Department of Hand-, Plastic and Reconstructive Surgery, University of Heidelberg Hand and Plastic Surgery, University Heidelberg, Germany.
Burns. 2013 Sep;39(6):1226-33. doi: 10.1016/j.burns.2013.01.005. Epub 2013 Mar 21.
Thermal injuries greater than 20% body surface area (BSA) lead to systemic edema and hypovolemic shock. Capillary leakage is induced by different immunomodulative cytokines. Serotonin (5-HT) plays an important role in inflammation, vasodilatation and vasoconstriction and many other pathways such as systemic inflammation in endotoxemia and burns. Cinanserin, a specific 5-HT2 receptor blocking agent was administered to observe whether burn induced systemic edema can be reduced.
Donor animals underwent thermal injury (100°C water, 30% BSA, 12s) for positive controls and negative controls underwent a shamburn procedure (37°C water, 30% BSA, 12s). Donor rat-plasma was transferred to healthy individuals after bolus injection of Cinanserin (5mg/kg body weight) was performed in recipient animals. Intravital microscopy was performed in mesenteric venules (0/60/120min) to asses systemic edema by FITC-albumin extravasation. Additionally, leukocyte activation (cells/mm(2)) was observed.
Burnplasma-transfer results in systemic capillary leakage that is not observed in sham burn controls. Intraveneous application of Cinanserin significantly reduces systemic burn edema to shamburn levels. Leukocyte-endothelial interactions are significantly reduced by administration of Cinanserin.
Specific 5-HT2 antagonism reduces systemic burn edema and leukocyte activation after plasma transfer. Reduction of capillary leakage may be partially mediated by leukocyte dependent as well as independent mechanisms. Future studies need to evaluate specific 5-HT2 receptor subtypes to distinguish between local and systemic effects of serotonin antagonists.
超过 20%体表面积的热损伤会导致全身水肿和低血容量性休克。毛细血管渗漏是由不同的免疫调节细胞因子引起的。5-羟色胺(5-HT)在炎症、血管舒张和血管收缩以及许多其他途径中发挥重要作用,如内毒素血症和烧伤中的全身炎症。赛庚啶,一种特定的 5-HT2 受体阻断剂,被给予观察是否可以减少烧伤引起的全身性水肿。
供体动物接受热损伤(100°C 水,30%BSA,12s)作为阳性对照,阴性对照动物接受 shamburn 处理(37°C 水,30%BSA,12s)。在接受动物给予赛庚啶(5mg/kg 体重)推注后,将供体大鼠血浆转移至健康个体。在肠系膜静脉(0/60/120min)中进行活体显微镜检查,通过 FITC-白蛋白外渗来评估全身性水肿。此外,观察白细胞激活(细胞/mm(2))。
烧伤血浆转移导致全身性毛细血管渗漏,而 shamburn 对照中未观察到。静脉内应用赛庚啶可显著降低全身性烧伤水肿至 shamburn 水平。白细胞-内皮细胞相互作用通过给予赛庚啶而显著减少。
特定的 5-HT2 拮抗作用可减少血浆转移后全身性烧伤水肿和白细胞激活。毛细血管渗漏的减少可能部分通过白细胞依赖和非依赖机制介导。未来的研究需要评估特定的 5-HT2 受体亚型,以区分 5-羟色胺拮抗剂的局部和全身作用。