Progressive, severe lung injury secondary to the interaction of insults in gastric aspiration
Progressive, severe lung injury secondary to the interaction of insults in gastric aspiration
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DOI：
10.1080/01902140490489162
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发表时间：
2004-10-01
影响因子：
1.7
通讯作者：
Holm, BA
中科院分区：
文献类型：
--
作者：
Knight, PR;Davidson, BA;Holm, BA
本研究检查了成年大鼠经气管内滴注盐酸（酸）、非酸性胃小颗粒（SNAP）或酸和小颗粒联合（CASP）后24小时内的肺损伤和炎症。根据PaO 2/FiO 2、支气管肺泡灌洗（BAL）白蛋白和BAL细胞数量，CASP的损伤严重程度和持续时间显著大于酸或SNAP。与CASP吸入性损伤相关的炎症反应在几个方面是不同的。与SNAP或酸相比，CASP中肿瘤坏死因子（TNF）-α显著降低，而白细胞介素（IL）-1 β升高。与其他形式的抽吸相比，在CASP损伤的动物中，灌洗液中的苦参碱诱导的中性粒细胞化学引诱物（CINC）-1、单核细胞化学引诱蛋白（MCP）-1和IL-10的水平也显著增加。统计分析显示，IL-10的BAL水平与6小时和24小时抽吸损伤动物中的白蛋白渗漏最强相关，其次是MCP-1的BAL水平。另外的细胞因子簇分析表明，来自所有损伤动物的BAL中的MCP-1和CINC-1水平与抽吸后6小时和24小时的炎性中性粒细胞数目强相关，并且BAL中的IL-10水平与24小时的炎性细胞数目强相关。初步阻断实验显示，在SNAP和CASP动物中，给予抗IL-10抗体增加了6小时的白蛋白渗透指数，但抗MCP-1抗体不影响损伤的严重程度。本研究的结果支持不同形式的抽吸与可识别的细胞因子谱相关的可能性，并且特定的细胞因子（包括IL-10和MCP-1）可在临床应用中作为诊断或预后标记物。
This study examines lung injury and inflammation over 24 hours following intratracheal instillation of hydrochloric acid (acid), small nonacidic gastric particles (SNAP), or combined acid and small particles (CASP) in adult rats. The severity and duration of injury was significantly greater for CASP compared to acid or SNAP based on PaO2/FiO2, bronchoalveolar lavage (BAL) albumin, and BAL cell numbers. The inflammatory response associated with aspiration injury from CASP was distinct in several respects. Tumor necrosis factor (TNF)-alpha was greatly reduced in CASP compared to SNAP or acid, whereas interleukin (IL)-1beta was increased. Levels of cytokine-induced neutrophil chemoattractant (CINC)-1, monocyte chemoattractant protein (MCP)-1, and IL-10 in lavage were also significantly increased in animals injured with CASP compared to other forms of aspiration. Statistical analysis showed that BAL levels of IL-10 correlated most strongly with albumin leakage in aspiration-injured animals at 6 and 24 hours, followed by BAL levels of MCP-1. Additional cytokine cluster analyses indicated that levels of MCP-1 and CINC-1 in BAL from all injured animals were strongly correlated with inflammatory neutrophil numbers at 6 and 24 hours post aspiration, and that IL-10 levels in BAL were strongly correlated with inflammatory cell numbers at 24 hours. Preliminary blocking experiments showed that administration of anti-IL-10 antibody increased the albumin permeability index at 6 hours in SNAP and CASP animals, but anti-MCP-1 antibody did not affect the severity of injury. The results of this study support the possibility that different forms of aspiration are associated with identifiable cytokine profiles, and that specific cytokines, including IL-10 and MCP-1, may have utility as diagnostic or prognostic markers in clinical applications.