Department of Intensive Care Medicine, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands.
Crit Care. 2010;14(4):R157. doi: 10.1186/cc9232. Epub 2010 Aug 23.
Aneurysmal subarachnoid hemorrhage (SAH) affects relatively young people and carries a poor prognosis with a case fatality rate of 35%. One of the major systemic complications associated with SAH is acute lung injury (ALI) which occurs in up to one-third of the patients and is associated with poor outcome. ALI in SAH may be predisposed by neurogenic pulmonary edema (NPE) and inflammatory mediators. The objective of this study was to assess the immunomodulatory effects of interferon-β (IFN-β) on inflammatory mediators in the lung after experimental SAH.
Male Wistar rats were subjected to the induction of SAH by means of the endovascular filament method. Sham-animals underwent sham-surgery. Rats received IFN-β for four consecutive days starting at two hours after SAH induction. After seven days, lungs were analyzed for the expression of inflammatory markers.
SAH induced the influx of neutrophils into the lung, and enhanced expression of the pulmonary adhesion molecules E-selectin, inter-cellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule (VCAM)-1 compared to sham-animals. In addition, SAH increased the expression of the chemokines macrophage inflammatory protein (MIP)-1α, MIP-2, and cytokine-induced neutrophil chemoattractant (CINC)-1 in the lung. Finally, tumor necrosis factor-α (TNF-α) was significantly increased in lungs from SAH-animals compared to sham-animals. IFN-β effectively abolished the SAH-induced expression of all pro-inflammatory mediators in the lung.
IFN-β strongly reduces lung inflammation after experimental SAH and may therefore be an effective drug to prevent SAH-mediated lung injury.
蛛网膜下腔出血(SAH)影响相对年轻的人群,其预后较差,病死率为 35%。SAH 相关的主要系统性并发症之一是急性肺损伤(ALI),多达三分之一的患者会发生这种并发症,且与不良预后相关。SAH 中的 ALI 可能由神经源性肺水肿(NPE)和炎症介质引起。本研究的目的是评估干扰素-β(IFN-β)对实验性 SAH 后肺部炎症介质的免疫调节作用。
雄性 Wistar 大鼠通过血管内纤维丝方法诱导 SAH。假手术动物接受假手术。大鼠在 SAH 诱导后 2 小时开始连续 4 天接受 IFN-β治疗。7 天后,分析肺部炎症标志物的表达。
SAH 导致中性粒细胞流入肺部,并增强了肺部黏附分子 E-选择素、细胞间黏附分子(ICAM)-1 和血管细胞黏附分子(VCAM)-1的表达,与假手术动物相比。此外,SAH 增加了肺部趋化因子巨噬细胞炎症蛋白(MIP)-1α、MIP-2 和细胞因子诱导的中性粒细胞趋化因子(CINC)-1的表达。最后,与假手术动物相比,SAH 动物的肺部肿瘤坏死因子-α(TNF-α)显著增加。IFN-β 可有效消除 SAH 诱导的肺部所有促炎介质的表达。
IFN-β 可强烈减轻实验性 SAH 后的肺部炎症,因此可能是预防 SAH 介导的肺损伤的有效药物。