Ge Chen, Zhang Yifan, Jia Hongwei, Luo Yuquan, Zu Yiwen, Yang Zhiwei, Jia Lijing, Wang Jingmei, Du Quansheng
Department of Intensive Care Unit, Hebei General Hospital, Shijiazhuang 050000, Hebei, China.
Department of Intensive Care Unit, Shijiazhuang People's Hospital, Shijiazhuang 050000, Hebei, China.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023 Feb;35(2):152-157. doi: 10.3760/cma.j.cn121430-20220509-00460.
To observe the expression of deleted in malignant brain tumor protein 1 (DMBT1) in rat acute respiratory distress syndrome (ARDS) model induced by sepsis and its relationship with ARDS related biomarkers.
Forty-eight healthy male rats were randomly divided into sham operation group (Sham group) and ARDS model group, and the rats in each group were further divided into three subgroups at 6, 12 and 24 hours after operation, with 8 rats in each subgroup. The rats in the Sham group were exposed to the cecum only, and sepsis induced ARDS model was reproduced by cecal ligation and puncture (CLP) in the ARDS model group. The general performance was observed at 6, 12, 24 hours after operation. Abdominal aortic blood of rats was collected, and the levels of DMBT1, surfactant-associated protein D (SP-D), vascular endothelial growth factor (VEGF), interleukins (IL-6, IL-10) in serum were determined by enzyme-linked immunosorbent assay (ELISA). The lung tissues were collected, and the lung wet/dry weight (W/D) ratio was determined. The lung tissue pathological changes were observed under light microscope after hematoxylin-eosin (HE) staining, and the lung tissue injury score was evaluated. The expression of DMBT1 protein in lung tissue was determined by Western blotting. The relationship between the serum DMBT1 and SP-D, VEGF, IL-6, IL-10, lung tissue injury score were analyzed by Pearson correlation analysis.
Rats in the ARDS model group showed obvious pathological manifestations after operation. The alveolar structure destruction, inflammatory cell infiltration, and alveolar hemorrhage were observed under microscope. Compared with the Sham group, the lung tissue injury score and the lung W/D ratio at 12 hours after operation in the ARDS model group were significantly increased (lung tissue injury score: 3.35±0.13 vs. 1.16±0.07, lung W/D ratio: 5.36±0.44 vs. 4.38±0.35, both P < 0.05), and pulmonary edema was present, which suggested that the ARDS model caused by CLP was successfully reproduced. The results of ELISA and Western blotting showed that the levels of serum DMBT1, SP-D, VEGF and IL-6 in the ARDS model group increased gradually with time, while the level of IL-10 increased first and then decreased. Compared with the Sham group, the levels of DMBT1 in serum and the expressions of DMBT1 protein in lung tissue in the ARDS model group were significantly increased from 6 hours after operation [serum (ng/L) : 231.96±19.17 vs. 187.44±10.19, lung tissue (DMBT1/β-actin): 2.05±0.19 vs. 0.93±0.25, both P < 0.05], and the levels of SP-D, VEGF, IL-6 and IL-10 in serum were significantly increased from 12 hours after operation [SP-D (ng/L): 73.35±8.05 vs. 43.28±5.77, VEGF (ng/L): 89.85±8.47 vs. 43.19±5.11, IL-6 (ng/L): 36.01±2.48 vs. 17.49±1.77, IL-10 (ng/L): 84.55±8.41 vs. 39.83±5.02, all P < 0.05]. Pearson correlation analysis showed that serum DMBT1 was positively correlated with serum SP-D, VEGF, IL-6, IL-10 and lung injury score at 12 hours and 24 hours in the ARDS model group (12 hours: r values were 0.946, 0.942, 0.931, 0.936, 0.748, respectively; 24 hours: r values were 0.892, 0.945, 0.951, 0.918, 0.973, respectively; all P < 0.05).
DMBT1 is a novel early biomarker of ARDS by affecting alveolar epithelial cell, alveolar capillary permeability and inflammatory response.
观察恶性脑肿瘤缺失蛋白1(DMBT1)在脓毒症诱导的大鼠急性呼吸窘迫综合征(ARDS)模型中的表达及其与ARDS相关生物标志物的关系。
将48只健康雄性大鼠随机分为假手术组(Sham组)和ARDS模型组,每组大鼠在术后6、12和24小时再进一步分为三个亚组,每个亚组8只大鼠。Sham组大鼠仅暴露盲肠,ARDS模型组采用盲肠结扎穿刺(CLP)复制脓毒症诱导的ARDS模型。术后6、12、24小时观察大鼠一般情况。采集大鼠腹主动脉血,采用酶联免疫吸附测定(ELISA)法测定血清中DMBT1、表面活性物质相关蛋白D(SP-D)、血管内皮生长因子(VEGF)、白细胞介素(IL-6、IL-10)水平。取肺组织,测定肺湿/干重(W/D)比值。苏木精-伊红(HE)染色后在光镜下观察肺组织病理变化,并评估肺组织损伤评分。采用蛋白质印迹法测定肺组织中DMBT1蛋白表达。采用Pearson相关分析血清DMBT1与SP-D、VEGF、IL-6、IL-10及肺组织损伤评分的关系。
ARDS模型组大鼠术后出现明显病理表现。镜下可见肺泡结构破坏、炎性细胞浸润及肺泡出血。与Sham组比较,ARDS模型组术后12小时肺组织损伤评分及肺W/D比值显著升高(肺组织损伤评分:3.35±0.13比1.16±0.07,肺W/D比值:5.36±0.44比4.38±0.35,均P<0.05),且出现肺水肿,提示CLP所致ARDS模型复制成功。ELISA及蛋白质印迹结果显示,ARDS模型组血清DMBT1、SP-D、VEGF及IL-6水平随时间逐渐升高,而IL-10水平先升高后降低。与Sham组比较,ARDS模型组术后6小时血清DMBT1水平及肺组织DMBT1蛋白表达显著升高[血清(ng/L):231.96±19.17比187.44±10.19,肺组织(DMBT1/β-肌动蛋白):2.05±0.19比0.93±0.25,均P<0.05],术后12小时血清SP-D、VEGF、IL-6及IL-10水平显著升高[SP-D(ng/L):73.35±8.05比43.28±5.77,VEGF(ng/L):89.85±8.47比43.19±5.11,IL-6(ng/L):36.01±2.48比17.49±1.77,IL-10(ng/L):84.55±8.41比39.83±5.02,均P<0.05]。Pearson相关分析显示,ARDS模型组术后12小时和24小时血清DMBT1与血清SP-D、VEGF、IL-6、IL-10及肺损伤评分呈正相关(12小时:r值分别为0.946、0.942、0.931、0.936、0.748;24小时:r值分别为0.892、0.945、0.951、0.918、0.973,均P<0.05)。
DMBT1通过影响肺泡上皮细胞、肺泡毛细血管通透性及炎症反应,是ARDS的一种新型早期生物标志物。