Savas M Cagri, Ozguner Meltem, Ozguner I Faruk, Delibas Namik
Department of Pediatric Surgery, Suleyman Demirel University Medical School, Isparta, Turkey.
J Pediatr Surg. 2003 Oct;38(10):1465-70. doi: 10.1016/s0022-3468(03)00497-4.
BACKGROUND/PURPOSE: Intestinal ischemia-reperfusion (IIR) induced acute lung injury (ALI) has been documented. Kupffer cell blockage with gadolinium chloride (GdCl(3)) has been shown to attenuate IIR-induced ALI. However, the effects of splenic monocytes/macrophages on IIR-induced ALI has not been studied previously. In the current study, the authors aimed to investigate the role of splenectomy in IIR-induced ALI.
Forty-eight rats were divided randomly into 6 groups as follows: SHAM, SHAM + KCB, SHAM + SPLN, IIR, IIR + KCB, IIR + SPLN. Two hours of ischemia and 1 hour of reperfusion has been applied by clipping the SMA. GdCl3 was given 24 hours before experiment. Splenectomy was done just before SMA clipping. Lung levels of tumor necrosis-factor (TNF), interleukin (IL)-6, myeloperoxidase (MPO), and malondialdehyde (MDA) were assayed biochemically. Lung leukosequestration was determined by counting PMNLs histologically. Kruskal-Wallis and Mann-Whitney U tests were done; P values less than.003 were considered significant.
Polimorphonuclear leukocyte (PMNL) counts and biochemical parameters in the IIR group were significantly higher than the other groups (P <.003). When compared with IIR group, PMNL counts and biochemical parameters were significantly decreased in the IIR+KCB and IIR+SPLN groups, respectively (P <.003). However, they were still significantly higher than their sham-operated controls (P <.003).
This study documents that splenectomy attenuates ALI as well as Kupffer cell blockage. Spleen, an important component of mononuclear phagocytic system as liver Kupffer cells, might play an important role in the IIR-induced ALI.
背景/目的:肠道缺血再灌注(IIR)诱导的急性肺损伤(ALI)已有文献报道。氯化钆(GdCl₃)阻断库普弗细胞已被证明可减轻IIR诱导的ALI。然而,脾单核细胞/巨噬细胞对IIR诱导的ALI的影响此前尚未被研究。在本研究中,作者旨在探讨脾切除术在IIR诱导的ALI中的作用。
48只大鼠随机分为6组:假手术组(SHAM)、假手术+库普弗细胞阻断组(SHAM + KCB)、假手术+脾切除组(SHAM + SPLN)、IIR组、IIR + KCB组、IIR + SPLN组。通过夹闭肠系膜上动脉(SMA)造成2小时缺血和1小时再灌注。实验前24小时给予GdCl₃。在夹闭SMA前进行脾切除术。通过生化方法检测肺组织中肿瘤坏死因子(TNF)、白细胞介素(IL)-6、髓过氧化物酶(MPO)和丙二醛(MDA)的水平。通过组织学计数多形核白细胞(PMNL)来确定肺白细胞扣押情况。采用Kruskal-Wallis检验和Mann-Whitney U检验;P值小于0.003被认为具有统计学意义。
IIR组的多形核白细胞(PMNL)计数和生化参数显著高于其他组(P < 0.003)。与IIR组相比,IIR + KCB组和IIR + SPLN组的PMNL计数和生化参数分别显著降低(P < 0.003)。然而,它们仍显著高于假手术对照组(P < 0.003)。
本研究证明脾切除术与库普弗细胞阻断一样可减轻ALI。脾脏作为单核吞噬系统的重要组成部分,与肝脏库普弗细胞类似,可能在IIR诱导的ALI中起重要作用。