From the Division of GI, Trauma, and Endocrine Surgery, Department of Surgery (J.-P.I., S.K.), Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, Burn Research Program (D.M.B., E.J.K.), and Department of Immunology and Microbiology (D.M.B., E.J.K.), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado; Department of Radiation Oncology (W.-L.Y.), Albert Einstein College of Medicine, Bronx, New York; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, Alcohol Research Program (E.J.K.), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado.
J Trauma Acute Care Surg. 2020 Oct;89(4):768-774. doi: 10.1097/TA.0000000000002865.
Burn injury still has a high attributable mortality. The elevated mortality rate of severe burns is still concerning. Hepatic inflammation and injury are common after burns and are associated with poor outcomes. Necroptosis is a programmed cell death linked with inflammation. Thus, assessing necroptotic pathways in the liver can lead to new therapeutic modalities to improve mortality after severe burns.
Mice underwent 15% total body surface area burn or sham injury. Three hours after burn, the mice were euthanized to collect blood and livers. Histology, injury markers, genes expression, and tissue protein levels were compared between groups.
Compared with sham, burned mice had heightened liver inflammatory cell infiltration and edema. Serum aspartate aminotransferase and alanine aminotransferase were increased by 4.9- and 3.4-fold, respectively, in burned mice relative to sham (p < 0.05). Expression of tumor necrosis factor α, interleukin-6, interleukin-1β, and CXCL1 (KC) genes were elevated in livers of burned mice by 10-, 86-, 10-, and 828-fold, respectively, compared with sham (p < 0.05). Expression of necroptotic genes, namely, receptor-interacting protein kinases 1 and 3, and mixed lineage kinase domain-like in livers of burned mice were increased by 10-, 13-, and 4.5-fold, respectively, relative to sham (p < 0.05). Receptor-interacting protein kinase 1 and phosphorylated mixed lineage kinase domain-like protein levels measured by Western-blot in livers after burn injury were elevated by 22- and 17-fold, respectively, compared with sham (p < 0.05).
Liver damage occurs early after burns in mice and is associated with elevation of proinflammatory cytokines, chemokine, and proteins involved in the necroptotic pathway. This study suggests that necroptosis plays a role in the pathogenesis of liver failure secondary to burn injury.
烧伤仍然具有较高的病死率。严重烧伤的高死亡率仍然令人担忧。烧伤后常发生肝炎症和损伤,与不良预后相关。坏死性凋亡是一种与炎症相关的程序性细胞死亡。因此,评估肝脏中的坏死性凋亡途径可以为改善严重烧伤后的死亡率提供新的治疗方法。
小鼠接受 15%的全身体表面积烧伤或假伤。烧伤后 3 小时处死小鼠,收集血液和肝脏。比较各组间的组织学、损伤标志物、基因表达和组织蛋白水平。
与假伤相比,烧伤小鼠的肝脏炎症细胞浸润和水肿增加。与假伤相比,烧伤小鼠的血清天冬氨酸转氨酶和丙氨酸转氨酶分别升高了 4.9 倍和 3.4 倍(p<0.05)。与假伤相比,烧伤小鼠肝脏肿瘤坏死因子 α、白细胞介素 6、白细胞介素 1β 和 CXCL1(KC)基因的表达分别升高了 10 倍、86 倍、10 倍和 828 倍(p<0.05)。与假伤相比,烧伤小鼠肝脏中坏死性凋亡基因受体相互作用蛋白激酶 1 和 3 以及混合谱系激酶结构域样的表达分别升高了 10 倍、13 倍和 4.5 倍(p<0.05)。与假伤相比,通过 Western blot 测量的烧伤后肝脏中受体相互作用蛋白激酶 1 和磷酸化混合谱系激酶结构域样蛋白的水平分别升高了 22 倍和 17 倍(p<0.05)。
在小鼠中,烧伤后早期即发生肝脏损伤,与促炎细胞因子、趋化因子和参与坏死性凋亡途径的蛋白质的升高有关。本研究表明,坏死性凋亡在烧伤后肝衰竭的发病机制中起作用。