HO-1/CO径路在肺缺血-再灌注损伤中的作用

目的：探讨血红素氧合酶-1（HO-1）/一氧化碳（CO）径路在肺缺血-再灌注损伤中的作用。 方法： 采用在体兔单肺原位缺血-再灌注模型。实验兔40只，随机均分为假手术对照（C）组、肺缺血-再灌注（I-R）组、肺缺血-再灌注加氯铁血红素(H)组和肺缺血-再灌注加锌原卟啉(Z)组。分别在缺血前、缺血后、再灌注1 h、2 h、3 h抽血，检测一氧化碳血红蛋白(COHb)浓度。实验结束时取肺组织检测湿干重比（W/D）、肺泡损伤率（IAR），观察肺组织超微结构的改变、HO-1的活力、表达部位及强度。 结果： 血浆COHb浓度，I-R组、H组明显高于C组，以H组为著（P<0.01）；H组、Z组显著高于、低于I-R组（P<0.01）。肺组织HO-1活力H组最高，其次是I-R组，Z组和C组最低（P<0.05和P<0.01）。I-R组、H组、Z组HO-1在肺血管内皮、部分血管平滑肌、外膜层及部分气道上皮均有阳性表达，明显高于C组，尤以H组最为明显（P<0.01）。W/D、IAR值，I-R组和Z组均明显高于C组，尤以Z组为著，H组虽较C组为高，但显著低于IR组和Z组（P<0.05和P<0.01）。肺组织形态学异常改变，以Z组为著，H组较轻。 结论： HO-1/CO径路对缺血-再灌注肺发挥积极的保护作用。

Role of heme oxygenase-1/carbon monoxide system in pulmonary ischemia-reperfusion injury

AIM: To investigate the effect of heme oxygenase-1 (HO-1)/carbon monoxide (CO) system on pulmonary ischemia-reperfusion injury (PIRI) in rabbits. METHODS: Single lung ischemia and reperfusion animal model was used in vivo. The rabbits were randomly divided into three groups (n=10 in each), control group (C), PIR group (I-R), PIR hemin group (H) and PIR zinc protoporphyrin IX (ZnPP) group (Z). Changes of several parameters which included plasma carboxyhemoglobin (COHb) at different time points, wet to dry ratio of lung tissue weight (W/D), the injured alveoli rate (IAR) and the HO-1 enzymatic activity were measured at 180 min after reperfusion in lung tissue. The tissue slides were also stained by immunohistochemistry (IHC) and in situ hybridization (ISH) for HO-1 to detect the expression of HO-1 in lung and to analyze the optical density. The lung tissue was prepared for electron microscopic observation at 180 min after reperfusion. RESULTS: The plasma content of COHb in I-R, H, and Z group increased in a time-dependent manner after I-R. But the increment of H group was higher than that of I-R group, while that of Z group was lower. The HO-1 activity in lung tissue was highest in H group, followed by IR group, Z group, and C group (P<0.05 and P<0.01). Except C group, HO-1 was upregulated in all other groups in the pulmonary endothelial cells, part of pulmonary vascular smooth muscle cells, extima of vessels and epithelial cells of airway. H group had the highest average optical density value, then the IR group, Z group and C group (P<0.05 and P<0.01). The value of W/D and IAR was highest in Z group, the second was in IR group, then the H group and C group (P<0.05 and P<0.01). The abnormal changes of the lung tissue in morphology in I-R group, Hemin treatment mitigated the injury of I-R in H group and ZnPP exacerbated the impairment of ultrastructure in Z group were also observed. CONCLUSION: (HO-1/CO) system possesses notable protective effects on lung during pulmonary ischemia-reperfusion injury in rabbits.