Dulchavsky S A, Ksenzenko S M, Saba A A, Diebel L N
Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
J Trauma. 1995 Jul;39(1):53-7; discussion 57-8. doi: 10.1097/00005373-199507000-00007.
Surfactant functional effectiveness is dependent on phospholipid compositional integrity: sepsis decreases this through an undefined mechanism. Sepsis-induced hypothyroidism is commensurate and may be related. This study examines the effect of triiodothyronine (T3) supplementation on surfactant function, metabolism, and composition during sepsis. Male Sprague-Dawley rats (n = 75) underwent sham laparotomy or cecal ligation and puncture (CLP) with or without T3 supplementation (CLP/T3; 3 ng/hr). Twenty-four hours later, surfactant was obtained by lavage. Total phospholipids were determined by chromatography. Choline phosphate cytidyltransferase (CT) activity was determined by the formation of cytidine diphosphate (CDP)-choline. In vivo lung compliance was determined by lung inflation; surfactant hysteresis plots were determined on a pulsating bubble surfactometer. Lung compliance and surfactant hysteresis plots were significantly affected by sepsis; T3 modulated this (dynamic compliance: sham = 0.66 +/- 0.02, CLP = 0.47 +/- 0.06, CLP/T3 = 0.56 +/- 0.02 mm Hg/mL; p < 0.05). Sepsis produced a decrease in phosphatidylglycerol, and phosphatidic acid, with an increase in lesser surface active lipids phosphatidylserine and phosphatidylinositol. Hormonal replacement prevented these alterations. Lung CT activity was increased by sepsis independent of T3 treatment. Thyroid hormone may have an active role in lung functional preservation during sepsis caused by maintenance of surfactant biophysical and compositional homeostasis.
脓毒症通过一种不明机制降低了这种完整性。脓毒症诱导的甲状腺功能减退与之相当，可能与之相关。本研究考察了补充三碘甲状腺原氨酸（T3）对脓毒症期间表面活性剂功能、代谢和组成的影响。雄性Sprague-Dawley大鼠（n = 75）接受假剖腹手术或盲肠结扎穿刺术（CLP），并给予或不给予T3补充（CLP/T3；3 ng/小时）。24小时后，通过灌洗获取表面活性剂。通过色谱法测定总磷脂。通过胞苷二磷酸（CDP）-胆碱的形成来测定胆碱磷酸胞苷转移酶（CT）活性。通过肺充气测定体内肺顺应性；在脉动气泡表面活性剂测定仪上测定表面活性剂滞后曲线。脓毒症显著影响肺顺应性和表面活性剂滞后曲线；T3对此有调节作用（动态顺应性：假手术组 = 0.66 ± 0.02，CLP组 = 0.47 ± 0.06，CLP/T3组 = 0.56 ± 0.02 mmHg/mL；p < 0.05）。脓毒症导致磷脂酰甘油和磷脂酸减少，同时表面活性较低的脂质磷脂酰丝氨酸和磷脂酰肌醇增加。激素替代可防止这些改变。脓毒症使肺CT活性增加，与T3治疗无关。甲状腺激素可能通过维持表面活性剂生物物理和组成的稳态，在脓毒症期间肺功能的保存中发挥积极作用。
