Meldrum D R, Ayala A, Perrin M M, Ertel W, Chaudry I H
Department of Surgery, Michigan State University, East Lansing 48824.
J Surg Res. 1991 Aug;51(2):158-64. doi: 10.1016/0022-4804(91)90088-4.
Various beneficial effects of calcium channel blockers on cell and organ function following endotoxic shock, organ ischemia, and reperfusion have been reported; however, it is not known whether these agents have any salutary or deleterious effects on immune responses after low-flow conditions. Therefore, the aim of this study was to determine (a) the effect of hemorrhage on lymphocyte IL-2, IL-3, IL-6, and IFN-gamma synthesis, and (b) whether diltiazem has any salutary or adverse effects on these parameters when administered following hemorrhage and resuscitation. To study this, C3H/HeN mice were bled to a mean blood pressure of 35 mm Hg, maintained at that level for 60 min, and resuscitated with shed blood plus twice that volume of Ringer's lactate. Immediately following resuscitation mice received either diltiazem (2400, 800, or 400 micrograms/kg body wt), or an equivalent volume of saline. The mice were sacrificed 24 hr later, splenic lymphocytes were obtained, and their capacity to produce lymphokines was assessed. The results indicated that in the vehicle-treated animals, hemorrhage significantly decreased (P less than 0.05) IL-2, IL-3, IL-6, and IFN-gamma synthesis by 82 +/- 19%, 64 +/- 28%, 71 +/- 11%, and 86 +/- 14%, respectively. However, diltiazem (400 but not 2400 micrograms/kg) treatment after hemorrhage restored lymphocyte capacity to produce IL-2, IL-3, IL-6, and IFN-gamma (P less than 0.05). Additional groups of animals were subjected to sepsis by cecal ligation and puncture 3 days following hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)
钙通道阻滞剂在内毒素休克、器官缺血及再灌注后对细胞和器官功能具有多种有益作用,这已见诸报道;然而,尚不清楚这些药物在低血流状态后对免疫反应是否具有有益或有害作用。因此,本研究的目的是确定:(a)出血对淋巴细胞白细胞介素-2(IL-2)、白细胞介素-3(IL-3)、白细胞介素-6(IL-6)和γ-干扰素(IFN-γ)合成的影响;(b)出血和复苏后给予地尔硫䓬对这些参数是否具有有益或不良影响。为研究此问题,将C3H/HeN小鼠放血至平均血压为35毫米汞柱,维持该水平60分钟,然后用自体血加两倍体积的乳酸林格液进行复苏。复苏后立即给小鼠注射地尔硫䓬(2400、800或400微克/千克体重),或等量的生理盐水。24小时后处死小鼠,获取脾淋巴细胞,并评估其产生淋巴因子的能力。结果表明,在给予赋形剂处理的动物中,出血显著降低(P<0.05)IL-2、IL-3、IL-6和IFN-γ的合成,分别降低82±19%、64±28%、71±11%和86±14%。然而,出血后给予地尔硫䓬(400微克/千克而非2400微克/千克)可恢复淋巴细胞产生IL-2、IL-3、IL-6和IFN-γ的能力(P<0.05)。另外几组动物在出血3天后通过盲肠结扎和穿刺诱发脓毒症。(摘要截短于250词)