Department of Anesthesia, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
Shock. 2010 Sep;34(3):281-90. doi: 10.1097/SHK.0b013e3181cdc327.
NO has been implicated in the pathogenesis of septic shock. However, the role of NO synthase 3 (NOS3) during sepsis remains incompletely understood. Here, we examined the impact of NOS3 deficiency on systemic inflammation and myocardial dysfunction during peritonitis-induced polymicrobial sepsis. Severe polymicrobial sepsis was induced by colon ascendens stent peritonitis (CASP) in wild-type (WT) and NOS3-deficient (NOS3KO) mice. NOS3KO mice exhibited shorter survival time than did WT mice after CASP. NOS3 deficiency worsened systemic inflammation assessed by the expression of inflammatory cytokines in the lung, liver, and heart. Colon ascendens stent peritonitis markedly increased the number of leukocyte infiltrating the liver and heart in NOS3KO but not in WT mice. The exaggerated systemic inflammation in septic NOS3KO mice was associated with more marked myocardial dysfunction than in WT mice 22 h after CASP. The detrimental effects of NOS3 deficiency on myocardial function after CASP seem to be caused by impaired Ca handling of cardiomyocytes. The impaired Ca handling of cardiomyocytes isolated from NOS3KO mice subjected to CASP was associated with depressed mitochondrial ATP production, a determinant of the Ca cycling capacity of sarcoplasmic reticulum Ca-ATPase. The NOS3 deficiency-induced impairment of the ability of mitochondria to produce ATP after CASP was at least in part attributable to reduction in mitochondrial respiratory chain complex I activity. These observations suggest that NOS3 protects against systemic inflammation and myocardial dysfunction after peritonitis-induced polymicrobial sepsis in mice.
NO 被认为与脓毒性休克的发病机制有关。然而,NOS3 在脓毒症中的作用仍不完全清楚。在这里,我们研究了 NOS3 缺乏对腹膜炎诱导的多微生物脓毒症期间全身炎症和心肌功能障碍的影响。通过结肠升支支架腹膜炎 (CASP) 在野生型 (WT) 和 NOS3 缺陷型 (NOS3KO) 小鼠中诱导严重的多微生物脓毒症。与 WT 小鼠相比,NOS3KO 小鼠在 CASP 后存活时间更短。NOS3 缺乏症通过肺、肝和心脏中炎性细胞因子的表达加重全身炎症。与 WT 小鼠相比,NOS3KO 小鼠的肝脏和心脏白细胞浸润明显增加。在 CASP 后 22 小时,脓毒症 NOS3KO 小鼠的全身炎症更为严重,心肌功能障碍也更为严重。与 WT 小鼠相比,NOS3KO 小鼠的心肌功能障碍更为严重,这似乎是由于 CASP 后心肌细胞钙处理受损所致。NOS3KO 小鼠的心肌细胞分离后,与 CASP 相关的 Ca 循环能力的决定因素——肌浆网 Ca-ATP 酶的线粒体 ATP 产生减少,导致 Ca 处理受损。CASP 后 NOS3 缺乏引起的线粒体产生 ATP 的能力受损至少部分归因于线粒体呼吸链复合物 I 活性的降低。这些观察结果表明,NOS3 可防止腹膜炎诱导的多微生物脓毒症后全身炎症和心肌功能障碍。