From the Department of Surgery (H.W.S., J.G.W., B.T., F.A.H., D.J., D.C.L., M.L.D., W.R.S.), Texas A&M Health Science Center College of Medicine and Scott & White Healthcare, Temple, Texas; and Morehouse School of Medicine (E.W.C.), Atlanta, Georgia.
J Trauma Acute Care Surg. 2013 Dec;75(6):1040-6; discussion 1046. doi: 10.1097/TA.0b013e3182aa9c79.
Burns induce systemic microvascular hyperpermeability resulting in shock, and if untreated, cardiovascular collapse. Damage to the endothelial cell adherens junctional complex plays an integral role in the pathophysiology of microvascular hyperpermeability. We hypothesized that doxycycline, a known inhibitor of matrix metalloproteinases (MMPs), could attenuate burn-induced adherens junction damage and microvascular hyperpermeability.
Male Sprague-Dawley rats were divided into sham, burn, and burn + doxycycline (n = 5). The experimental groups underwent a 30% total body surface area full-thickness burn. Fluorescein isothiocyanate-albumin was administered intravenously. Mesenteric postcapillary venules were examined with intravital microscopy to determine flux of albumin from the intravascular space to the interstitium. Fluorescence intensity was compared between the intravascular space to the interstitium at 30, 60, 80, 100, 120, 140, 160, and 180 minutes after burn. Parallel experiments were performed in which rat lung microvascular endothelial cells were treated with sera from sham or burn animals as well as separate groups pretreated with either doxycycline or a specific inhibitor of MMP-9. Monolayer permeability was determined by fluorescein isothiocyanate albumin-flux across Transwell plates and immunofluorescense staining for the adherens junction protein β-catenin was performed. Western blot and gelatin zymography were performed to assess MMP-9 level and activity.
MMP-9 levels were increased after burn. Monolayer permeability was significantly increased with burn serum treatment; this was attenuated with doxycycline as well as the specific MMP-9 inhibitor (p < 0.05). Damage of the endothelial cell adherens junction complex was induced by serum from burned rats, and doxycycline restored the integrity of the adherens junction similar to the MMP-9 inhibitor. Intravital microscopy revealed microvascular hyperpermeability after burn; this was attenuated with doxycycline (p < 0.05).
Burns induce microvascular hyperpermeability via endothelial adherens junction disruption associated with MMP-9, and this is attenuated with doxycycline.
烧伤会引起全身微血管通透性增加,导致休克,如果不加以治疗,还会导致心血管衰竭。内皮细胞黏附连接复合体的损伤在微血管通透性增加的病理生理学中起着重要作用。我们假设,多西环素是一种已知的基质金属蛋白酶(MMPs)抑制剂,可以减轻烧伤引起的黏附连接损伤和微血管通透性增加。
雄性 Sprague-Dawley 大鼠分为假手术组、烧伤组和烧伤+多西环素组(n = 5)。实验组进行 30%的全身体表面积的全层烧伤。静脉内给予荧光素异硫氰酸白蛋白。用活体显微镜检查肠系膜后微静脉,以确定白蛋白从血管内空间到间质的通量。在烧伤后 30、60、80、100、120、140、160 和 180 分钟时,比较血管内空间和间质之间的荧光强度。还进行了平行实验,即用来自假手术或烧伤动物的血清以及分别用多西环素或 MMP-9 特异性抑制剂预处理的单独组处理大鼠肺微血管内皮细胞。通过 Transwell 板上的荧光素异硫氰酸白蛋白通量测定单层通透性,并进行黏附连接蛋白β-连环蛋白的免疫荧光染色。进行 Western blot 和明胶酶谱分析以评估 MMP-9 水平和活性。
烧伤后 MMP-9 水平增加。用烧伤血清处理后,单层通透性显著增加;用多西环素和 MMP-9 特异性抑制剂处理也能减轻这种增加(p < 0.05)。来自烧伤大鼠的血清诱导内皮细胞黏附连接复合体的损伤,多西环素恢复了黏附连接的完整性,类似于 MMP-9 抑制剂。活体显微镜显示烧伤后微血管通透性增加;用多西环素处理可减轻这种增加(p < 0.05)。
烧伤通过与 MMP-9 相关的内皮细胞黏附连接破坏引起微血管通透性增加,而多西环素可减轻这种增加。