Sato Hiroaki, Kasai Kentaro, Tanaka Toshiko, Kita Toshiro, Tanaka Noriyuki
Department of Forensic Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Med Sci Monit. 2008 May;14(5):BR79-87.
Hemorrhagic shock occasionally causes a fatal outcome following an outbreak of lung dysfunction, but the precise mechanism has not been clearly elucidated. Several studies have indicated that hemorrhagic shock causes a delayed vascular inflammatory decompensation and leads to inflammation-related organ dysfunction. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta are known as major proinflammatory cytokines that play an important role in excessive autolytic inflammation, finally inducing organ dysfunctions. In this study, the role of TNF-alpha and IL-1beta on lung dysfunction following hemorrhagic shock was examined by using FR167653, a potent inhibitor of TNF-alpha and IL-1beta production that acts by suppressing p38 mitogen-activated protein kinase (MAPK).
MATERIAL/METHODS: Hemorrhagic shock was induced in anesthetized male rats by bleeding via a common carotid catheter for 20 minutes to 25% of total body blood volume without fluid resuscitation. Mean blood pressure, heart rate and arterial blood gas components were recorded up to 5 hours after the bleeding. The levels of TNF-alpha, IL-1beta and lactic dehydrogenase (LDH)-3 isozyme were measured in the serum of pulmonary venous blood. The lung tissue was excised for the assay of mRNA and for histopathological study.
The expressions of mRNA for TNF-alpha and IL-1beta in the lung tissue and the concentrations of both cytokines in pulmonary serum increased after a hemorrhage. Inflammation-related injuries and function deterioration were observed in the lung following hemorrhagic shock. These hemorrhagic changes were inhibited by pretreatment with FR167653.
TNF-alpha and IL-1beta play a key role in the development of inflammation-related lung dysfunction following hemorrhagic shock. Our model should be useful to explain the pathogenesis of lung dysfunction following hemorrhagic shock.
失血性休克偶尔会在肺功能障碍发作后导致致命后果,但确切机制尚未完全阐明。多项研究表明,失血性休克会导致血管炎症延迟性失代偿,并引发与炎症相关的器官功能障碍。肿瘤坏死因子(TNF)-α和白细胞介素(IL)-1β是已知的主要促炎细胞因子,在过度自溶性炎症中起重要作用,最终导致器官功能障碍。在本研究中,通过使用FR167653(一种通过抑制p38丝裂原活化蛋白激酶(MAPK)来抑制TNF-α和IL-1β产生的强效抑制剂),研究了TNF-α和IL-1β在失血性休克后肺功能障碍中的作用。
材料/方法:通过经颈总动脉导管放血20分钟,使麻醉的雄性大鼠失血至全身血容量的25%,且不进行液体复苏,从而诱导失血性休克。记录放血后长达5小时的平均血压、心率和动脉血气成分。测定肺静脉血血清中TNF-α、IL-1β和乳酸脱氢酶(LDH)-3同工酶的水平。切除肺组织用于mRNA检测和组织病理学研究。
出血后肺组织中TNF-α和IL-1β的mRNA表达以及肺血清中两种细胞因子的浓度均升高。失血性休克后肺中观察到与炎症相关的损伤和功能恶化。用FR167653预处理可抑制这些出血性变化。
TNF-α和IL-1β在失血性休克后与炎症相关的肺功能障碍的发展中起关键作用。我们的模型有助于解释失血性休克后肺功能障碍的发病机制。