Bierman Alexis, Yerrapureddy Adi, Reddy Narsa M, Hassoun Paul M, Reddy Sekhar P
Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
Transl Res. 2008 Dec;152(6):265-72. doi: 10.1016/j.trsl.2008.10.004. Epub 2008 Oct 31.
Mechanical ventilation (MV) is used as therapy to support critically ill patients; however, the mechanisms by which MV induces lung injury and inflammation remain unclear. Epidermal growth factor receptor (EGFR)-mediated signaling plays a key role in various physiologic and pathologic processes, which include those modulated by mechanical and shear forces, in various cell types. We hypothesized that EGFR-activated signaling plays a key role in ventilator-induced lung injury and inflammation (VILI). To test this hypothesis, we assessed lung vascular and alveolar permeability as well as inflammation, which are cardinal features of VILI, in mice treated with the EGFR inhibitor AG1478. Inhibition of EGFR activity greatly diminished MV-induced lung alveolar permeability and neutrophil accumulation in the bronchoalveolar lavage (BAL) fluid, as compared with vehicle-treated controls. Similarly, AG1478 inhibition diminished lung vascular leak (as assessed by Evans blue extravasation), but it did not affect interstitial neutrophil accumulation. Inhibition of the EGFR pathway also blocked expression of genes induced by MV. However, intratracheal instillation of EGF alone failed to induce lung injury. Collectively, our findings suggest that EGFR-activated signaling is necessary but not sufficient to produce acute lung injury in mice.
机械通气(MV)被用作支持重症患者的治疗手段;然而,MV诱发肺损伤和炎症的机制仍不清楚。表皮生长因子受体(EGFR)介导的信号传导在各种生理和病理过程中起着关键作用,这些过程包括在各种细胞类型中由机械力和剪切力调节的过程。我们假设EGFR激活的信号传导在呼吸机诱发的肺损伤和炎症(VILI)中起关键作用。为了验证这一假设,我们评估了用EGFR抑制剂AG1478处理的小鼠的肺血管和肺泡通透性以及炎症,这些是VILI的主要特征。与载体处理的对照组相比,EGFR活性的抑制大大降低了MV诱导的肺泡通透性和支气管肺泡灌洗(BAL)液中的中性粒细胞积聚。同样,AG1478抑制减少了肺血管渗漏(通过伊文思蓝外渗评估),但不影响间质中性粒细胞积聚。EGFR途径的抑制也阻断了MV诱导的基因表达。然而,单独气管内滴注EGF未能诱发肺损伤。总的来说,我们的研究结果表明,EGFR激活的信号传导是产生小鼠急性肺损伤所必需的,但并不充分。