模型组心肌组织TNF-α、IL-1、MIP-2蛋白表达和MIP-2 mRNA表达分别较青龄对照组和老龄对照组增强,老龄对照组的表达均弱于青龄对照组,老龄模型组的表达均较青龄模型组增强。结论细胞因子TNF-α和IL-1及MIP-2表达增强参与肺炎导致心肌损伤的发生,这些因子的过度表达可能是老年肺炎导致心肌损伤严重的部分机制。     

毒素清对肺炎双球菌肺炎老龄大鼠肺脏免疫功能的影响

目的 :从肺脏免疫功能探讨毒素清治疗老年肺炎的机制。方法 :复制肺炎双球菌肺炎老龄大鼠模型 ,分为对照组 ,模型组 ,毒素清高、低剂量组 ,头孢氨苄组 ;观察各组肺脏组织病理改变和肺泡灌洗液免疫球蛋白、纤维连接蛋白 (FN )和中性粒细胞计数。结果 :肺炎老龄大鼠肺组织损伤明显 ,与对照组比较 ,模型组分泌型Ig A (s Ig A)和 FN降低 ,Ig A和中性粒细胞增高 ;与模型组比较 ,用药各组 Ig A含量降低 ,毒素清高剂量组s Ig A、FN含量升高和中性粒细胞降低。结论 :肺脏中性粒细胞和免疫球蛋白含量增多及 s Ig A、FN含量减少与老年肺炎的发生发展有着密切关系 ;毒素清对肺炎的作用机制与其降低中性粒细胞数量和提高 s Ig A、FN含量等有关     

毒素清对大肠杆菌肺炎老龄大鼠小肠组织自由基和前列腺素代谢变化的影响

目的：研究老年肺炎时小肠损伤的病理生理特点与中药毒素清的作用机制。方法：复制大肠杆菌肺炎模型,分为老龄对照组、模型组、毒素清高低剂量组和氟哌酸组5组。主要观察肺脏和小肠组织病理改变及其含水量,小肠组织6－酮－前列腺素F1α（6-keto-PGF1α）和血栓素B2（TXB2）含量,一氧化氮（NO）、丙二醛（MDA）含量及超氧化物歧化酶（SOD）活性。结果：肺炎时肺、小肠组织损伤明显,含水量增高。老龄模型组SOD活性、6－keto-PGF1α含量的降低和NO、MDA、TXB2含 量的增高均较老龄对照组显著。结论：前列腺素及自由基介导的损伤参与肺炎时小肠组织损伤的发生、发展。毒素清对老龄大鼠肺炎的小肠损伤改善作用明显,其机制与其拮抗自由基损伤和调节前列腺素代谢平衡有关。     

克雷伯杆菌肺炎老龄大鼠多器官损伤模型的建立

目的 建立细菌性老龄大鼠多器官损伤模型.方法 将大鼠随机分为老龄对照组、老龄模型组和青年对照组、青年模型组.采用气管插管法注入肺炎克雷伯杆菌引起肺部炎症,根据脏器有关生化指标变化、病理学改变及动物死亡率等情况评价该模型.结果 青年模型组和老龄模型组制模24 h后大鼠死亡率分别为33.3%(5/15)和60.0%(15/25).与同龄对照组比较,青年模型组和老龄模型组外周血白细胞计数和中性粒细胞比例明显增高(P均<0.01);肺、心、肝功能障碍发生率为60%～100%;肺动脉血氧分压(PaO2)明显下降,动脉血二氧化碳分压(PaCO2)显著上升(P<0.05或P<0.01);血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)明显增高(P<0.05或P<0.01);脏器组织学发生了明显的病理学改变.与青年模型组比较,老龄模型组肺PaO2明显下降、PaCO2显著上升;血清CK、CK-MB、LDH和ALT、AST明显增高(P<0.05或P<0.01);肺、心、小肠病理损伤评分显著增高(P均<0.05),肝、肾亦有增高趋势.结论 成功地制备了细菌性老龄大鼠多器官损伤模型,符合老年"肺启动"机制多器官功能障碍综合征(MODS)特征,该模型制备简便,成功率高.脏器损伤重、死亡率高为老龄大鼠多器官损伤的特点.     

毒素清对大肠杆菌肺炎老龄大鼠小肠组织自由基

目的研究老年肺炎时小肠损伤的病理生理特点与中药毒素清的作用机制。方法复制大肠杆菌肺炎模型,分为老龄对照组、模型组、毒素清高低剂量组和氟哌酸组5组。主要观察肺脏和小肠组织病理改变及其含水量,小肠组织6-酮-前列腺素F1α(6-keto-PGF1α)和血栓素B2(TXB2)含量,一氧化氮(NO)、丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性。结果肺炎时肺、小肠组织损伤明显,含水量增高。老龄模型组SOD活性、6-keto-PGF1α含量的降低和NO、MDA、TXB2含量的增高均较老龄对照组显著。与老龄模型组比较,毒素清用药各组MDA和NO含量降低,SOD活性和6-keto-PGF1α含量提高。结论前列腺素及自由基介导的损伤参与肺炎时小肠组织损伤的发生、发展。毒素清对老龄大鼠肺炎的小肠损伤改善作用明显,其机制与其拮抗自由基损伤和调节前列腺素代谢平衡有关。     

热毒清口服液对克雷伯菌老年肺炎大鼠模型炎症反应的影响

目的:观察热毒清口服液对肺炎克雷伯菌感染大鼠炎症反应的影响,探讨其部分作用机制,为热毒清口服液治疗老年肺炎的临床应用提供实验基础和依据。方法 :将75只老龄雄性大鼠随机分为5组,分别为正常对照组、模型组、中药组、西药组和中西医结合组,每组15只。气管内注射肺炎克雷伯菌建立肺炎感染模型,治疗组分别用热毒清口服液(中药组)、头孢呋辛酯(西药组)、热毒清口服液+头孢呋辛酯(中西医结合组)治疗,于末次给药后24h取材。观察各组大鼠的一般情况、肺组织病理、影像学变化,检测外周血中白细胞总数及中性粒细胞计数,用ELISA法检测血清中C反应蛋白的含量。结果 :模型组大鼠出现明显的感染中毒症状,肺组织大体充血水肿,触摸有实质感,光镜下显示肺组织炎症细胞浸润,影像学提示实变征象,外周血白细胞总数、中性粒细胞计数及C反应蛋白含量均增高。与模型组比,各治疗组的上述表现均较模型组减轻,外周血白细胞总数、中性粒细胞计数及C反应蛋白含量均降低,以中西医结合组改善明显。结论 :热毒清口服液可以降低老年肺炎大鼠模型的炎症反应,减轻炎症损伤,保护肺组织。热毒清口服液对肺炎的治疗机制可能与减轻炎症反应有关。     

Th17细胞相关因子在重症肺炎克雷伯菌肺炎大鼠中的调控作用

目的探究辅助性T细胞17(Th-17)相关因子在重症肺炎克雷伯菌肺炎发病过程中的调控作用。方法将60只SD大鼠随机分为对照组(10只)和重症肺炎组(50只),采用气管滴注肺炎克雷伯菌建立重症肺炎大鼠模型,重症肺炎组根据肺炎克雷伯菌感染时间分为12 h组、1 d组、3 d组、5 d组和7 d组,每组各10只。观察大鼠行为学变化、肺组织形态学变化,检测肺泡灌洗液中白细胞和中性粒细胞的数量,采用ELISA检测肺泡灌洗液中白细胞介素17(IL-17)、白细胞介素23(IL-23)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)的表达。分析中性粒细胞数目与IL-17、IL-23水平的相关性。结果与对照组相比,重症肺炎组大鼠出现明显的感染症状,呼吸加重、颜面部和四肢呈紫绛色等,且肺组织表现出明显病变,接种第3天最为严重;肺泡灌洗液中白细胞和中性粒细胞的数目、IL-17、IL-23、TNF-α、IL-1β水平显著升高(P 0. 05),白细胞和中性粒细胞的数目、IL-17、IL-23水平于第3天达到峰值,TNF-α、IL-1β水平于第5天达到峰值;肺泡灌洗液中IL-17、IL-23水平分别与中性粒细胞的数目呈正相关(P 0. 05)。结论 IL-17、IL-23为重症肺炎克雷伯菌肺炎中早期促炎因子,可通过刺激中性粒细胞的活性,参与重症肺炎的发生发展。     

老龄大鼠脑缺血再灌注肺损伤机制研究

目的从ATP酶活性变化和自由基损伤方面研究老龄大鼠脑缺血再灌注肺脏损伤机制。方法青年(5月龄)和老龄(20月龄以上)大鼠均分为模型组和对照组,观察大鼠全脑缺血30min再灌注60min后肺脏组织形态和丙二醛(MDA)含量及超氧化物岐化酶(SOD)、ATP酶活性的变化。结果青年和老龄模型组大鼠肺脏组织均出现明显的病理改变,老龄模型组较青年模型组严重。老龄对照组肺组织MDA/SOD比值高于青年对照组组。青年模型组肺Ca2+-ATP酶活性低于青年对照组和老龄模型组。结论脑缺血再灌注肺损伤老龄大鼠较青年大鼠严重,Ca2＋-ATP酶活性的降低和自由基损伤可能是肺损伤发生的机制之一。     

Mediators of hypersensitivity pneumonitis

Inhalation of Saccharopolyspora rectivirgula (S. rectivirgula) causes farmer's lung disease, a classic example of hypersensitivity pneumonitis (HP). HP is characterized by bronchoalveolar lavage fluid (BALF) neutrophilia (within the first 48 hours after inhalation), followed by BALF lymphocytosis. We utilized a well-described murine model of HP to determine the timing of the appearance of the C-C chemokines monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1alpha (MIP-1alpha); the inflammatory cytokines tumor necrosis factor (TNF), interleukin-1alpha (IL-1alpha), and interleukin-6 (IL-6); and the Th1 -differentiating cytokine interleukin-12 (IL-12) in BALF. After a single intratracheal administration of S. rectivirgula, there was remarkable BALF neutrophilia (peak 24 to 48 hours), followed by a BALF lymphocytosis (peak 48 to 72 hours) in both C57Bl/6 and BALB/c mice that was preceded by the appearance of MIP-1alpha in BALF (peak 4 to 6 hours) and MCP-1 (peak at 48 hours). In both strains of mice there was a striking increase of BALF IL-12 (peak 48 to 72 hours). There was also an increase in BALF IL-6, IL-1alpha, and TNF that was greater in the BALB/c mice than in the C57Bl/6 mice. S. rectivirgula induced the secretion of MIP-1alpha, MCP-1, IL-6, IL-1alpha, and IL-12 from the murine macrophage cell line J774A.1; MIP-1alpha, IL-6, IL-1alpha, IL-12, and TNF from C57Bl/6 alveolar macrophages; and IL-1alpha, IL-6, and TNF-but not IL-12-from BALB/c alveolar macrophages. We conclude that chemokines and cytokines induced by intratracheal administration of S. rectivirgula precede BALF neutrophilia and lymphocytosis and may cause differentiation of Th1 cells; we also conclude that pulmonary macrophages represent a potential source of these substances.     

不同细胞因子在重症肺炎诊断中的临床意义

【目的】探讨不同细胞因子在重症肺炎患者临床诊断中的意义。【方法】收集肺炎患者100例,根据患者病情将其分为重症肺炎组40例、普通肺炎组60例;另选取健康体检者50例作为对照组,检测并比较三组患者白细胞介素-6（IL-6）、白介素-8（IL-8）、肿瘤坏死因子（TNF）、C-反应蛋白（CRP）及白细胞（WBC）水平。【结果】重症肺炎组血清细胞因子TNF、IL-6、IL-8、CRP及WBC水平均显著高于普通肺炎组及对照组,且普通肺炎组显著高于对照组,其差异均有统计学意义（P〈0．05）。【结论】血清细胞因子TNF、IL-6、IL-8的升高对重症肺炎患者的诊断具有一定意义。     

Cytokine production in IgG-mediated red cell incompatibility

The transfusion of incompatible red cells may result in fever and systemic symptoms. The mechanisms by which these symptoms are produced in the setting of antibodies that do not usually fix complement, as in the Rh system, are obscure. It has been hypothesized, on the basis of their known biologic activities, that a specific set of cytokines may be involved in such transfusion reactions. Therefore, the production of the inflammatory cytokines interleukin-1 beta (IL-1 beta), tumor necrosis factor (TNF), interleukin-6 (IL-6), and interleukin-8 (IL-8) by human monocytes in response to red cells sensitized with anti-D was investigated, as a model of IgG-dependent hemolytic transfusion reactions. IL-1 beta, IL-6, and IL-8 were detectable in the culture supernatants at 4 to 6 hours and increased up to 24 hours, whereas TNF peaked at 6 hours. Immunocytochemical stains of cell preparations demonstrated IL-1 beta, IL-8, and TNF in monocytes engaged in erythrophagocytosis. IL-8 production and phagocytosis could be inhibited by monomeric IgG, but Fab fragments of a monoclonal antibody specific for the low-affinity IgG receptor Fc gamma RII could not be, which suggests the involvement of the high-affinity receptor Fc gamma RI. Neutralizing antisera to IL-1 beta and TNF did not abrogate the production of IL-8, which suggests that sensitized red cells serve as a primary signal for this cytokine. These findings indicate that the production of inflammatory cytokines by phagocytes may be responsible for the symptomatology of IgG-mediated hemolytic transfusion reactions.     

Dysregulation of in vitro cytokine production by monocytes during sepsis.

The production by monocytes of interleukin-1 alpha (IL-1 alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF alpha) in intensive care unit (ICU) patients with sepsis syndrome (n = 23) or noninfectious shock (n = 6) is reported. Plasma cytokines, cell-associated cytokines within freshly isolated monocytes and LPS-induced in vitro cytokine production were assessed at admission and at regular intervals during ICU stay. TNF alpha and IL-6 were the most frequently detected circulating cytokines. Despite the fact that IL-1 alpha is the main cytokine found within monocytes upon in vitro activation of cells from healthy individuals, it was very rarely detected within freshly isolated monocytes from septic patients, and levels of cell-associated IL-1 beta were lower than those of TNF alpha. Cell-associated IL-1 beta and TNF alpha were not correlated with corresponding levels in plasma. Upon LPS stimulation, we observed a profound decrease of in vitro IL-1 alpha production by monocytes in all patients, and of IL-1 beta, IL-6, and TNF alpha in septic patients. This reduced LPS-induced production of cytokines was most pronounced in patients with gram-negative infections. Finally, monocytes from survival patients, but not from nonsurvival ones recovered their capacity to produce normal amounts of cytokines upon LPS stimulation. In conclusion, our data indicate an in vivo activation of circulating monocytes during sepsis as well as in noninfectious shock and suggest that complex regulatory mechanisms can downregulate the production of cytokines by monocytes during severe infections.