Emergency Medicine Department, Medical School of University of São Paulo, São Paulo, Brazil.
Shock. 2012 May;37(5):524-30. doi: 10.1097/SHK.0b013e31824c7665.
Despite significant advances in the care of critically ill patients, acute lung injury continues to be a complex problem with high mortality. The present study was designed to characterize early lipopolysaccharide (LPS)-induced pulmonary injury and small interfering RNA targeting focal adhesion kinase (FAK) as a possible therapeutic tool in the septic lung remodeling process. Male Wistar rats were assigned into endotoxemic group and control group. Total collagen deposition was performed 8, 16, and 24 h after LPS injection. Focal adhesion kinase expression, interstitial and vascular collagen deposition, and pulmonary mechanics were analyzed at 24 h. Intravenous injection of small interfering RNA targeting FAK was used to silence expression of the kinase in pulmonary tissue. Focal adhesion kinase, total collagen deposition, and pulmonary mechanics showed increased in LPS group. Types I, III, and V collagen showed increase in pulmonary parenchyma, but only type V increased in vessels 24 h after LPS injection. Focal adhesion kinase silencing prevented lung remodeling in pulmonary parenchyma at 24 h. In conclusion, LPS induced a precocious and important lung remodeling. There was fibrotic response in the lung characterized by increased amount in total and specific-type collagen. These data may explain the frequent clinical presentation during sepsis of reduced lung compliance, oxygen diffusion, and pulmonary hypertension. The fact that FAK silencing was protective against lung collagen deposition underscores the therapeutic potential of FAK targeting by small interfering RNA.
尽管危重病患者的治疗取得了重大进展,但急性肺损伤仍然是一个复杂的问题,死亡率很高。本研究旨在描述早期脂多糖(LPS)诱导的肺损伤和针对粘着斑激酶(FAK)的小干扰 RNA 作为脓毒症肺重塑过程中的一种可能的治疗工具。雄性 Wistar 大鼠被分为内毒素血症组和对照组。在 LPS 注射后 8、16 和 24 小时进行总胶原蛋白沉积。在 24 小时时分析粘着斑激酶表达、间质和血管胶原蛋白沉积和肺力学。静脉注射靶向 FAK 的小干扰 RNA 用于沉默肺组织中激酶的表达。粘着斑激酶、总胶原蛋白沉积和肺力学在 LPS 组中增加。I、III 和 V 型胶原蛋白在肺实质中增加,但仅在 LPS 注射后 24 小时血管中增加了 V 型胶原蛋白。FAK 沉默可防止肺实质在 24 小时时的肺重塑。总之,LPS 诱导了早期和重要的肺重塑。肺中存在纤维化反应,表现为总胶原蛋白和特定类型胶原蛋白的含量增加。这些数据可能解释了脓毒症期间经常出现的肺顺应性降低、氧气扩散和肺动脉高压的临床症状。FAK 沉默可防止肺胶原蛋白沉积,这突显了小干扰 RNA 靶向 FAK 的治疗潜力。