Baudry Nathalie, Campeanu Aurélie, Aussel Clotilde, Doutrelon Caroline, Grosbot Marion, Banzet Sébastien, Vicaut Eric, Peltzer Juliette
Laboratoire d'Etude de La Microcirculation, UMRS 942 INSERM, Université Paris Cité, Paris, France.
Institut de Recherche Biomédicale Des Armées (IRBA), 1, Rue du Lieutenant Raoul Batany, 92141, Clamart, France.
J Transl Med. 2024 Dec 24;22(1):1143. doi: 10.1186/s12967-024-05961-7.
Hemorrhagic shock (HS) corresponds to absolute hypovolemia creating an imbalance between oxygen supply and consumption. This causes an impaired hemostasis, a systemic inflammatory response, and microvascular permeability which can lead to multiple organ failure (MOF). There is no specific treatment for the endothelial dysfunction that plays a major role in the evolution towards MOF. Mesenchymal stromal cells (MSC) have been used in clinical trials for their immunomodulation and tissue repair capabilities for many years. Moreover, we previously showed that IL-1β-primed-MSC (MSCp) attenuated HS-induced organ injuries. The objective of the study was to determine whether MSCp could prevent the onset of MOF after HS by preventing endothelial dysfunction.
We established a rat model of HS, inducing 90 min of HS at a fixed mean arterial pressure of 35 mmHg, followed by resuscitation and transfusion. MSCp treatment was administered intravenously at the onset of resuscitation. After 6 h, we assessed plasma levels of endothelial markers, vascular permeability using Evans Blue (EB) dye, and renal and hepatic water content by measuring the wet-to-dry weight difference. Additionally, we investigated the ability of MSCp to inhibit leukocyte adhesion to activated endothelium in vitro.
Our results indicate that early administration of MSCp significantly reduced the percentage of water content and EB dye in the liver but not in the kidney. These results were associated with a trend toward decreased plasma levels of Syndecan-1, ICAM-1, vWF, and VCAM-1. In vitro, MSCp reduced leukocyte-endothelial cell adhesion. Together, our results suggest that MSCp help to prevent endothelial dysfunction and vascular leakage, which, in turn, could protect the liver from injury.
失血性休克(HS)相当于绝对血容量不足,导致氧供与氧耗失衡。这会引起止血功能受损、全身炎症反应以及微血管通透性增加,进而可能导致多器官功能衰竭(MOF)。对于在MOF发展过程中起主要作用的内皮功能障碍,目前尚无特效治疗方法。间充质基质细胞(MSC)因其免疫调节和组织修复能力,已在临床试验中应用多年。此外,我们之前的研究表明,白细胞介素-1β预处理的MSC(MSCp)可减轻HS诱导的器官损伤。本研究的目的是确定MSCp是否能通过预防内皮功能障碍来防止HS后MOF的发生。
我们建立了HS大鼠模型,在固定平均动脉压35 mmHg下诱导90分钟的HS,随后进行复苏和输血。在复苏开始时静脉给予MSCp治疗。6小时后,我们评估血浆内皮标志物水平、使用伊文思蓝(EB)染料检测血管通透性,以及通过测量湿重与干重差值评估肾脏和肝脏的含水量。此外,我们还研究了MSCp在体外抑制白细胞黏附于活化内皮的能力。
我们的结果表明,早期给予MSCp可显著降低肝脏中的含水量百分比和EB染料含量,但对肾脏无此作用。这些结果与血浆中Syndecan-1、ICAM-1、vWF和VCAM-1水平降低的趋势相关。在体外,MSCp减少了白细胞与内皮细胞的黏附。综合来看,我们的结果表明MSCp有助于预防内皮功能障碍和血管渗漏,进而保护肝脏免受损伤。