Ohar J A, Waller K S, Pantano J, Demello D E, Dahms T E
Department of Internal Medicine, St. Louis University Medical Center, MO 63110-0250.
Am J Respir Crit Care Med. 1994 Jun;149(6):1628-34. doi: 10.1164/ajrccm.149.6.8004322.
We have previously demonstrated that chronic intravenous platelet-activating factor (PAF) induces morphologic remodeling of pulmonary arteries characterized by a decrease in internal and external elastic lamina circumference, pulmonary arterial contracture, and internal elastic lamina duplication. The mechanism of PAF-induced arterial contracture is unknown. In this study we determined whether PAF caused arterial contracture through cell loss by calculating the number of cell nuclei/total cross-sectional area of arteries. The nuclear ratio was increased in intra- and preacinar pulmonary arteries of PAF-treated rabbits. Hydroxyproline content of lungs stratified by anatomic region was significantly reduced in intra-acinar tissue of PAF-treated rabbits, indicating that PAF-induced vascular contracture was associated with loss of interstitial collagen. We next tested whether these morphologic alterations were associated with decreased pulmonary vascular compliance and increased resistance. Compliance and resistance were determined in isolated, perfused lungs from rabbits chronically treated with PAF. Compliance was calculated: (1) from the slope of the venous occlusion trace (CVO), (2) by increasing left atrial pressure (CLA), (3) by increasing flow (CHF), and (4) by the classic static technique (CAV) of adding volume (2 ml) to a passively drained lung. Vascular compliance was significantly reduced in PAF-treated lungs when measured by all four methods; however, pulmonary vascular resistance was unchanged. We conclude that structural changes that result from chronic intravenous PAF infusion affect the elastic modulus to a greater extent than factors that influence pulmonary vascular resistance.
我们之前已经证明,慢性静脉注射血小板活化因子(PAF)可诱导肺动脉形态重塑,其特征为内、外弹性膜周长减小、肺动脉挛缩以及内弹性膜重复。PAF诱导动脉挛缩的机制尚不清楚。在本研究中,我们通过计算细胞核数量/动脉总横截面积来确定PAF是否通过细胞丢失导致动脉挛缩。PAF处理的兔子的腺泡内和腺泡前肺动脉的核比率增加。PAF处理的兔子的腺泡内组织中,按解剖区域分层的肺组织羟脯氨酸含量显著降低,表明PAF诱导的血管挛缩与间质胶原丢失有关。接下来,我们测试了这些形态学改变是否与肺血管顺应性降低和阻力增加有关。在慢性接受PAF处理的兔子的离体灌注肺中测定顺应性和阻力。顺应性的计算方法如下:(1)根据静脉闭塞曲线的斜率(CVO);(2)通过增加左心房压力(CLA);(3)通过增加流量(CHF);(4)通过向被动引流的肺中添加体积(2 ml)的经典静态技术(CAV)。用所有四种方法测量时,PAF处理的肺的血管顺应性均显著降低;然而,肺血管阻力未发生变化。我们得出结论,慢性静脉注射PAF所导致的结构变化对弹性模量的影响程度大于对肺血管阻力的影响因素。