Hill J, Lindsay T, Valeri C R, Shepro D, Hechtman H B
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02215.
J Appl Physiol (1985). 1993 Feb;74(2):659-64. doi: 10.1152/jappl.1993.74.2.659.
Antibodies to the neutrophil CD18 integrin have been shown to ameliorate the local effects of intestinal ischemia and reperfusion (I/R). In addition to local mucosal injury, intestinal I/R results in systemic hypotension and injury to the lungs with lung leukosequestration. This study tests the effect of a CD18 monoclonal antibody on the hypotension and lung injury after intestinal I/R. In anesthetized rabbits, the superior mesenteric artery was clamped for 60 min followed by 3 h of reperfusion. Animals were treated with saline, an anti-CD18 monoclonal antibody (R15.7 MAb), or nonspecific immunoglobulin G. Another non-ischemic group were sham controls. Neutrophil sequestration was assessed by measure of lung myeloperoxidase (MPO) and permeability by lung-to-blood concentration ratio of 125I-labeled bovine serum albumin and wet-to-dry weight ratio. Immediately after reperfusion, mean arterial pressure fell to 49 +/- 2.1 mmHg and remained at this level. The hypotension was unaffected by treatment with R15.7 MAb. Thirty minutes after reperfusion, the circulating white blood cell count fell to 2.91 +/- 0.53 x 10(3)/mm3 vs. sham 6.40 +/- 0.66 x 10(3)/mm3 (P < 0.05). Treatment with R15.7 MAb prevented this fall in white blood cell count (5.75 +/- 1.59 x 10(3)/mm3). At 3 h of reperfusion in saline-treated animals there was increased MPO, 74.8 +/- 4.9 U/g vs. 42.0 +/- 4.8 U/g in sham animals (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
针对中性粒细胞CD18整合素的抗体已被证明可改善肠道缺血再灌注(I/R)的局部影响。除了局部黏膜损伤外,肠道I/R还会导致系统性低血压以及伴有肺白细胞滞留的肺部损伤。本研究测试了一种CD18单克隆抗体对肠道I/R后低血压和肺损伤的影响。在麻醉的兔子中,夹闭肠系膜上动脉60分钟,然后再灌注3小时。动物分别接受生理盐水、抗CD18单克隆抗体(R15.7单克隆抗体)或非特异性免疫球蛋白G治疗。另一个非缺血组为假手术对照组。通过测量肺髓过氧化物酶(MPO)评估中性粒细胞滞留情况,并通过125I标记的牛血清白蛋白的肺血浓度比和湿干重比评估通透性。再灌注后即刻,平均动脉压降至49±2.1 mmHg并维持在该水平。R15.7单克隆抗体治疗对低血压无影响。再灌注30分钟后,循环白细胞计数降至2.91±0.53×10³/mm³,而假手术组为6.40±0.66×10³/mm³(P<0.05)。R15.7单克隆抗体治疗可防止白细胞计数下降(5.75±1.59×10³/mm³)。在生理盐水治疗的动物再灌注3小时时,MPO增加,为74.8±4.9 U/g,而假手术动物为42.0±4.8 U/g(P<0.05)。(摘要截短至250字)