Dayal Saraswati D, Haskó György, Lu Qi, Xu Da-Zhong, Caruso Joseph M, Sambol Justin T, Deitch Edwin A
UMDNJ-New Jersey Medical School, Newark 07103, USA.
Shock. 2002 Jun;17(6):491-5. doi: 10.1097/00024382-200206000-00009.
Trauma/hemorrhagic shock (T/HS) is associated with significant lung injury, which is mainly due to an inflammatory process, resulting from the local activation and subsequent interaction of endothelial cells and leukocytes. Adhesion molecules expressed by both cell types play a crucial role in the process of neutrophil-mediated endothelial cell injury. We have previously shown that mesenteric lymph duct ligation prevents T/HS-induced lung leukocyte infiltration and endothelial injury, suggesting that inflammatory factors originating from the gut and carried in the lymph are responsible for the lung injury observed following T/HS. Based on these observations, we hypothesized that inflammatory substances in T/HS lymph trigger lung injury by a mechanism involving the upregulation of adhesion molecules. To test this hypothesis, we examined whether T/HS mesenteric lymph induces the expression of E-selectin, P-selectin, and intracellular adhesion molecule-1 (ICAM-1) in human umbilical vein endothelial cells (HUVECs). Furthermore, because the cytokine IL-6 is an important component of the endothelial inflammatory process, we investigated how T/HS lymph affects the production of IL-6 by HUVECs. Mesenteric lymph from T/HS rats increased both E- and P-selectin, as well as ICAM-1 expression on HUVECS, as compared to trauma/sham shock (T/SS) lymph or medium only groups. However, T/HS lymph failed to induce the shedding of E-selectin. In HUVECs treated with T/HS lymph, IL-6 concentrations were higher than HUVECs treated with T/SS lymph. These findings suggest that mesenteric lymph produced after hemorrhagic shock potentiates lung injury by the upregulation of endothelial cell adhesion molecule expression and IL-6 production.
创伤/失血性休克(T/HS)与严重的肺损伤相关,这主要归因于炎症过程,该炎症过程由内皮细胞和白细胞的局部激活及随后的相互作用引起。两种细胞类型所表达的黏附分子在中性粒细胞介导的内皮细胞损伤过程中起关键作用。我们之前已经表明,肠系膜淋巴管结扎可预防T/HS诱导的肺白细胞浸润和内皮损伤,这表明源自肠道并通过淋巴携带的炎症因子是T/HS后观察到的肺损伤的原因。基于这些观察结果,我们推测T/HS淋巴中的炎症物质通过涉及黏附分子上调的机制引发肺损伤。为了验证这一假设,我们检测了T/HS肠系膜淋巴是否诱导人脐静脉内皮细胞(HUVECs)中E-选择素、P-选择素和细胞间黏附分子-1(ICAM-1)的表达。此外,由于细胞因子IL-6是内皮炎症过程的重要组成部分,我们研究了T/HS淋巴如何影响HUVECs产生IL-6。与创伤/假手术休克(T/SS)淋巴或仅培养基组相比,T/HS大鼠的肠系膜淋巴增加了HUVECs上E-选择素和P-选择素以及ICAM-1的表达。然而,T/HS淋巴未能诱导E-选择素的脱落。在用T/HS淋巴处理的HUVECs中,IL-6浓度高于用T/SS淋巴处理的HUVECs。这些发现表明,失血性休克后产生的肠系膜淋巴通过上调内皮细胞黏附分子表达和IL-6产生来加重肺损伤。