Densmore John C, Signorino Paul R, Ou Jingsong, Hatoum Ossama A, Rowe J Jordi, Shi Yang, Kaul Sushma, Jones Deron W, Sabina Robert E, Pritchard Kirkwood A, Guice Karen S, Oldham Keith T
Department of Surgery, Medical College of Wisconsin and Children's Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
Shock. 2006 Nov;26(5):464-71. doi: 10.1097/01.shk.0000228791.10550.36.
Acute lung injury (ALI) carries a high mortality in critically ill patients. Recent reports correlate elevated concentrations of endothelium-derived microparticles (EMPs) with diseases of endothelial dysfunction. Many of these diseases have ALI sequelae. We hypothesize that EMPs contribute to endothelial cell (EC) dysfunction and development of ALI. To test this hypothesis, we treated isolated vessels with EMPs and examined changes in vasodilation. Endothelial cell cultures were incubated with EMPs and examined for changes in stimulated nitric oxide (*NO) production and nitric oxide synthase (eNOS) activation. Finally, EMPs were injected into rats and mice and lungs examined for ALI. In both mouse and human ex vivo vessel preparations, we found a marked attenuation of endothelium-mediated vasodilation after EMP treatment (4 x 10(6)/mL). This dysfunction was not corrected by pretreatment of EMPs with free radical scavengers. Coincubation of EMPs with EC cultures yielded a three-fold reduction in A23187-stimulated *NO release. Western analysis of these cells showed a corresponding decrease in eNOS phosphorylation at Ser1179 and a decrease in hsp90 association. Measurements of lung permeability, myeloperoxidase activity, and histology of EMPs-treated Brown Norway rats demonstrated pulmonary edema, neutrophil recruitment, and compromise of the endothelial-alveolar barrier as a second hit phenomenon. In C57BL/6 mice, exogenous EMPs caused a significant rise in pulmonary capillary permeability both as a primary and secondary injury. These findings demonstrate EMPs are capable of inducing significant lung injury at pathophysiologically relevant concentrations. Endothelium-derived microparticles inhibit endothelium-mediated vasodilation and *NO generation from eNOS. Once elucidated, EMP mechanisms of inducing ALI and endothelial dysfunction may present new therapeutic targets.
急性肺损伤(ALI)在危重症患者中死亡率很高。最近的报告表明,内皮细胞衍生微粒(EMPs)浓度升高与内皮功能障碍疾病相关。这些疾病中的许多都有ALI后遗症。我们假设EMPs促成了内皮细胞(EC)功能障碍和ALI的发展。为了验证这一假设,我们用EMPs处理分离的血管,并检测血管舒张的变化。将内皮细胞培养物与EMPs一起孵育,检测刺激型一氧化氮(NO)生成和一氧化氮合酶(eNOS)激活的变化。最后,将EMPs注射到大鼠和小鼠体内,检查肺部是否发生ALI。在小鼠和人类离体血管制剂中,我们发现用EMPs处理(4×10⁶/mL)后,内皮介导的血管舒张明显减弱。自由基清除剂预处理EMPs并不能纠正这种功能障碍。EMPs与EC培养物共同孵育导致A23187刺激的NO释放减少了三倍。对这些细胞的蛋白质免疫印迹分析显示,Ser1179处eNOS磷酸化相应减少,hsp90结合减少。对经EMPs处理的棕色挪威大鼠的肺通透性、髓过氧化物酶活性和组织学测量表明,肺水肿、中性粒细胞募集以及内皮-肺泡屏障受损是一种二次打击现象。在C57BL/6小鼠中,外源性EMPs作为原发性和继发性损伤均导致肺毛细血管通透性显著升高。这些发现表明,EMPs在病理生理相关浓度下能够诱导显著的肺损伤。内皮细胞衍生微粒抑制内皮介导的血管舒张和eNOS产生*NO。一旦阐明,EMPs诱导ALI和内皮功能障碍的机制可能会带来新的治疗靶点。