Tao Guanghua, Pan Linghui, Jing Ren, Lin Fei, Dai Huijun, Ge Wanyun
Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China. Corresponding author: Pan Linghui, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Mar;29(3):249-254. doi: 10.3760/cma.j.issn.2095-4352.2017.03.011.
To investigate the role of Ras-related C3 botulinum toxin substrate 1/mitogen-activated protein kinase/extracellular signal-regulated kinase (Rac1/MAPK/ERK) signal pathway in rats with ventilator induced lung injury (VILI) and its mechanism.
Thirty Sprague-Dawley (SD) rats were randomly divided into spontaneous respiration group, normal tidal volume (VT) group and high VT group with 10 rats in each group. The rats in spontaneous respiration group were kept their spontaneous breathing. The rats in normal VT group and high VT group were performed tracheal intubation after tracheostomy, and underwent mechanical ventilation on bilateral lungs with 6 mL/kg and 40 mL/kg VT respectively with maintenance anesthesia. After 4-hour ventilation, heart blood, bronchoalveolar lavage fluid (BALF) and lung tissues were harvested. The levels of interleukins (IL-1β, IL-6), tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO) and macrophage inflammatory protein-2 (MIP-2) in serum and BALF were determined by enzyme linked immunosorbent assay (ELISA). Lung wet/dry radio (W/D) was determined. The lung tissues were stained with hematoxylin and eosin (HE), and pathological changes were observed, and pathological scores were evaluated. The ultra structure changes in type II alveolar epithelial cells (AEC II) were observed with transmission electron microscope. The positive expressions of phosphorylation of extracellular signal-regulated kinase (p-ERK) were determined by immunohistochemistry, and those of Rac1 and F-actin were determined by immunofluorescence. The mRNA expressions of ERK and Rac1 were determined by real-time fluorescent quantitation reverse transcription-polymerase chain reaction (RT-qPCR), and protein expressions of Rac-1, p-ERK and F-actin were determined by Western Blot.
(1) Compared with spontaneous breathing group, lung W/D in both mechanical ventilation groups was significantly increased, with more significant increase in the high VT group (6.64±0.88 vs. 1.79±0.36, P < 0.01). (2) There was no obvious pathological changes in the lung tissue and AEC II of the spontaneously breathing group. In the normal VT group, there was slight edema and infiltration of inflammatory cells; AEC II had less lamellar bodies and uniform distribution of the villi of the alveolar epithelium. In the high VT group, the edema of the lung tissue, the widening of the pulmonary septum, the alveolus congestion, the infiltration of inflammatory cells, and alveolar structure disorder were found; and AEC II was irregular, the number of lamellar bodies in the plastids was decreased and was unevenly distributed. The pulmonary histopathological score in the high VT group was significantly higher than that in the spontaneous breathing group and the normal VT group (12.00±2.00 vs. 6.00±1.51, 8.50±0.53, both P < 0.01). (3) Compared with spontaneous breathing group, IL-1β, IL-6, TNF-α, MPO, and MIP-2 in serum and BALF in both mechanical ventilation groups were significantly increased, with more significant increase in the high VT group [serum IL-1β (ng/L): 104.2±15.1 vs. 20.3±8.3, IL-6 (ng/L): 46.6±11.5 vs. 22.7±7.5, TNF-α (ng/L): 39.4±6.5 vs. 5.4±1.9, MPO (ng/L): 0.66±0.24 vs. 0.06±0.03, MIP-2 (ng/L): 109.2±25.8 vs. 22.8±8.4; BALF IL-1β (ng/L): 121.5±25.6 vs. 24.0±7.5, IL-6 (ng/L): 136.7±32.7 vs. 31.4±10.5, TNF-α (ng/L): 98.0±14.8 vs. 10.1±2.6, MPO (ng/L): 0.80±0.31 vs. 0.08±0.04, MIP-2 (ng/L): 144.4±28.9 vs. 41.2±20.7; all P < 0.01]. (4) There were only a few p-ERK, Rac1 and F-actin positive expressions in the spontaneous breathing group. The positive expressions in normal VT group were increased. In high VT group, the positive expression of p-ERK was significantly increased; Rac1 and F-actin were mainly distributed in the cell membrane and cytoplasm respectively, the positive expressions were further enhanced. (5) The gene expressions of ERK and Rac1, and protein expressions of p-ERK, Rac1 and F-actin in the high VT group were significantly higher than those in the spontaneous breathing group and normal VT group [ERK mRNA (2): 8.23±2.83 vs. 1, 3.02±1.38, p-ERK protein (gray value): 1.15±0.36 vs. 0.61±0.23, 0.88±0.22; Rac1 mRNA (2): 4.45±2.26 vs. 1, 1.22±0.39, Rac1 protein (gray value): 0.91±0.16 vs. 0.48±0.11, 0.55±0.10; F-actin protein (gray value): 0.70±0.09 vs. 0.49±0.08, 0.55±0.04; all P < 0.01].
F-actin expression in lung tissue was up-regulated in rats with VILI, which resulted in reconstruction of AEC II cyto-skeleton, and variation of cell membrane permeability through Rac1/MAPK/ERK signaling pathway during VILI.
探讨Ras相关C3肉毒杆菌毒素底物1/丝裂原活化蛋白激酶/细胞外信号调节激酶(Rac1/MAPK/ERK)信号通路在呼吸机诱导的肺损伤(VILI)大鼠中的作用及其机制。
将30只Sprague-Dawley(SD)大鼠随机分为自主呼吸组、正常潮气量(VT)组和高潮气量组,每组10只。自主呼吸组大鼠保持自主呼吸。正常VT组和高潮气量组大鼠在气管切开后进行气管插管,并在维持麻醉下分别以6 mL/kg和40 mL/kg的VT对双侧肺进行机械通气。通气4小时后,采集心脏血液、支气管肺泡灌洗液(BALF)和肺组织。采用酶联免疫吸附测定(ELISA)法测定血清和BALF中白细胞介素(IL-1β、IL-6)、肿瘤坏死因子-α(TNF-α)、髓过氧化物酶(MPO)和巨噬细胞炎性蛋白-2(MIP-2)的水平。测定肺湿/干比(W/D)。对肺组织进行苏木精-伊红(HE)染色,观察病理变化,并进行病理评分。用透射电子显微镜观察Ⅱ型肺泡上皮细胞(AECⅡ)的超微结构变化。采用免疫组织化学法测定细胞外信号调节激酶(p-ERK)磷酸化的阳性表达,采用免疫荧光法测定Rac1和F-肌动蛋白的阳性表达。采用实时荧光定量逆转录-聚合酶链反应(RT-qPCR)法测定ERK和Rac1的mRNA表达,采用蛋白质免疫印迹法测定Rac-1、p-ERK和F-肌动蛋白的蛋白质表达。
(1)与自主呼吸组相比,两个机械通气组的肺W/D均显著增加,高潮气量组增加更显著(6.64±0.88 vs. 1.79±0.36,P < 0.01)。(2)自主呼吸组肺组织和AECⅡ无明显病理变化。正常VT组有轻度水肿和炎性细胞浸润;AECⅡ板层小体较少,肺泡上皮绒毛分布均匀。高潮气量组可见肺组织水肿、肺间隔增宽、肺泡充血、炎性细胞浸润及肺泡结构紊乱;AECⅡ不规则,质体内板层小体数量减少且分布不均。高潮气量组肺组织病理评分显著高于自主呼吸组和正常VT组(12.00±2.00 vs. 6.00±1.51,8.50±0.53,均P < 0.01)。(3)与自主呼吸组相比,两个机械通气组血清和BALF中的IL-1β、IL-6、TNF-α、MPO和MIP-2均显著增加,高潮气量组增加更显著[血清IL-1β(ng/L):104.2±15.1 vs. 20.3±8.3,IL-6(ng/L):46.6±11.5 vs. 22.7±7.5,TNF-α(ng/L):39.4±6.5 vs. 5.4±1.9,MPO(ng/L):0.66±0.24 vs. 0.06±0.03,MIP-2(ng/L):109.2±25.8 vs. 22.8±8.4;BALF IL-1β(ng/L):121.5±25.6 vs. 24.0±7.5,IL-6(ng/L):136.7±32.7 vs. 31.4±10.5,TNF-α(ng/L):98.0±14.8 vs. 10.1±2.6,MPO(ng/L):0.80±0.31 vs. 0.08±0.04,MIP-2(ng/L):144.4±28.9 vs. 41.2±20.7;均P < 0.01]。(4)自主呼吸组p-ERK、Rac1和F-肌动蛋白阳性表达较少。正常VT组阳性表达增加。高潮气量组p-ERK阳性表达显著增加;Rac1和F-肌动蛋白分别主要分布于细胞膜和细胞质,阳性表达进一步增强。(5)高潮气量组ERK和Rac1的基因表达以及p-ERK、Rac1和F-肌动蛋白的蛋白质表达显著高于自主呼吸组和正常VT组[ERK mRNA(2):8.23±2.83 vs. 1,3.02±1.38,p-ERK蛋白(灰度值):1.15±0.36 vs. 0.61±0.23,0.88±0.22;Rac1 mRNA(2):4.45±2.26 vs. 1,1.22±0.39,Rac1蛋白(灰度值):0.91±0.16 vs. 0.48±0.11,0.55±0.10;F-肌动蛋白蛋白(灰度值):0.70±0.09 vs. 0.49±0.08,0.55±0.04;均P < 0.01]。
VILI大鼠肺组织中F-肌动蛋白表达上调,通过Rac1/MAPK/ERK信号通路导致AECⅡ细胞骨架重构及细胞膜通透性改变。