Ventilation-Mediated Injury After Preterm Delivery of Ureaplasma parvum Colonized Fetal Lambs
Ventilation-Mediated Injury After Preterm Delivery of Ureaplasma parvum Colonized Fetal Lambs
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DOI：
10.1203/pdr.0b013e3181dbbd18
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发表时间：
2010-06-01
影响因子：
3.6
通讯作者：
Jobe, Alan H.
中科院分区：
文献类型：
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作者：
Polglase, Graeme R.;Hillman, Noah H.;Jobe, Alan H.
脲原体是最常从早产妇女中分离出的微生物，与支气管肺发育不良的风险增加有关。采用高潮气量（V-T）开始通气会导致肺损伤和炎症。我们调查了是否产前定植与脲原体血清型3（UP）将改变炎症反应的早产羔羊机械通气。美利奴母羊在妊娠55天羊膜内注射UP，羔羊在妊娠128 +/- 1天手术分娩，并分为三组：1）轻度通气（GV），2）高V-T通气，或3）不通气对照组。从非殖民化母羊交付的羔羊被分配到平行组。GV羔羊在通气前接受表面活性剂，V-T为7 mL/kg，呼气末正压（PEEP）为5 cm H2O。高V-T羔羊不接受PEEP，并在15 min时将V-T升高至15 mL/kg。支气管肺泡灌洗液中单核细胞增多，但定植不影响肺功能。与GV相比，高V-T通气增加了Egr-1信号传导、促炎细胞因子表达和损伤评分。UP的脑内定植并不改变肺功能或调节由高V-T通气引起的肺损伤和炎症。（Pediatr Res 67：630-635，2010）
Ureaplasma species are the microorganisms most frequently isolated from women with preterm birth and are associated with an increased risk of bronchopulmonary dysplasia. Initiation of ventilation with high tidal volumes (V-T) causes lung injury and inflammation. We investigated whether antenatal colonization with Ureaplasma parvum serovar 3 (UP) would alter the inflammatory response to mechanical ventilation of preterm lambs. Merino ewes were given intraamniotic injections of UP at 55-d gestation, and the lambs were surgically delivered at 128 +/- 1 d gestation and assigned to three groups: 1) gentle ventilation (GV), 2) high V-T ventilation, or 3) unventilated control. Lambs delivered from noncolonized ewes were assigned to parallel groups. GV lambs received surfactant before ventilation with a V-T of 7 mL/kg, positive end expiratory pressure (PEEP) 5 cm H2O High V-T lambs received no PEEP and escalating V-T to 15 mL/kg by 15 min. At 15 min, surfactant was given, V-T was reduced to 7 mL/kg, and PEEP was increased to 5 cm H2O. Monocytes in bronchoalveolar lavage were increased by UP, but colonization did not affect lung function. High V-T ventilation increased Egr-1 signaling, proinflammatory cytokine expression, and injury scores compared with GV. Antenatal colonization with UP did not change lung function or modulate the lung injury and inflammation caused by high V-T ventilation. (Pediatr Res 67: 630-635, 2010)