Chronic pneumonia with Pseudomonas aeruginosa and impaired alveolar fluid clearance -: art. no. 17
Chronic pneumonia with Pseudomonas aeruginosa and impaired alveolar fluid clearance -: art. no. 17
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DOI：
10.1186/1465-9921-6-17
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发表时间：
2005-02-11
影响因子：
5.8
通讯作者：
Guery, BP
中科院分区：
文献类型：
--
作者：
Boyer, S;Faure, K;Guery, BP
背景：虽然急性肺部感染的功能后果被广泛记录，但很少有研究关注慢性肺炎。我们评估慢性假单胞菌肺部感染对肺泡功能的影响。方法：将铜绿假单胞菌包埋于琼脂微珠中，经气管灌胃给药。第2 ~ 21天进行分析，对照组仅给予无菌琼脂球。使用血管（I-131-Albumin）和肺泡示踪剂（I-125-Albumin）测量肺泡-毛细血管屏障通透性、肺液清除率（LLC）和远端肺泡液清除率（DAFC）。结果：通透性和LLC的增加在第2天达到高峰，第5天恢复到基线。DAFC的增加独立于tnf - α或内源性儿茶酚胺的产生。尽管病原体在肺泡内持续存在，但DAFC在第5天恢复到基线。特布他林刺激不能增加DAFC。用头孢他啶根除病原体不能恢复DAFC反应。结论：从这些结果中，我们观察到随着DAFC的增加，肺泡对通透性的增加有足够的初始反应。然而，DAFC的增加在第5天后不会持续，并且对刺激没有反应。这种DAFC损伤可能部分解释了慢性感染患者对随后肺损伤的易感性更高。
Background: While the functional consequences of acute pulmonary infections are widely documented, few studies focused on chronic pneumonia. We evaluated the consequences of chronic Pseudomonas lung infection on alveolar function.Methods: P. aeruginosa, included in agar beads, was instilled intratracheally in Sprague Dawley rats. Analysis was performed from day 2 to 21, a control group received only sterile agar beads. Alveolar-capillary barrier permeability, lung liquid clearance (LLC) and distal alveolar fluid clearance (DAFC) were measured using a vascular (I-131-Albumin) and an alveolar tracer (I-125-Albumin).Results: The increase in permeability and LLC peaked on the second day, to return to baseline on the fifth. DAFC increased independently of TNF-alpha or endogenous catecholamine production. Despite the persistence of the pathogen within the alveoli, DAFC returned to baseline on the 5(th) day. Stimulation with terbutaline failed to increase DAFC. Eradication of the pathogen with ceftazidime did not restore DAFC response.Conclusions: From these results, we observe an adequate initial alveolar response to increased permeability with an increase of DAFC. However, DAFC increase does not persist after the 5th day and remains unresponsive to stimulation. This impairment of DAFC may partly explain the higher susceptibility of chronically infected patients to subsequent lung injury.