Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China.
Artif Cells Nanomed Biotechnol. 2024 Dec;52(1):370-383. doi: 10.1080/21691401.2024.2367444. Epub 2024 Jul 17.
The objective of this study was to test the therapeutic effect of carbon monoxide polyhemoglobin (polyCOHb) in haemorrhagic shock/resuscitation and its underlying mechanisms.
48 rats were divided into two experimental parts, and 36 rats in the first experiment and 12 rats in the second experiment. In the first experimental part, 36 animals were randomly assigned to the following groups: hydroxyethyl starch group (HES group, = 12), polyhemoglobin group (polyHb group, = 12), and carbon monoxide polyhemoglobin group (polyCOHb group, = 12). In the second experimental part, 12 animals were randomly assigned to the following groups: polyHb group ( = 6), and polyCOHb group ( = 6). Then the anaesthetised rats were haemorrhaged by withdrawing 50% of the animal's blood volume (BV), and resuscitated to the same volume of the animal's withdrawing BV with HES, polyHb, polyCOHb. In the first experimental part, the 72h survival rates of each groups animals were measured. In the second experimental part, the rats' mean arterial pressure (MAP), heart rate (HR), blood gas levels and other indicators were dynamically monitored in baseline, haemorrhagic shock (HS), at 0point resuscitation (RS 0h) and after 1 h resuscitation (RS 1h). The concentrations of malondialdehyde (MDA), superoxide dismutase (SOD), tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured by ELISA kits in both groups of rats at RS 1h. Changes in pathological sections were examined by haematoxylin-eosin (HE) staining. Nuclear factor erythroid 2-related factor 2 (Nrf2) and haem oxygenase-1 (HO-1) levels were detected by immunohistochemical analysis, while myeloperoxidase (MPO) levels were detected by immunofluorescence. DHE staining was used to determine reactive oxygen species (ROS) levels.
The 72h survival rates of the polyHb and polyCOHb groups were 50.00% (6/12) and 58.33% (7/12) respectively, which were significantly higher than that of the 8.33% (1/12) in the HES group ( < 0.05). At RS 0h and RS 1h, the HbCO content of rats in the polyCOHb group (1.90 ± 0.21, 0.80 ± 0.21) g/L were higher than those in the polyHb group (0.40 ± 0.09, 0.50 ± 0.12)g/L ( < 0.05); At RS 1h, the MDA (41.47 ± 3.89 vs 34.17 ± 3.87 nmol/ml) in the plasma, Nrf2 and HO-1 content in the colon of rats in the polyCOHb group were lower than the polyHb group. And the SOD in the plasma (605.01 ± 24.46 vs 678.64 ± 36.37) U/mg and colon (115.72 ± 21.17 vs 156.70 ± 21.34) U/mg and the MPO content in the colon in the polyCOHb group were higher than the polyHb group ( < 0.05).
In these haemorrhagic shock/resuscitation models, both polyCOHb and polyHb show similar therapeutic effects, and polyCOHb has more effective effects in maintaining MAP, correcting acidosis, reducing inflammatory responses than that in polyHb.
本研究旨在测试一氧化碳多血红素(polyCOHb)在失血性休克/复苏中的治疗效果及其潜在机制。
将 48 只大鼠分为两个实验部分,其中 36 只大鼠用于第一个实验,12 只大鼠用于第二个实验。在第一个实验部分,将 36 只动物随机分为以下几组:羟乙基淀粉组(HES 组,n=12)、多血红素组(polyHb 组,n=12)和一氧化碳多血红素组(polyCOHb 组,n=12)。在第二个实验部分,将 12 只动物随机分为以下两组:polyHb 组(n=6)和 polyCOHb 组(n=6)。然后,通过抽取动物总血量(BV)的 50%使麻醉大鼠发生出血,并使用 HES、polyHb、polyCOHb 将动物 BV 等量复苏。在第一个实验部分,测量各组动物的 72 小时生存率。在第二个实验部分,动态监测大鼠的平均动脉压(MAP)、心率(HR)、血气水平等指标,分别在基础状态、失血性休克(HS)、复苏 0 小时(RS 0h)和复苏 1 小时(RS 1h)时进行监测。在 RS 1h 时,通过 ELISA 试剂盒测量两组大鼠的丙二醛(MDA)、超氧化物歧化酶(SOD)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的浓度。通过苏木精-伊红(HE)染色观察病理切片的变化。通过免疫组化分析检测核因子红细胞 2 相关因子 2(Nrf2)和血红素加氧酶-1(HO-1)水平,通过免疫荧光检测髓过氧化物酶(MPO)水平。通过 DHE 染色确定活性氧(ROS)水平。
polyHb 和 polyCOHb 组的 72 小时生存率分别为 50.00%(6/12)和 58.33%(7/12),明显高于 HES 组的 8.33%(1/12)( < 0.05)。在 RS 0h 和 RS 1h 时,polyCOHb 组大鼠血液中 HbCO 含量(1.90 ± 0.21、0.80 ± 0.21)g/L 高于 polyHb 组(0.40 ± 0.09、0.50 ± 0.12)g/L( < 0.05);在 RS 1h 时,polyCOHb 组大鼠血浆中 MDA(41.47 ± 3.89 vs 34.17 ± 3.87 nmol/ml)、结肠中 Nrf2 和 HO-1 含量均低于 polyHb 组,而 polyCOHb 组大鼠血浆中 SOD(605.01 ± 24.46 vs 678.64 ± 36.37)U/mg 和结肠中 SOD(115.72 ± 21.17 vs 156.70 ± 21.34)U/mg 和 MPO 含量均高于 polyHb 组( < 0.05)。
在这些失血性休克/复苏模型中,polyCOHb 和 polyHb 均表现出相似的治疗效果,而 polyCOHb 在维持 MAP、纠正酸中毒、减轻炎症反应方面的效果优于 polyHb。