Klein N J, Levin M, Strobel S, Finn A
Department of Paediatrics, St. Mary's Hospital Medical School, London, United Kingdom.
J Infect Dis. 1993 Apr;167(4):890-8. doi: 10.1093/infdis/167.4.890.
Vascular endothelial injury observed in overwhelming sepsis may be caused by neutrophil-derived enzymes. Adherence to the endothelium, a prerequisite for this process, is mediated sequentially by the neutrophil adhesion molecules L-selectin and the beta 2 integrins including CD11b/CD18. The relationship between expression of these molecules, neutrophil adherence, endothelial activation, and consequent endothelial injury was assessed by changes in heparan sulfate and fibronectin matrices. Endothelial prestimulation with lipopolysaccharide caused both an increase in adherence and a generalized reduction in heparan sulfate; disruption of the fibronectin matrix occurred only on the further addition of FMLP. Although maximal disruption of these matrices was associated with elevation of neutrophil CD11b/CD18 and reduction in L-selectin expression, these changes did not determine either the nature or extent of endothelial damage. This model may provide further insights into the interrelationship between neutrophil activation and endothelial damage in gram-negative sepsis.
在暴发性脓毒症中观察到的血管内皮损伤可能由中性粒细胞衍生的酶引起。中性粒细胞与内皮细胞的黏附是这一过程的前提条件,该过程依次由中性粒细胞黏附分子L-选择素和包括CD11b/CD18在内的β2整合素介导。通过硫酸乙酰肝素和纤连蛋白基质的变化来评估这些分子的表达、中性粒细胞黏附、内皮细胞活化以及随之而来的内皮损伤之间的关系。用脂多糖对内皮细胞进行预刺激会导致黏附增加以及硫酸乙酰肝素普遍减少;仅在进一步添加N-甲酰甲硫氨酰-亮氨酰-苯丙氨酸(FMLP)时,纤连蛋白基质才会发生破坏。尽管这些基质的最大破坏与中性粒细胞CD11b/CD18的升高和L-选择素表达的降低有关,但这些变化并不能决定内皮损伤的性质或程度。该模型可能为深入了解革兰氏阴性脓毒症中中性粒细胞活化与内皮损伤之间的相互关系提供进一步的见解。