Liu Zhihai, Yu Yingqun, Jiang Yun, Li Jieshou
Department of Surgery, College of Medicine, Nanjing University, Nanjing 210093, China.
J Surg Res. 2002 Jun 15;105(2):195-9. doi: 10.1006/jsre.2002.6374.
Growth hormone (GH) has been shown to increase mortality in critical illness, illustrating the need for better understanding of GH treatment. The neutrophil is a key mediator in producing organ injury following shock and trauma and is regulated by GH. Therefore, the purpose of the present study was to examine the effects of GH on circulating neutrophil activation and subsequent lung injury induced by sepsis in rats.
Sepsis was induced in male Wistar rats via cecal ligation and puncture (CLP). Recombinant human growth hormone (1 IU/kg) was given subcutaneously right after CLP with an additional injection at 12 h after CLP. CD11b expression and an oxidative burst of neutrophils were detected using flow cytometric analysis. Lung myeloperoxidase activity was determined as an index of tissue neutrophil accumulation. Lung microvascular injury was assessed by quantitating extravasation of Evan's blue dye into lung parenchyma.
Growth hormone significantly increased sepsis-induced expression of CD11b and sepsis-induced circulating neutrophil activation. Also growth hormone increased neutrophil accumulation in lungs induced by sepsis. Lung microvascular injury was aggravated by growth hormone treatment in septic rats.
It is worthwhile to rethink GH administration in critical illness and further studies are required to determine the safety and clinical benefits of GH administration in critical illness.
生长激素(GH)已被证明会增加危重病患者的死亡率,这表明需要更好地了解GH治疗。中性粒细胞是休克和创伤后导致器官损伤的关键介质,且受GH调节。因此,本研究的目的是探讨GH对脓毒症诱导的大鼠循环中性粒细胞活化及随后肺损伤的影响。
通过盲肠结扎和穿刺(CLP)诱导雄性Wistar大鼠发生脓毒症。CLP后立即皮下注射重组人生长激素(1 IU/kg),并在CLP后12小时额外注射一次。采用流式细胞术分析检测中性粒细胞的CD11b表达和氧化爆发。测定肺髓过氧化物酶活性作为组织中性粒细胞聚集的指标。通过定量伊文思蓝染料渗入肺实质来评估肺微血管损伤。
生长激素显著增加脓毒症诱导的CD11b表达和脓毒症诱导的循环中性粒细胞活化。生长激素还增加了脓毒症诱导的肺内中性粒细胞聚集。生长激素治疗加重了脓毒症大鼠的肺微血管损伤。
值得重新思考危重病中GH的给药方式,需要进一步研究以确定危重病中GH给药的安全性和临床益处。