Effects of overinflation on procollagen type III expression in experimental acute lung injury
Effects of overinflation on procollagen type III expression in experimental acute lung injury
复制标题
DOI：
10.1186/cc5702
复制
发表时间：
2007-01-01
期刊：
影响因子：
15.1
通讯作者：
Deheinzelin, Daniel
中科院分区：
文献类型：
--
作者：
de Carvalho, Maria-Eudoxia Pilotto;Dolhnikoff, Marisa;Deheinzelin, Daniel
简介 在急性肺损伤 (ALI) 中，III 型原胶原 (PC III) 较早出现升高，并对预后产生不利影响。我们检查了油酸 (OA) ALI 中机械通气 (MV) 的不同高充气策略是否会改变 PC III 的区域表达。方法我们设计了一种实验、随机和对照方案，其中将大鼠分配到两个对照组（无损伤，招募[气管切开后进行肺泡募集操作，无 MV；n = 4 只大鼠]和对照组 [n = 5 只大鼠]）或四个受伤组（一组仅暴露于 OA [n = 10 只大鼠]和三组） OA-损伤和通风）。三个OA损伤组按照以下策略通气1小时：LVHP-S（低容量-高呼气末正压[PEEP]，仰卧位；n = 10只大鼠，潮气量[VT] = 8 ml/kg，PEEP = 12 cm H2O），HVLP-S（高容量-低PEEP，仰卧位；n = 10只大鼠，VT = 20 ml/kg，PEEP = 5 cm H2O）和 HVLP-P（高容量-低 PEEP，俯卧；n = 10 只大鼠）。在非依赖性和依赖性区域进行 PC III 和白细胞介素 1 β (IL-1 β) 的 Northern 印迹分析以及多形核浸润指数 (PMI) 计数。对数变换和事后检验后通过双向方差分析评估组间的区域差异。结果 PC III 中观察到组和区域效应的显着交互作用 (p = 0.012)，其中 HVLP-S 和 LVHP-S 的非依赖性区域表达较高，OA 和 HVLP-P 的表达中等，对照组的表达较低（组效应，p < 0.00001，部分 eta(2) = 0.767；区域效应，p = 0.0007，部分 eta(2) = 0.091)。我们发现 OA、HVLP-S 和 HVLP-P 组中 IL-1 beta 高表达（群体效应，p < 0.00001，部分 eta(2) = 0.944），没有区域差异（p = 0.16）。 PMI 表现相似（群体效应，p < 0.00001，部分 eta(2) = 0.832）。结论 PC III 表达在非依赖性区域和导致过度扩张的通气策略中较高。这种反应因俯卧位而部分减弱。
Introduction In acute lung injury ( ALI), elevation of procollagen type III ( PC III) occurs early and has an adverse impact on outcome. We examined whether different high-inflation strategies of mechanical ventilation ( MV) in oleic acid ( OA) ALI alter regional expression of PC III.Methods We designed an experimental, randomized, and controlled protocol in which rats were allocated to two control groups ( no injury, recruited [ alveolar recruitment maneuver after tracheotomy without MV; n = 4 rats] and control [ n = 5 rats]) or four injured groups ( one exposed to OA only [ n = 10 rats] and three OA-injured and ventilated). The three OA-injured groups were ventilated for 1 hour according to the following strategies: LVHP-S ( low volume-high positive end-expiratory pressure [ PEEP], supine; n = 10 rats, tidal volume [ VT] = 8 ml/kg, PEEP = 12 cm H2O), HVLP-S ( high volume-low PEEP, supine; n = 10 rats, VT = 20 ml/kg, PEEP = 5 cm H2O), and HVLP-P ( high volume-low PEEP, prone; n = 10 rats). Northern blot analysis for PC III and interleukin-1-beta ( IL-1 beta) and polymorphonuclear infiltration index ( PMI) counting were performed in nondependent and dependent regions. Regional differences between groups were assessed by two-way analysis of variance after logarithmic transformation and post hoc tests.Results A significant interaction for group and region effects was observed for PC III ( p = 0.012) with higher expression in the nondependent region for HVLP-S and LVHP-S, intermediate for OA and HVLP-P, and lower for control ( group effect, p < 0.00001, partial eta(2) = 0.767; region effect, p = 0.0007, partial eta(2) = 0.091). We found high expression of IL-1 beta ( group effect, p < 0.00001, partial eta(2) = 0.944) in the OA, HVLP-S, and HVLP-P groups without regional differences ( p = 0.16). PMI behaved similarly ( group effect, p < 0.00001, partial eta(2) = 0.832).Conclusion PC III expression is higher in nondependent regions and in ventilatory strategies that caused overdistension. This response was partially attenuated by prone positioning.