Departments of Anesthesiology, The University of Texas Medical Branch at Galveston, Galveston, Texas 77555, USA.
Shock. 2011 Oct;36(4):402-9. doi: 10.1097/SHK.0b013e318228f614.
We investigated the effect of the angiotensin-converting enzyme (ACE) inhibitor captopril in a clinically relevant ovine model of smoke and burn injury, with special reference to oxidative stress and activation of poly(ADP-ribose) polymerase, in the lung and in circulating leukocytes. Female, adult sheep (28-40 kg) were divided into three groups. After tracheostomy and under deep anesthesia, both vehicle-control-treated (n = 5) and captopril-treated (20 mg/kg per day, i.v., starting 0.5 h before the injury) (n = 5) groups were subjected to 2 × 20%, third-degree burn injury and were insufflated with 48 breaths of cotton smoke. A sham group not receiving burn/smoke was also studied (n = 5). Animals were mechanically ventilated and fluid resuscitated for 24 h in the awake state. Burn and smoke injury resulted in an upregulation of ACE in the lung, evidenced by immunohistochemical determination and Western blotting. Burn and smoke injury resulted in pulmonary dysfunction, as well as systemic hemodynamic alterations. Captopril treatment of burn and smoke animals improved PaO2/FiO2 ratio and pulmonary shunt fraction and reduced the degree of lung edema. There was a marked increase in PAR levels in circulating leukocytes after burn/smoke injury, which was significantly decreased by captopril. The pulmonary level of ACE and the elevated pulmonary levels of transforming growth factor β in response to burn and smoke injury were significantly decreased by captopril treatment. Our results suggest that the ACE inhibitor captopril exerts beneficial effects on the pulmonary function in burn/smoke injury. The effects of the ACE inhibitor may be related to the prevention of reactive oxygen species-induced poly(ADP-ribose)polymerase overactivation. Angiotensin-converting enzyme inhibition may also exert additional beneficial effects by inhibiting the expression of the profibrotic mediator transforming growth factor β.
我们研究了血管紧张素转换酶(ACE)抑制剂卡托普利在绵羊烟雾和烧伤的临床相关模型中的作用,特别关注氧化应激和多聚(ADP-核糖)聚合酶的激活,在肺和循环白细胞中。雌性成年绵羊(28-40 公斤)分为三组。在气管切开术和深度麻醉下,接受 vehicle-control 治疗(n=5)和卡托普利治疗(每天 20mg/kg,静脉注射,在损伤前 0.5 小时开始)(n=5)的两组均接受 2×20%,三度烧伤,并接受 48 次棉烟吸入。还研究了未接受烧伤/烟雾的假手术组(n=5)。动物在清醒状态下进行机械通气和液体复苏 24 小时。烧伤和烟雾伤导致肺 ACE 的上调,通过免疫组织化学测定和 Western 印迹证实。烧伤和烟雾伤导致肺功能障碍以及全身血流动力学改变。烧伤和烟雾动物的卡托普利治疗改善了 PaO2/FiO2 比值和肺分流分数,并降低了肺水肿的程度。烧伤/烟雾损伤后循环白细胞中的 PAR 水平显著增加,卡托普利显著降低。卡托普利治疗显著降低了肺 ACE 和对烧伤和烟雾反应的升高的肺转化生长因子β水平。我们的结果表明,ACE 抑制剂卡托普利对烧伤/烟雾伤的肺功能有有益的影响。ACE 抑制剂的作用可能与预防活性氧诱导的多聚(ADP-核糖)聚合酶过度激活有关。ACE 抑制也可能通过抑制促纤维化介质转化生长因子β的表达发挥额外的有益作用。