Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
J Surg Res. 2020 Sep;253:272-279. doi: 10.1016/j.jss.2020.03.060. Epub 2020 May 8.
Mechanical ventilation (MV) is life saving; yet it may induce severe lung injury and lead to multisystem organ failure and death. Thyroid hormones (THs) promote alveolar fluid clearance and alleviates hypoxia-induced lung injury. Given that the mechanism involved in hypoxia-induced lung injury is different from that of ventilator-induced lung injury, we examined the effects of thyroid function on lung extravascular fluid (LF), aquaporin 5 (AQP 5) expression, and alveolar viscoelasticity (AVE) in mechanically ventilated rat.
Hypothyroid (hypo) and hyperthyroid (hyper) animals were generated by administration of metimazole and L-thyroxine, respectively. Lung injury was induced by high-tidal volume MV. The LF was estimated by lung wet weight-to-dry weight ratio assessment. Expression of AQP 5 was evaluated by western blotting and in situ immunohistochemistry. The AVE was judged by elastic lung pressure/volume curve recording.
Injurious MV significantly reduced lung AQP 5 expression and altered LF and AVE in a thyroid function-dependent manner. Regardless of animals' ventilation mode, hyper state caused significant reductions in LF and lung AQP 5 protein. It also improved AVE irrespective of animals' ventilation mode. The effects of hypo condition on LF, AQP 5 expression, and AVE were in contrast to that of hyper state.
These data indicate that thyroid function has profound effects on LF, AQP 5, and AVE in mechanically ventilated lungs. Given that the effects of thyroidal status were as prominent as that of injurious MV, we suggest that thyroid function should be considered when patients are to be subjected to MV.
机械通气(MV)可挽救生命;然而,它可能会引起严重的肺损伤,并导致多器官功能衰竭和死亡。甲状腺激素(THs)促进肺泡液体清除,并缓解缺氧性肺损伤。鉴于缺氧性肺损伤的机制与呼吸机诱导性肺损伤不同,我们研究了甲状腺功能对机械通气大鼠肺血管外液(LF)、水通道蛋白 5(AQP5)表达和肺泡粘弹性(AVE)的影响。
通过给予甲巯咪唑和左甲状腺素分别产生甲状腺功能减退(hypo)和甲状腺功能亢进(hyper)动物。高潮气量 MV 诱导肺损伤。通过肺湿重/干重比评估 LF。通过 Western blot 和原位免疫组化评估 AQP5 的表达。通过弹性肺压/容积曲线记录判断 AVE。
损伤性 MV 显著降低了肺 AQP5 的表达,并以甲状腺功能依赖性的方式改变了 LF 和 AVE。无论动物的通气模式如何,高状态都会导致 LF 和肺 AQP5 蛋白显著减少。它还改善了 AVE,而与动物的通气模式无关。低状态对 LF、AQP5 表达和 AVE 的影响与高状态相反。
这些数据表明,甲状腺功能对机械通气肺的 LF、AQP5 和 AVE 有深远的影响。鉴于甲状腺状态的影响与损伤性 MV 一样显著,我们建议在患者接受 MV 时应考虑甲状腺功能。