Departments of Anesthesiology, Pathology, and Surgery, Investigational Intensive Care Unit, The University of Texas Medical Branch and Shriners Burns Hospital for Children, Galveston, Texas, USA.
Shock. 2011 Feb;35(2):148-55. doi: 10.1097/SHK.0b013e3181eb4556.
Systemic inflammatory response syndrome is associated with excessive production of nitric oxide (NO·) and superoxide (O2), forming peroxynitrite, which in turn, acts as a terminal mediator of cellular injury by producing cell necrosis and apoptosis. We examined the effect of the peroxynitrite decomposition catalyst, WW-85, in a sheep model of acute lung injury and septic shock. Eighteen sheep were operatively prepared and randomly allocated to the sham, control, or WW-85 group (n = 6 each). After a tracheotomy, acute lung injury was produced in the control and WW-85 groups by insufflation of four sets of 12 breaths of cotton smoke. Then, a 30-mL suspension of live Pseudomonas aeruginosa bacteria (containing 2 - 5 × 10¹¹ colony-forming units) was instilled into the lungs according to an established protocol. The sham group received only the vehicle (30 mL saline). The sheep were studied in awake state for 24 h and ventilated with 100% oxygen. WW-85 was administered 1 h after injury as bolus infusion (0.1 mg/kg), followed by a continuous infusion of 0.02 mg·kg⁻¹·h⁻¹ until the end of the 24-h experimental period. Compared with injured but untreated controls, WW-85-treated animals had significantly improved gas exchange, reductions in airway obstruction, shunt formation, lung myeloperoxidase concentrations, lung malondialdehyde concentrations, lung 3-nitrotyrosine concentrations, and plasma nitrate-to-nitrite levels. Animals treated with WW-85 exhibited less microvascular leakage and improvements in pulmonary function. These results provide evidence that blockade of the nitric oxide-peroxynitrite pathway improves disturbances from septic shock, as demonstrated in a clinically relevant ovine experimental model.
全身炎症反应综合征与一氧化氮(NO·)和超氧阴离子(O2)的过度产生有关,形成过氧亚硝酸盐,进而通过产生细胞坏死和凋亡作为细胞损伤的终末介质。我们在急性肺损伤和感染性休克的绵羊模型中检查了过氧亚硝酸盐分解催化剂 WW-85 的作用。18 只绵羊进行手术准备,并随机分配到假手术、对照组或 WW-85 组(每组 6 只)。在对照组和 WW-85 组中,通过对 4 套 12 次棉烟吹气来产生急性肺损伤。然后,根据既定方案将含有 2-5×10¹¹个菌落形成单位的活铜绿假单胞菌细菌悬浮液(30 毫升)注入肺部。假手术组仅接受载体(30 毫升生理盐水)。绵羊在清醒状态下研究 24 小时,并接受 100%氧气通气。损伤后 1 小时给予 WW-85 静脉推注(0.1 mg/kg),然后以 0.02 mg·kg⁻¹·h⁻¹的速度持续输注,直到 24 小时实验期结束。与未治疗的损伤对照组相比,WW-85 治疗的动物的气体交换明显改善,气道阻塞、分流形成、肺髓过氧化物酶浓度、肺丙二醛浓度、肺 3-硝基酪氨酸浓度和血浆硝酸盐-亚硝酸盐水平降低。用 WW-85 治疗的动物微血管渗漏减少,肺功能改善。这些结果提供了证据,表明阻断一氧化氮-过氧亚硝酸盐途径可改善临床相关绵羊实验模型中感染性休克引起的紊乱。