Hofford J M, Milakofsky L, Pell S, Vogel W
Department of Pharmacology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
J Lab Clin Med. 1996 Dec;128(6):545-51. doi: 10.1016/s0022-2143(96)90126-2.
The identification of plasma markers of the course of the acute respiratory distress syndrome (ARDS) is needed to improve its treatment and to further advance the development of new therapeutic agents. The status of markers of lung injury in ARDS is reviewed and some new potential markers are proposed. This study focused on plasma amino acids, related amino compounds, and catecholamine levels during the acute phase of endotoxin-induced lung injury in 8 sheep characterized by the onset of pulmonary edema caused by increased microvascular permeability. A number of significant changes from baseline values were found. During the sixth hour of a 12-hour period of endotoxin infusion, norepinephrine, epinephrine, and alanine levels increased whereas the isoleucine level decreased. During the sixth hour of the immediate postendotoxin period, the taurine level increased while the levels of arginine, citrulline, glycine, isoleucine, methionine, ornithine, serine, threonine, and tryptophan decreased. These findings are compared with prior studies in human subjects detailing the amino acid profile characteristic of advanced sepsis. We conclude that the present profile of catecholamine and amino acid changes during endotoxemia in sheep deserves further study in human subjects to determine its significance as a marker of the early stage of ARDS.
为了改善急性呼吸窘迫综合征(ARDS)的治疗并进一步推进新型治疗药物的研发,需要确定该疾病病程中的血浆标志物。本文综述了ARDS中肺损伤标志物的状况,并提出了一些新的潜在标志物。本研究聚焦于8只绵羊在内毒素诱导的肺损伤急性期的血浆氨基酸、相关氨基化合物和儿茶酚胺水平,该损伤以微血管通透性增加导致肺水肿发作为特征。研究发现了许多与基线值相比的显著变化。在内毒素输注12小时期间的第6小时,去甲肾上腺素、肾上腺素和丙氨酸水平升高,而异亮氨酸水平降低。在内毒素输注后即刻的第6小时,牛磺酸水平升高,而精氨酸、瓜氨酸、甘氨酸、异亮氨酸、蛋氨酸、鸟氨酸、丝氨酸、苏氨酸和色氨酸水平降低。这些发现与先前在人类受试者中详细描述晚期脓毒症氨基酸谱特征的研究进行了比较。我们得出结论,绵羊内毒素血症期间儿茶酚胺和氨基酸变化的当前情况值得在人类受试者中进一步研究,以确定其作为ARDS早期标志物的意义。