Hill J, Lindsay T F, Ortiz F, Yeh C G, Hechtman H B, Moore F D
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
J Immunol. 1992 Sep 1;149(5):1723-8.
We examined the role of C activation in ischemia reperfusion injury by inhibiting C activation in a rat model of mesenteric arterial occlusion. In anesthetized rats, 60 min of mesenteric arterial occlusion was followed by 3 h of reperfusion. PBS alone or containing soluble C receptor 1 (3 or 6 mg) was administered i.v. Controls underwent laparotomy without ischemia. Relative serum C activities were assessed by hemolytic assay, neutrophil (polymorphonuclear leukocyte) sequestration by tissue content of myeloperoxidase (MPO) activity, intestinal mucosal injury by histologic grading, lung vascular permeability by the ratio of bronchoalveolar lavage to blood concentration of radiolabeled BSA, and endothelial cell injury was quantified by measurement of plasma factor VIII-related Ag. After reperfusion, PBS-treated animals had increased intestinal MPO (0.048 +/- 0.007 U/g) compared to sham (0.022 +/- 0.005 U/g (p less than 0.05)) and intestinal mucosal injury score (2.490 +/- 0.221) compared to sham (0.331 +/- 0.045 (p less than 0.05)). Treatment with 6 mg soluble C receptor 1 15 min before reperfusion reduced intestinal MPO (0.017 +/- 0.003 U/g (p less than 0.05)) and mucosal injury (1.733 +/- 0.168 (p less than 0.05)) compared to PBS control. PBS-treated animals also demonstrated increased lung MPO (0.314 +/- 0.025 U/g vs 0.085 +/- 0.018 in sham (p less than 0.05)) and increased lung permeability (bronchoalveolar lavage/blood cpm 11.32 +/- 1.35 x 10(-3) vs sham 2.22 +/- 0.19 x 10(-3) (p less than 0.05)). Treatment with 6 mg soluble C receptor 1 15 min before reperfusion or at reperfusion reduced the lung permeability (bronchoalveolar lavage/blood cpm 3.90 +/- 0.79 x 10(-3) and 5.08 +/- 0.75, respectively (both p less than 0.05)) compared to PBS control, but did not reduce lung MPO (0.342 +/- 0.031 U/g and 0.246 +/- 0.025), respectively. Treatment with sCR1 also reduced the release of factor VIII-related Ag, 5-day mortality, and C hemolytic activity. In this model, C is a major mediator of intestinal injury and extraintestinal injury.
我们通过在大鼠肠系膜动脉闭塞模型中抑制补体(C)激活,研究了C激活在缺血再灌注损伤中的作用。在麻醉的大鼠中,肠系膜动脉闭塞60分钟后进行3小时的再灌注。静脉注射单独的PBS或含有可溶性C受体1(3毫克或6毫克)的PBS。对照组进行未发生缺血的剖腹手术。通过溶血试验评估相对血清C活性,通过髓过氧化物酶(MPO)活性的组织含量评估中性粒细胞(多形核白细胞)滞留,通过组织学分级评估肠黏膜损伤,通过支气管肺泡灌洗与放射性标记牛血清白蛋白血浓度的比值评估肺血管通透性,通过测量血浆因子VIII相关抗原定量内皮细胞损伤。再灌注后,与假手术组(0.022±0.005 U/g(p<0.05))相比,PBS处理的动物肠MPO增加(0.048±0.007 U/g),与假手术组(0.331±0.045(p<0.05))相比,肠黏膜损伤评分增加(2.490±0.221)。再灌注前15分钟用6毫克可溶性C受体1治疗,与PBS对照组相比,可降低肠MPO(0.017±0.003 U/g(p<0.05))和黏膜损伤(1.733±0.168(p<0.05))。PBS处理的动物还表现出肺MPO增加(0.314±0.025 U/g,假手术组为0.085±0.018(p<0.05))和肺通透性增加(支气管肺泡灌洗/血每分钟计数11.32±1.35×10⁻³,假手术组为2.22±0.19×10⁻³(p<0.05))。再灌注前15分钟或再灌注时用6毫克可溶性C受体1治疗,与PBS对照组相比,可降低肺通透性(支气管肺泡灌洗/血每分钟计数分别为3.90±0.79×10⁻³和5.08±0.75,均p<0.05),但未降低肺MPO(分别为0.342±0.031 U/g和0.246±0.025)。用可溶性C受体1治疗还可降低因子VIII相关抗原的释放、5天死亡率和C溶血活性。在该模型中,补体是肠损伤和肠外损伤的主要介质。