Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Anesthesiology. 2011 Oct;115(4):804-11. doi: 10.1097/ALN.0b013e31822e94bd.
Sepsis impairs hypoxic pulmonary vasoconstriction (HPV) in patients and animal models, contributing to systemic hypoxemia. Concentrations of cysteinyl leukotrienes are increased in the bronchoalveolar lavage fluid of patients with sepsis, but the contribution of cysteinyl leukotrienes to the impairment of HPV is unknown.
Wild-type mice, mice deficient in leukotriene C(4) synthase, the enzyme responsible for cysteinyl leukotriene synthesis, and mice deficient in cysteinyl leukotriene receptor 1 were studied 18 h after challenge with either saline or endotoxin. HPV was measured by the increase in left pulmonary vascular resistance induced by left mainstem bronchus occlusion. Concentrations of cysteinyl leukotrienes were determined in the bronchoalveolar lavage fluid.
In the bronchoalveolar lavage fluid of all three strains, cysteinyl leukotrienes were not detectable after saline challenge; whereas endotoxin challenge increased cysteinyl leukotriene concentrations in wild-type mice and mice deficient in cysteinyl leukotriene receptor 1, but not in mice deficient in leukotriene C(4) synthase. HPV did not differ among the three mouse strains after saline challenge (120 ± 26, 114 ± 16, and 115 ± 24%, respectively; mean ± SD). Endotoxin challenge markedly impaired HPV in wild-type mice (41 ± 20%) but only marginally in mice deficient in leukotriene C(4) synthase (96 ± 16%, P < 0.05 vs. wild-type mice), thereby preserving systemic oxygenation. Although endotoxin modestly decreased HPV in mice deficient in cysteinyl leukotriene receptor 1 (80 ± 29%, P < 0.05 vs. saline challenge), the magnitude of impairment was markedly less than in endotoxin-challenged wild-type mice.
Cysteinyl leukotrienes importantly contribute to endotoxin-induced impairment of HPV in part via a cysteinyl leukotriene receptor 1-dependent mechanism.
脓毒症会损害患者和动物模型的低氧性肺血管收缩(HPV),导致全身低氧血症。脓毒症患者支气管肺泡灌洗液中的半胱氨酰白三烯浓度升高,但半胱氨酰白三烯对 HPV 损害的贡献尚不清楚。
在挑战生理盐水或内毒素 18 小时后,研究了野生型小鼠、负责半胱氨酰白三烯合成的酶白三烯 C(4)合酶缺乏的小鼠以及半胱氨酰白三烯受体 1 缺乏的小鼠。通过左主支气管闭塞引起的左肺血管阻力增加来测量 HPV。在支气管肺泡灌洗液中测定半胱氨酰白三烯的浓度。
在所有三种菌株的支气管肺泡灌洗液中,生理盐水挑战后均无法检测到半胱氨酰白三烯;而内毒素挑战增加了野生型小鼠和半胱氨酰白三烯受体 1 缺乏的小鼠的半胱氨酰白三烯浓度,但白三烯 C(4)合酶缺乏的小鼠则没有。生理盐水挑战后,三种小鼠株的 HPV 无差异(分别为 120±26%、114±16%和 115±24%;平均值±标准差)。内毒素挑战显著损害了野生型小鼠的 HPV(41±20%),但对缺乏白三烯 C(4)合酶的小鼠只有轻微影响(96±16%,与野生型小鼠相比,P<0.05),从而保持了全身氧合。尽管内毒素轻微降低了半胱氨酰白三烯受体 1 缺乏的小鼠的 HPV(80±29%,与生理盐水挑战相比,P<0.05),但其损害程度明显小于内毒素挑战的野生型小鼠。
半胱氨酰白三烯通过半胱氨酰白三烯受体 1 依赖机制,对内毒素诱导的 HPV 损害有重要贡献。