Steinhauser M L, Hogaboam C M, Kunkel S L, Lukacs N W, Strieter R M, Standiford T J
Department of Medicine, University of Michigan Medical School, Ann Arbor 48109-0360, USA.
J Immunol. 1999 Jan 1;162(1):392-9.
To explore the mechanism of immunosuppression associated with sepsis, we developed a murine model of sepsis-induced Pseudomonas aeruginosa pneumonia. CD-1 mice underwent either cecal ligation and 26-gauge needle puncture (CLP) or sham surgery, followed by the intratracheal (i.t.) administration of P. aeruginosa or saline. Survival in mice undergoing CLP followed 24 h later by the i.t. administration of saline or P. aeruginosa was 58% and 10%, respectively, whereas 95% of animals undergoing sham surgery followed by P. aeruginosa administration survived. Increased mortality in the CLP/P. aeruginosa group was attributable to markedly impaired lung bacterial clearance and the early development of P. aeruginosa bacteremia. The i.t. administration of bacteria to CLP-, but not sham-, operated mice resulted in an impressive intrapulmonary accumulation of neutrophils. Furthermore, P. aeruginosa challenge in septic mice resulted in a relative shift toward enhanced lung IL-10 production concomitant with a trend toward decreased IL-12. The i.p., but not i.t., administration of IL-10 Abs given just before P. aeruginosa challenge in septic mice significantly improved both survival and clearance of bacteria from the lungs of septic animals administered P. aeruginosa. Finally, alveolar macrophages isolated from animals undergoing CLP displayed a marked impairment in the ability to ingest and kill P. aeruginosa ex vivo, and this defect was partially reversed by the in vivo neutralization of IL-10. Collectively, these observations indicate that the septic response substantially impairs lung innate immunity to P. aeruginosa, and this effect is mediated primarily by endogenously produced IL-10.
为探究脓毒症相关免疫抑制的机制,我们构建了脓毒症诱导的铜绿假单胞菌肺炎小鼠模型。CD-1小鼠接受盲肠结扎和26号针头穿刺(CLP)或假手术,随后经气管内(i.t.)给予铜绿假单胞菌或生理盐水。CLP术后24小时再经i.t.给予生理盐水或铜绿假单胞菌的小鼠,其生存率分别为58%和10%,而接受假手术并给予铜绿假单胞菌的动物95%存活。CLP/铜绿假单胞菌组死亡率增加归因于肺部细菌清除明显受损以及铜绿假单胞菌菌血症的早期发生。向CLP手术而非假手术的小鼠经i.t.给予细菌导致肺内中性粒细胞显著积聚。此外,脓毒症小鼠受到铜绿假单胞菌攻击后导致肺内白细胞介素-10(IL-10)产生相对增加,同时白细胞介素-12(IL-12)有下降趋势。在脓毒症小鼠受到铜绿假单胞菌攻击前经腹腔内(i.p.)而非i.t.给予IL-10抗体,可显著提高脓毒症动物(给予铜绿假单胞菌)的生存率及肺部细菌清除率。最后,从接受CLP的动物分离的肺泡巨噬细胞在体外摄取和杀灭铜绿假单胞菌的能力明显受损,且这种缺陷通过体内中和IL-10得以部分逆转。总体而言,这些观察结果表明脓毒症反应严重损害了肺部对铜绿假单胞菌的固有免疫,且这种效应主要由内源性产生的IL-10介导。