Energy metabolism and reperfusion injury on cold ischemia of lungs.

我们比较了单糖（葡萄糖）、二糖（海藻糖、麦芽糖、蔗糖）和三糖（棉子糖）的防腐效果，以研究海藻糖对肺防腐的影响是否取决于其分子量、能量水平维持和细胞保护作用。肺保护剂的作用可能取决于其细胞保护作用，而不是损伤活性或能量水平的维持。海藻糖被证明是上级的其他物质。能量消耗与实体器官的缺血-再灌注（I-R）损伤密切相关，但对于含有空气的肺还没有结论。我们研究了离体大鼠肺模型在冷藏过程中的肺泡状态及其与能量代谢和I-R损伤的关系。分别于4℃下将大鼠肺放气（DEF组）、充气（RA组）或充氮（N2组）6 h，收集再灌注液或支气管肺泡灌洗液（BALF）。测定肺静态顺应性、肺内高能磷酸盐、乳酸盐和丙酮酸盐水平。DEF组和N2组肺功能明显差于RA组。N2组肺内能荷水平和丙酮酸/乳酸比值显著低于DEF组和RA组，而DEF组和RA组之间无显著差异。DEF组BALF中总蛋白和乳酸脱氢酶显著高于N2组和RA组，而静态肺顺应性显著低于N2组和RA组。我们的结论是，有氧代谢将是必不可少的衰减I-R损伤的肺，和充气的肺泡将是必要的，以避免机械损伤，在再扩张。

We compared the preservative effects of a monosaccharide (glucose), disaccharides (trehalose, maltose, sucrose), and a trisaccharide (raffinose) to investigate whether or not the effects of saccharides on lung preservation depend on their molecular weight, energy-level maintenance and cytoprotective effects. The effects of saccharides may depend on their cytoprotective effect rather than on impairment activity or energy-level maintenance of the preserved lung. Trehalose proved to be superior to the other saccharides.Energy depletion closely correlates with ischemia-reperfusion (I-R) injury in solid organs, but there has been no conclusion about the lungs that contain air. We investigated the alveolar state during cold storage and its relation to energy metabolism and I-R injury in an ex-vivo rat lung model. The lung was deflated (DEF group) or inflated with either room air (RA group) or nitrogen (N2 group) for six hours at 4℃, and reperfused or bronchoalveolar lavage fluid (BALF) was collected (N=6, each). Furthermore, the static lung compliance, the intrapulmonary levels of high energy phosphates, lactate and pyruvate were measured. The pulmonary functions of the DEF and N2 groups were significantly worse than those of the RA group. In the N2 group, the intrapulmonary levels of energy charge and pyruvate/lactate ratio were significantly lower than those in the DEF and RA groups, while there were no significant differences between the DEF and RA groups. In the DEF group, total protein and lactate dehydrogenase in the BALF were significantly higher while the static lung compliance was significantly lower compared with the N2 and RA groups. We concluded that aerobic metabolism would be essential for attenuating I-R injury of the lung, and inflation of the alveoli would be necessary for avoiding mechanical damage during re-expansion.