Muranaka H, Suga M, Nakagawa K, Sato K, Gushima Y, Ando M
First Department of Internal Medicine, Kumamoto University School of Medicine, Japan.
Infect Immun. 1997 Aug;65(8):3422-9. doi: 10.1128/iai.65.8.3422-3429.1997.
We produced disseminated trichosporonosis in a neutropenic murine model with Trichosporon asahii, which was identified by DNA relatedness analysis. We then assessed the efficacy of granulocyte colony-stimulating factor (G-CSF) (30 to 100 microg/kg of body weight per day) and granulocyte-macrophage colony-stimulating factor (GM-CSF) (0.8 to 2 microg/kg x day). The administration of G-CSF either before or after infection improved the survival rate from less than 25% up to 100% (P < 0.05). The effects of G-CSF on organ clearance and histological examinations were most remarkable in the lungs. The levels of tumor necrosis factor alpha (TNF-alpha) in bronchoalveolar lavage fluid (BALF) of neutropenic and G-CSF-pretreated mice were 60 +/- 6 ng/ml and 18 +/- 6 pg/ml, respectively, at 24 h after infection. Immunohistologically, alveolar macrophages proved to be the main source of TNF-alpha in BALF. GM-CSF increased neutrophil counts less significantly than did G-CSF and increased the lethality (P < 0.05) with a high level of TNF-alpha in BALF. Expecting to inhibit TNF-alpha, we administered anti-TNF-alpha intraperitoneally at the dose completely inhibiting TNF-alpha in plasma (2 x 10(4) U), but the TNF-alpha level in BALF and the lethality increased. Though the number of neutrophils at the early stage of infection appeared to be the most critical, the results suggest that other host defense mechanisms, such as TNF-alpha overproduction in the lungs, have an important role in the prognosis of trichosporonosis.
我们在中性粒细胞减少的小鼠模型中用阿萨希毛孢子菌制造了播散性毛孢子菌病,该菌通过DNA相关性分析得以鉴定。然后我们评估了粒细胞集落刺激因子(G-CSF)(每天30至100微克/千克体重)和粒细胞-巨噬细胞集落刺激因子(GM-CSF)(0.8至2微克/千克×天)的疗效。在感染前或感染后给予G-CSF可将存活率从不到25%提高至100%(P<0.05)。G-CSF对器官清除和组织学检查的作用在肺部最为显著。感染后24小时,中性粒细胞减少和G-CSF预处理小鼠的支气管肺泡灌洗液(BALF)中肿瘤坏死因子α(TNF-α)水平分别为60±6纳克/毫升和18±6皮克/毫升。免疫组织学检查显示,肺泡巨噬细胞是BALF中TNF-α的主要来源。GM-CSF增加中性粒细胞计数的作用不如G-CSF显著,且随着BALF中TNF-α水平升高增加了致死率(P<0.05)。为了抑制TNF-α,我们以完全抑制血浆中TNF-α的剂量(2×10⁴单位)腹腔注射抗TNF-α,但BALF中TNF-α水平和致死率却升高了。尽管感染早期中性粒细胞数量似乎最为关键,但结果表明其他宿主防御机制,如肺部TNF-α过度产生,在毛孢子菌病的预后中具有重要作用。