INTERLEUKIN-1 INDUCED NEUTROPHIL MEDIATED ARDS

由于未知的原因，患有ARDS的患者具有增加的白细胞介素（IL-1）， 中性粒细胞、过氧化氢（H2 O2）和肺水肿， 肺部和全身氧化-抗氧化平衡改变的证据。 我们的假设是来自黄嘌呤氧化酶的有毒O2自由基 (XO)和/或嗜中性粒细胞导致给予IL-1或IL-2的大鼠的肺渗漏。 ARDS患者。 O2自由基通过过氧化脂质、氧化 谷胱甘肽（GSH），灭活抗蛋白酶，消耗维生素E- 这些过程导致肺渗漏并进一步激活嗜中性粒细胞。 我们认为，这些事件与细胞外的增加有关， 在SOD、过氧化氢酶、XO、髓过氧化物酶（MPO）、GSSG和H2）中， 并改变这些过程。 我们的初步数据支持这一假设。 肠内IL-1引起 中性粒细胞聚集和嗜中性粒细胞依赖性肺渗漏， 与肺GSSG水平增加相关的完整大鼠。 泄漏 DMSO、超临界流体雾化 维生素E、脂质体包封的PGE或N-乙酰半胱氨酸--在一些情况下 即使在IL-1损伤后给予这些干预措施的情况下。IL-1 也引起离体肺渗漏和灌注液过氧化氢酶增加 灌注正常中性粒细胞，但不灌注热灭活中性粒细胞 其不能产生O2自由基。 同时，MnSOD、过氧化氢酶和 弹性蛋白酶-α 1 Pi复合物在脓毒症患者血液中增加， 与无ARDS的脓毒症患者相比。 我们当前的具体目标是确定 对于气管内给予IL-1或分离的IL-1的完整大鼠的肺渗漏， 用中性粒细胞灌注的处理的大鼠肺。 我们的调查涉及 确定中性粒细胞、XO、氧化损伤的关系 以及用IL-1处理的肺中细胞外标记物的出现。 调查还包括研究一个精心挑选的 一系列干预措施，不仅定义了这些过程， 可以潜在地用于治疗ARDS患者。 平行研究 将评估患有和有风险的患者的中性粒细胞和血清 ARDS作为ARDS进展和干预的函数。 这些研究的意义在于（1）提高对 急性肺损伤的基本机制，（2）获得新的 关于预测和功能价值的信息， 细胞外标志物和（3）识别和定义干预， 可能有助于治疗或预防ARDS。

For unknown reasons, patients wit ARDS have increased interleukin (IL-1), neutrophils, hydrogen peroxide (H202) and edema in their lungs and evidence of an altered lung and systemic oxidant-antioxidant balance. Our hypothesis is that toxic O2 radicals derived from xanthine oxidase (XO) and/or neutrophils contribute to lung leak in rats given IL-1 or ARDS patients. O2 radicals cause leak by peroxidizing lipids, oxidizing glutathione (GSH), inactivating antiprotease, and depleting vitamin E- processes which contribute to lung leak and further activate neutrophils. We propose that these events are associated with extracellular increases in SOD, catalase, XO, myeloperoxidase (MPO), GSSG and H2) which reflect and alter these processes. Our preliminary data supports this premise. Intratracheal IL-1 caused neutrophil accumulation and a neutrophil-dependent leak in lungs of intact rats which is associated with increased lung GSSG levels. Leak was decreased by treatment with DMSO, supercritical fluid aerosolized vitamin E, liposomal encapsulated PGE, or N-acetylcysteine-- in some cases even when these interventions are given after the IL-1 insult. IL-1 also caused leak and perfusate catalase increases in isolated lungs perfused with normal neutrophils but not heat-inactivated neutrophils which fail to make 02 radicals. In parallel, MnSOD, catalase and elastase-alpha1Pi complexes were increased in the blood of septic patients with ARDS compared to septic patients without ARDS. Our immediate specific aims are to determine the mechanisms responsible for lung leak in intact rats given IL-1 intratracheally or isolated IL-1 treated rat lungs perfused with neutrophils. Our investigations involve determination of the relationship of neutrophils, XO, oxidative injury and the appearance of extracellular markers in lungs treated with IL-1. Investigation also involves study of the effect of a carefully selected sequence of interventions that not only define these processes but also can potentially be used for treating ARDS patients. Parallel studies will evaluate neutrophils and serum from patients with and at risk for ARDS as a function of ARDS progression and intervention. The significance of these studies is (1) to improve understanding of fundamental mechanisms responsible for acute lung injury, (2) to gain new information regarding the predictive and functional value of extracellular markers and (3) to identify and define interventions which might be useful in treating or preventing ARDS.