中性粒细胞激活在胸部创伤后脓毒症性急性肺损伤中的作用。
Role of activated neutrophils in chest trauma-induced septic acute lung injury.
机构信息
Department of Trauma, Hand, Plastic, and Reconstructive Surgery, University of Ulm, Ulm, Germany.
出版信息
Shock. 2012 Jul;38(1):98-106. doi: 10.1097/SHK.0b013e318254be6a.
More than 50% of severely injured patients have chest trauma. Second insults frequently result in acute lung injury (ALI), with sepsis being the main underlying condition. We aimed to develop a standardized, reproducible, and clinically relevant double-hit mouse model of ALI induced by chest trauma and polymicrobial sepsis and to investigate the pathophysiologic role of activated neutrophils. Lung contusion was applied to C57Bl/6 mice via a focused blast wave. Twenty-four hours later, sepsis was induced by cecal ligation and puncture. For polymorphonuclear leukocyte (PMN) depletion, animals received intravenous injections of PMN-depleting antibody. In response to blunt chest trauma followed by sepsis as well as after sepsis alone, a significant local and systemic inflammatory response with increased cytokine/chemokine levels in lung and plasma was observed. In contrast, lung apoptosis was markedly elevated only after a double hit. Intra-alveolar neutrophils and total bronchoalveolar lavage protein concentrations were markedly increased following isolated chest trauma or the combined insult, but not after sepsis alone. Lung myeloperoxidase activity was enhanced only in response to the double hit accompanied by histological disruption of the alveolar architecture, lung congestion, and marked cellular infiltrates. Neutrophil depletion significantly diminished lung interleukin 1β and interleukin 6 concentrations and reduced the degree of septic ALI. Here we have established a novel and highly reproducible mouse model of chest trauma-induced septic ALI characterizing a clinical relevant double-hit scenario. In particular, the depletion of neutrophils substantially mitigated the extent of lung injury, indicating a pathomechanistic role for neutrophils in chest trauma-induced septic ALI.
超过 50%的严重创伤患者存在胸部创伤。二次打击常导致急性肺损伤(ALI),其中脓毒症是主要潜在病因。我们旨在开发一种标准化、可重现且与临床相关的双打击小鼠模型,用于诱导胸部创伤和多微生物脓毒症引起的 ALI,并研究活化中性粒细胞的病理生理作用。通过聚焦的冲击波对 C57Bl/6 小鼠实施肺挫伤。24 小时后,通过盲肠结扎和穿刺术诱导脓毒症。为了耗竭多形核白细胞(PMN),动物接受 PMN 耗竭抗体的静脉注射。在钝性胸部创伤后继发脓毒症以及单纯脓毒症后,均观察到明显的局部和全身炎症反应,肺和血浆中的细胞因子/趋化因子水平增加。相比之下,仅在双打击后才明显升高肺细胞凋亡。在单独的胸部创伤或联合打击后,肺泡内中性粒细胞和总支气管肺泡灌洗蛋白浓度明显增加,但在单纯脓毒症后则不然。仅在双打击伴有肺泡结构破坏、肺充血和明显细胞浸润时,肺髓过氧化物酶活性才增强。中性粒细胞耗竭显著降低了肺内白细胞介素 1β和白细胞介素 6 浓度,并减轻了脓毒症性 ALI 的严重程度。在此,我们建立了一种新型且高度可重现的用于诱导脓毒症性 ALI 的小鼠模型,其特点是存在临床相关的双打击情况。特别地,中性粒细胞耗竭大大减轻了肺损伤程度,表明中性粒细胞在胸部创伤诱导的脓毒症性 ALI 中具有发病机制作用。