Colletti L M, Cortis A, Lukacs N, Kunkel S L, Green M, Strieter R M
Department of Surgery, University of Michigan Medical School, Ann Arbor 48109, USA.
Shock. 1998 Sep;10(3):182-91. doi: 10.1097/00024382-199809000-00006.
Tumor necrosis factor (TNF) is released during hepatic ischemia/reperfusion (I/R) and plays an important role in the ensuing neutrophil-mediated lung and liver injury. Since TNF is not a direct neutrophil chemotaxin, we hypothesized that TNF may up-regulate neutrophil adhesion molecules, specifically intercellular adhesion molecule-1 (ICAM-1), following hepatic I/R, and that this molecule then plays an important role in tissue neutrophil influx. Rats underwent 90 min of lobar hepatic ischemia with reperfusion. Pulmonary and hepatic ICAM-1 expression were assessed by reverse transcription-polymerase chain reaction, Western blot analysis, and immunohistochemical staining. Increases in hepatic ICAM-1 were demonstrated within 1 h of reperfusion, while increases in pulmonary ICAM-1 were not seen until 6 h of reperfusion. Next, rats were treated with anti-TNF antibody or control antibody without TNF neutralizing properties prior to hepatic I/R. Pretreatment with anti-TNF antibody significantly decreased pulmonary and hepatic ICAM-1 expression after hepatic I/R. We next investigated the effects of pretreatment with anti-ICAM-1 antibodies on the lung and liver injury that follows hepatic I/R. Lung injury was assessed by changes in pulmonary capillary permeability as estimated by extravasation of Evans Blue dye and pulmonary neutrophil influx as measured by lung myeloperoxidase levels. Liver injury was assessed by hepatic neutrophil morphometrics and plasma liver enzymes (alanine aminotransferase). Pretreatment with anti-ICAM-1 antibodies significantly decreased pulmonary capillary permeability, pulmonary myeloperoxidase, hepatic neutrophil influx, and plasma alanine aminotransferase, as compared to animals pretreated with control antibody. These data suggest that TNF is a proximal trigger for pulmonary and hepatic ICAM-1 up-regulation following hepatic ischemia with reperfusion, and that ICAM-1 is important for pulmonary and hepatic neutrophil influx, with the resultant tissue injury, following hepatic I/R.
肿瘤坏死因子(TNF)在肝脏缺血/再灌注(I/R)过程中释放,并在随后由中性粒细胞介导的肺和肝损伤中起重要作用。由于TNF不是直接的中性粒细胞趋化因子,我们推测TNF可能在肝脏I/R后上调中性粒细胞黏附分子,特别是细胞间黏附分子-1(ICAM-1),并且该分子随后在组织中性粒细胞浸润中起重要作用。对大鼠进行90分钟的叶状肝缺血再灌注。通过逆转录-聚合酶链反应、蛋白质印迹分析和免疫组织化学染色评估肺和肝ICAM-1的表达。再灌注1小时内肝脏ICAM-1增加,而肺ICAM-1直到再灌注6小时才增加。接下来,在肝脏I/R之前,用抗TNF抗体或无TNF中和特性的对照抗体处理大鼠。用抗TNF抗体预处理可显著降低肝脏I/R后肺和肝ICAM-1的表达。我们接下来研究了用抗ICAM-1抗体预处理对肝脏I/R后肺和肝损伤的影响。通过伊文思蓝染料外渗估计的肺毛细血管通透性变化和通过肺髓过氧化物酶水平测量的肺中性粒细胞浸润来评估肺损伤。通过肝中性粒细胞形态计量学和血浆肝酶(丙氨酸转氨酶)评估肝损伤。与用对照抗体预处理的动物相比,用抗ICAM-1抗体预处理可显著降低肺毛细血管通透性、肺髓过氧化物酶、肝中性粒细胞浸润和血浆丙氨酸转氨酶。这些数据表明TNF是肝脏缺血再灌注后肺和肝ICAM-1上调的近端触发因素,并且ICAM-1对于肝脏I/R后肺和肝中性粒细胞浸润以及由此导致的组织损伤很重要。