Pinault G C, Sanson A J, Malangoni M A
Department of Surgery, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, Ohio 44109-1998, USA.
J Trauma. 1997 Dec;43(6):911-5. doi: 10.1097/00005373-199712000-00007.
Resuscitated hemorrhagic shock causes global ischemia reperfusion with generation of toxic oxygen metabolites. We hypothesized that the immunosuppression that follows hemorrhagic shock may be linked to this process.
Forty-five male Sprague-Dawley rats (weight, 250-300 g) were bled to a mean arterial pressure of 30 mm Hg for 60 minutes, then were resuscitated with three times the maximum blood loss of lactated Ringer's solution. Immune response was assessed by splenocyte proliferation and interleukin-2 (IL-2) production 72 hours after hemorrhage. Allopurinol (50 mg/kg) was given after hemorrhage and immediately before resuscitation.
Hemorrhagic shock caused significant decreases in splenocyte proliferation (cpm: (157,880 +/- 22,068 (mean +/- SD) vs. 37,787 +/- 15,849) and IL-2 production (1/2 max U/ml: 79.6 +/- 7.9 vs. 48.0 +/- 7.7) (both p < 0.05). Hepatic xanthine oxidase was significantly increased with hemorrhage and resuscitation. Hepatic xanthine oxidase activity after hemorrhage and resuscitation was significantly decreased after treatment with allopurinol (74.2 +/- 41.7 vs. 9.2 +/- 9.40). Allopurinol did not affect splenocyte proliferation (cpm: 21,875 +/- 9,316) or IL-2 production (1/2 max U/ml: 45.0 +/- 7.1).
These results demonstrate that inhibition of xanthine oxidase by allopurinol after hemorrhagic shock did not affect splenocyte proliferation or IL-2 production. We conclude that the immunosuppression after hemorrhagic shock is not dependent on xanthine oxidase-induced production of toxic oxygen metabolites.
复苏后的失血性休克会导致全身缺血再灌注,并产生有毒的氧代谢产物。我们推测失血性休克后的免疫抑制可能与这一过程有关。
45只雄性Sprague-Dawley大鼠(体重250 - 300克)被放血至平均动脉压30毫米汞柱并持续60分钟,然后用三倍于最大失血量的乳酸林格氏液进行复苏。在出血72小时后,通过脾细胞增殖和白细胞介素-2(IL-2)产生来评估免疫反应。在出血后且复苏前立即给予别嘌呤醇(50毫克/千克)。
失血性休克导致脾细胞增殖显著降低(每分钟计数:(157,880 ± 22,068(平均值±标准差)对37,787 ± 15,849))以及IL-2产生显著降低(最大活性的1/2单位/毫升:79.6 ± 7.9对48.0 ± 7.7)(两者p < 0.05)。出血和复苏后肝脏黄嘌呤氧化酶显著增加。用别嘌呤醇治疗后,出血和复苏后的肝脏黄嘌呤氧化酶活性显著降低(74.2 ± 41.7对9.2 ± 9.40)。别嘌呤醇不影响脾细胞增殖(每分钟计数:21,875 ± 9,316)或IL-2产生(最大活性的1/2单位/毫升:45.0 ± 7.1)。
这些结果表明,失血性休克后别嘌呤醇对黄嘌呤氧化酶的抑制并不影响脾细胞增殖或IL-2产生。我们得出结论,失血性休克后的免疫抑制不依赖于黄嘌呤氧化酶诱导产生的有毒氧代谢产物。