Expression of inducible nitric oxide synthase and inflammatory cytokines in alveolar macrophages of ARDS following sepsis
Expression of inducible nitric oxide synthase and inflammatory cytokines in alveolar macrophages of ARDS following sepsis
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DOI：
10.1378/chest.113.6.1632
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发表时间：
1998-06-01
期刊：
影响因子：
9.6
通讯作者：
Ashihara, T
中科院分区：
文献类型：
--
作者：
Kobayashi, A;Hashimoto, S;Ashihara, T
研究目的：本研究的目的是评估肺泡巨噬细胞（AM）中诱导型一氧化氮合酶（iNOS）和促炎细胞因子在脓毒症后ARDS发病机制中的作用，地点：一所大学医院的ICU。设计：进行了前瞻性探索性、开放性研究。患者：总共调查了24名患者：8名诊断为脓毒症后患有ARDS的患者（ARDS组）；手术室全身麻醉肺功能正常的患者8例（对照组）； 8例在ICU插管人工通气1周，肺功能未恶化，未达到ARDS标准，一般状态符合脓毒症标准（长期通气组，或LTV组）。 测量及结果：BAL液中iNOS、白细胞介素1β（IL-1β）、白细胞介素6（IL-6）、白细胞介素8（IL-8）在AR中的表达(BALF)通过免疫荧光技术测定。仅在ARDS组中观察到iNOS、IL-6和IL-8的显着表达，同时，APDS组BALF上清液中NOx（NO2-+NO3-之和）升高，BALF上清液和血清中IL-6和IL-8水平也升高。仅在对照组和 LTV 组中未检测到显着表达。结论：仅在脓毒症后的 ARDS 患者中检测到 iNOS 的结果表明，iNOS 与 AM 产生的促炎细胞因子一起可能在急性肺损伤的发病机制中发挥关键作用，并可用于监测此类情况下的肺部疾病。
Study objective: The objective of this study was to evaluate the role of inducible nitric oxide synthase (iNOS) and proinflammatory cytokines in alveolar macrophages (AMs) in the pathogenesis of ARDS following sepsis,Setting: ICU in a university hospital.Design: Prospective exploratory, open-labeled study was carried out.Patients: A total of 24 patients were investigated: 8 patients diagnosed as having ARDS following sepsis (ARDS group); 8 patients under general anesthesia in the operating room whose lung functions were normal (control group); and 8 patients who were intubated and artificially ventilated for 1 week in the ICU whose lung functions were not deteriorated without fulfilling the ARDS criteria and whose general state fulfilled the sepsis criteria (long-term ventilation group, or LTV group).Measurements and results: The expression of iNOS, interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and interleukin-8 (IL-8) in AR ls obtained from BAL fluid (BALF) was determined by the immunofluorescent technique. We observed the significant expression of iNOS, IL-6, and IL-8 only in the ARDS group, Meanwhile, NOx (the sum of NO2- + NO3-) was elevated in the BALF supernatant, and IL-6 and IL-8 levels in both the BALF supernatant and the serum were also elevated in the APDS group. No significant expressions Mere detected in the control and the LTV group,Conclusions: The result that iNOS, was detected only in ARDS patients following sepsis suggests that iNOS together with proinflammatory cytokines produced by AMs might play a pivotal role in the pathogenesis of acute lung injury and be useful for monitoring disorders in the lung in such conditions.