Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Scand J Trauma Resusc Emerg Med. 2018 Nov 16;26(1):97. doi: 10.1186/s13049-018-0566-2.
This study was performed to gain insights into novel therapeutic approaches for acute systemic inflammation in heatstroke. Bone marrow-derived mononuclear cells (BMMNCs) secrete anti-inflammatory proteins and have protective effects against acute inflammation. Recent evidence suggested that transplantation of BMMNCs can reduce the acute tissue injury caused by regional myocardial reperfusion and the lung dysfunction induced by lipopolysaccharides. We evaluated whether BMMNCs attenuate systemic inflammatory response induced by severe heatstroke.
Anesthetized 12-week-old male Wistar rats were subjected to heat stress (41.8 °C for 30 min) with/without transplantation of BMMNCs. Bone marrow cells were harvested from the femur and tibia of other Wistar rats. BMMNCs were separated by density centrifugation, dissolved in phosphate-buffered saline (PBS), and injected intravenously immediately after heat stress (HS-BMMNCs group). The control group was administered an equal volume of PBS, and the sham group underwent the same procedure without heat stress.
Seven-day survival improved significantly in the HS-BMMNCs group versus control group (83.3% vs 41.7%). Transplantation of BMMNCs significantly suppressed serum levels of pro-inflammatory mediators, such as tumor necrosis factor-alpha, interleukin-6 and histone H3 at 3, 6, and 12 h after heat stress. Besides, the elevation of serum syndecan-1, a main component of the vascular endothelial glycocalyx layer, in the BMMNCs group was significantly suppressed compared to that in the control group at 6 and 12 h after heat stress. Histological analysis revealed that edema of the alveolar septum and vascular endothelial injury in the lung were evident in the control group 6 h after heat stress, whereas the morphological alteration was ameliorated in the HS-BMMNCs group. Also, histological analysis using BMMNCs derived from green fluorescent protein transgenic rats showed that the transplanted BMMNCs migrated into lung, kidney, and spleen at 24 h after heat stress but did not engraft to host tissues.
Transplantation of BMMNCs attenuated acute systemic inflammation and vascular endothelial injury, reduced organ dysfunction, and improved survival in a rat heatstroke model. These findings provide a possible therapeutic strategy against critical heatstroke.
本研究旨在探讨中暑急性全身炎症的新治疗方法。骨髓来源的单核细胞(BMMNCs)分泌抗炎蛋白,对急性炎症具有保护作用。最近的证据表明,BMMNC 移植可以减轻局部心肌再灌注引起的急性组织损伤和内毒素引起的肺功能障碍。我们评估了 BMMNC 是否可以减轻严重中暑引起的全身炎症反应。
麻醉的 12 周龄雄性 Wistar 大鼠在有/无 BMMNC 移植的情况下接受热应激(41.8°C 30 分钟)。从其他 Wistar 大鼠的股骨和胫骨中采集骨髓细胞。通过密度离心分离 BMMNC,溶解于磷酸盐缓冲盐水(PBS)中,并在热应激后立即静脉注射(HS-BMMNC 组)。对照组给予等量 PBS,假手术组不进行热应激但进行相同操作。
与对照组相比,HS-BMMNC 组的 7 天存活率显著提高(83.3% vs 41.7%)。BMMNC 移植显著抑制了血清中促炎介质的水平,如肿瘤坏死因子-α、白细胞介素-6 和组蛋白 H3,在热应激后 3、6 和 12 小时。此外,与对照组相比,HS-BMMNC 组在热应激后 6 和 12 小时时血清中主要成分血管内皮糖萼层的 syndecan-1 升高明显受到抑制。组织学分析显示,对照组在热应激后 6 小时时肺泡隔水肿和血管内皮损伤明显,而 HS-BMMNC 组的形态改变得到改善。此外,使用源自绿色荧光蛋白转基因大鼠的 BMMNC 进行的组织学分析显示,移植的 BMMNC 在热应激后 24 小时迁移到肺、肾和脾,但不植入宿主组织。
BMMNC 移植减轻了中暑大鼠模型的急性全身炎症和血管内皮损伤,降低了器官功能障碍,提高了存活率。这些发现为严重中暑的治疗提供了一种可能的策略。