Thom Stephen R, Bennett Michael, Banham Neil D, Chin Walter, Blake Denise F, Rosen Anders, Pollock Neal W, Madden Dennis, Barak Otto, Marroni Alessandro, Balestra Costantino, Germonpre Peter, Pieri Massimo, Cialoni Danilo, Le Phi-Nga Jeannie, Logue Christopher, Lambert David, Hardy Kevin R, Sward Douglas, Yang Ming, Bhopale Veena B, Dujic Zeljko
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland;
Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, New South Wales, Australia;
J Appl Physiol (1985). 2015 Sep 1;119(5):427-34. doi: 10.1152/japplphysiol.00380.2015. Epub 2015 Jul 2.
Decompression sickness (DCS) is a systemic disorder, assumed due to gas bubbles, but additional factors are likely to play a role. Circulating microparticles (MPs)--vesicular structures with diameters of 0.1-1.0 μm--have been implicated, but data in human divers have been lacking. We hypothesized that the number of blood-borne, Annexin V-positive MPs and neutrophil activation, assessed as surface MPO staining, would differ between self-contained underwater breathing-apparatus divers suffering from DCS vs. asymptomatic divers. Blood was analyzed from 280 divers who had been exposed to maximum depths from 7 to 105 meters; 185 were control/asymptomatic divers, and 90 were diagnosed with DCS. Elevations of MPs and neutrophil activation occurred in all divers but normalized within 24 h in those who were asymptomatic. MPs, bearing the following proteins: CD66b, CD41, CD31, CD142, CD235, and von Willebrand factor, were between 2.4- and 11.7-fold higher in blood from divers with DCS vs. asymptomatic divers, matched for time of sample acquisition, maximum diving depth, and breathing gas. Multiple logistic regression analysis documented significant associations (P < 0.001) between DCS and MPs and for neutrophil MPO staining. Effect estimates were not altered by gender, body mass index, use of nonsteroidal anti-inflammatory agents, or emergency oxygen treatment and were modestly influenced by divers' age, choice of breathing gas during diving, maximum diving depth, and whether repetitive diving had been performed. There were no significant associations between DCS and number of MPs without surface proteins listed above. We conclude that MP production and neutrophil activation exhibit strong associations with DCS.
减压病(DCS)是一种全身性疾病,推测是由气泡引起的,但其他因素可能也起作用。循环微粒(MPs)——直径为0.1 - 1.0μm的囊泡结构——与之有关,但人类潜水员的数据一直缺乏。我们假设,以表面髓过氧化物酶(MPO)染色评估,患有DCS的自给式水下呼吸器潜水员与无症状潜水员相比,血源性膜联蛋白V阳性MPs的数量和中性粒细胞活化情况会有所不同。对280名潜水深度达7至105米的潜水员的血液进行了分析;185名是对照/无症状潜水员,90名被诊断患有DCS。所有潜水员的MPs和中性粒细胞活化均升高,但无症状者在24小时内恢复正常。携带以下蛋白质的MPs:CD66b、CD41、CD31、CD142、CD235和血管性血友病因子,在患有DCS的潜水员血液中比无症状潜水员高2.4至11.7倍,样本采集时间、最大潜水深度和呼吸气体相匹配。多因素logistic回归分析表明DCS与MPs以及中性粒细胞MPO染色之间存在显著关联(P < 0.001)。效应估计不受性别、体重指数、非甾体抗炎药的使用或紧急吸氧治疗的影响,仅受潜水员年龄、潜水时呼吸气体的选择、最大潜水深度以及是否进行重复潜水的适度影响。DCS与未携带上述表面蛋白的MPs数量之间无显著关联。我们得出结论,MPs产生和中性粒细胞活化与DCS密切相关。