Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
Am J Physiol Lung Cell Mol Physiol. 2011 May;300(5):L718-29. doi: 10.1152/ajplung.00227.2010. Epub 2011 Mar 4.
Ischemia-reperfusion (IR) injury following lung transplantation remains a major source of early morbidity and mortality. Histologically, this inflammatory process is characterized by neutrophil infiltration and activation. We previously reported that lung IR injury was significantly attenuated in plasminogen activator inhibitor-1-deficient mice. In this study, we explored the potential role of tissue plasminogen activator (tPA) in a mouse lung IR injury model. As a result, tPA knockout (KO) mice were significantly protected from lung IR injury through several mechanisms. At the cellular level, tPA KO specifically blocked neutrophil extravasation into the interstitium, and abundant homotypic neutrophil aggregation (HNA) was detected in the lung microvasculature of tPA KO mice after IR. At the molecular level, inhibition of neutrophil extravasation was associated with reduced expression of platelet endothelial cell adhesion molecule-1 mediated through the tPA/ LDL receptor-related protein/NF-κB signaling pathway, whereas increased P-selectin triggered HNA. At the functional level, tPA KO mice incurred significantly decreased vascular permeability and improved lung function following IR. Protection from lung IR injury in tPA KO mice occurs through a fibrinolysis-independent mechanism. These results suggest that tPA could serve as an important therapeutic target for the prevention and treatment of acute IR injury after lung transplantation.
肺移植后缺血再灌注(IR)损伤仍然是早期发病率和死亡率的主要原因。从组织学上看,这个炎症过程的特征是中性粒细胞浸润和激活。我们之前的报告表明,纤溶酶原激活物抑制剂-1 缺乏的小鼠的肺 IR 损伤明显减轻。在这项研究中,我们探讨了组织型纤溶酶原激活物(tPA)在小鼠肺 IR 损伤模型中的潜在作用。结果显示,tPA 敲除(KO)小鼠通过多种机制显著免受肺 IR 损伤。在细胞水平上,tPA KO 特异性地阻止了中性粒细胞渗出到间质中,并且在 IR 后 tPA KO 小鼠的肺微血管中检测到大量同源中性粒细胞聚集(HNA)。在分子水平上,通过 tPA/LDL 受体相关蛋白/NF-κB 信号通路介导的血小板内皮细胞黏附分子-1 的表达减少与中性粒细胞渗出抑制有关,而增加的 P-选择素则触发 HNA。在功能水平上,tPA KO 小鼠在 IR 后血管通透性显著降低,肺功能得到改善。tPA KO 小鼠的肺 IR 损伤保护是通过一种与纤维蛋白溶解无关的机制发生的。这些结果表明,tPA 可以作为预防和治疗肺移植后急性 IR 损伤的一个重要治疗靶点。