Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
Department of Emergency and Critical Care Medicine, Guangdong General Hospital and Guangdong Academy of Medical Sciences, 106 ZhongshanEr Road, Guangzhou, 510080, China.
J Neuroinflammation. 2018 Jan 5;15(1):4. doi: 10.1186/s12974-017-1051-y.
Cognitive impairment is one of common complications of acute respiratory distress syndrome (ARDS). Increasing evidence suggests that interleukin-1 beta (IL-1β) plays a role in inducing neuronal apoptosis in cognitive dysfunction. The lung protective ventilatory strategies, which serve to reduce pulmonary morbidity for ARDS patients, almost always lead to hypercapnia. Some studies have reported that hypercapnia contributes to the risk of cognitive impairment and IL-1β secretion outside the central nervous system (CNS). However, the underlying mechanism of hypercapnia aggravating cognitive impairment under hypoxia has remained uncertain. This study was aimed to explore whether hypercapnia would partake in increasing IL-1β secretion via activating the NLRP3 (NLR family, pyrin domain-containing 3) inflammasome in the hypoxic CNS and in aggravating cognitive impairment.
The Sprague-Dawley (SD) rats that underwent hypercapnia/hypoxemia were used for assessment of NLRP3, caspase-1, IL-1β, Bcl-2, Bax, and caspase-3 expression by Western blotting or double immunofluorescence, and the model was also used for Morris water maze test. In addition, Z-YVAD-FMK, a caspase-1 inhibitor, was used to treat BV-2 microglia to determine whether activation of NLRP3 inflammasome was required for the enhancing effect of hypercapnia on expressing IL-1β by Western blotting or double immunofluorescence. The interaction effects were analyzed by factorial ANOVA. Simple effects analyses were performed when an interaction was observed.
There were interaction effects on cognitive impairment, apoptosis of hippocampal neurons, activation of NLRP3 inflammasome, and upregulation of IL-1β between hypercapnia treatment and hypoxia treatment. Hypercapnia + hypoxia treatment caused more serious damage to the learning and memory of rats than those subjected to hypoxia treatment alone. Expression levels of Bcl-2 were reduced, while that of Bax and caspase-3 were increased by hypercapnia in hypoxic hippocampus. Hypercapnia markedly increased the expression of NLRP3, caspase-1, and IL-1β in hypoxia-activated microglia both in vivo and in vitro. Pharmacological inhibition of NLRP3 inflammasome activation and release of IL-1β might ameliorate apoptosis of neurons.
The present results suggest that hypercapnia-induced IL-1β overproduction via activating the NLRP3 inflammasome by hypoxia-activated microglia may augment neuroinflammation, increase neuronal cell death, and contribute to the pathogenesis of cognitive impairments.
认知障碍是急性呼吸窘迫综合征(ARDS)的常见并发症之一。越来越多的证据表明白细胞介素-1β(IL-1β)在诱导认知功能障碍中的神经元凋亡中起作用。旨在降低 ARDS 患者肺部发病率的肺保护性通气策略几乎总是导致高碳酸血症。一些研究报道,高碳酸血症会导致认知障碍的风险增加和中枢神经系统(CNS)外的 IL-1β 分泌增加。然而,高碳酸血症在低氧条件下加重认知障碍的潜在机制仍不确定。本研究旨在探讨高碳酸血症是否会通过激活低氧中枢神经系统中的 NLRP3(NLR 家族,含 pyrin 结构域的 3)炎性小体来增加 IL-1β 的分泌,从而加重认知障碍。
采用高碳酸血症/低氧血症 SD 大鼠评估 NLRP3、半胱天冬酶-1、IL-1β、Bcl-2、Bax 和半胱天冬酶-3 的表达,采用 Western 印迹或双重免疫荧光法检测,采用 Morris 水迷宫试验检测模型。此外,还使用 caspase-1 抑制剂 Z-YVAD-FMK 处理 BV-2 小胶质细胞,以确定 NLRP3 炎性小体的激活是否需要高碳酸血症增强 IL-1β 的表达。采用析因方差分析分析交互作用。当观察到交互作用时,进行简单效应分析。
认知障碍、海马神经元凋亡、NLRP3 炎性小体激活和 IL-1β 上调之间存在高碳酸血症治疗和缺氧治疗的交互作用。高碳酸血症+缺氧处理比单独缺氧处理对大鼠的学习记忆造成更严重的损害。Bcl-2 的表达水平降低,而 Bax 和半胱天冬酶-3 的表达水平在低氧海马中升高。高碳酸血症显著增加了体内和体外低氧激活小胶质细胞中 NLRP3、半胱天冬酶-1 和 IL-1β 的表达。NLRP3 炎性小体激活和 IL-1β 释放的药理学抑制可能改善神经元凋亡。
本研究结果表明,高碳酸血症通过激活低氧激活的小胶质细胞中的 NLRP3 炎性小体诱导 IL-1β 的过度产生,可能加重神经炎症,增加神经元细胞死亡,导致认知障碍的发病机制。