Department of Cardiovascular Surgery, West China Hospital, Sichuan University, GuoXue Alley 37, Cheng du, Sichuan 610041, People's Republic of China.
Department of Cardiovascular Surgery, West China Hospital, Sichuan University, GuoXue Alley 37, Cheng du, Sichuan 610041, People's Republic of China; Intensive Care Unit, West China Hospital, Sichuan University, GuoXue Alley 37, Cheng du, Sichuan 610041, People's Republic of China.
Phytomedicine. 2018 Sep 15;48:120-128. doi: 10.1016/j.phymed.2018.05.017. Epub 2018 Jun 2.
We aim to investigate the role of mitochondrial DNA (mtDNA), a novel endogenous pro-inflammatory cytokine, in the development of ventilator-induced lung injury (VILI). Moreover, the protective effect of epigallocatechin gallate (EGCG) on VILI through inhibiting local mtDNA release was examined.
From March 2015 to March 2016, bronchoalveolar lavage fluid (BALF) from 36 patients with VILI and well-matched 36 patients without VILI after major surgery were consecutively collected. The expression levels of mtDNA and inflammatory cytokines in BALF were tested. SD rats were divided into five groups: control, low tidal volume (7 ml/kg) group, high tidal volume (HTV, 40 ml/kg) group, HTV+low dose EGCG and HTV+high dose EGCG groups. BALF were collected to examine the expression levels of mtDNA and several inflammatory cytokines and the lung tissue was harvested for pathological examinations. In addition, cyclic stretch cell culture was used and culture media was collected to analyze expressions of inflammatory cytokines. Administration of mtDNA in a rat model and in vitro cell culturing were used to confirm its pro-inflammatory properties in the development of inflammatory lung injury.
A Significant elevation of mtDNA was detected in BALF from patients with VILI (581 ± 193 vs. 311 ± 137, p < 0.05) and also in rats ventilated with HTV. EGCG could significantly inhibit HTV-induced local mtDNA release and attenuate the level of inflammatory lung injuries (reduced infiltration of local inflammatory cells, lower lung wet/dry ratio and expression levels of inflammatory cytokines). The beneficial effects of EGCG on preventing inflammatory lung injuries were in a concentration-dependent manner. Meanwhile, higher expression levels of mtDNA and inflammatory cytokines were observed in the media of cyclic stretched cell culture compared to those in the control group (p < 0.05). Furthermore, intra-tracheal administration of mtDNA in rats could lead to a marked increase of local inflammatory cytokines and subsequent inflammatory lung injuries (p < 0.05). And by adding mtDNA into the cell culture, higher level of inflammatory cytokines in the media was detected (p < 0.05). EGCG also showed preventive effects on inflammatory responses on a concentration-dependent manner (p < 0.05).
The increased expression level of mtDNA and subsequent inflammatory cytokines overproduction may play an important role in the development of VILI. EGCG may be a potential novel therapeutic candidate for protection against VILI by inhibiting the local release of mtDNA.
我们旨在研究线粒体 DNA(mtDNA)作为一种新型内源性促炎细胞因子在呼吸机诱导性肺损伤(VILI)中的作用。此外,还研究了表没食子儿茶素没食子酸酯(EGCG)通过抑制局部 mtDNA 释放对 VILI 的保护作用。
从 2015 年 3 月至 2016 年 3 月,连续收集了 36 例 VILI 患者和 36 例大手术后无 VILI 患者的支气管肺泡灌洗液(BALF)。检测 BALF 中 mtDNA 和炎症细胞因子的表达水平。SD 大鼠分为五组:对照组、小潮气量(7ml/kg)组、大潮气量(HTV,40ml/kg)组、HTV+低剂量 EGCG 组和 HTV+高剂量 EGCG 组。收集 BALF 检测 mtDNA 和几种炎症细胞因子的表达水平,并采集肺组织进行病理检查。此外,还进行了循环拉伸细胞培养,并收集培养介质分析炎症细胞因子的表达。在大鼠模型和体外细胞培养中给予 mtDNA,以确认其在炎症性肺损伤发展中的促炎特性。
VILI 患者(581±193 比 311±137,p<0.05)和接受 HTV 通气的大鼠的 BALF 中均检测到 mtDNA 显著升高。EGCG 可显著抑制 HTV 诱导的局部 mtDNA 释放,并减轻炎症性肺损伤的程度(减少局部炎症细胞浸润,降低肺湿/干比和炎症细胞因子的表达水平)。EGCG 预防炎症性肺损伤的有益作用呈浓度依赖性。同时,与对照组相比,循环拉伸细胞培养介质中 mtDNA 和炎症细胞因子的表达水平更高(p<0.05)。此外,大鼠气管内给予 mtDNA 可导致局部炎症细胞因子的显著增加,并随后发生炎症性肺损伤(p<0.05)。并且在细胞培养中加入 mtDNA 后,检测到介质中炎症细胞因子水平升高(p<0.05)。EGCG 也表现出对炎症反应的预防作用,且呈浓度依赖性(p<0.05)。
mtDNA 表达水平升高和随后的促炎细胞因子过度产生可能在 VILI 的发生发展中起重要作用。EGCG 可能通过抑制局部 mtDNA 释放成为一种有潜力的新型治疗 VILI 的候选药物。