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右美托咪定通过抑制 Toll 样受体 4(TLR4)/核因子(NF)-κB 信号通路减轻呼吸机所致肺损伤(VILI)。

Dexmedetomidine reduces ventilator-induced lung injury (VILI) by inhibiting Toll-like receptor 4 (TLR4)/nuclear factor (NF)-κB signaling pathway.

机构信息

Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shandong, China.

出版信息

Bosn J Basic Med Sci. 2018 May 20;18(2):162-169. doi: 10.17305/bjbms.2018.2400.

Abstract

Mechanical ventilation (MV) may lead to ventilator-induced lung injury (VILI). Previous research has shown that dexmedetomidine attenuates pulmonary inflammation caused by MV, but the underlying mechanisms remain unclear. Our study aims to test whether dexmedetomidine has a protective effect against VILI and to explore the possible molecular mechanisms using the rat model. Thirty adult male Wistar rats weighing 200-250 g were randomly assigned to 5 groups (n = 6): control, low tidal volume MV (LMV), high tidal volume (HVT) MV (HMV), HVT MV + dexmedetomidine (DEX), HVT MV + dexmedetomidine + yohimbine (DEX+Y). Rats were euthanized after being ventilated for 4 hours. Pathological changes, lung wet/dry (W/D) weight ratio, lung myeloperoxidase (MPO) activity, levels of inflammatory cytokines (i.e., interleukin [IL]-1β, tumor necrosis factor alpha [TNF-α], and IL-6) in the bronchoalveolar lavage fluid (BALF) and lung tissues, expression of Toll-like receptor 4 (TLR4) and nuclear factor (NF)-κB, and activation of NF-κB in lung tissues were measured. Compared with HMV, DEX group showed fewer pathological changes, lower W/D ratios and decreased MPO activity of the lung tissues and lower concentrations of the inflammatory cytokines in the BALF and lung tissues. Dexmedetomidine significantly inhibited the expression of TLR4 and NF-κB and activation of NF-κB. Yohimbine partly alleviated the effects of dexmedetomidine. Dexmedetomidine reduced the inflammatory response to HVT-MV and had a protective effect against VILI, with the inhibition of the TLR4/NF-κB signaling pathway, at least partly via α2-adrenoceptors.

摘要

机械通气(MV)可能导致呼吸机引起的肺损伤(VILI)。先前的研究表明,右美托咪定可减轻 MV 引起的肺炎症,但潜在机制尚不清楚。我们的研究旨在使用大鼠模型测试右美托咪定是否对 VILI 具有保护作用,并探讨可能的分子机制。

30 只成年雄性 Wistar 大鼠,体重 200-250 g,随机分为 5 组(n = 6):对照组、低潮气量 MV(LMV)、大潮气量(HMV)MV、大潮气量 MV +右美托咪定(DEX)、大潮气量 MV +右美托咪定 +育亨宾(DEX+Y)。通气 4 小时后处死大鼠。测量病理变化、肺湿/干(W/D)重量比、肺髓过氧化物酶(MPO)活性、支气管肺泡灌洗液(BALF)和肺组织中炎症细胞因子(白细胞介素[IL]-1β、肿瘤坏死因子α[TNF-α]和 IL-6)的水平、Toll 样受体 4(TLR4)和核因子(NF)-κB 在肺组织中的表达以及 NF-κB 的激活。与 HMV 相比,DEX 组的病理变化较少,肺组织 W/D 比值和 MPO 活性降低,BALF 和肺组织中炎症细胞因子浓度降低。右美托咪定显著抑制 TLR4 和 NF-κB 的表达以及 NF-κB 的激活。育亨宾部分缓解了右美托咪定的作用。

右美托咪定减轻了对 HVT-MV 的炎症反应,对 VILI 具有保护作用,至少部分通过 α2-肾上腺素能受体抑制 TLR4/NF-κB 信号通路。

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