The effect of blood substitute and stored blood for multiple organ dysfunction following hemorrhagic shock

1.失血性休克后肠系膜淋巴炎性介质的鉴定我们在失血性休克后肠系膜淋巴中发现了肿瘤坏死因子、细胞因子诱导的中性粒细胞趋化因子-1、亚油酸溶磷脂酰乙醇胺(LPE)、亚油酸溶磷脂酰胆碱(LPC)、花生四烯酸LPE和花生四烯酸LPC六种炎性介质。肠系膜淋巴中脂质介质生物活性的分析我们评估了我们在肠系膜淋巴中发现的溶血磷脂对人中性粒细胞的生物活性(超氧化物产生、弹性酶释放和迁移)。四种溶血磷脂以剂量依赖的方式诱导中性粒细胞的生物学活性。这是首次在肠系膜淋巴中发现炎性介质的报道。失血性休克后多器官功能衰竭(MOF)发生的部位和机制的阐明有望成为MOF治疗策略的重要环节。生物活性…失血性休克时输血后肠系膜淋巴的活性我们测定了输血大鼠肠系膜淋巴的生物活性(人中性粒细胞超氧化物产生)。与输入新鲜血液的大鼠相比，储血组大鼠肠系膜淋巴液中超氧化物歧化酶的生成显著增加。另一方面，输血大鼠肠系膜淋巴可显著降低超氧化物歧化酶的生成。因此，血液代用品有可能减轻失血性休克后的肺损伤和全身炎症反应综合征。血液代用品对失血性休克后肠道氧代谢的影响为探讨血液代用品对肠道氧代谢的影响，我们采用核磁共振波谱技术对失血性休克大鼠肠道组织氧代谢标志物乳酸和丙氨酸进行了检测。血液代用品对肠道氧代谢的改善作用与新鲜血液相当。以往的研究报道，储存血液与肠缺血和多器官功能衰竭有关。因此，血液代用品可能是治疗多器官功能衰竭的策略之一。较少

1. Identification of inflammatory mediators in mesenteric lymph following hemorrhagic shockWe found six inflammatory mediators, tumor necrosis factor, cytokine-induced neutrophil chemoattractant-1, linoleic lyso-phosphatidylethanolamine (LPE), linoleic lyso-phosphatidylcholine (LPC), arachidonic LPE, and arachidonic LPC, in mesenteric lymph following hemorrhagic shock.2. Analysis of biological activities of lipid mediators identified in mesenteric lymphWe evaluated biological activities for human neutrophils (superoxide production, elastase release, and transmigration) of lyso-phospholipids which we discovered in mesenteric lymph. Four lyso-phospholipids induced biological activities to human neutrophils in dose-dependent manner. This was the first report of the presence of inflammatory mediators in mesenteric lymph. It is expected that elucidation of the site and mechanism of production links to the strategies for multiple organ failure (MOF) after hemorrhagic shock.3. Biological acti … More vity of mesenteric lymph after transfusion of stored blood for hemorrhagic shockWe measured the biological activity (superoxide production of human neutrophil) of mesenteric lymph from rats transfused with stored blood. Compared to rats transfused with fresh blood, mesenteric lymph in stored blood group significantly increased superoxide production. On the other hand, Mesenteric lymph from rats transfused with blood substitute induced the significant decrease in superoxide production. Consequently, it is possible that blood substitute attenuates lung injury and systemic inflammatory response syndrome following hemorrhagic shock.4. The effect of blood substitute on the intestinal oxygen metabolism after hemorrhagic shockTo evaluate the effect of blood substitute on the intestinal oxygen metabolism, we measured lactate and alanine, as a maker of tissue oxygen metabolism, in the intestine exposed to hemorrhagic shock with nuclear magnetic resonance spectroscopy. Blood substitute improved the intestinal oxygen metabolism equal to fresh blood. Previous studies reported that stored blood was associated with the intestinal ischemia and MOF. Therefore, blood substitute may be one of strategy for MOF. Less