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过氧亚硝酸盐是热损伤诱导的肺损伤中的一种重要介质。

Peroxynitrite is an important mediator in thermal injury-induced lung damage.

作者信息

Chen Lee-Wei, Wang Jyh-Seng, Chen Hua-Lin, Chen Jin-Shyr, Hsu Ching-Mei

机构信息

Department of Surgery, Kaohsiung Veterans General Hospital, National Yang-Ming Medical University, Taipei, Taiwan.

出版信息

Crit Care Med. 2003 Aug;31(8):2170-7. doi: 10.1097/01.CCM.0000079605.28852.D0.

Abstract

OBJECTIVE

Intestinal ischemia and reperfusion injury was known to cause postinjury multiple organ failure by neutrophil and unclear nonneutrophil factors. Peroxynitrite formed by the rapid reaction between superoxide and nitric oxide, is a toxic substance that contributes to tissue injury in a number of biological systems. In this study, the role of nitric oxide and neutrophils on lung damage after burn was investigated.

DESIGN

Prospective, experimental study.

SETTING

Research laboratory at a university hospital.

SUBJECTS

Thermal injury models in the rat.

INTERVENTIONS

In experiment 1, specific pathogen-free Sprague-Dawley rats underwent 35% total body surface area burn. At 4, 8, 16, and 24 hrs after burn, intestinal mucosa and lung tissue were harvested for myeloperoxidase (MPO) assay, blood was collected for measurement of peroxynitrite-mediated oxidation of dihydrorhodamine 123, and pulmonary microvascular dysfunction was quantified by measuring the extravasation of Evans blue dye. In experiment 2, polymorphonuclear granulocyte antibody (0.12 mL/100 g administered intraperitoneally 16 hrs before burn), S-methylisothiourea (7.5 mg/kg, intraperitoneally, immediately after burn), a specific inducible nitric oxide synthase inhibitor, and sterile saline (15 mL/kg, intraperitoneally, immediately after burn) were given to different groups of thermally injured animals individually. The plasma dihydrorhodamine 123 oxidation level, intestinal and lung MPO activity, lung permeability, and lung histology were evaluated at 8 hrs after burn. The cellular localization of nitrotyrosine, a marker for peroxynitrite reactivity, was also examined by immunostaining. In experiment 3, 3-morpholinosydnonimine (10 mM, intraperitoneally), a peroxynitrite donor, was given to nonburned rats to examine the peroxynitrite effect on lung inducible nitric oxide synthase expression.

MEASUREMENTS AND MAIN RESULTS

The level of MPO activity in intestine and lung, blood dihydrorhodamine 123 oxidation, and lung permeability were increased up to 2-fold, 2.5-fold, 2-fold, and 2-fold of normal, respectively, at 8 hrs after burn. S-methylisothiourea injection significantly decreased (p <.05) 31% of the lung MPO activity, 41% of the blood peroxynitrite level, 54% of the lung permeability, and the lung peroxynitrite production in burned rats. Polymorphonuclear granulocyte antibody pretreatment significantly decreased 60% of the intestinal MPO, 92% of the blood peroxynitrite level, and 56% the lung MPO activity in burned rats, but the lung permeability was only slightly decreased by polymorphonuclear granulocyte antibody pretreatment. Furthermore, 3-morpholinosydnonimine increased the lung inducible nitric oxide synthase messenger RNA levels.

CONCLUSIONS

Thermal injury induces blood dihydrorhodamine 123 oxidation, intestinal and lung neutrophil deposition, lung nitrotyrosine production, and lung damage. Both specific inhibition of inducible nitric oxide synthase and polymorphonuclear granulocyte antibody pretreatment decrease blood dihydrorhodamine 123 oxidation and intestinal and lung neutrophil deposition, but only inducible nitric oxide synthase inhibition with S-methylisothiourea reduces lung peroxynitrite production and thermal injury-induced lung damage. Nitric oxide and the ensuing peroxynitrite production in lung play a more important role than neutrophil in contributing to thermal injury-induced lung damage.

摘要

目的

已知肠道缺血再灌注损伤通过中性粒细胞和不明非中性粒细胞因子导致损伤后多器官功能衰竭。超氧化物和一氧化氮快速反应形成的过氧亚硝酸盐是一种有毒物质,在许多生物系统中会导致组织损伤。在本研究中,调查了一氧化氮和中性粒细胞在烧伤后肺损伤中的作用。

设计

前瞻性实验研究。

设置

大学医院的研究实验室。

对象

大鼠热损伤模型。

干预措施

在实验1中,特定病原体-free的Sprague-Dawley大鼠接受35%体表面积烧伤。在烧伤后4、8、16和24小时,采集肠黏膜和肺组织进行髓过氧化物酶(MPO)检测,采集血液测量过氧亚硝酸盐介导的二氢罗丹明123氧化,通过测量伊文思蓝染料外渗来量化肺微血管功能障碍。在实验2中,分别给不同组的热损伤动物腹腔注射多形核粒细胞抗体(烧伤前16小时腹腔注射0.12 mL/100 g)、S-甲基异硫脲(7.5 mg/kg,烧伤后立即腹腔注射),一种特异性诱导型一氧化氮合酶抑制剂,以及无菌生理盐水(15 mL/kg,烧伤后立即腹腔注射)。在烧伤后8小时评估血浆二氢罗丹明123氧化水平、肠和肺MPO活性、肺通透性和肺组织学。还通过免疫染色检查过氧亚硝酸盐反应性标志物硝基酪氨酸的细胞定位。在实验3中,给未烧伤的大鼠腹腔注射过氧亚硝酸盐供体3-吗啉代辛二酮(10 mM),以检查过氧亚硝酸盐对肺诱导型一氧化氮合酶表达的影响。

测量指标及主要结果

烧伤后8小时,肠和肺中的MPO活性水平、血液中二氢罗丹明123氧化水平和肺通透性分别增加至正常水平的2倍、2.5倍、2倍和2倍。注射S-甲基异硫脲显著降低(p<.05)烧伤大鼠肺MPO活性的31%、血液过氧亚硝酸盐水平的41%、肺通透性的54%以及肺过氧亚硝酸盐生成。多形核粒细胞抗体预处理显著降低烧伤大鼠肠MPO的60%、血液过氧亚硝酸盐水平的92%和肺MPO活性的56%,但多形核粒细胞抗体预处理仅使肺通透性略有降低。此外,3-吗啉代辛二酮增加了肺诱导型一氧化氮合酶信使核糖核酸水平。

结论

热损伤诱导血液中二氢罗丹明123氧化、肠和肺中性粒细胞沉积、肺硝基酪氨酸生成以及肺损伤。诱导型一氧化氮合酶的特异性抑制和多形核粒细胞抗体预处理均降低血液中二氢罗丹明123氧化以及肠和肺中性粒细胞沉积,但只有用S-甲基异硫脲抑制诱导型一氧化氮合酶才能减少肺过氧亚硝酸盐生成和热损伤诱导的肺损伤。一氧化氮以及随之而来肺中过氧亚硝酸盐的生成在导致热损伤诱导的肺损伤中比中性粒细胞起更重要的作用。

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