Hernekamp J F, Harenberg P S, Lehnhardt M, Germann G, Walther A, Kremer T
BG Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische- und Rekonstruktive Chirurgie-Schwerbrandverletztenzentrum, Ludwigshafen.
Handchir Mikrochir Plast Chir. 2012 Aug;44(4):209-19. doi: 10.1055/s-0032-1321890. Epub 2012 Aug 29.
Thermal injuries with more than 20% of burned body surface area (BSA) lead to systemic shock with generalised oedema in addition to local tissue destruction. This condition, known as burn injury, is caused by immunmodulative mediators whose individual significance is not known in detail. We present an experimental model where plasma of burned animals (burn plasma) is transmitted to healthy animals, to trigger burn iniury without performing direct burn trauma.
The systemic oedema is measured by extravasation of fluorescent albumin in mesenterial venules of Wistar rats. In addition, leukocyte-endothelial interactions ("leukocyte rolling and sticking") is examined.
The systemic capillary leak is induced by both direct thermal trauma as well as by infusion of burn plasma. This is evident even after plasma dilution (1% in Ringer's lactate) of the burn plasma. In addition, topical therapy for burned animals (donors) with cerium nitrate led to a significant reduction of plasma extravasation in receiver animals. In addition, systemic antioxidant therapy with high-dose vitamin C of receiver animals, led to a significant reduction of the capillary leak. Leukocyte-endothelial interactions are not significantly affected in either case.
In summary, for the first time a reliable model of burn injury has been established, which eliminates mediator-independent effects. In addition, our studies show that antioxidant therapy with high doses of vitamin C and topical treatment with cerium nitrate both reduce the systemic capillary leak in receiver animals. Their positive influence could therefore soon be integrated in clinical treatment algorithms.
烧伤体表面积超过20%的热损伤除了导致局部组织破坏外,还会引发全身性休克和全身性水肿。这种被称为烧伤的病症是由免疫调节介质引起的,其个体意义尚不清楚。我们提出了一种实验模型,将烧伤动物的血浆(烧伤血浆)输注到健康动物体内,在不进行直接烧伤创伤的情况下引发烧伤。
通过荧光白蛋白在Wistar大鼠肠系膜小静脉中的外渗来测量全身性水肿。此外,还检测白细胞与内皮细胞的相互作用(“白细胞滚动和黏附”)。
直接热创伤以及输注烧伤血浆均可诱导全身性毛细血管渗漏。即使在烧伤血浆用乳酸林格氏液稀释至1%后,这种情况仍然明显。此外,用硝酸铈对烧伤动物(供体)进行局部治疗,可使受体动物的血浆外渗显著减少。此外,对受体动物进行高剂量维生素C的全身抗氧化治疗,也可使毛细血管渗漏显著减少。在这两种情况下,白细胞与内皮细胞的相互作用均未受到显著影响。
总之,首次建立了一种可靠的烧伤模型,该模型消除了与介质无关的影响。此外,我们的研究表明,高剂量维生素C的抗氧化治疗和硝酸铈的局部治疗均可减少受体动物的全身性毛细血管渗漏。因此,它们的积极影响可能很快会被纳入临床治疗方案。