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在酸吸入性肺炎模型中,单次外源性表面活性剂冲击对肺顺应性的影响持续到治疗后两周。

The effect of a single bolus of exogenous surfactant on lung compliance persists until two weeks after treatment in a model of acid aspiration pneumonitis.

机构信息

Department of Experimental Medicine, University of Milano-Bicocca, Monza, Italy; Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy.

出版信息

Pulm Pharmacol Ther. 2011 Feb;24(1):141-6. doi: 10.1016/j.pupt.2010.07.004. Epub 2010 Jul 30.

Abstract

Aspiration pneumonitis, a direct cause of acute lung injury, is associated to a severe deterioration of lung function due in part to endogenous surfactant system impairment. We evaluated the effects of selective exogenous surfactant administration in a murine model of acid-induced lung injury both at short and long term. Hydrochloric acid was instilled into the right bronchus of the mice (0.1 M, 1.5 ml/kg). Six hours from acid instillation, they received, in the injured lung, a 1 ml/kg bolus of porcine surfactant (Curosurf®) 40 or 80 mg phospholipids/ml (Surf₄₀ or Surf₈₀), or saline (0.9% NaCl, vehicle) Functional, biochemical, histological and inflammatory results were obtained 24 h after injury. In the Surf₈₀ and vehicle group, lung mechanics and histology were assessed again after two weeks. Micro-Computed Tomography scans were performed at 24 h and two weeks. 24 h after injury in the Surf₈₀ group respiratory system compliance and oxygenation were significantly improved compared to the vehicle, while neutrophilic fraction in bronchoalveolar lavage was significantly lower. Surfactant-treated mice maintained a better compliance and a significantly reduced inflammatory infiltrate also two weeks after treatment compared to vehicle. Micro-Computed Tomography scan suggested a more pronounced reduction of injury in surfactant-treated animals two weeks after injury (p = 0.09). We showed a beneficial effect on lung function of a single bolus of exogenous surfactant in unilateral acid-induced lung injury up to two weeks after treatment. Our results may suggest a role of surfactant replacement in modulating spontaneous evolution of injury.

摘要

吸入性肺炎是急性肺损伤的直接原因,与肺功能严重恶化有关,部分原因是内源性表面活性剂系统受损。我们评估了在酸诱导的肺损伤的小鼠模型中,短期和长期使用选择性外源性表面活性剂的效果。将盐酸(0.1 M,1.5 ml/kg)注入小鼠的右支气管。在酸注入后 6 小时,它们在受伤的肺中接受 1 ml/kg 的猪表面活性剂(Curosurf®)40 或 80 mg 磷脂/ml(Surf₄₀ 或 Surf₈₀)或生理盐水(0.9% NaCl,载体)的冲击剂量。伤后 24 小时获得功能、生化、组织学和炎症结果。在 Surf₈₀ 和载体组中,在两周后再次评估肺力学和组织学。在 24 小时和两周时进行微型计算机断层扫描扫描。伤后 24 小时,与载体相比,Surf₈₀ 组的呼吸系统顺应性和氧合明显改善,而支气管肺泡灌洗液中的中性粒细胞分数明显降低。与载体相比,在治疗两周后,接受表面活性剂治疗的小鼠保持更好的顺应性和明显减少的炎症浸润。微型计算机断层扫描扫描表明,在损伤两周后,接受表面活性剂治疗的动物的损伤程度明显降低(p = 0.09)。我们在单侧酸诱导的肺损伤中显示了单次冲击剂量的外源性表面活性剂对肺功能的有益影响,直至治疗后两周。我们的结果可能提示表面活性剂替代在调节损伤的自发演变中发挥作用。

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