van Heeckeren Anna M, Schluchter Mark D, Xue Wei, Davis Pamela B
Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
Am J Respir Crit Care Med. 2006 Feb 1;173(3):288-96. doi: 10.1164/rccm.200506-917OC. Epub 2005 Nov 4.
Cystic fibrosis is caused by defects in the cystic fibrosis transmembrane conductance regulator gene, which codes for a chloride channel, but the role of this chloride channel in inflammation induced by lung infection with Pseudomonas aeruginosa remains to be defined.
We tested the hypothesis that loss of this chloride channel alone is sufficient to cause excessive inflammation in response to inflammatory stimuli.
We investigated the response of cystic fibrosis and wild-type mice to mucoid P. aeruginosa administered by insufflation.
The host responses measured included survival, weight change, lung morphometry, bacterial clearance, and inflammatory mediators, and cell counts were assessed in bronchoalveolar lavage fluid.
Depending on the dose administered and frequency of dosing, cystic fibrosis mice experienced significantly higher mortality rates, greater weight loss, higher lung pathology scores, and higher inflammatory mediator and neutrophil levels compared with wild-type mice, even after the bacteria had been cleared. Surprisingly, bacteria were cleared just as rapidly in cystic fibrosis mice as in wild-type mice, and sepsis was not observed. Chronic lung infections could not be established with mucoid P. aeruginosa in either cystic fibrosis or wild-type mice.
Absence of this chloride channel alone appears sufficient for exaggerated inflammation and excess mortality compared with wild-type controls in the face of mucoid P. aeruginosa lung infection. To establish chronic infection, additional factors such as bacterial trapping or poor clearance may be required.
囊性纤维化由囊性纤维化跨膜传导调节基因缺陷引起,该基因编码一种氯离子通道,但这种氯离子通道在铜绿假单胞菌肺部感染诱导的炎症中的作用仍有待确定。
我们检验了这样一种假设,即仅这种氯离子通道的缺失就足以导致对炎症刺激产生过度炎症反应。
我们研究了囊性纤维化小鼠和野生型小鼠对通过吹入法给予的黏液型铜绿假单胞菌的反应。
所测量的宿主反应包括存活率、体重变化、肺形态计量学、细菌清除率以及炎症介质,并且对支气管肺泡灌洗液中的细胞计数进行了评估。
根据给药剂量和给药频率,与野生型小鼠相比,囊性纤维化小鼠的死亡率显著更高、体重减轻更明显、肺部病理评分更高,炎症介质和中性粒细胞水平也更高,即使在细菌已被清除之后。令人惊讶的是,囊性纤维化小鼠体内的细菌清除速度与野生型小鼠一样快,并且未观察到败血症。黏液型铜绿假单胞菌在囊性纤维化小鼠或野生型小鼠中均无法建立慢性肺部感染。
与野生型对照相比,仅这种氯离子通道的缺失似乎就足以在面对黏液型铜绿假单胞菌肺部感染时引发过度炎症和过高死亡率。要建立慢性感染,可能需要诸如细菌滞留或清除不佳等其他因素。