Fischer Lars G, Hilpert Jan H, Freise Hendrik, Wendholt Doreen, Van Aken Hugo, Sielenkämper Andreas W
Department of Anesthesiology and Intensive Care, University of Münster, Münster, Germany.
Anesth Analg. 2004 Sep;99(3):864-871. doi: 10.1213/01.ANE.0000133000.65613.F5.
In an isolated perfused lung model, bradykinin induced pulmonary vasoconstriction in rats made septic by the injection of lipopolysaccharide (LPS). To mimic the pathophysiology of sepsis in humans more closely, we investigated pulmonary endothelial injury in a peritonitis model (cecal ligation and perforation; CLP). Male Sprague-Dawley rats were randomly divided into nine groups (n = 6-8). LPS and CLP rats were compared after 6 h with and without treatment with a selective inhibitor of inducible nitric oxide synthase (iNOS), L-N(6)-(1-iminoethyl)-lysine. Time dependency was investigated in CLP-treated rats at 24 h. The pulmonary circulation was isolated and perfused with a constant flow after the rats' tracheas were intubated and ventilated. Bradykinin (1, 3, and 6 microg) was injected, and changes in perfusion pressure were measured. Lungs were harvested for Western blot analysis to determine the role of iNOS in pulmonary endothelial dysfunction. In contrast to CLP 24 h rats, dose-dependent bradykinin-induced pulmonary vasoconstriction was observed in LPS and CLP 6 h rats. Concomitant administration of L-N(6)-(1-iminoethyl)-lysine significantly attenuated this vasoconstriction in both groups. The iNOS protein was expressed in lung homogenates from LPS 6 h and CLP 6 h but not from CLP 24 h rats. Both sepsis models caused bradykinin-induced pulmonary vasoconstriction, with the CLP groups demonstrating a time dependency of this effect. In conjunction with the time-dependent decrease in iNOS protein, the attenuated bradykinin-induced vasoconstriction due to selective iNOS inhibition suggests an important role for iNOS in pulmonary endothelial injury for both sepsis models.
在一个离体灌注肺模型中,缓激肽可使通过注射脂多糖(LPS)而发生脓毒症的大鼠出现肺血管收缩。为了更密切地模拟人类脓毒症的病理生理学,我们在一个腹膜炎模型(盲肠结扎和穿孔;CLP)中研究了肺内皮损伤。雄性Sprague-Dawley大鼠被随机分为九组(n = 6 - 8)。对LPS组和CLP组大鼠在6小时时进行比较,比较有无用诱导型一氧化氮合酶(iNOS)的选择性抑制剂L-N(6)-(1-亚氨基乙基)-赖氨酸进行治疗的情况。对CLP处理的大鼠在24小时时研究时间依赖性。在大鼠气管插管并通气后,分离肺循环并以恒定流量进行灌注。注射缓激肽(1、3和6微克),并测量灌注压力的变化。采集肺组织用于蛋白质印迹分析,以确定iNOS在肺内皮功能障碍中的作用。与CLP 24小时的大鼠不同,在LPS和CLP 6小时的大鼠中观察到剂量依赖性的缓激肽诱导的肺血管收缩。同时给予L-N(6)-(1-亚氨基乙基)-赖氨酸可显著减弱两组中的这种血管收缩。iNOS蛋白在LPS 6小时和CLP 6小时的肺匀浆中表达,但在CLP 24小时的大鼠中不表达。两种脓毒症模型均导致缓激肽诱导的肺血管收缩,CLP组显示出这种效应的时间依赖性。与iNOS蛋白随时间的减少相一致,由于选择性iNOS抑制而导致的缓激肽诱导的血管收缩减弱表明iNOS在两种脓毒症模型的肺内皮损伤中起重要作用。