Emergency Department, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Cardiology Department, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Int J Biol Sci. 2019 Nov 8;15(13):2872-2884. doi: 10.7150/ijbs.38315. eCollection 2019.
Mechanical ventilation has significant therapeutic benefits, but it may cause or aggravate lung injury, which is called ventilator-induced lung injury (VILI). Endogenous hydrogen sulfide (H2S) has roles including regulating inflammation, and promoting vasodilatation; it also exhibits anti-oxidative stress and anti-fibrosis effects. H2S has been reported to alleviate lung injury, but the effects and mechanism of H2S on VILI remain unclear. The present study established a rat model of VILI and treated them with H2S, then measured the changes in respiratory function indicators, lung tissue histopathology, and oxidative, inflammatory, and apoptotic indicators. The effect of H2S on autophagy in the VILI model and the involvement of endoplasmic reticulum (ER) stress were also investigated. To further explore the mechanism, L2 alveolar epithelial cells were treated with cyclic strain to mimic mechanical strain along with the H2S donor NaHS, and the involvement of the NF-κB/MAPK signaling pathway was examined. The results showed that H2S significantly alleviated VILI and inhibited the inflammation and oxidative stress induced by VILI. H2S also significantly reduced autophagy and ER stress in rats. The phosphorylation of IRE1α, PERK and eIF2α and the expression of nuclear ATF4, and GADD34 in L2 cells were all significantly reduced with NaHS. Nuclear NF-κB p65, MAPK p38, JNK, and ERK were all activated by cyclic strain, but inhibited by the ER stress inhibitor 4-PBA or NaHS. Our findings revealed that H2S treatment alleviated VILI by regulating autophagy and ER stress, and the PERK/eIF2α/ATF4/GADD34 and NF-κB/MAPK pathways were involved in the underlying mechanism.
机械通气具有显著的治疗益处,但它也可能导致或加重肺损伤,这被称为呼吸机相关性肺损伤(VILI)。内源性硫化氢(H2S)具有调节炎症、促进血管舒张等作用,还具有抗氧化应激和抗纤维化作用。有报道称 H2S 可减轻肺损伤,但 H2S 对 VILI 的作用及其机制尚不清楚。本研究建立了大鼠 VILI 模型,并给予 H2S 治疗,然后测量呼吸功能指标、肺组织病理变化以及氧化、炎症和凋亡指标的变化。还研究了 H2S 对 VILI 模型中自噬的影响及其涉及的内质网(ER)应激。为了进一步探讨其机制,用 H2S 供体 NaHS 处理 L2 肺泡上皮细胞,模拟机械应变,检测 NF-κB/MAPK 信号通路的参与情况。结果表明,H2S 可显著减轻 VILI,并抑制 VILI 引起的炎症和氧化应激。H2S 还可显著减少大鼠的自噬和 ER 应激。L2 细胞中 IRE1α、PERK 和 eIF2α 的磷酸化以及核 ATF4 和 GADD34 的表达均随 NaHS 而显著降低。环应变激活核 NF-κB p65、MAPK p38、JNK 和 ERK,但 ER 应激抑制剂 4-PBA 或 NaHS 可抑制其活性。我们的研究结果表明,H2S 通过调节自噬和 ER 应激来减轻 VILI,PERK/eIF2α/ATF4/GADD34 和 NF-κB/MAPK 途径参与了其潜在机制。
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