Albadawi Hassan, Oklu Rahmi, Raacke Malley Rita Elise, O'Keefe Ryan M, Uong Thuy P, Cormier Nicholas R, Watkins Michael T
Department of Surgery, Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
Department of Radiology, Division of Vascular Imaging and Intervention, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
J Vasc Surg. 2016 Aug;64(2):484-493. doi: 10.1016/j.jvs.2015.01.031. Epub 2015 Dec 15.
Extracellular traps (ETs) consisting of DNA-protein complexes formed after tissue injury contribute to the inflammatory and thrombosis cascades, thereby exacerbating injury. Exogenous DNase I has been suggested as a therapeutic strategy to limit injury in the brain and myocardium. These studies were designed to evaluate the effects of exogenous DNase I treatment on skeletal muscle injury after acute hindlimb ischemia-reperfusion (IR) injury in mice and to determine whether neutrophils are a major source of ETs in postischemic muscle tissue.
C57BL6 mice were subjected to 1.5 hours of tourniquet ischemia and 24 hours of reperfusion with and without human recombinant DNase I treatment. A separate set of mice was subjected to neutrophil depletion (ND), followed by the same intervals of IR. Laser Doppler imaging and tissue harvesting were done at 24 hours for assessment of limb perfusion, muscle fiber injury, adenosine triphosphate (ATP) level, markers of inflammation, thrombosis, and formation of ETs.
DNase I treatment significantly reduced detection of ETs in postischemic muscle but did not alter skeletal muscle fiber injury, levels of proinflammatory molecules, or ATP level. DNase I treatment did enhance postischemic hindlimb perfusion, decreased infiltrating inflammatory cells, and reduced the expression of thrombin-antithrombin III. ND resulted in a significant yet small reduction in ETs in the postischemic muscle. ND did not alter skeletal muscle fiber injury, hindlimb perfusion, or ATP levels.
These data suggest that neither DNase I treatment nor ND was protective against IR injury, even though both decreased detection of ETs in skeletal muscle after IR. Neutrophils are not the only source of ETs after IR.
组织损伤后形成的由DNA-蛋白质复合物组成的细胞外陷阱(ETs)会促成炎症和血栓形成级联反应,从而加剧损伤。外源性脱氧核糖核酸酶I(DNase I)已被提议作为一种限制脑和心肌损伤的治疗策略。这些研究旨在评估外源性DNase I治疗对小鼠急性后肢缺血再灌注(IR)损伤后骨骼肌损伤的影响,并确定中性粒细胞是否是缺血后肌肉组织中ETs的主要来源。
对C57BL6小鼠进行1.5小时的止血带缺血和24小时的再灌注,分别给予或不给予人重组DNase I治疗。另一组小鼠进行中性粒细胞清除(ND),然后进行相同时间间隔的IR。在24小时时进行激光多普勒成像和组织采集,以评估肢体灌注、肌纤维损伤、三磷酸腺苷(ATP)水平、炎症标志物、血栓形成以及ETs的形成。
DNase I治疗显著减少了缺血后肌肉中ETs的检测,但未改变骨骼肌纤维损伤、促炎分子水平或ATP水平。DNase I治疗确实增强了缺血后后肢灌注,减少了浸润的炎症细胞,并降低了凝血酶-抗凝血酶III的表达。ND导致缺血后肌肉中ETs有显著但较小的减少。ND未改变骨骼肌纤维损伤、后肢灌注或ATP水平。
这些数据表明,尽管DNase I治疗和ND都降低了IR后骨骼肌中ETs的检测,但二者均对IR损伤无保护作用。中性粒细胞不是IR后ETs的唯一来源。