Tsai Jen-Pi, Lee Chung-Jen, Subeq Yi-Maun, Lee Ru-Ping, Hsu Bang-Gee
Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan.
Cytokine. 2016 Jul;83:262-268. doi: 10.1016/j.cyto.2016.05.008. Epub 2016 May 12.
Resuscitation after hemorrhagic shock (HS) could result in increased pro-inflammatory cytokines and then multiple organ dysfunctions. Calcitriol exerts pleiotropic effects in a wide variety of target tissues and has a role against anti-inflammation. The present study was aimed to investigate the modulatory effects of calcitriol on the pathophysiological and inflammatory markers following HS in rats.
By withdrawing 60% of the total blood volume over 30min via a femoral artery catheter in rats, HS was induced. Afterwards, 10ng/kg calcitriol was injected intravenously in rats. After performing these procedures, hemodynamic status of mean arterial pressure (MAP) and heart rate (HR) were continuously monitored for 12h. Hemoglobin, lactic dehydrogenase (LDH), creatine phosphokinase (CPK), liver and renal function were measured at 30min before the induction of HS and 0, 1, 3, 6, 9, and 12h after HS, while an equal volume of normal saline as replacement fluid. At 1 and 12h after inducing HS, serum levels of tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were measured, and the livers, kidneys and lungs were taken out and then examined histo-pathologically at 48h after inducing HS.
Hemoglobin and MAP were significantly decreased, liver and renal function were significantly impaired, but HR and the levels of LDH, CPK, TNF-α and IL-6 were significantly increased after HS in rats. After being treated with calcitriol following HS resulted in better survival rate, lower serum levels of TNF-α and IL-6, and lesser hepatic, renal, and pulmonary histo-pathologic scores of injury in rats.
Being treated with calcitriol after HS could ameliorate the pro-inflammatory reactions by modulating the effects of cytokines, which lead to prevention of subsequent major organ damages.
失血性休克(HS)复苏后可导致促炎细胞因子增加,进而引发多器官功能障碍。骨化三醇在多种靶组织中发挥多效性作用,具有抗炎作用。本研究旨在探讨骨化三醇对大鼠HS后病理生理和炎症标志物的调节作用。
通过股动脉导管在30分钟内抽取大鼠总血容量的60%诱导HS。之后,给大鼠静脉注射10ng/kg骨化三醇。进行这些操作后,连续监测平均动脉压(MAP)和心率(HR)的血流动力学状态12小时。在诱导HS前30分钟以及HS后0、1、3、6、9和12小时测量血红蛋白、乳酸脱氢酶(LDH)、肌酸磷酸激酶(CPK)、肝肾功能,同时用等体积的生理盐水作为替代液。在诱导HS后1小时和12小时,测量血清肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平,并在诱导HS后48小时取出肝脏、肾脏和肺,然后进行组织病理学检查。
大鼠HS后血红蛋白和MAP显著降低,肝肾功能显著受损,但HR以及LDH、CPK、TNF-α和IL-6水平显著升高。HS后用骨化三醇治疗可提高大鼠存活率,降低血清TNF-α和IL-6水平,并降低大鼠肝脏、肾脏和肺部的组织病理学损伤评分。
HS后用骨化三醇治疗可通过调节细胞因子的作用改善促炎反应,从而预防随后的主要器官损伤。