Sehic E, Li S, Ungar A L, Blatteis C M
Department of Physiology and Biophysics, University of Tennessee, Memphis, Memphis, Tennessee 38163, USA.
Am J Physiol. 1998 Jun;274(6):R1594-603. doi: 10.1152/ajpregu.1998.274.6.R1594.
Although it is generally believed that circulating exogenous pyrogens [e.g., lipopolysaccharides (LPS)] induce fever via the mediation of endogenous pyrogens (EP) such as cytokines, the first of these, tumor necrosis factor-alpha, is usually not detectable in blood until at least 30 min after intravenous administration of LPS, whereas the febrile rise begins within 15 min after its administration. Moreover, although abundant evidence indicates that circulating LPS is cleared primarily by liver macrophages [Kupffer cells (KC)], these do not secrete EP in immediate response. This would imply that other factors, presumably evoked earlier than EP, may mediate the onset of the febrile response to intravenous LPS. It is well known that blood-borne LPS very rapidly activates the intravascular complement (C) system, some components of which in turn stimulate the quick release into blood of various substances that have roles in the acute inflammatory reaction. KC contain receptors for C components and are in close contact with afferent vagal terminals in the liver; the involvement of hepatic vagal afferents in LPS-induced fever has recently been shown. In this study, we tested the hypothesis that the initiation of fever by intravenous LPS involves, sequentially, the C system and KC. To test this postulated mechanism, we measured directly the levels of prostaglandin E2 (PGE2) in the interstitial fluid of the preoptic anterior hypothalamus (POA), the presumptive site of the fever-producing controller, of conscious guinea pigs over their entire febrile course, before and after C depletion by cobra venom factor (CVF) and before and after elimination of KC by gadolinium chloride (GdCl3). CVF and GdCl3 pretreatment each individually attenuated the first of the biphasic core temperature (Tc) rises after intravenous LPS, inverted the second into a Tc fall, and greatly reduced the usual fever-associated increase in POA PGE2. We conclude, therefore, that C activation may indeed be pivotal in the induction of fever by intravenous LPS and that substance(s) generated presumably by KC in almost immediate reaction to the presence of LPS and/or C may transmit pyrogenic signals via hepatic vagal afferents to the POA, where they rapidly induce the production of PGE2 and, hence, fever.
尽管人们普遍认为,循环中的外源性致热原[如脂多糖(LPS)]通过细胞因子等内源性致热原(EP)的介导来引发发热,但在静脉注射LPS后至少30分钟内,血液中通常检测不到其中最早出现的肿瘤坏死因子-α,而发热反应在注射后15分钟内就开始了。此外,尽管大量证据表明循环中的LPS主要由肝脏巨噬细胞[库普弗细胞(KC)]清除,但这些细胞并不会立即分泌EP。这意味着其他因素,可能比EP更早被诱发,可能介导了对静脉注射LPS的发热反应的起始。众所周知,血源性LPS能非常迅速地激活血管内补体(C)系统,其中一些成分继而刺激多种在急性炎症反应中起作用的物质快速释放到血液中。KC含有C成分的受体,并与肝脏中的传入迷走神经末梢紧密接触;最近已证实肝脏迷走神经传入在LPS诱导的发热中起作用。在本研究中,我们检验了这样一个假说,即静脉注射LPS引发发热依次涉及C系统和KC。为了检验这一假定机制,我们在清醒豚鼠整个发热过程中,在通过眼镜蛇毒因子(CVF)耗竭C之前和之后,以及在通过氯化钆(GdCl3)清除KC之前和之后,直接测量了视前区下丘脑前部(POA)间质液中前列腺素E2(PGE2)的水平,POA被认为是发热产生控制器的所在部位。CVF和GdCl3预处理各自单独减弱了静脉注射LPS后双相核心体温(Tc)升高的第一阶段,使第二阶段转变为Tc下降,并大大降低了POA中PGE2通常与发热相关的升高。因此,我们得出结论,C激活在静脉注射LPS诱导发热过程中可能确实起关键作用,并且可能由KC在几乎对LPS和/或C的存在立即做出反应时产生的物质,可能通过肝脏迷走神经传入将致热信号传递至POA,在那里它们迅速诱导PGE2的产生,从而引发发热。