Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg Hand und Plastic Surgery, Heidelberg, Germany.
Microvasc Res. 2013 Sep;89:115-21. doi: 10.1016/j.mvr.2013.03.002. Epub 2013 May 11.
Thermal injuries of more than 20% total body surface area result in systemic shock with generalized edema. Burn shock is induced by a variety of mediators, mainly immunomodulative cytokines. Administration of methysergide (Met), a serotoninergic receptor blocking agent, reduces generalized edema in endotoxemia in rats. In this study we evaluated the systemic effects of Met after thermal injury.
Donor rats (DR [n=8]) for positive controls and study groups underwent thermal injury (100°C water, 30% TBSA (Total Burn Surface Area), 12s). Shamburn plasma was harvested after a shamburn procedure ([n=4], 37°C water, 30% TBSA, 12s). Plasma was harvested 4h posttrauma and was transferred to healthy individuals. Recipient animals were randomized in 3 groups (1: burnplasma, 2: shamburn, 3: burnplasma plus methysergide (Bolus of 1mg/kg body weight)). Intravital microscopy was performed in mesenteric venules (0/60/120min). Edema was assessed by FITC-albumin extravasation. Leukocyte sticking (cells/mm(2)) and microhemodynamic parameters were assessed.
Significant systemic capillary leakage was observed after burnplasma-transfer. Edema formation was significantly lower in negative controls. Application of methysergide reduced FITC-efflux to baseline levels. Adherent leukocytes increased in all groups, at 120min the amount of adherent leukocytes in positive controls was significantly higher in comparison to shamburn, differences to MET-groups were not significant.
Burnplasma transfer to healthy individuals induces leukocyte activation and plasma extravasation and this effect is reduced by administration of Met. This may be attributed to leukocyte dependent as well as independent mechanisms. Evaluation of more specific serotoninergic antagonists is required to distinguish between systemic and local effects.
超过 20%的总体表面积的热损伤导致全身性休克和全身性水肿。烧伤休克是由多种介质引起的,主要是免疫调节细胞因子。给予麦角乙脲(Met),一种 5-羟色胺能受体阻断剂,可以减少大鼠内毒素血症中的全身性水肿。在这项研究中,我们评估了 Met 在热损伤后的全身作用。
供体大鼠(DR [n=8])作为阳性对照和研究组接受热损伤(100°C 水,30%TBSA(总烧伤表面积),12s)。Shamburn 程序后采集 Shamburn 血浆([n=4],37°C 水,30%TBSA,12s)。创伤后 4 小时采集血浆,并转移至健康个体。受体动物随机分为 3 组(1:烧伤血浆,2:Shamburn,3:烧伤血浆加麦角乙脲(1mg/kg 体重的推注))。在肠系膜静脉中进行活体显微镜检查(0/60/120min)。通过 FITC-白蛋白外渗评估水肿。评估白细胞贴壁(细胞/mm(2)) 和微血管动力学参数。
烧伤血浆转移后观察到明显的全身毛细血管渗漏。阴性对照的水肿形成明显较低。应用麦角乙脲可将 FITC 流出物减少至基线水平。所有组的贴壁白细胞均增加,在 120min 时,阳性对照的贴壁白细胞数量明显高于 Shamburn,与 MET 组之间的差异无统计学意义。
将烧伤血浆转移至健康个体可诱导白细胞激活和血浆外渗,而给予 Met 可减少这种作用。这可能归因于白细胞依赖和非依赖机制。需要评估更特异性的 5-羟色胺能拮抗剂,以区分全身和局部作用。