Goto M, Zeller W P, Picken M, Goto M P, Hurley R M
Department of Pediatrics, Stritch School of Medicine, Loyola University of Chicago, Maywood, IL 60153.
Circ Shock. 1993 May;40(1):53-60.
Gram-negative sepsis/septic shock in the newborn continues to be a major medical problem, causing high mortality. Hyperglycemia followed by hypoglycemia is a common symptom in endotoxic shock. However, the mechanism of newborn glucoregulatory response to endotoxin has not been well understood. Paradoxically, monocyte-phagocytes can contribute to shock by overwhelming secretion of cytokines and also host defense by detoxifying endotoxin. Since monocyte-phagocyte function is immature in the newborn, this study was performed to evaluate Kupffer cell's role in liver glycogenolysis during endotoxic shock. Endotoxin (LPS) induced hyperglycemia in 10-day-old rats, and increased net glucose output in the isolated perfused liver. 1) Cytarabine decreased Kupffer cell function (decreased hepatic colloid carbon uptake) and blunted LPS-increased liver net glucose output in the Cytarabine + LPS-treated group (104 +/- 4 vs. 146 +/- 3 micrograms/min/g wet liver in the LPS-treated group: P < .001). 2) Indomethacin (IND) suppressed LPS-induced liver net glucose output in the LPS + IND-treated group (133 +/- 5 vs. 146 +/- 3 micrograms/min/g wet liver, P < .05). Thus, prostaglandins were suggested to contribute to glycogenolysis in the 10-day-old rat liver. 3) Phorbol 12-myristate 13-acetate (PMA) increased liver net glucose output (166 +/- 4 micrograms/min/g wet liver), and H-7, a protein kinase C inhibitor, blunted PMA-induced liver glucose output (140 +/- 2 micrograms/min/g wet liver, P < .05). H-7 enhanced LPS-induced liver net glucose output (196 +/- 9 micrograms/min/g wet liver, P < .01). Therefore, protein kinase C may not be the dominant cell signaling system for LPS stimulation in suckling rat Kupffer cells.
新生儿革兰氏阴性菌败血症/感染性休克仍然是一个主要的医学问题,导致高死亡率。高血糖继之以低血糖是内毒素休克的常见症状。然而,新生儿对内毒素的葡萄糖调节反应机制尚未完全明了。矛盾的是,单核吞噬细胞可因细胞因子的大量分泌而导致休克,也可通过对内毒素解毒而起到宿主防御作用。由于新生儿单核吞噬细胞功能不成熟,本研究旨在评估内毒素休克期间库普弗细胞在肝糖原分解中的作用。内毒素(LPS)可使10日龄大鼠发生高血糖,并增加离体灌注肝脏的葡萄糖净输出量。1)阿糖胞苷降低了库普弗细胞功能(肝胶体碳摄取减少),并减弱了阿糖胞苷+LPS处理组中LPS增加的肝脏葡萄糖净输出量(LPS处理组为146±3微克/分钟/克湿肝,阿糖胞苷+LPS处理组为104±4微克/分钟/克湿肝:P<0.001)。2)吲哚美辛(IND)抑制了LPS+IND处理组中LPS诱导的肝脏葡萄糖净输出量(LPS+IND处理组为133±5微克/分钟/克湿肝,LPS处理组为146±3微克/分钟/克湿肝,P<0.05)。因此,提示前列腺素有助于10日龄大鼠肝脏的糖原分解。3)佛波酯(PMA)增加了肝脏葡萄糖净输出量(166±4微克/分钟/克湿肝),而蛋白激酶C抑制剂H-7减弱了PMA诱导的肝脏葡萄糖输出量(140±2微克/分钟/克湿肝,P<0.05)。H-7增强了LPS诱导的肝脏葡萄糖净输出量(196±9微克/分钟/克湿肝,P<0.01)。因此,蛋白激酶C可能不是乳鼠库普弗细胞中LPS刺激的主要细胞信号系统。