Wang Fu-Zhou, Jing Liang, Chen Jian, Huang Yao-Yao
Department of Anesthesia, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China.
Zhonghua Yi Xue Za Zhi. 2007 Mar 20;87(11):768-73.
To investigate the role of macrophage migration inhibitory factor (MIF) in septic shock-induced cardiovascular dysfunction.
56 SD rats were randomly divided into 7 equal groups: CLP group (undergoing cecal ligation and puncture so as to cause septic shock), CLP + ISO-1 group (ISO-1, was injected before and after CLP), CLP + MIF antibody group (MIF-Ab was injected before and after CLP), CLP + dexamethasone (DEX)-1, 5, and 20 groups [I, 5, or 20 mg/kg was injected 1 h after CLP), and sham operation group. Echocardiography was performed 6 h after CLP to measure the LVEDD, LVESD, FS%, CO, and PP. Catheters were inserted into the femoral artery and vein to measure the mean arterial pressure (MAP) and to be used as the route of drug administration. Phenylephrine (PE) of the concentrations of 0.5, 1, 2, and 2.5 microg/kg was injected intravenously and then the MAP increase percentage (DeltaMAP%) was calculated. Then the rats were euthanized with their hearts and aortas taken out. The aortas were cut into rings, and bathed in Krebs solution. PE of the concentrations of 1 mol/L to 30 micromol/L was added into the solution cumulatively to produce the dose-reaction curve of PE. The maximum energy (Emax) and median effective concentration (EC50) of PE were calculated. Western blotting was used to examine the protein expression of MIF in the myocardium and aorta. Another 70 SD rats were divided into 7 groups as mentioned above to observe the cumulative survival rates within 72 h.
The LVEDD and LVESD of the CLP group decreased by 56% and 54% respectively 6 h after CLP, and the LVEDD and LVESD of the ISO-1, MOF-Ab, and DEX-20 groups were all significantly higher than that of the CLP group (all P < 0.05) The FS% of the CLP group was significantly lower than that of the Sham groups, and the FS% of the ISO-1, MOF-Ab, and DEX-20 groups were all significantly higher than that of the CLP group (all P < 0.05). The PP value of the ISO-1, MIF-Ab, and DEX-20 groups were all significantly higher than that of the CLP group (all P < 0.06). The CO of the CLP group was significantly lower than that of the Sham group, and those of the ISO-1, MIF-Ab, and DEX-20 groups were all significantly higher than that of the CLP group (all P < 0.001). The DeltaMAP% of different group all increased after the addition of PE dose-dependently, however, the DeltaMAP% was significantly lower in the CLP group than in the Sham group (P < 0.05), and t significantly higher in the ISO-1, MIF-Ab, and DEX-20 groups than in the CLP group (all P < 0.05). The values of PE-induced maximum aorta tension of the SO-1 and MIF-Ab groups were both significantly higher than that of the CLP group (both P < 0.05). The values of PE-induced maximum aorta tension of the DEX-20 group were all higher than those of the CLP group when the PE concentration was between 1.0 x 10(-6) - 1.0 x 10(-5) mol/L (all P < 0.05), however, were not significantly different those of the CLP group when the PE concentration was over 1.0 x 10(-5) mol/L. The values of Emax were significantly lower in the 6 experimental groups than in the Sham group (all P < 0.05), however, were all significantly higher in the ISO-1, MIF-Ab, and DEX-20 groups than in the CLP group (all P < 0.05). The values of EC50 were significantly higher in the 6 experimental groups than in the Sham group (all P < 0.05), however, were significantly lower in the ISO-1, MIF-Ab, and DEX-20 groups than in the CLP group (all P < 0.05). The protein expression levels of MIF in the heart and aorta were significantly higher in the 6 experimental groups than in the Sham group (all P < 0.05), however, the DEX-1 and DEX-5 groups showed significantly higher MIF expression than DEX-20 group (both P < 0.05). The 72 h survival rates of the ISO-1 and MIF-Ab groups were both significantly higher than that of the CLP group (0%, both P < 0.05). DEX of different dose failed to increase the survival rate.
MIF plays a pivotal role in the circulation dysfunction in septic ambience. Antagonism and blockade of MIF improve corresponding hemodynamics, vascular responsiveness, and prognosis. Glycocorticoid of high and low dose are poles apart in effects on septic hemodynamics and vaso-reactivity, however, fails to improve the prognosis of sepsis no matter how high is the dose.
探讨巨噬细胞移动抑制因子(MIF)在脓毒症休克所致心血管功能障碍中的作用。
将56只SD大鼠随机分为7组,每组8只:盲肠结扎穿孔术(CLP)组(行盲肠结扎和穿刺以造成脓毒症休克)、CLP + ISO - 1组(CLP前后均注射ISO - 1)、CLP + MIF抗体组(CLP前后均注射MIF - Ab)、CLP + 地塞米松(DEX)- 1、5和20组(CLP后1 h分别注射1、5或20 mg/kg),以及假手术组。CLP术后6 h行超声心动图检查,测量左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室短轴缩短率(FS%)、心输出量(CO)和脉压(PP)。将导管插入股动脉和静脉以测量平均动脉压(MAP)并作为给药途径。静脉注射浓度为0.5、1、2和2.5 μg/kg的去氧肾上腺素(PE),然后计算MAP升高百分比(ΔMAP%)。然后将大鼠安乐死,取出心脏和主动脉。将主动脉切成环,置于Krebs溶液中。向溶液中依次加入浓度为1 μmol/L至30 μmol/L的PE以绘制PE的剂量 - 反应曲线。计算PE的最大效应(Emax)和半数有效浓度(EC50)。采用蛋白质印迹法检测心肌和主动脉中MIF的蛋白表达。另取70只SD大鼠按上述方法分为7组,观察72 h内的累计生存率。
CLP组CLP术后6 h的LVEDD和LVESD分别下降了56%和54%,ISO - 1组、MIF - Ab组和DEX - 20组的LVEDD和LVESD均显著高于CLP组(均P < 0.05)。CLP组的FS%显著低于假手术组,ISO - 1组、MIF - Ab组和DEX - 20组的FS%均显著高于CLP组(均P < 0.05)。ISO - 1组、MIF - Ab组和DEX - 20组的PP值均显著高于CLP组(均P < 0.06)。CLP组的CO显著低于假手术组,ISO - 1组、MIF - Ab组和DEX - 20组的CO均显著高于CLP组(均P < 0.001)。不同组加入PE后ΔMAP%均呈剂量依赖性增加,但CLP组的ΔMAP%显著低于假手术组(P < 0.05),ISO - 1组、MIF - Ab组和DEX - 20组的ΔMAP%显著高于CLP组(均P < 0.05)。ISO - 1组和MIF - Ab组PE诱导的主动脉最大张力值均显著高于CLP组(均P < 0.05)。当PE浓度在1.0×10⁻⁶ - 1.0×10⁻⁵ mol/L之间时,DEX - 20组PE诱导的主动脉最大张力值均高于CLP组(均P < 0.05),但当PE浓度超过1.0×10⁻⁵ mol/L时,与CLP组无显著差异。6个实验组的Emax值均显著低于假手术组(均P < 0.05),但ISO - 1组、MIF - Ab组和DEX - 20组均显著高于CLP组(均P < 0.05)。6个实验组的EC50值均显著高于假手术组(均P < 0.05),但ISO - 1组、MIF - Ab组和DEX -