The adult respiratory distress syndrome. Cell populations and soluble mediators in the air spaces of patients at high risk.
The adult respiratory distress syndrome. Cell populations and soluble mediators in the air spaces of patients at high risk.
复制标题
成人呼吸窘迫综合征。
DOI：
10.1164/ajrccm/136.5.1225
复制
发表时间：
1987
期刊：
影响因子：
--
通讯作者：
Webster,RO
中科院分区：
文献类型：
--
作者：
Fowler,AA;Hyers,TM;Fisher,BJ;Bechard,DE;Centor,RM;Webster,RO
为了更好地了解成人呼吸窘迫综合征 (ARDS) 发展过程中多形核中性粒细胞流入肺部的调节，我们评估了对照受试者 (n = 9)、发生 ARDS 高风险患者 (n = 12) 和 ARDS 患者 (n = 11) 的支气管肺泡灌洗液的细胞和蛋白质含量以及促进中性粒细胞粘附到组织培养塑料的能力。对高危患者和 ARDS 患者灌洗液的分析显示，细胞总数增加 8 至 10 倍，中性粒细胞百分比增加（对照受试者 = 1 ± 0.4%，高危 = 53 ± 8%，ARDS = 70 ± 7%），蛋白质含量增加 10 至 40 倍。用浓缩灌洗液、BALF 超滤液或血浆样品预处理后，测定正常中性粒细胞对塑料表面的粘附，以评估每种物质的中性粒细胞粘附促进活性。与对照灌洗液相比，来自高危患者和 ARDS 患者的灌洗液促进中性粒细胞粘附性增加约 3 倍。血浆和灌洗滤液（分子量<500道尔顿）的中性粒细胞粘附促进活性与对照受试者没有显着差异。 ARDS 灌洗中发现的粘附促进活性在 56°C 30 分钟内保持稳定。较高的温度 (100° C) 和暴露于胰蛋白酶或兔抗人 C5a 会降低但不会消除活性。这些结果表明，ARDS 高危患者的中性粒细胞流入气腔和通透性变化发生在该综合征发生之前。此外，在 ARDS 发作之前，能够增强中性粒细胞粘附的物质存在于空气空间中，但不存在于血浆中。这些物质具有脂质和蛋白质的共同特征。
In order to better understand the modulation of polymorphonuclear neutrophil influx into the lung during the development of the adult respiratory distress syndrome (ARDS), we evaluated bronchoalveolar lavage fluids from control subjects (n = 9), patients at high risk of developing ARDS (n = 12), and patients with ARDS (n = 11) for cellular and protein content and capacity to promote neutrophil adhesion to tissue culture plastic. Analysis of the lavage fluids from high risk patients and patients with ARDS showed an 8- to 10-fold increase in the total number of cells, an increase in the percentage of neutrophils present (control subjects = 1 ± 0.4%, high risk = 53 ± 8%, ARDS = 70 ± 7%), and a 10- to 40-fold increase in protein content. The adherence of normal neutrophils to plastic surfaces after pretreatment with either concentrated lavage fluid, ultrafiltrates of BALF, or plasma samples was determined to evaluate the neutrophil adherence-promoting activity of each. Lavage fluid from high risk patients and patients with ARDS promoted an approximate 3-fold increase in neutrophil adherence when compared with control lavage fluid. Neutrophil adhesion-promoting activity of the plasma and lavage filtrates (mw < 500 daltons) was not significantly different from that of control subjects. The adherence-promoting activity found in ARDS lavage was stable at 56° C for 30 min. Higher temperatures (100° C) and exposure to trypsin or rabbit antihuman-C5a reduced, but did not abolish, activity. These results indicate that neutrophil influx into the air spaces and permeability changes in patients at high risk for ARDS occur prior to development of the syndrome. Further, substances capable of enhancing neutrophil adhesion are present in the air spaces, but not in plasma, prior to the onset of ARDS. These substances share both lipid and protein characteristics.