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右美托咪定通过调控 p38/HO-1 通路缓解 LPS 诱导的急性肺损伤。

Dexmedetomidine alleviates LPS‑induced acute lung injury via regulation of the p38/HO‑1 pathway.

机构信息

Department of Anesthesiology, Anhui Provincial Children's Hospital of Anhui Medical University, Hefei, Anhui 230051, P.R. China.

出版信息

Mol Med Rep. 2020 Sep;22(3):2442-2450. doi: 10.3892/mmr.2020.11330. Epub 2020 Jul 10.

Abstract

Acute lung injury (ALI) is a common critical illness in clinical anesthesia and the intensive care unit that can cause acute hypoxic respiratory insufficiency. Despite various therapeutic regimes having been investigated, there is currently no effective pharmacotherapy available to treat ALI. Previous studies have reported that the NOD‑like receptor protein 3 (NLRP3) signaling pathway plays an important role in the inflammatory response and is involved in the pathogenesis of ALI. Moreover, dexmedetomidine (Dex), an α2‑adrenergic receptor activating agent, has been routinely used as an adjuvant therapy in treating inflammatory diseases, including ALI. However, the precise pathological mechanisms of Dex in ALI remain to be elucidated. Thus, the present study aimed to investigate the effects of the p38/heme oxygenase 1 (HO‑1) signaling pathways in the pathological mechanisms of Dex in ALI. Newborn male Sprague‑Dawley rats (n=48) were randomly divided into four groups (n=12 each), and an intravenous injection of lipopolysaccharide (LPS) was used to successfully induce the ALI model, with increased pulmonary damage, cell apoptosis, interleukin‑1β (IL‑1β) secretion and edema fluid in lungs. Moreover, the mRNA and protein expression levels of NLRP3 were significantly upregulated, while that of HO‑1 were downregulated by LPS treatment. Furthermore, the levels of phosphorylated p38 were also upregulated in ALI rats. It was demonstrated that Dex administration significantly alleviated LPS‑induced ALI, downregulated the secretion of IL‑1β, decreased the expression of NLRP3, inhibited the phospho‑activation of p38 and increased HO‑1 expression. In addition, pharmacological inhibition of p38 using the inhibitor SB20380 further enhanced the effect of Dex. Collectively, these preliminarily results identified the effects of Dex intervention on the pathogenesis of ALI via the regulation of p38/HO‑1 signaling pathways, which impacted the inflammatory effects, thus providing a theoretical basis and novel evidence for the development of new targets for clinical treatment of ALI.

摘要

急性肺损伤(ALI)是临床麻醉和重症监护病房中常见的危重病,可导致急性低氧性呼吸功能不全。尽管已经研究了各种治疗方案,但目前尚无有效的药物治疗方法可用于治疗 ALI。先前的研究报道,NOD 样受体蛋白 3(NLRP3)信号通路在炎症反应中发挥重要作用,并参与 ALI 的发病机制。此外,作为 α2-肾上腺素能受体激动剂的右美托咪定(Dex)已常规用于治疗炎症性疾病,包括 ALI。然而,Dex 在 ALI 中的确切病理机制仍有待阐明。因此,本研究旨在探讨 p38/血红素加氧酶 1(HO-1)信号通路在 Dex 治疗 ALI 中的病理机制中的作用。将新生雄性 Sprague-Dawley 大鼠(n=48)随机分为四组(n=12 只/组),并静脉注射脂多糖(LPS)成功诱导 ALI 模型,导致肺损伤、细胞凋亡、白细胞介素-1β(IL-1β)分泌和肺部水肿增加。此外,LPS 处理后 NLRP3 的 mRNA 和蛋白表达水平显著上调,而 HO-1 的表达水平下调。此外,ALI 大鼠中磷酸化 p38 的水平也上调。结果表明,Dex 给药可显著缓解 LPS 诱导的 ALI,下调 IL-1β的分泌,降低 NLRP3 的表达,抑制 p38 的磷酸化激活,增加 HO-1 的表达。此外,使用抑制剂 SB20380 抑制 p38 还进一步增强了 Dex 的作用。综上所述,这些初步结果确定了 Dex 通过调节 p38/HO-1 信号通路对 ALI 发病机制的干预作用,影响炎症作用,为 ALI 临床治疗新靶点的开发提供了理论依据和新证据。

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