Wiener-Kronish J P, Albertine K H, Matthay M A
Cardiovascular Research Institute, University of California, San Francisco 94143-0130.
J Clin Invest. 1991 Sep;88(3):864-75. doi: 10.1172/JCI115388.
Although intravenous Escherichia coli endotoxin has been used extensively in experimental studies to increase lung endothelial permeability, the effect of E. coli endotoxin on lung epithelial permeability has not been well studied. To examine this issue in sheep, bidirectional movement of protein across the lung epithelial barrier was studied by labeling the vascular space with 131I-albumin and by instilling 3 ml/kg of an isosmolar protein solution with 125I-albumin into the alveoli. E. coli endotoxin was administered according to one of three protocols: intravenous alone (5-500 micrograms/kg), intravenous (5 micrograms/kg) plus low-dose alveolar endotoxin (10 micrograms/kg), and high-dose alveolar endotoxin alone (50-100 micrograms/kg). Alveolar liquid clearance was estimated based on the concentration of the instilled native protein. Sheep were studied for either 4 or 24 h. Although intravenous E. coli endotoxin produced a marked increase in transvascular protein flux and interstitial pulmonary edema, there was no effect on the clearance of either the vascular (131I-albumin) or the alveolar (125I-albumin) protein tracer across the epithelial barrier. High-dose alveolar E. coli endotoxin caused a 10-fold increase in the number of leukocytes, particularly neutrophils, that accumulated in the air spaces. In spite of the marked chemotactic effect of alveolar endotoxin, there was no change in the permeability of the epithelial barrier to the vascular or alveolar protein tracers. Also, alveolar epithelial liquid clearance was normal. Morphologic studies confirmed that the alveolar epithelial barrier was not injured by either intravenous or alveolar E. coli endotoxin. Thus, the alveolar epithelium in sheep is significantly more resistant than the lung endothelium to the injurious effects of E. coli endotoxin.
尽管静脉注射大肠杆菌内毒素已在实验研究中广泛用于增加肺内皮通透性,但大肠杆菌内毒素对肺上皮通透性的影响尚未得到充分研究。为了在绵羊中研究这个问题,通过用131I-白蛋白标记血管腔,并向肺泡内滴注3 ml/kg含125I-白蛋白的等渗蛋白质溶液,研究了蛋白质在肺上皮屏障的双向移动。大肠杆菌内毒素按以下三种方案之一给药:单独静脉注射(5-500微克/千克)、静脉注射(5微克/千克)加低剂量肺泡内毒素(10微克/千克)、单独高剂量肺泡内毒素(50-100微克/千克)。根据注入的天然蛋白质浓度估算肺泡液体清除率。对绵羊进行4小时或24小时的研究。尽管静脉注射大肠杆菌内毒素使跨血管蛋白质通量和间质性肺水肿显著增加,但对血管内(131I-白蛋白)或肺泡内(125I-白蛋白)蛋白质示踪剂穿过上皮屏障的清除率没有影响。高剂量肺泡内大肠杆菌内毒素使积聚在气腔内的白细胞数量增加了10倍,尤其是中性粒细胞。尽管肺泡内毒素有明显的趋化作用,但上皮屏障对血管或肺泡蛋白质示踪剂的通透性没有变化。此外,肺泡上皮液体清除率正常。形态学研究证实,静脉注射或肺泡注射大肠杆菌内毒素均未损伤肺泡上皮屏障。因此,绵羊的肺泡上皮比肺内皮对大肠杆菌内毒素的损伤作用具有显著更高的抵抗力。