Institute of Microcirculation, Hebei North University, 11 Diamond South Road, Hebei, 075000, Zhangjiakou, People's Republic of China.
Inflammation. 2015 Apr;38(2):584-94. doi: 10.1007/s10753-014-9965-3.
Disturbance of immunity is an important factor to modulate inflammatory responses after severe shock. Post-shock mesenteric lymph (PSML) return plays an adverse role in multiple organ injuries induced by the hemorrhagic shock, and the inflammatory factors are involved in this process. However, whether the PSML can exacerbate immune dysfunctions that modulate inflammatory response to the hemorrhagic shock remains unknown. In the present study, the effects of PSML drainage on the distribution of T lymphocyte subgroup, the release of inflammatory factors, and apoptosis of thymocytes were investigated; the effect of PSML on the specific parameters of cellular immune function was also determined. Results showed that PSML drainage reduced the increased levels of CD3+, CD3+CD4+, CD4+CD25+ lymphocytes, IFN-γ, and the ratios of CD3 + CD4+/CD3 + CD4- in blood of the shocked rats at 3 h after resuscitation; PSML drainage also abolished the decreased IL-4 level and restored the higher ratio of IFN-γ/IL-4 to normal levels. Tissue injury, including enlarged intermembrance space and edema with congestion in the medulla, increased apoptotic cells and bax expression, decreased number of cells in the S phase, and bcl-2 expression were observed in the thymus after hemorrhagic shock. PSML drainage reversed these effects. In particular, PSML drainage increased the proliferation index and decreased p53 expression of thymocytes. These results suggest that hyperimmunity occurred at early stages of hemorrhagic shock with resuscitation and that PSML drainage could markedly improve cellular immune function that is responsible for the reduced inflammatory responses.
免疫紊乱是调节严重休克后炎症反应的一个重要因素。休克后肠系膜淋巴(PSML)回流在出血性休克引起的多器官损伤中起不良作用,炎症因子参与了这一过程。然而,PSML 是否会加剧调节出血性休克炎症反应的免疫功能障碍尚不清楚。在本研究中,研究了 PSML 引流对 T 淋巴细胞亚群分布、炎症因子释放和胸腺细胞凋亡的影响;还确定了 PSML 对细胞免疫功能特定参数的影响。结果表明,PSML 引流可降低复苏后 3 小时休克大鼠血液中 CD3+、CD3+CD4+、CD4+CD25+淋巴细胞、IFN-γ和 CD3+CD4+/CD3+CD4-的升高水平;PSML 引流还消除了 IL-4 水平的降低,并将 IFN-γ/IL-4 的比值恢复至正常水平。出血性休克后,观察到胸腺组织损伤,包括隔室增大和髓质充血水肿,凋亡细胞和 bax 表达增加,S 期细胞数量减少,bcl-2 表达减少。PSML 引流逆转了这些效应。特别是,PSML 引流增加了胸腺细胞的增殖指数并降低了 p53 表达。这些结果表明,出血性休克复苏后早期出现超免疫反应,PSML 引流可显著改善细胞免疫功能,从而降低炎症反应。