Chung C S, Yang S, Song G Y, Lomas J, Wang P, Simms H H, Chaudry I H, Ayala A
Surgical Research, Department of Surgery, Brown University School of Medicine and Rhode Island Hospital, Providence, RI 02903, USA.
Surgery. 2001 Aug;130(2):339-45. doi: 10.1067/msy.2001.116540.
Fas/Fas ligand (FasL) system is one of the major pathways triggering apoptosis that has been shown to play an important role in development and pathogenesis of various diseases including liver and gastrointestinal diseases. Studies indicate that FasL deficiency provides a survival advantage in mice subjected to polymicrobial sepsis. However, the extent to which Fas/FasL contributes to organ injury during sepsis is unclear. Thus, the aim of this study was to determine whether in vivo administration of a Fas-signaling inhibitor during sepsis preserves organ function.
Male adult C3H/HeN mice were subjected to cecal ligation and puncture (CLP) or sham CLP (sham). Twelve hours after CLP, mice received either Fas-receptor fusion protein (FasFP) (200 microg/kg body weight) or the saline vehicle. Twenty-four hours after the onset of sepsis, cardiac output and organ blood flow were measured with radioactive microspheres. Plasma levels of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase were assessed as indexes of liver damage. Changes in systemic cytokines were measured by enzyme-linked immunosorbent assay. RESULTS. The data indicate that although cardiac output and organ blood flow in the liver, intestine, kidneys, spleen, and heart decreased markedly at 24 hours after CLP, treatment with FasFP maintained the measured hemodynamic parameters and improved hepatic, intestinal, and heart blood flow (P <.05) and partially restored spleen and renal blood flow. Moreover, FasFP treatment markedly attenuated the systemic rise in alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and interleukin 10 (P <.05).
These results not only indicate that there is a role for Fas/FasL-mediated processes in the induction of organ injury but suggest that inhibition of Fas/FasL pathway may represent a novel therapeutic modality for maintaining organ perfusion and preventing liver injury during sepsis.
Fas/Fas配体(FasL)系统是触发细胞凋亡的主要途径之一,已证明其在包括肝脏和胃肠道疾病在内的各种疾病的发生发展过程中发挥重要作用。研究表明,FasL缺陷在遭受多微生物败血症的小鼠中提供了生存优势。然而,Fas/FasL在败血症期间对器官损伤的影响程度尚不清楚。因此,本研究的目的是确定在败血症期间体内给予Fas信号抑制剂是否能保护器官功能。
雄性成年C3H/HeN小鼠接受盲肠结扎和穿刺(CLP)或假CLP(假手术)。CLP后12小时,小鼠接受Fas受体融合蛋白(FasFP)(200微克/千克体重)或生理盐水载体。败血症发作后24小时,用放射性微球测量心输出量和器官血流量。评估血浆丙氨酸转氨酶、天冬氨酸转氨酶和乳酸脱氢酶水平作为肝损伤指标。通过酶联免疫吸附测定法测量全身细胞因子的变化。结果。数据表明,尽管CLP后24小时肝脏、肠道、肾脏、脾脏和心脏的心输出量和器官血流量显著下降,但FasFP治疗维持了所测量的血流动力学参数,改善了肝脏、肠道和心脏的血流量(P<.05),并部分恢复了脾脏和肾脏的血流量。此外,FasFP治疗显著减轻了丙氨酸转氨酶、天冬氨酸转氨酶、乳酸脱氢酶和白细胞介素10的全身升高(P<.05)。
这些结果不仅表明Fas/FasL介导的过程在器官损伤诱导中起作用,而且表明抑制Fas/FasL途径可能代表一种维持器官灌注和预防败血症期间肝损伤的新型治疗方式。