Koo D J, Chaudry I H, Wang P
Center for Surgical Research and Department of Surgery, Brown University School of Medicine and Rhode Island Hospital, Providence, Rhode Island 02903, USA.
J Surg Res. 1999 May 15;83(2):151-7. doi: 10.1006/jsre.1999.5584.
Although hepatocellular dysfunction occurs early after the onset of sepsis, the mechanism responsible for this remains unknown. We tested the hypothesis that the reduction in Kupffer cell (KC) numbers prior to the onset of sepsis prevents the occurrence of hepatocellular dysfunction and reduces levels of the proinflammatory cytokines IL-1beta and IL-6 during the early stage of polymicrobial sepsis.
The number of KC in male adult rats was reduced in vivo by intravenous injection of gadolinium chloride 48 h before the induction of sepsis. KC-reduced and KC-normal rats were then subjected to cecal ligation and puncture (CLP, i.e., a model of polymicrobial sepsis) or sham operation followed by administration of normal saline solution. At 5 h after CLP (the early stage of sepsis), hepatocellular function [i.e., the maximal velocity of clearance (Vmax) and efficiency of active transport (Km) of indocyanine green] was measured using a fiber-optic catheter and in vivo hemoreflectometer. Whole blood was drawn to measure plasma levels of IL-1beta and IL-6 using enzyme-linked immunosorbent assays.
Hepatocellular function was depressed and the circulating levels of IL-1beta and IL-6 were increased significantly at 5 h after CLP. KC reduction by prior administration of gadolinium chloride, however, prevented the occurrence of hepatocellular dysfunction and the upregulation of IL-1beta and IL-6.
The KC-derived proinflammatory cytokines IL-1beta and IL-6 appear to be directly or indirectly responsible for producing hepatocellular dysfunction during early sepsis. Thus, pharmacologic agents that downregulate the production of one or both of these proinflammatory cytokines in the liver may be useful for maintaining hepatocellular function during the early stage of sepsis.
尽管在脓毒症发作后早期会出现肝细胞功能障碍,但其发生机制仍不清楚。我们检验了这样一个假设,即在脓毒症发作前减少库普弗细胞(KC)数量可预防肝细胞功能障碍的发生,并降低多微生物脓毒症早期促炎细胞因子白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的水平。
在诱导脓毒症前48小时,通过静脉注射氯化钆在体内减少成年雄性大鼠的KC数量。然后,对KC减少和KC正常的大鼠进行盲肠结扎和穿刺(CLP,即多微生物脓毒症模型)或假手术,随后给予生理盐水。在CLP后5小时(脓毒症早期),使用光纤导管和体内血液反射仪测量肝细胞功能[即吲哚菁绿的最大清除速度(Vmax)和主动转运效率(Km)]。采集全血,使用酶联免疫吸附测定法测量血浆中IL-1β和IL-6的水平。
CLP后5小时,肝细胞功能受到抑制,IL-1β和IL-6的循环水平显著升高。然而,预先给予氯化钆减少KC可预防肝细胞功能障碍的发生以及IL-1β和IL-6的上调。
KC衍生的促炎细胞因子IL-1β和IL-6似乎直接或间接导致脓毒症早期肝细胞功能障碍。因此,下调肝脏中一种或两种这些促炎细胞因子产生的药物可能有助于在脓毒症早期维持肝细胞功能。