Gonzalez R J, Moore E E, Ciesla D J, Biffl W L, Offner P J, Silliman C C
Department of Surgery, Denver Health Medical Center and University of Colorado Health Sciences Center, Colorado 80204, USA.
Surgery. 2001 Aug;130(2):198-203. doi: 10.1067/msy.2001.115824.
Our previous work identified posthemorrhagic shock mesenteric lymph (PHSML) lipids as key elements in polymorphonuclear neutrophil (PMN)--provoked acute lung injury. We hypothesize that gut phospholipase A(2) (PLA(2)) is responsible for the generation of proinflammatory lipids in PHSML that primes circulating PMNs for enhanced oxidative burst.
Mesenteric lymph was collected from rats (n = 5) before (preshock), during the induction of hemorrhagic shock (mean arterial pressure, 40 mm Hg x 30 minutes), and at resuscitation (shed blood + 2x lactated Ringer's solution). PLA(2) inhibition (quinacrine, 10 mg/kg, intravenously) was given before shock was induced. Extracted lipids were separated by normal phase high-pressure liquid chromatography and resuspended in albumin. PMNs were exposed to a 5% vol:vol concentration of eluted lipids and activated with N-formyl-methionyl-leucyl-phenylalanine (1 micromol/L). Superoxide production was assessed by cytochrome C reduction.
High-pressure liquid chromatography--extracted neutral lipids of lymph collected before hemorrhagic shock did not prime the PMN oxidase, whereas isolated neutral lipids of postshock lymph primed PMNs 2.6- +/- 0.32-fold above baseline (P <.05). PLA(2) inhibition returned PHSML neutral lipid priming to baseline levels.
PLA(2) inhibition before hemorrhagic shock abrogates the neutrophil priming effects of PHSML through reduction of the accumulation of proinflammatory neutral lipids. Identification of these PLA(2)-dependent lipids provides a mechanistic link that may have therapeutic implications for postshock acute lung injury.
我们之前的研究确定,出血性休克后肠系膜淋巴(PHSML)脂质是多形核中性粒细胞(PMN)引发急性肺损伤的关键因素。我们假设肠道磷脂酶A2(PLA2)负责PHSML中促炎脂质的生成,这些脂质使循环中的PMN致敏,从而增强氧化爆发。
从大鼠(n = 5)身上收集肠系膜淋巴,分别在出血性休克诱导前(休克前)、诱导过程中(平均动脉压40 mmHg,持续30分钟)以及复苏时(回输失血+2倍乳酸林格氏液)。在诱导休克前给予PLA2抑制(奎纳克林,10 mg/kg,静脉注射)。提取的脂质通过正相高压液相色谱分离,并重悬于白蛋白中。将PMN暴露于洗脱脂质5%体积比的浓度下,并用N-甲酰甲硫氨酰亮氨酰苯丙氨酸(1 μmol/L)激活。通过细胞色素C还原评估超氧化物的产生。
出血性休克前收集的淋巴经高压液相色谱提取的中性脂质不能使PMN氧化酶致敏,而休克后淋巴分离出的中性脂质使PMN致敏程度比基线高2.6±0.32倍(P <.05)。PLA2抑制使PHSML中性脂质致敏作用恢复到基线水平。
出血性休克前抑制PLA2可通过减少促炎中性脂质的积累消除PHSML对中性粒细胞的致敏作用。鉴定这些依赖PLA2的脂质提供了一种机制联系,可能对休克后急性肺损伤具有治疗意义。