Bird Melanie D, Morgan Michelle O, Ramirez Luis, Yong Sherri, Kovacs Elizabeth J
Department of Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
J Burn Care Res. 2010 Jul-Aug;31(4):652-60. doi: 10.1097/BCR.0b013e3181e4c58c.
Clinical and laboratory evidence suggests that alcohol consumption dysregulates immune function. Burn patients who consume alcohol before their injuries demonstrate higher rates of morbidity and mortality, including acute respiratory distress syndrome, than patients without alcohol at the time of injury. Our laboratory observed higher levels of proinflammatory cytokines and leukocyte infiltration in the lungs of mice after ethanol exposure and burn injury than with either insult alone. To understand the mechanism of the increased pulmonary inflammatory response in mice treated with ethanol and burn injury, we investigated the role of intercellular adhesion molecule (ICAM)-1. Wild-type and ICAM-1 knockout (KO) mice were treated with vehicle or ethanol and subsequently given a sham or burn injury. Twenty-four hours postinjury, lungs were harvested and analyzed for indices of inflammation. Higher numbers of neutrophils were observed in the lungs of wild-type mice after burn and burn with ethanol treatment. This increase in pulmonary inflammatory cell accumulation was significantly lower in the KO mice. In addition, levels of KC, interleukin-1beta, and interleukin-6 in the lung were decreased in the ICAM-1 KO mice after ethanol exposure and burn injury. Interestingly, no differences were observed in serum or lung tissue content of soluble ICAM-1 24 hours postinjury. These data suggest that upregulation of adhesion molecules such as ICAM-1 on the vascular endothelium may play a critical role in the excessive inflammation seen after ethanol exposure and burn injury.
临床和实验室证据表明,饮酒会使免疫功能失调。与受伤时未饮酒的患者相比,在受伤前饮酒的烧伤患者出现包括急性呼吸窘迫综合征在内的发病率和死亡率更高。我们的实验室观察到,乙醇暴露和烧伤后,小鼠肺部的促炎细胞因子水平和白细胞浸润比单独遭受任何一种损伤时更高。为了了解乙醇处理和烧伤的小鼠肺部炎症反应增加的机制,我们研究了细胞间黏附分子(ICAM)-1的作用。对野生型和ICAM-1基因敲除(KO)小鼠分别用赋形剂或乙醇处理,随后进行假手术或烧伤。受伤后24小时,采集肺部并分析炎症指标。在烧伤和乙醇处理后的野生型小鼠肺部观察到更多的中性粒细胞。在基因敲除小鼠中,肺部炎症细胞积聚的这种增加明显较低。此外,乙醇暴露和烧伤后,ICAM-1基因敲除小鼠肺部的KC、白细胞介素-1β和白细胞介素-6水平降低。有趣的是,受伤后24小时,血清或肺组织中可溶性ICAM-1的含量没有差异。这些数据表明,血管内皮上ICAM-1等黏附分子的上调可能在乙醇暴露和烧伤后出现的过度炎症中起关键作用。