Tian J, Lin X, Li Y H, Xu J G
Department of Anesthesiology, Renji Hospital, Shanghai, China.
Acta Anaesthesiol Scand. 2005 Oct;49(9):1311-7. doi: 10.1111/j.1399-6576.2005.00849.x.
Several studies have shown beneficial effects of hydroxyethyl starch (HES) on organ damage in the treatment of severe inflammatory situations, but the mechanisms remain unclear. Nuclear factor-kappa B (NF-kappaB) activation is known to contribute to many aspects of inflammatory injury and organ dysfunction in critical illness, and tumor necrosis factor-alpha (TNF-alpha) is considered the most important pro-inflammatory cytokine. The present study was undertaken to test whether HES (200/0.5) has some effects on tissue NF-kappaB activity and systemic TNF-alpha expression induced by lipopolysaccharide in order to define a possible mechanism of the beneficial effects of HES.
Male Wistar rats were randomly divided into seven groups treated with saline, lipopolysaccharide (LPS, 6 mg/kg), LPS plus HES (3.75, 7.5, 15, 30 ml/kg), or HES (30 ml/kg) alone. Two hours after LPS challenge, NF-kappaB activation in the lungs, hearts, livers, and kidneys were examined with an electrophoretic mobility shift assay. Four hours after LPS challenge, plasma TNF-alpha concentrations were measured using an enzyme-linked immunosorbance assay.
3.75 and 7.5 ml/kg HES suppressed LPS-induced NF-kappaB activation in the four tissues and decreased plasma TNF-alpha elevation. The effects of 15 ml/kg HES was only significant in inhibiting NF-kappaB activity in the lung and liver. No effect of 30 ml/kg HES was revealed in all the cases.
Lower doses of HES may inhibit tissue NF-kappaB activation and systemic TNF-alpha elevation after LPS challenge, which might be helpful during sepsis.
多项研究表明羟乙基淀粉(HES)在治疗严重炎症状态时对器官损伤具有有益作用,但其机制尚不清楚。已知核因子-κB(NF-κB)激活在危重病的炎症损伤和器官功能障碍的许多方面起作用,并且肿瘤坏死因子-α(TNF-α)被认为是最重要的促炎细胞因子。本研究旨在测试HES(200/0.5)是否对脂多糖诱导的组织NF-κB活性和全身TNF-α表达有影响,以确定HES有益作用的可能机制。
将雄性Wistar大鼠随机分为七组,分别用生理盐水、脂多糖(LPS,6mg/kg)、LPS加HES(3.75、7.5、15、30ml/kg)或单独的HES(30ml/kg)处理。LPS攻击后两小时,用凝胶电泳迁移率变动分析检测肺、心、肝和肾中的NF-κB激活情况。LPS攻击后四小时,用酶联免疫吸附测定法测量血浆TNF-α浓度。
3.75和7.5ml/kg的HES抑制了LPS诱导的四个组织中的NF-κB激活,并降低了血浆TNF-α升高。15ml/kg的HES仅在抑制肺和肝中的NF-κB活性方面有显著作用。在所有情况下均未发现30ml/kg的HES有作用。
较低剂量的HES可能抑制LPS攻击后组织NF-κB激活和全身TNF-α升高,这在脓毒症期间可能是有益的。