Department of Acupuncture, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Inflammation. 2017 Aug;40(4):1275-1284. doi: 10.1007/s10753-017-0570-0.
Acute lung injury caused by cardiopulmonary bypass (CPB) increases the mortality after cardiac surgery. Our previous clinical study suggested that electroacupuncture (EAc) has a protective effect during CPB, but the mechanism was unclear. So, we design this study to investigate the effects of EAc on CPB-induced lung injury and the underlying mechanism. Male Sprague Dawley rats were randomly divided into control, CPB, and CPB + EAc groups. A lung injury model was created by CPB surgery to serve as the CPB group, and EAc (2/100 Hz) was used before CPB in the CPB + EAc group. Lung tissue was collected at 0.5, 1, and 2 h after CPB. Pulmonary malondialdehyde (MDA) concentrations as well as superoxide dismutase (SOD), myeloperoxidase (MPO), and caspase-3 activity were determined. c-Jun N-terminal kinase (JNK), ERK, p38 and cleaved caspase 3 in the lung were analyzed by western blotting. A549 cells were treated by rat serum from the CPB and CPB + EAc groups, and cleaved caspase-3 activity was detected by fluorescent immunohistochemistry. CPB significantly increased the MPO activity, MDA content, apoptosis, caspase-3 activity, and phosphorylated p38 but decreased SOD activity compared with the control group. EAc significantly increased SOD activity at 0.5 and 2 h (p < 0.01 vs CPB) and reduced CPB-induced histological changes, MPO activity at 1 and 2 h (p < 0.05 vs CPB), MDA content at 2 h (p < 0.05 vs CPB), caspase-3 activity at 1 h (p < 0.05 vs CPB), and phosphorylated p38 and JNK at 0.5 h after CPB. The serum from the CPB group increased more positive staining cells of cleaved caspase-3 than that from the CPB + EAc group. EAc reversed the CPB-induced lung inflammation, oxidative damage, and apoptosis; the mechanism may involve decreased phosphorylation of p38 along with caspase-3 activity and activation.
体外循环(CPB)引起的急性肺损伤会增加心脏手术后的死亡率。我们之前的临床研究表明,电针(EAc)在 CPB 期间具有保护作用,但机制尚不清楚。因此,我们设计了这项研究来探讨 EAc 对 CPB 诱导的肺损伤的影响及其潜在机制。雄性 Sprague Dawley 大鼠随机分为对照组、CPB 组和 CPB+EAc 组。CPB 手术创建肺损伤模型作为 CPB 组,CPB+EAc 组在 CPB 前使用 EAc(2/100 Hz)。CPB 后 0.5、1 和 2 h 收集肺组织。测定肺组织丙二醛(MDA)浓度以及超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)和半胱氨酸天冬氨酸蛋白酶-3(caspase-3)的活性。通过 Western blot 分析肺组织中 c-Jun N-末端激酶(JNK)、细胞外信号调节激酶(ERK)、p38 和 cleaved caspase-3。用 CPB 和 CPB+EAc 组大鼠血清处理 A549 细胞,通过荧光免疫组化检测 cleaved caspase-3 活性。与对照组相比,CPB 显著增加 MPO 活性、MDA 含量、细胞凋亡、caspase-3 活性和磷酸化 p38,但降低 SOD 活性。EAc 显著增加 SOD 在 0.5 和 2 h 的活性(与 CPB 相比,p<0.01),并减轻 CPB 诱导的组织学变化、1 和 2 h 的 MPO 活性(与 CPB 相比,p<0.05)、2 h 的 MDA 含量(与 CPB 相比,p<0.05)、1 h 的 caspase-3 活性(与 CPB 相比,p<0.05)以及 CPB 后 0.5 h 的磷酸化 p38 和 JNK。CPB 组血清中 cleaved caspase-3 阳性染色细胞较 CPB+EAc 组增多。EAc 逆转 CPB 诱导的肺炎症、氧化损伤和细胞凋亡;其机制可能与降低 caspase-3 活性和磷酸化 p38 以及激活有关。