Heller A, Schmeck J, Heller S, Phan H, Nebe T, Urbaschek R, Koch T
Department of Anesthesiology, University Hospital Carl Gustav Carus, Dresden, Germany.
Crit Care Med. 2000 May;28(5):1515-21. doi: 10.1097/00003246-200005000-00043.
During systemic inflammation, elevated levels of endothelin (ET)-1 have been reported. The aim of this study was to investigate the effects of ET-1 on neutrophil (PMN) respiratory burst, phagocytosis, and elimination of Escherichia coli from blood and tissues.
Prospective, randomized, controlled trial.
Experimental laboratory in a university hospital.
A total of 18 female chinchilla rabbits.
To quantify the clearance process, defined numbers (10(8) colony-forming units) of E. coli were injected intravenously into anesthetized rabbits, 60 mins after onset of continuous 0.2 microg/kg/min ET-1 administration (n = 9) and after saline infusion (control group, n = 9), respectively. To evaluate potential effects of ET-1 on bacterial elimination and killing, blood clearance of E. coli and colonization of different organs were investigated.
Variables monitored were neutrophil respiratory burst and phagocytosis activity, rates of bacterial elimination from the blood, arterial blood pressure, blood gases, serum lactate concentrations, and nitrite and nitrate levels. The animals were killed 3 hrs after bacterial injection and tissue samples of liver, kidney, spleen, and lung were collected for bacterial counts.
Compared with the control group, ET-1 significantly impaired PMN respiratory burst (p < .05) and prolonged elimination of injected E. coli from the blood (p < .01), whereas phagocytosis functions remained unaltered. The reduced PMN burst activity after ET-1 was associated with a higher bacterial colonization of all organs (lung, p < .01; spleen, p < .05). Endothelin-1 induced increases in mean arterial pressure (p < .01) and serum lactate concentrations, whereas nitrite and nitrate levels remained unaltered.
Endothelin-1 impairs respiratory burst and bacterial clearance from the blood and tissue. Thus, elevated levels of ET-1 during sepsis could induce organ hypoperfusion and cause disturbances in immune functions, increasing the risk of bacterial infections.
据报道,在全身炎症反应期间,内皮素(ET)-1水平会升高。本研究的目的是探讨ET-1对中性粒细胞(PMN)呼吸爆发、吞噬作用以及从血液和组织中清除大肠杆菌的影响。
前瞻性、随机、对照试验。
大学医院的实验实验室。
总共18只雌性龙猫兔。
为了量化清除过程,在持续静脉输注0.2微克/千克/分钟ET-1 60分钟后(n = 9)和输注生理盐水后(对照组,n = 9),分别向麻醉的兔子静脉注射确定数量(10⁸个菌落形成单位)的大肠杆菌。为了评估ET-1对细菌清除和杀灭的潜在影响,研究了大肠杆菌的血液清除率和不同器官的定植情况。
监测的变量包括中性粒细胞呼吸爆发和吞噬活性、血液中细菌清除率、动脉血压、血气、血清乳酸浓度以及亚硝酸盐和硝酸盐水平。在注射细菌3小时后处死动物,收集肝脏、肾脏、脾脏和肺的组织样本进行细菌计数。
与对照组相比,ET-1显著损害PMN呼吸爆发(p <.05),并延长了血液中注射的大肠杆菌的清除时间(p <.01),而吞噬功能保持不变。ET-1作用后PMN爆发活性降低与所有器官(肺,p <.01;脾脏,p <.05)更高的细菌定植有关。内皮素-1导致平均动脉压(p <.01)和血清乳酸浓度升高,而亚硝酸盐和硝酸盐水平保持不变。
内皮素-1损害呼吸爆发以及血液和组织中的细菌清除。因此,脓毒症期间ET-1水平升高可能导致器官灌注不足,并引起免疫功能紊乱,增加细菌感染的风险。