Dunzendorfer S, Schratzberger P, Reinisch N, Kähler C M, Wiedermann C J
Department of Internal Medicine, Medical Faculty, University of Innsbruck, Austria.
Ann N Y Acad Sci. 1997 Dec 15;832:330-40. doi: 10.1111/j.1749-6632.1997.tb46261.x.
TNF is produced by monocytes/macrophages in response to endotoxin, which may lead to septic shock. TNF stimulates neutrophil adherence, degranulation, and superoxide production, but inhibits neutrophil migration. A mitigating anti-inflammatory effect can be experimentally induced in septic shock by TNF blockers, such as pentoxifylline, and is also suggested for treatment with hrG-CSF. With regard to the combination of pentoxifylline and hrG-CSF, the purpose of this investigation was to explore whether and in what way the effects of hrG-CSF and pentoxifylline interact with each other in neutrophils. To this end, we studied the effects of pentoxifylline on TNF- and G-CSF-induced modulation of neutrophil chemotaxis and O2 release. TNF and G-CSF decreased directed migration of neutrophils to FMLP or IL-8. High-dose pentoxifylline (1 mM) was able to counteract the effect of TNF but not that of G-CSF on neutrophil migration. In the presence of pentoxifylline, TNF and G-CSF were unable to stimulate respiratory burst. In contrast, pre-exposure of cells to pentoxifylline followed by washing increased the priming effect of TNF or hrG-CSF on neutrophil respiratory burst activity. The methylxanthine derivative by itself showed no effect on spontaneous and fMLP-stimulated O2 release by neutrophils. Stimulation of neutrophil respiratory burst by pentoxifylline may not be detectable in the presence of pentoxifylline due to its known oxygen-radical scavenging function. Results suggest that by blocking the inflammatory action of TNF on neutrophils, pentoxifylline may diminish endothelial cell damage caused by inhibited neutrophil chemotaxis. On the other hand, since transiently present pentoxifylline may enhance the respiratory burst activity of TNF- or hrG-CSF-primed neutrophils, concomitant administration of pentoxifylline and hrG-CSF to patients with SIRS/sepsis might diminish beneficial effects of the latter and additional deleterious effects might occur.
肿瘤坏死因子(TNF)由单核细胞/巨噬细胞对内毒素作出反应而产生,这可能导致感染性休克。TNF刺激中性粒细胞黏附、脱颗粒和超氧化物生成,但抑制中性粒细胞迁移。通过TNF阻滞剂(如己酮可可碱)可在实验中诱导感染性休克产生减轻炎症的效应,并且也有人建议用人重组粒细胞集落刺激因子(hrG-CSF)进行治疗。关于己酮可可碱与hrG-CSF的联合使用,本研究的目的是探讨hrG-CSF和己酮可可碱的作用在中性粒细胞中是否以及以何种方式相互影响。为此,我们研究了己酮可可碱对TNF和G-CSF诱导的中性粒细胞趋化性和氧释放调节的影响。TNF和G-CSF降低了中性粒细胞向N-甲酰甲硫氨酸-亮氨酸-苯丙氨酸(FMLP)或白细胞介素-8(IL-8)的定向迁移。高剂量己酮可可碱(1 mM)能够抵消TNF对中性粒细胞迁移的影响,但不能抵消G-CSF的影响。在己酮可可碱存在的情况下,TNF和G-CSF无法刺激呼吸爆发。相反,细胞预先暴露于己酮可可碱后洗涤,会增加TNF或hrG-CSF对中性粒细胞呼吸爆发活性的启动作用。甲基黄嘌呤衍生物本身对中性粒细胞的自发和FMLP刺激的氧释放没有影响。由于己酮可可碱具有已知的氧自由基清除功能,在其存在的情况下可能无法检测到它对中性粒细胞呼吸爆发的刺激作用。结果表明,通过阻断TNF对中性粒细胞的炎症作用,己酮可可碱可能减少因中性粒细胞趋化性受抑制而导致的内皮细胞损伤。另一方面,由于短暂存在的己酮可可碱可能增强TNF或hrG-CSF启动的中性粒细胞的呼吸爆发活性,因此对全身炎症反应综合征/脓毒症患者同时给予己酮可可碱和hrG-CSF可能会削弱后者的有益作用,并且可能会产生额外的有害作用。