Wang X, Sun Z, Börjesson A, Andersson R
Department of Surgery, Lund University Hospital, Sweden.
Br J Surg. 1999 Mar;86(3):411-6. doi: 10.1046/j.1365-2168.1999.01028.x.
Endothelial barrier dysfunction is a critical link in the development of tissue injury and organ dysfunction, via upregulation and exposure of adhesion molecules, intercellular signals and leucocyte-endothelial cell interactions. Inhibitors of inflammatory mediators and receptors have been suggested as a means of downregulating the cascade of both local and systemic inflammation.
The potential therapeutic inhibition of platelet-activating factor (PAF), intercellular adhesion molecule (ICAM) 1 and platelet endothelial cell adhesion molecule (PECAM) 1 was investigated in pancreatitis-associated gut endothelial dysfunction in rats, by treatment with a PAF antagonist (lexipafant, BB-882) and monoclonal antibodies against rat ICAM-1 (anti-ICAM1-Mb) and PECAM (anti-PECAMA1-Mb). Alterations in gut endothelial barrier dysfunction and leucocyte recruitment, and systemic levels of interleukins were evaluated.
Plasma exudation measured by the albumin leakage index and tissue leucocyte recruitment in the distal small intestine and colon increased significantly 12 h after induction of pancreatitis and treatment with saline. These alterations were to varying degrees counteracted by treatment with lexipafant, anti-ICAM1-Mb or anti-PECAM1-Mb. Alterations in levels of interleukin (IL) 1 paralleled the changes in gut endothelial barrier dysfunction and leucocyte trapping.
Treatment with lexipafant and monoclonal antibodies against ICAM-1 or PECAM-1 reduced the severity of pancreatitis-associated gut endothelial dysfunction, and decreased systemic concentrations of IL-1 and local leucocyte recruitment.
内皮屏障功能障碍是组织损伤和器官功能障碍发展过程中的关键环节,可通过上调和暴露黏附分子、细胞间信号以及白细胞 - 内皮细胞相互作用来实现。炎症介质和受体抑制剂已被提议作为下调局部和全身炎症级联反应的一种手段。
通过用血小板活化因子(PAF)拮抗剂(来昔帕泛,BB - 882)以及抗大鼠细胞间黏附分子 - 1(抗ICAM - 1单克隆抗体)和抗血小板内皮细胞黏附分子 - 1(抗PECAM - 1单克隆抗体)治疗,研究了在大鼠胰腺炎相关肠道内皮功能障碍中对PAF、细胞间黏附分子(ICAM)1和血小板内皮细胞黏附分子(PECAM)1的潜在治疗性抑制作用。评估了肠道内皮屏障功能障碍和白细胞募集的改变以及白细胞介素的全身水平。
在诱导胰腺炎并用生理盐水治疗12小时后,通过白蛋白渗漏指数测量的血浆渗出以及远端小肠和结肠中的组织白细胞募集显著增加。用BB - 882、抗ICAM - 1单克隆抗体或抗PECAM - 1单克隆抗体治疗可在不同程度上抵消这些改变。白细胞介素(IL)1水平的改变与肠道内皮屏障功能障碍和白细胞滞留的变化平行。
用BB - 882以及抗ICAM - 1或抗PECAM - 1单克隆抗体治疗可降低胰腺炎相关肠道内皮功能障碍的严重程度,并降低IL - 1的全身浓度和局部白细胞募集。