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血液细胞因子表达与心肺转流中中低温伴停循环小鼠模型早期多器官损伤相关。

Blood cytokine expression correlates with early multi-organ damage in a mouse model of moderate hypothermia with circulatory arrest using cardiopulmonary bypass.

机构信息

Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Lower Saxony, Germany.

Department of Nephrology, Hannover Medical School, Hannover, Lower Saxony, Germany.

出版信息

PLoS One. 2018 Oct 11;13(10):e0205437. doi: 10.1371/journal.pone.0205437. eCollection 2018.

Abstract

Cardiopulmonary bypass (CPB) with moderate hypothermic cardiac arrest (MHCA) is essential for prolonged complex procedures in cardiac surgery and is associated with postoperative complications. Although cytokine release provoked through MHCA under CPB plays a pivotal role in postoperative organ damage, the pathomechanisms are unclear. Here, we investigated the cytokine release pattern and histological organ damage after MHCA using a recently described mouse CPB model. Eight BALB/c mice underwent 60 minutes of circulatory arrest under CPB, were successively rewarmed and reperfused. Blood cytokine concentrations and liver and kidney function parameters were measured and histological changes to these organs were compared to control animals. Our results showed a marked increase in proinflammatory cytokines and histological changes in the kidney, lung, and liver after CPB. Furthermore, clinical chemistry showed signs of hemolysis and acute kidney injury. These results suggest early onset of solid organ injury which correlates with increased leukocyte infiltration. A better understanding of the interplay between pro-inflammatory cytokine activation and solid organ injury in this model of CBP with MHCA will inform strategies to reduce organ damage during cardiac surgeries in the clinic.

摘要

体外循环(CPB)伴中度低温心脏停搏(MHCA)是心脏手术中长时间复杂手术所必需的,并且与术后并发症有关。尽管 CPB 下 MHCA 引发的细胞因子释放在术后器官损伤中起关键作用,但发病机制尚不清楚。在这里,我们使用最近描述的小鼠 CPB 模型研究了 MHCA 后的细胞因子释放模式和组织学器官损伤。8 只 BALB/c 小鼠在 CPB 下进行 60 分钟的循环骤停,随后复温并再灌注。测量血液细胞因子浓度和肝肾功能参数,并将这些器官的组织学变化与对照动物进行比较。我们的结果表明,CPB 后促炎细胞因子和肾脏、肺和肝脏的组织学变化明显增加。此外,临床化学显示出溶血和急性肾损伤的迹象。这些结果表明,实体器官损伤的早期发生与白细胞浸润增加有关。更好地了解 CPB 伴 MHCA 模型中促炎细胞因子激活与实体器官损伤之间的相互作用,将为减少临床心脏手术中器官损伤的策略提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dfc/6181365/ef67492d0d4e/pone.0205437.g001.jpg

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