Liu Qing-yang, Hu Sen, Cheng Ai-guo, Qiu Fang, Pu Jian-yi, Li Jun-you, Lv Yi, Zhou Guo-yong, Sheng Zhi-yong
Burn Institute, First Affiliated Hospital to PLA General Hospital, Beijing, PR China.
Zhonghua Shao Shang Za Zhi. 2006 Dec;22(6):415-8.
To investigate the influence of escharectomy at different time-points after burn injury on the lymphocyte apoptosis and the antigen presentation function of monocytes in peripheral blood of scalded rats.
One hundred and thirty-six Wistar rats were randomly divided into normal control ( C,n = 8 ), scald ( S, n = 64,without treatment after scald) , A ( n = 40, with escharectomy at 36 post-burn hour( PSH) ) , B ( n = 24, with escharectomy at 72 PSH ) groups. The rats in A , B, S groups were inflicted with 30% TBSA full-thickness scald. The rats in S group were sacrificed on 6,12,24,72,120,168,216, 288 PSH, while those in A and B groups were sacrificed at 72 -288 PSH, 168 -288PSH, respectively. The rats in C group were also sacrificed as control. The apoptotic rate of peripheral lymphocytes, the positive expression rate of MHC- II in mononuclear cells, the changes in concentration of IL-4 and gamma-IFN were determined in each group. The correlation of above indices were also analyzed.
(1) The apoptotic rate of peripheral lymphocyte in S group were increased dramatically at 6PSH, peaking at 24 PSH( 18. 19+/-1.42% ) , then decreasing gradually, reaching the lowest level at 72 PSH(8. 25+/-0.56% ) , then it increased gradually again, approaching almost the peak value at 288 PSH( 17.81 +/- 1.99% ). The values were all obviously higher than those in C group( P <0.05). The apoptotic rates of peripheral lymphocyte in A and B groups were evidently lower than that in S group ( P <0. 01). (2) The positive expression rate of MHC-II in monocyte was decreased sharply at 6 PSH, and it was 20% lower than that in C group (37. 2 +/- 2. 4% ) at 24 PSH. It then increased gradually, but it was significantly lower than that in A, B groups at 288 PSH (18. 8 +/-2. 8, P <0.01). (3) The plasma level of y-IFN in S group increased gradually from 6 PSH on, peaking at 24 PSH(440. 8 +/-25. 1 )ng/L,then decreasing gradually , and it reached the lowest level at 288 PSH (51.3 +/-37.0) ng/L. The IL-4 level in S group was increased gradually ,peaking at 288 PSH (78. 1+/-2. 8) ng/L. (4) There was negative correlation between the expression rate of MHC- II in S group and IL-4/gamma-IFN ratio in escharectomy groups during 72 - 288 PSH ( r = - 0. 96, P < 0. 05).
Eacharectomy after scald can inhibit peripheral lymphocyte apoptosis, slow down the insertional tendency of IL-4/gamma-IFN , and ameliorate the antigen presentation function of monocytes. Moreover, escharectomy during shock stage can markedly promote the immune function of monocytes.
探讨烧伤后不同时间点切痂对烫伤大鼠外周血淋巴细胞凋亡及单核细胞抗原呈递功能的影响。
将136只Wistar大鼠随机分为正常对照组(C组,n = 8)、烫伤组(S组,n = 64,烫伤后未处理)、A组(n = 40,伤后36小时切痂)、B组(n = 24,伤后72小时切痂)。A、B、S组大鼠均行30%总体表面积的全层烫伤。S组大鼠于伤后6、12、24、72、120、168、216、288小时处死,A、B组大鼠分别于伤后72 - 288小时、168 - 288小时处死,C组大鼠作为对照同样处死。检测各组外周血淋巴细胞凋亡率、单核细胞中MHC-II阳性表达率、IL-4和γ-干扰素浓度变化,并分析上述指标的相关性。
(1)S组外周血淋巴细胞凋亡率在伤后6小时显著升高,24小时达峰值(18.19±1.42%),随后逐渐下降,72小时达最低水平(8.25±0.56%),之后又逐渐升高,288小时接近峰值(17.81±1.99%)。各时间点数值均明显高于C组(P < 0.05)。A、B组外周血淋巴细胞凋亡率明显低于S组(P < 0.01)。(2)单核细胞中MHC-II阳性表达率在伤后6小时急剧下降,24小时比C组低20%(37.2±2.4%)。随后逐渐升高,但288小时仍显著低于A、B组(18.8±2.8,P < 0.01)。(3)S组血浆γ-干扰素水平从伤后6小时起逐渐升高,24小时达峰值(440.8±25.1)ng/L,随后逐渐下降,288小时达最低水平(51.3±37.0)ng/L。S组IL-4水平逐渐升高,288小时达峰值(78.1±2.8)ng/L。(4)切痂组在伤后72 - 288小时,S组MHC-II表达率与IL-4/γ-干扰素比值呈负相关(r = - 0.96,P < 0.05)。
烫伤后切痂可抑制外周血淋巴细胞凋亡,减缓IL-4/γ-干扰素失衡趋势,改善单核细胞抗原呈递功能。且休克期切痂可显著促进单核细胞免疫功能。