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脾脏在大鼠迷走神经刺激治疗脓毒症休克中的作用。

The role of spleen in vagus nerve stimulation for treatment against septic shock in rats.

作者信息

Xue Na, Liang Hui, Yao Hui, Song Xue-min, Li Jian-guo

机构信息

Intensive Care Unit, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2011 May;23(5):263-6.

Abstract

OBJECTIVE

To investigate the role of spleen in vagus nerve stimulation for treatment against septic shock in rats and its underlying mechanism.

METHODS

Sixty-four male Sprague-Dawley (SD) rats were randomly divided into eight groups (n = 8 in each group): sham group, model group, vagotomy group, vagus nerve stimulation group, splenectomy group, splenectomy and vagus nerve stimulation group, common celiac branch vagotomy group, and selective subdiaphragmatic ventral vagotomy group. The septic shock model was reproduced by cecal ligation and puncture (CLP). All the animals were subjected to left cervical vagus nerve isolation or vagotomy, splenectomy was done 3 days before CLP, common celiac branch vagotomy and selective subdiaphragmatic ventral vagotomy were performed after CLP. Mean arterial pressure (MAP) was continuously monitored. Blood was collected 4 hours after CLP for arterial blood gas analysis. The concentrations of tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1) in plasma and spleen were measured by enzyme-linked immunosorbent assay (ELISA). The spleen mRNA expressions of TNF-α and IL-1 were determined by quantitative reverse transcription-polymerase chain reaction (RT-PCR).

RESULTS

Compared with sham group, MAP continuously declined, and lactic acid accumulation and metabolic acidosis appeared in model group, and the contents of TNF-α and IL-1 in plasma and spleen, and mRNA expression of TNF-α and IL-1 in spleen were significantly increased in model group C plasma TNF-α (ng/L) 113.24 5.69 vs. 24. 69 2.56, plasma IL-1 (ng/L) 226.33±9. 12 vs. 34. 58 ± 3.45; spleen TNF-α (ng/g) 286. 1216. 66 vs. 41. 33 2. 35, spleen TNF-a mRNA 1. 12+0.08 vs. 0.22± 0. 02, spleen IL-1 (ng/g) 447. 34 ± 12. 36 vs. 42. 95 ± 2. 33, spleen IL-1 mRNA 0. 93 ± 0. 06 vs. 0. 28 ± 0. 02, all P<0. 013. Compared with model group, lowering of MAP was retarded, lactic acid value and the negative value of base excess (BE) were significantly decreased, the contents of TNF-α and IL-1 in plasma and spleen, and mRNA expression of TNF-α and IL-1 in spleen Uplasma TNF-α (ng/L) 41.00 ± 3.22, plasma IL-1 (ng/L) 63.29±2. 56; spleen TNF-α (ng/g) 74. 22-3.12, spleen TNF-α mRNA 0. 32± 0. 03, spleen IL-1 (ng/g) 81. 54- 5. 48, spleen IL-1 mRNA 0. 35+0.03] were also significantly decreased in vagus nerve stimulation group (P<0. 05 or P<0. 01). However, vagus nerve stimulation after splenectomy failed to show the similar effect as seen in the vagus nerve stimulation group. Compared with vagus nerve stimulation group, the contents of TNF-a and IL-1 in plasma and spleen, and mRNA expression of TNF-α and IL-1 in spleen Eplasma TNF-a (ng/L) 118.38±8. 52, plasma IL-1 (ng/L) 252. 23 9. 55; spleen TNF-α (ng/g) 297.88± 5.44, spleen TNF-a mRNA 0. 68+0. 04, spleen IL-1 (ng/g) 450. 26 12. 45, spleen IL-1 mRNA 0. 96±0. 063 were significantly increased in common celiac branch vagotomy group (P<0. 05 or P< 0. 01). In the selective subdiaphragmatic ventral vagotomy group similar effect with that of the vagus nerve stimulation group was found.

CONCLUSION

Vagus nerve stimulation fails to protect against septic shock in rats subjected to splenectomy or common celiac branch vagotomy, indicating that the spleen may be a vital target of the cholinergic anti-inflammatory pathway which is functionally linking with the spleen via the common celiac branch of vagus nerve.

摘要

目的

探讨脾脏在迷走神经刺激治疗大鼠脓毒性休克中的作用及其潜在机制。

方法

将64只雄性Sprague-Dawley(SD)大鼠随机分为8组(每组n = 8):假手术组、模型组、迷走神经切断组、迷走神经刺激组、脾切除组、脾切除加迷走神经刺激组、腹腔干分支迷走神经切断组和选择性膈下腹部迷走神经切断组。采用盲肠结扎穿孔(CLP)法复制脓毒性休克模型。所有动物均进行左颈迷走神经分离或切断,脾切除在CLP术前3天进行,腹腔干分支迷走神经切断和选择性膈下腹部迷走神经切断在CLP术后进行。连续监测平均动脉压(MAP)。CLP术后4小时采集血液进行动脉血气分析。采用酶联免疫吸附测定(ELISA)法检测血浆和脾脏中肿瘤坏死因子-α(TNF-α)和白细胞介素-1(IL-1)的浓度。采用定量逆转录-聚合酶链反应(RT-PCR)法测定脾脏中TNF-α和IL-1的mRNA表达。

结果

与假手术组相比,模型组MAP持续下降,出现乳酸蓄积和代谢性酸中毒,模型组血浆和脾脏中TNF-α和IL-1的含量以及脾脏中TNF-α和IL-1的mRNA表达均显著升高(血浆TNF-α(ng/L)113.24±5.69 vs. 24.69±2.56,血浆IL-1(ng/L)226.33±9.12 vs. 34.58±3.45;脾脏TNF-α(ng/g)286.12±16.66 vs. 41.33±2.35,脾脏TNF-α mRNA 1.12±0.08 vs. 0.22±0.02,脾脏IL-1(ng/g)447.34±12.36 vs. 42.95±2.33,脾脏IL-1 mRNA 0.93±0.06 vs. 0.28±0.02,均P<0.01)。与模型组相比,迷走神经刺激组MAP下降减缓,乳酸值和碱剩余(BE)负值显著降低,血浆和脾脏中TNF-α和IL-1的含量以及脾脏中TNF-α和IL-1的mRNA表达也显著降低(血浆TNF-α(ng/L)41.00±3.22,血浆IL-1(ng/L)63.29±2.56;脾脏TNF-α(ng/g)74.22±3.12,脾脏TNF-α mRNA 0.32±0.03,脾脏IL-1(ng/g)81.54±5.48,脾脏IL-1 mRNA 0.35±0.03)(P<0.05或P<0.01)。然而,脾切除后迷走神经刺激未显示出与迷走神经刺激组相似的效果。与迷走神经刺激组相比,腹腔干分支迷走神经切断组血浆和脾脏中TNF-α和IL-1的含量以及脾脏中TNF-α和IL-1的mRNA表达显著升高(血浆TNF-α(ng/L)118.38±8.52,血浆IL-1(ng/L)252.23±9.55;脾脏TNF-α(ng/g)297.88±5.44,脾脏TNF-α mRNA 0.68±0.04,脾脏IL-1(ng/g)450.26±12.45,脾脏IL-1 mRNA 0.96±0.06)(P<0.05或P<0.01)。选择性膈下腹部迷走神经切断组与迷走神经刺激组效果相似。

结论

在脾切除或腹腔干分支迷走神经切断的大鼠中,迷走神经刺激不能预防脓毒性休克,表明脾脏可能是胆碱能抗炎通路的重要靶点,该通路通过迷走神经的腹腔干分支与脾脏在功能上相联系。

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