Truflandier Karine, Beaumont Eric, Charbonney Emmanuel, Maghni Karim, de Marchie Michel, Spahija Jadranka
Research Center, CIUSSS du Nord-de-l'Ile-de-Montréal, Sacré-Coeur Hospital, Department of Medicine, Université de Montréal, 5400 boul. Gouin Ouest, Montréal, Quebec, H4J 1C5, Canada.
Research Center, CIUSSS du Nord-de-l'Ile-de-Montréal, Sacré-Coeur Hospital, Department of Medicine, Université de Montréal, 5400 boul. Gouin Ouest, Montréal, Quebec, H4J 1C5, Canada; Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
Neurosci Lett. 2018 Apr 3;671:13-18. doi: 10.1016/j.neulet.2018.01.028. Epub 2018 Jan 31.
Spinal cord injury (SCI) may induce significant respiratory muscle weakness and paralysis, which in turn may cause a patient to require ventilator support. Central nervous system alterations can also exacerbate local inflammatory responses with immune cell infiltration leading to additional risk of inflammation at the injury site. Although mechanical ventilation is the traditional treatment for respiratory insufficiency, evidence has shown that it may directly affect distant organs through systemic inflammation.
This study aimed to better understand the impact of invasive mechanical ventilation on local spinal cord inflammatory responses following cervical or thoracic SCI.
Five groups of female Sprague-Dawley rats were anesthetised for 24 h. Three groups received mechanical ventilation: seven rats without SCI, seven rats with cervical injury (C4-C5), and seven rats with thoracic injury (T10); whereas, two groups were non-ventilated: six rats without SCI; and six rats with thoracic injury (T10). Changes in inflammatory responses were determined in the spinal cord tissues collected at the local site of injury. Cytokines were measured using ELISA.
SCI induced local pro-inflammatory cytokine IL-6 expression for all groups. Mechanical ventilation also had effects on pro-inflammatory cytokines and independently increased TNF-α and decreased IL-1β levels in the spinal cords of anesthetized rats.
These data provide the first evidence that mechanical ventilation contributes to local inflammation after SCI and in the absence of direct tissue injury.
脊髓损伤（SCI）可能会导致显著的呼吸肌无力和麻痹，进而可能使患者需要呼吸机支持。中枢神经系统改变还会加剧局部炎症反应，伴有免疫细胞浸润，导致损伤部位出现额外的炎症风险。尽管机械通气是治疗呼吸功能不全的传统方法，但有证据表明它可能通过全身炎症直接影响远处器官。
本研究旨在更好地了解有创机械通气对颈段或胸段脊髓损伤后局部脊髓炎症反应的影响。
将五组雌性Sprague-Dawley大鼠麻醉24小时。三组接受机械通气：七只无脊髓损伤的大鼠、七只颈段损伤（C4-C5）的大鼠和七只胸段损伤（T10）的大鼠；而两组不进行通气：六只无脊髓损伤的大鼠和六只胸段损伤（T10）的大鼠。在损伤局部收集的脊髓组织中测定炎症反应的变化。使用酶联免疫吸附测定法测量细胞因子。
脊髓损伤在所有组中均诱导了局部促炎细胞因子白细胞介素-6（IL-6）的表达。机械通气也对促炎细胞因子有影响，并独立增加了麻醉大鼠脊髓中肿瘤坏死因子-α（TNF-α）的水平，降低了白细胞介素-1β（IL-1β）的水平。
这些数据首次证明，在没有直接组织损伤的情况下，机械通气会导致脊髓损伤后的局部炎症。
