Yamashita M, Tanaka J, Yamashita M
Department of Emergency Medicine, University of Tsukuba School of Medicine, Amakubo, Japan.
Surg Today. 1997;27(2):159-62. doi: 10.1007/BF02385907.
The role of cytokines in hemorrhagic shock remains controversial, with some studies showing an elevation of cytokines, whereas others do not. We thus analyzed the changes in tumor necrosis factor (TNF) activity and in mRNA of TNF alpha, interleukin-1beta (IL-1beta), and interleukin-6 (IL-6) after transient and prolonged hypotension. In the transient hypotension group (TH group), chronically cannulated rats were bled (20 ml/kg x 3 min) without fluid resuscitation. They showed transient hypotension, but their blood pressure (BP) quickly stabilized. In the prolonged hypotension group (PH group), the rats were bled and maintained at a mean BP of 40 mmHg for 60 min, and then were resuscitated with the shed blood and an equal volume of saline over 60 min. The serum TNF activity was measured by cytotoxicity against the L929 tumorigenic murine fibroblast. Messenger RNA of TNF alpha, IL-1beta, and IL-6 in liver was measured semi-quantitatively by high-performance liquid chromatography after reverse transcription and polymerase chain reaction. The increases in the TNF activity were not significant in either of the groups above the prehemorrhage levels, whereas mRNA of TNF alpha and IL-1beta showed a transient elevation in the TH group and a persistent elevation in the PH group. IL-6 mRNA did not increase significantly in the TH group, but did increase in the PH group. These results show that a large hemorrhage induces cytokine mRNA in the liver and also show the differences in the changes of cytokine mRNA after transient and prolonged hypotension.
细胞因子在失血性休克中的作用仍存在争议,一些研究显示细胞因子水平升高,而另一些研究则未发现此现象。因此,我们分析了短暂性和持续性低血压后肿瘤坏死因子(TNF)活性以及TNF-α、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)mRNA的变化。在短暂性低血压组(TH组),对长期插管的大鼠进行放血(20 ml/kg×3分钟),不进行液体复苏。它们出现了短暂性低血压,但血压(BP)很快稳定下来。在持续性低血压组(PH组),大鼠放血后维持平均血压40 mmHg达60分钟,然后在60分钟内用放出的血液和等量的生理盐水进行复苏。通过对L929致瘤性小鼠成纤维细胞的细胞毒性测定血清TNF活性。逆转录和聚合酶链反应后,采用高效液相色谱法半定量测定肝脏中TNF-α、IL-1β和IL-6的信使RNA。上述两组中,TNF活性高于出血前水平的升高均不显著,而TNF-α和IL-1β的mRNA在TH组出现短暂升高,在PH组持续升高。IL-6 mRNA在TH组未显著增加,但在PH组增加。这些结果表明,大出血可诱导肝脏中的细胞因子mRNA,并显示了短暂性和持续性低血压后细胞因子mRNA变化的差异。