Ueda M, Hasegawa S, Nakamura T, Hirata T, Fukuse T, Suzuki Y, Wada H
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Eur Surg Res. 2000;32(5):289-96. doi: 10.1159/000008778.
Dibutyryl cyclic adenosine monophosphate (db-cAMP) has been shown to protect vascular endothelial cells by increasing the level of intracellular cAMP, and we have previously reported its effectiveness in lung preservation. Here, the effects of db-cAMP in lung preservation were ultrastructurally investigated, and the ultrastructural changes before reperfusion were correlated with pulmonary function after reperfusion.
The lungs of 17 Lewis rats were flushed with perfusate and prostaglandin E(1), and were then divided into three groups. In the fresh group (n = 6), the lungs were flushed with extracellular-type trehalose-containing (ET-K) solution and were reperfused immediately. In the control group (n = 6) and db-cAMP group (n = 5), the lungs were flushed with ET-K solution and ET-K solution plus db-cAMP (2 mM), respectively, and were reperfused after cold preservation at 4 degrees C for 15 h. Before reperfusion, tissue was sampled and ultrastructurally analyzed by transmission electron microscopy.
In the endothelial cells of pulmonary arterioles, the incidence of protrusion was significantly lower in the fresh and db-cAMP groups than in the control group (p < 0.05). The incidence of detachment and microvillus formation were significantly lower in the fresh and db-cAMP groups than in the control group (p < 0.01). The ultrastructure of the alveoli did not allow separation of the control and db-cAMP groups. The shunt fraction and wet to dry weight ratio of the lung tissue after reperfusion were significantly lower in the fresh and db-cAMP groups than in the control group (p < 0.01). Positive correlations were found between the incidence of these ultrastructural changes in the endothelial cells of the pulmonary arterioles and pulmonary function after reperfusion.
These findings suggest that db-cAMP might attenuate the lung injury caused by cold preservation and ischemia-reperfusion, partly by suppressing the acceleration of the structural changes in the endothelial cells in the pulmonary arterioles.
已证实二丁酰环磷腺苷(db - cAMP)可通过提高细胞内cAMP水平来保护血管内皮细胞,并且我们之前已报道其在肺保存中的有效性。在此,对db - cAMP在肺保存中的作用进行了超微结构研究,并将再灌注前的超微结构变化与再灌注后的肺功能相关联。
用灌注液和前列腺素E(1)冲洗17只Lewis大鼠的肺,然后将其分为三组。在新鲜组(n = 6)中,用含细胞外型海藻糖的(ET - K)溶液冲洗肺并立即进行再灌注。在对照组(n = 6)和db - cAMP组(n = 5)中,分别用ET - K溶液和ET - K溶液加db - cAMP(2 mM)冲洗肺,并在4℃冷保存15小时后进行再灌注。在再灌注前,采集组织并通过透射电子显微镜进行超微结构分析。
在肺小动脉的内皮细胞中,新鲜组和db - cAMP组的突出发生率显著低于对照组(p < 0.05)。新鲜组和db - cAMP组的脱离和微绒毛形成发生率显著低于对照组(p < 0.01)。肺泡的超微结构无法区分对照组和db - cAMP组。再灌注后新鲜组和db - cAMP组肺组织的分流分数和湿重与干重比显著低于对照组(p < 0.01)。肺小动脉内皮细胞中这些超微结构变化的发生率与再灌注后的肺功能之间存在正相关。
这些发现表明,db - cAMP可能部分通过抑制肺小动脉内皮细胞结构变化的加速来减轻冷保存和缺血再灌注引起的肺损伤。