Department of Anesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China.
Acta Pharmacol Sin. 2012 May;33(5):635-43. doi: 10.1038/aps.2012.5. Epub 2012 Apr 2.
Ischemia/reperfusion is an initial triggering event that leads to gut-induced acute lung injury (ALI). In this study, we investigated whether hypoxia inducible factor-1α (HIF-1α) played a role in the pathogenesis of lung injury induced by trauma and hemorrhagic shock (T/HS).
Male Wistar rats underwent laparotomy and hemorrhagic shock for 60 min. Sham-shock animals underwent laparotomy but without hemorrhagic shock. After resuscitation for 3 hr, the rats were sacrificed. Morphologic changes of the lungs and intestines were examined. Bronchoalveolar lavage fluid (BALF) was collected. Lung water content, pulmonary myeloperoxidase (MPO) activity and the levels of malondialdehyde (MDA), nitrite/nitrate, TNF-α, IL-1β, and IL-6 in the lungs were measured. The gene expression of pulmonary HIF-1α and iNOS, and HIF-1α transcriptional activity in the lungs were also assessed. The apoptosis in the lungs was determined using TUNEL assay and cleaved caspase-3 expression.
Lung and intestinal injuries induced by T/HS were characterized by histological damages and a significant increase in lung water content. Compared to the sham-shock group, the BALF cell counts, the pulmonary MPO activity and the MDA, nitrite/nitrate, TNF-α, IL-1β, and IL-6 levels in the T/HS group were significantly increased. Acute lung injury was associated with a higher degree of pulmonary HIF-1α and iNOS expression as well as apoptosis in the lungs. Intratracheal delivery of HIF-1α inhibitor YC-1 (1 mg/kg) significantly attenuated lung injury, and reduced pulmonary HIF-1α and iNOS expression and HIF-1α transcriptional activity in the T/HS group.
Local inhibition of HIF-1α by YC-1 alleviates the lung injury induced by T/HS. Our results provide novel insight into the pathogenesis of T/HS-induced ALI and a potential therapeutic application.
缺血/再灌注是导致肠源性急性肺损伤(ALI)的初始触发事件。本研究旨在探讨低氧诱导因子-1α(HIF-1α)是否在创伤和失血性休克(T/HS)引起的肺损伤发病机制中发挥作用。
雄性 Wistar 大鼠接受剖腹术和 60 分钟失血性休克。假休克动物接受剖腹术,但不进行失血性休克。复苏 3 小时后,处死大鼠。观察肺和肠的形态变化。收集支气管肺泡灌洗液(BALF)。测量肺水含量、肺髓过氧化物酶(MPO)活性以及肺组织中丙二醛(MDA)、亚硝酸盐/硝酸盐、TNF-α、IL-1β和 IL-6 的水平。还评估了肺中 HIF-1α和 iNOS 的基因表达以及肺中 HIF-1α 的转录活性。使用 TUNEL 测定和 cleaved caspase-3 表达来确定肺中的细胞凋亡。
T/HS 引起的肺和肠损伤的特征是组织学损伤和肺水含量显著增加。与假休克组相比,T/HS 组 BALF 细胞计数、肺 MPO 活性以及 MDA、亚硝酸盐/硝酸盐、TNF-α、IL-1β和 IL-6 水平均显著升高。急性肺损伤与肺中 HIF-1α和 iNOS 表达以及凋亡程度增加相关。气管内给予 HIF-1α 抑制剂 YC-1(1mg/kg)可显著减轻肺损伤,并降低 T/HS 组肺中 HIF-1α 和 iNOS 表达以及 HIF-1α 的转录活性。
YC-1 局部抑制 HIF-1α 可减轻 T/HS 引起的肺损伤。我们的研究结果为 T/HS 诱导的 ALI 的发病机制提供了新的见解,并为潜在的治疗应用提供了依据。