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抑制急性肺部炎症和损伤是中暑损伤后脑部降温的一个目标。

Inhibition of acute lung inflammation and injury is a target of brain cooling after heatstroke injury.

作者信息

Hsi-Hsing Yang, Ching-Ping Chang, Juei-Tang Cheng, Lin Mao-Tsun

机构信息

Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan.

出版信息

J Trauma. 2010 Oct;69(4):805-12. doi: 10.1097/TA.0b013e3181cb43fd.

Abstract

BACKGROUND

Although brain cooling has recently been reported as effective in improving the survival after heatstroke generation in rats, the mechanisms underlying the therapeutic effects of brain cooling are not fully elucidated. This study was conducted to test whether the acute lung inflammation and damage that might occur during heatstroke could be affected by brain cooling.

METHODS

Anesthetized rats were randomized into four groups as follows: (a) normothermic controls (n = 8); (b) heatstroke rats without saline delivery (n = 8); (c) heatstroke rats treated with 36°C saline via retrograde jugular vein (n = 8); and (d) heatstroke rats treated with 4°C saline via retrograde jugular vein (n = 8). Heatstroke was induced by putting the animals in a folded heating pad of 42°C for 68 minutes controlled by circulating hot water. The core temperatures of normothermic groups were maintained at about 36°C. The cardiovascular parameters and core temperatures were monitored for all experiments. Bronchoalveolar lavage (BAL) was done in the left lung 20 minutes after termination of heat stress for determination of cellular ischemia markers (e.g., glutamate, lactate-to-pyruvate ratio), proinflammatory cytokines (interleukin-1, tumor necrosis factor-alpha), and nitric oxide metabolites. Parts of the right lung were excised for meloperoxidase measurement, whereas the rest was collected for lung damage score assessments.

RESULTS

When compared with those of normothermic controls, untreated or 36°C saline-treated heatstroke rats had higher values of BAL fluid levels of cellular ischemia markers, proinflammatory cytokines, nitric oxide metabolites, lung meroperoxidase activity, lung damage score, and neutrophil infiltration. Brain cooling causes by 4°C saline infusion significantly reduced the heat-induced increased BAL levels of cellular ischemia markers, proinflammatory cytokines, and nitric oxide metabolites, and reduced lung damage score and neutrophil infiltration.

CONCLUSIONS

These experimental data indicate that acute lung inflammation and damage is a target of brain cooling after heatstroke injury.

摘要

背景

尽管最近有报道称脑部降温对改善大鼠中暑后的存活率有效,但脑部降温治疗效果的潜在机制尚未完全阐明。本研究旨在测试中暑期间可能发生的急性肺部炎症和损伤是否会受到脑部降温的影响。

方法

将麻醉的大鼠随机分为四组:(a) 正常体温对照组(n = 8);(b) 未输注生理盐水的中暑大鼠(n = 8);(c) 通过逆行颈静脉输注36°C生理盐水治疗的中暑大鼠(n = 8);(d) 通过逆行颈静脉输注4°C生理盐水治疗的中暑大鼠(n = 8)。通过将动物置于由循环热水控制的42°C折叠加热垫中68分钟来诱导中暑。正常体温组的核心温度维持在约36°C。在所有实验中监测心血管参数和核心温度。热应激结束后20分钟,对左肺进行支气管肺泡灌洗(BAL),以测定细胞缺血标志物(如谷氨酸、乳酸与丙酮酸比值)、促炎细胞因子(白细胞介素-1、肿瘤坏死因子-α)和一氧化氮代谢产物。切除部分右肺用于测定髓过氧化物酶,其余部分用于评估肺损伤评分。

结果

与正常体温对照组相比,未治疗或接受36°C生理盐水治疗的中暑大鼠的BAL液中细胞缺血标志物、促炎细胞因子、一氧化氮代谢产物、肺髓过氧化物酶活性、肺损伤评分和中性粒细胞浸润的值更高。输注4°C生理盐水引起的脑部降温显著降低了热诱导的BAL液中细胞缺血标志物、促炎细胞因子和一氧化氮代谢产物水平的升高,并降低了肺损伤评分和中性粒细胞浸润。

结论

这些实验数据表明,急性肺部炎症和损伤是中暑损伤后脑部降温的靶点。

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