Chang Jui-Chih, Finn Sadé M, Davis Robert Patrick, Sanders Nathan L, Holzknecht Zoie E, Everett Mary Lou, Barbas Andrew S, Parker William, Lin Shu S
From the Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA and the Department of Surgery, Tzu Chi University, Hualien, Taiwan.
Exp Clin Transplant. 2019 Feb;17(1):84-92. doi: 10.6002/ect.2017.0152. Epub 2018 Apr 26.
Chronic aspiration of gastric fluid contents can decrease long-term survival of pulmonary transplants due to development of obliterative bronchiolitis. However, little is known about the early immune response and the cascade of events involved in the development of obliterative bronchiolitis.
We utilized a rat orthotopic pulmonary transplant model and a single aspiration of either gastric fluid or normal saline to investigate the histologic, cellular, and cytokine changes associated with an acute gastric fluid aspiration event compared with normal saline at 2 and 10 days after aspiration.
Our observations included a decrease in pulmonary compliance and increased airway inflammation and acute rejection of the transplanted lung, as well as increases in macrophages, granulocytes, and proinflammatory cytokines such as interleukin 1β, transforming growth factor β1 and β2, and tumor necrosis factor α in bronchoalveolar lavage fluid from the transplanted lung of gastric fluid-aspirated rats compared with normal saline-aspirated rats.
The acute inflammatory response observed in the present study is consistent with changes found in chronic models of aspiration-associated injury and suggests a potentially important role for mast cells in the development of obliterative bronchiolitis.
由于闭塞性细支气管炎的发展，长期吸入胃液内容物会降低肺移植的长期存活率。然而，对于早期免疫反应以及闭塞性细支气管炎发展过程中涉及的一系列事件知之甚少。
我们利用大鼠原位肺移植模型，单次吸入胃液或生理盐水，以研究与急性胃液吸入事件相关的组织学、细胞和细胞因子变化，并与吸入生理盐水后2天和10天的情况进行比较。
我们的观察结果包括肺顺应性降低、气道炎症增加和移植肺的急性排斥反应，以及与吸入生理盐水的大鼠相比，吸入胃液的大鼠移植肺支气管肺泡灌洗液中的巨噬细胞、粒细胞和促炎细胞因子如白细胞介素1β、转化生长因子β1和β2以及肿瘤坏死因子α增加。
本研究中观察到的急性炎症反应与吸入相关损伤的慢性模型中发现的变化一致，并提示肥大细胞在闭塞性细支气管炎的发展中可能起重要作用。
