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急性给予重组血管生成素-1可改善脓毒症小鼠多器官功能障碍综合征并提高存活率。

Acute administration of recombinant Angiopoietin-1 ameliorates multiple-organ dysfunction syndrome and improves survival in murine sepsis.

机构信息

Department of Nephrology & Hypertension, Hannover Medical School, Carl-NeubergStrasse1, D- 30625, Hannover, Germany.

出版信息

Cytokine. 2011 Aug;55(2):251-9. doi: 10.1016/j.cyto.2011.04.005. Epub 2011 Apr 30.

Abstract

INTRODUCTION

Endothelial activation leading to vascular barrier breakdown plays an essential role in the pathophysiology of multiple-organ dysfunction syndrome (MODS) in sepsis. Increasing evidence suggests that the function of the vessel-protective factor Angiopoietin-1 (Ang-1), a ligand of the endothelial-specific Tie2 receptor, is inhibited by its antagonist Angiopoietin-2 (Ang-2) during sepsis. In order to reverse the effects of the sepsis-induced suppression of Ang-1 and elevation of Ang-2 we aimed to investigate whether an intravenous injection of recombinant human (rh) Ang-1 protects against MODS in murine sepsis.

METHODS

Polymicrobiological abdominal sepsis was induced by cecal ligation and puncture (CLP). Mice were treated with either 1 μg of intravenous rhAng-1 or control buffer immediately after CLP induction and every 8h thereafter. Sham-operated animals served as time-matched controls.

RESULTS

Compared to buffer-treated controls, rhAng-1 treated septic mice showed significant improvements in several hematologic and biochemical indicators of MODS. Moreover, rhAng-1 stabilized endothelial barrier function, as evidenced by inhibition of protein leakage from lung capillaries into the alveolar compartment. Histological analysis revealed that rhAng-1 treatment attenuated leukocyte infiltration in lungs and kidneys of septic mice, probably due to reduced endothelial adhesion molecule expression in rhAng-1 treated mice. Finally, the protective effects of rhAng-1 treatment were reflected by an improved survival time in a lethal CLP model.

CONCLUSIONS

In a clinically relevant murine sepsis model, intravenous rhAng-1 treatment alone is sufficient to significantly improve a variety of sepsis-associated organ dysfunctions and survival time, most likely by preserving endothelial barrier function. Further studies are needed to pave the road for clinical application of this therapy concept.

摘要

简介

内皮细胞激活导致血管屏障破裂在脓毒症多器官功能障碍综合征(MODS)的病理生理学中起着重要作用。越来越多的证据表明,血管保护因子血管生成素-1(Ang-1)的功能在脓毒症中被其拮抗剂血管生成素-2(Ang-2)抑制。为了逆转脓毒症引起的 Ang-1抑制和 Ang-2 升高的影响,我们旨在研究静脉注射重组人(rh)Ang-1是否能预防小鼠脓毒症中的 MODS。

方法

通过盲肠结扎和穿刺(CLP)诱导多微生物性腹部脓毒症。CLP 诱导后立即给予小鼠 1μg 静脉注射 rhAng-1 或对照缓冲液,并每 8 小时给予一次。假手术动物作为时间匹配的对照。

结果

与缓冲液治疗的对照组相比,rhAng-1 治疗的脓毒症小鼠多项 MODS 的血液学和生化指标显著改善。此外,rhAng-1 稳定了内皮屏障功能,表现为抑制肺毛细血管蛋白渗漏到肺泡腔。组织学分析表明,rhAng-1 治疗减轻了脓毒症小鼠肺部和肾脏的白细胞浸润,这可能是由于 rhAng-1 治疗小鼠内皮细胞黏附分子表达减少所致。最后,rhAng-1 治疗的保护作用反映在致命性 CLP 模型中存活时间的延长。

结论

在一种临床相关的小鼠脓毒症模型中,单独静脉注射 rhAng-1 就足以显著改善多种与脓毒症相关的器官功能障碍和存活时间,这很可能是通过维持内皮屏障功能实现的。需要进一步的研究为这种治疗概念的临床应用铺平道路。

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