Jiang Zhilong, Zhou Qianlin, Gu Chenlin, Li Dandan, Zhu Lei
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Am J Physiol Lung Cell Mol Physiol. 2017 Feb 1;312(2):L231-L242. doi: 10.1152/ajplung.00389.2016. Epub 2016 Dec 2.
Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is an important cause of mortality in critically ill patients. Macrophages play an important role in the pathogenesis of ALI/ARDS. To investigate the role and underlying mechanisms of circulating monocytes and resident alveolar macrophages (AMs) in ALI/ARDS, we depleted circulating monocytes and AMs by clodronate-loaded liposome (CL) in a lipopolysaccharide (LPS)-induced ALI/ARDS mouse model. Our results indicated that depletion of circulating monocytes by intravenous injection of CL 2 days before intratracheal LPS treatment significantly suppressed the acute lung injury in mice with ALI/ARDS, accompanied with significant reduction in neutrophil influx, interleukin-17, monocyte chemoattractant protein 1, high-mobility group box 1 protein, suppressor of cytokine signaling 3, and surfactant protein D (SP-D) in the lungs of 2 days intratracheal LPS-treated mice. In contrast, depletion of AMs by intratracheal delivery of CL enhanced the acute lung injury in association with upregulation of these mediators. Blocking monocyte chemoattractant protein 1 signaling by intraperitoneal instillation of anti-mouse CCL2 neutralizing antibody significantly reduced acute lung injury and neutrophil influx. In addition, SP-D was upregulated by mediators released from AMs because primary murine type II alveolar epithelial cells expressed more SP-D after treatment with bronchoalveolar lavage from LPS-treated mice or the conditioned media from LPS-treated RAW 264.7 cells. The results indicated that circulating monocytes are proinflammatory, but AMs have anti-inflammatory functions in the early phase of ALI/ARDS. The study provided a molecular basis for the treatment of ALI/ARDS through modulation of circulating monocytes and AMs.
急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)是危重症患者死亡的重要原因。巨噬细胞在ALI/ARDS的发病机制中起重要作用。为了研究循环单核细胞和驻留肺泡巨噬细胞(AMs)在ALI/ARDS中的作用及潜在机制,我们在脂多糖(LPS)诱导的ALI/ARDS小鼠模型中,通过氯膦酸盐脂质体(CL)清除循环单核细胞和AMs。我们的结果表明,在气管内注射LPS治疗前2天静脉注射CL清除循环单核细胞,可显著抑制ALI/ARDS小鼠的急性肺损伤,同时气管内注射LPS治疗2天的小鼠肺内中性粒细胞浸润、白细胞介素-17、单核细胞趋化蛋白1、高迁移率族蛋白B1、细胞因子信号传导抑制因子3和表面活性蛋白D(SP-D)显著减少。相反,气管内给予CL清除AMs会加重急性肺损伤,并伴有这些介质的上调。腹腔内注入抗小鼠CCL2中和抗体阻断单核细胞趋化蛋白1信号传导,可显著减轻急性肺损伤和中性粒细胞浸润。此外,SP-D由AMs释放的介质上调,因为用LPS处理小鼠的支气管肺泡灌洗物或LPS处理的RAW 264.7细胞的条件培养基处理后,原代小鼠II型肺泡上皮细胞表达更多的SP-D。结果表明,循环单核细胞具有促炎作用,而AMs在ALI/ARDS早期具有抗炎功能。该研究为通过调节循环单核细胞和AMs治疗ALI/ARDS提供了分子基础。