Effects of positive end-expiratory pressure, inhaled nitric oxide and surfactant on expression of proinflammatory cytokines and growth factors in preterm piglet lungs
Effects of positive end-expiratory pressure, inhaled nitric oxide and surfactant on expression of proinflammatory cytokines and growth factors in preterm piglet lungs
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呼气末正压、吸入一氧化氮和表面活性剂对早产仔猪肺促炎细胞因子和生长因子表达的影响
DOI：
10.1203/pdr.0b013e31817330a6
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发表时间：
2008-07-01
影响因子：
3.6
通讯作者：
Sun, Bo
中科院分区：
文献类型：
--
作者：
Qian, Liling;Liu, Haipei;Sun, Bo
我们假设出生后早期未成熟肺中促炎细胞因子和生长因子（GF）的不平衡可能受到保护性通气策略的影响，并评估了这些方面的相关性。对早产仔猪进行机械通气，采用低潮气量和 5-6 或 10-12 cm H2O 呼气末正压 (PEEP)，加或不加表面活性剂和吸入一氧化氮 (iNO)，持续 6 小时，然后对肺损伤严重程度进行生化、生物物理和组织病理学评估。与表面活性剂和对照组相比，iNO联合较低PEEP的氧合效果更好，髓过氧化物酶活性较低，白细胞介素（IL）-1β、IL-6、IL-8和血小板衍生生长因子-B（PDGF-B）mRNA表达较低，但胰岛素样生长因子-I（IGF-I）表达较高，而肿瘤坏死因子-a、角质形成细胞GF、肝细胞GF、血管内皮生长的表达较高。因子和 TGF-β1 没有变化或变化不大。 IL-1β、IL-6 mRNA与PDGF-B mRNA和髓过氧化物酶密切相关，但与IGF-I mRNA、Pao(2)/FiO(2)和6小时动态肺顺应性呈负相关。这些结果表明，较低的 PEEP 和 iNO 的联合可能比表面活性剂更能通过影响促炎细胞因子和 GF 的表达来预防肺损伤并促进修复。
We hypothesized that imbalance of proinflammatory cytokines and growth factors (GFs) in immature lungs of early postnatal life may be affected by protective ventilation strategy, and evaluated correlations of these aspects. Preterm neonate piglets were mechanically ventilated with low tidal volume and 5-6 or 10-12 cm H2O positive end-expiratory pressure (PEEP) with or without surfactant and inhaled nitric oxide (iNO) for 6 h, followed by biochemical, biophysical, and histopathological assessment of lung injury severity. Compared with surfactant and the control, iNO combined with lower PEEP exerted better oxygenation, lower activity of myeloperoxidase, lower expression of mRNA of interleukin (IL)-1 beta, IL-6, IL-8, and platelet derived growth factor-B (PDGF-B), but higher expression of insulin-like growth factor-I (IGF-I), whereas that of tumor necrosis factor-a, keratinocyte GF, hepatocyte GF, vascular endothelial growth factor, and TGF-beta 1 had no or modest changes. IL-1 beta, IL-6 mRNA were closely correlated to PDGF-B mRNA and myeloperoxidase, but inversely to IGF-I mRNA, Pao(2)/FiO(2) and dynamic lung compliance at 6 h. These results indicate that the association of lower PEEP and iNO may be more protective than surfactant on preventing lung injury and facilitating reparation by affecting the expression of proinflammatory cytokines and GFs.