Laboratory of Inflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil.
Anesthesiology. 2012 Sep;117(3):580-91. doi: 10.1097/ALN.0b013e31826687d5.
Evidence suggests that nebulized lidocaine is beneficial in asthma therapy, but to what extent and the mechanisms underlying this effect remain poorly understood. The aim of this study was to assess the impact of lidocaine treatment using a murine model of allergic asthma characterized by expression of pivotal features of the disease: inflammation, mucus production, and lung remodeling.
A/J mice sensitized with ovalbumin were treated with inhaled lidocaine or vehicle immediately after ovalbumin intranasal challenges. Lung function, total and differential leukocytes in bronchoalveolar lavage fluid, peribronchial eosinophil density, interleukin (IL)-4, IL-5 and eotaxin-1 levels, epithelial mucus, collagen, extracellular-matrix deposition, matrix metalloproteinase-9 activity, and GATA-3 expression were evaluated. Between five and eight animals per group were used.
Inhaled lidocaine inhibited ovalbumin-induced airway hyperreactivity to methacholine, and accumulation of lymphocytes, neutrophils, and eosinophils in bronchoalveolar lavage fluid 24 h after the last allergen provocation. Lidocaine administration also prevented other pathophysiological changes triggered by ovalbumin in lung tissue, including peribronchial eosinophil and neutrophil infiltration, subepithelial fibrosis, increased content of collagen and mucus, matrix metalloproteinase-9 activity, and increased levels of IL-4, IL-5, IL-13, and eotaxin-1. Furthermore, inhaled lidocaine inhibited lung tissue GATA-3 expression in ovalbumin-challenged mice. We also demonstrated that lidocaine inhibited the expression of GATA-3 in ovalbumin-stimulated T cells in vitro.
Inhaled lidocaine prevents eosinophilic inflammation, overproduction of mucus, and peribronchial fibrosis in a murine model of asthma, and impaired airway hyperreactivity, possibly by inhibiting allergen-evoked GATA-3 expression and the subsequent up-regulation of proinflammatory cytokines and chemokines.
有证据表明,雾化利多卡因有益于哮喘治疗,但这种效果的程度和机制仍知之甚少。本研究旨在通过一种以疾病关键特征为特征的变应性哮喘小鼠模型来评估利多卡因治疗的影响:炎症、黏液产生和肺重塑。
用卵清蛋白致敏的 A/J 小鼠,在用卵清蛋白进行鼻内激发后立即用吸入性利多卡因或载体进行治疗。评估肺功能、支气管肺泡灌洗液中的总白细胞和分类白细胞、周围支气管嗜酸性粒细胞密度、白细胞介素(IL)-4、IL-5 和嗜酸性粒细胞趋化因子-1 水平、上皮黏液、胶原、细胞外基质沉积、基质金属蛋白酶-9 活性和 GATA-3 表达。每组使用五到八只动物。
吸入性利多卡因抑制了卵清蛋白诱导的气道对乙酰甲胆碱的高反应性,并且在最后一次过敏原激发后 24 小时抑制了支气管肺泡灌洗液中淋巴细胞、中性粒细胞和嗜酸性粒细胞的积累。利多卡因给药还防止了卵清蛋白在肺组织中引发的其他病理生理变化,包括周围支气管嗜酸性粒细胞和中性粒细胞浸润、上皮下纤维化、胶原和黏液含量增加、基质金属蛋白酶-9 活性增加以及 IL-4、IL-5、IL-13 和嗜酸性粒细胞趋化因子-1 水平升高。此外,吸入性利多卡因抑制了卵清蛋白激发的 GATA-3 在哮喘小鼠肺组织中的表达。我们还证明了利多卡因抑制了卵清蛋白刺激的 T 细胞在体外表达 GATA-3。
吸入利多卡因可预防哮喘小鼠模型中的嗜酸性粒细胞炎症、黏液过度产生和周围支气管纤维化,以及气道高反应性受损,可能是通过抑制过敏原诱导的 GATA-3 表达以及随后上调促炎细胞因子和趋化因子。