Seeger W, Walter H, Suttorp N, Muhly M, Bhakdi S
Department of Internal Medicine, Justus-Liebig-University Giessen, Federal Republic of Germany.
J Clin Invest. 1989 Jul;84(1):220-7. doi: 10.1172/JCI114144.
Escherichia coli hemolysin has been implicated as a pathogenicity factor in extraintestinal E. coli infections including sepsis. In the present study the effects of intravascular administration of hemolysin were investigated in isolated blood-free perfused rabbit lungs. Low concentrations of the toxin in the perfusate (0.05-5 hemolytic units/ml, corresponding to approximately 5-500 ng/ml), caused a dose- and time-dependent release of potassium, thromboxane A2, and prostaglandin I2, but not of lactate dehydrogenase, into the recirculating medium, as well as a dose-dependent liberation of the prostanoids into the bronchoalveolar space. These events were paralleled by a dose-dependent pulmonary hypertension, and studies with different inhibitors collectively indicated that the vasoconstrictor response was mediated predominantly by pulmonary thromboxane generation. In addition, E. coli hemolysin elicited a protracted, dose-dependent increase in the lung capillary filtration coefficient, which was independent of the prostanoid-mediated pressor response and resulted in severe pulmonary edema formation. We conclude that E. coli hemolysin can elicit thromboxane-mediated pulmonary hypertension combined with severe vascular leakage in isolated lungs in the absence of circulating inflammatory cells and humoral mediator systems, mimicking the key events in the development of acute respiratory failure in states of septicemia.
大肠杆菌溶血素被认为是包括败血症在内的肠外大肠杆菌感染中的一种致病因素。在本研究中,在离体无血灌注兔肺中研究了血管内注射溶血素的影响。灌注液中低浓度的毒素(0.05 - 5个溶血单位/毫升,相当于约5 - 500纳克/毫升)导致钾、血栓素A2和前列腺素I2呈剂量和时间依赖性释放到循环介质中,但乳酸脱氢酶未释放,同时前列腺素类物质呈剂量依赖性释放到支气管肺泡间隙中。这些事件与剂量依赖性肺动脉高压同时发生,并且用不同抑制剂进行的研究共同表明,血管收缩反应主要由肺血栓素生成介导。此外,大肠杆菌溶血素引起肺毛细血管滤过系数持续的、剂量依赖性增加,这与前列腺素介导的升压反应无关,并导致严重肺水肿形成。我们得出结论,在没有循环炎症细胞和体液介质系统的情况下,大肠杆菌溶血素可在离体肺中引发血栓素介导的肺动脉高压并伴有严重的血管渗漏,模拟败血症状态下急性呼吸衰竭发展过程中的关键事件。