Larsson Niklas, Claesson Jonas, Lehtipalo Stefan, Behndig Annelie, Mobarrez Fariborz, Haney Michael
Department of Diagnostics and Intervention, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
PLoS One. 2025 Apr 9;20(4):e0320144. doi: 10.1371/journal.pone.0320144. eCollection 2025.
Harmful effects of mechanical ventilation with large tidal volumes, volutrauma, may contribute much to diffuse acute lung injury. Extracellular vesicles have been noted in the context of vital organ injury. We hypothesized that extracellular vesicles from acutely injured lung can be found in both lung and blood. In a two-hit experimental porcine model, we tested if extracellular vesicles could be detected in bronchoalveolar lavage fluid and in plasma over a six-hour period of large tidal volume ventilation after surfactant depletion. After 2 hours of volutrauma, bronchoalveolar lavage fluid showed increased levels of extracellular vesicles containing nucleic acids (stained by SYTO 13) and those positive for both SYTO 13 and HMGB1. No such increase was detected in plasma at any timepoint during the six-hour experiments. This shows that nucleic acid-containing extracellular vesicles appear to be involved in progression of lung injury, possibly indicating cellular damage, but their potential to serve as diagnostic biomarkers of acute lung injury progression, based on plasma sampling, and in the very early phase, is not confirmed by these findings.
大潮气量机械通气的有害影响，即容积伤，可能在弥漫性急性肺损伤中起很大作用。在重要器官损伤的情况下已发现细胞外囊泡。我们假设在急性损伤的肺中发现的细胞外囊泡可在肺和血液中均被检测到。在一个双打击实验性猪模型中，我们测试了在表面活性剂耗竭后的大潮气量通气6小时期间，支气管肺泡灌洗液和血浆中是否能检测到细胞外囊泡。在容积伤2小时后，支气管肺泡灌洗液中含有核酸的细胞外囊泡（用SYTO 13染色）以及对SYTO 13和HMGB1均呈阳性的细胞外囊泡水平升高。在6小时实验期间的任何时间点，血浆中均未检测到这种升高。这表明含核酸的细胞外囊泡似乎参与了肺损伤的进展，可能表明细胞损伤，但基于血浆采样，这些发现并未证实它们在急性肺损伤进展的极早期作为诊断生物标志物的潜力。
