人参皂苷Rg5对脓毒血症大鼠急性肺损伤的保护作用

目的:观察人参皂苷Rg5对脓毒血症大鼠引起急性肺损伤(ALI)的作用.方法:30只大鼠建立盲肠结扎穿孔法(CLP)脓毒症模型,随机均分为以下3组(n=10):阴性对照组(Sham组)、CLP组及CLP+Rg5组.各组分别于手术后24 h时检测大鼠血清TNF-、IL-6、高迁移率族蛋白1(HMGB1)及IL-10含量;手术24 h后检测肺组织干湿重比(W/D)、髓过氧化物酶活性(MPO)及NF-кB活性;HE法进行肺组织学评分.结果:CLP+Rg5组血浆及肺组织HMGB1和TNF-水平明显低于CLP组(P＜0.05).CLP+Rg5组肺组织W/D、MPO活性、NF-кB活性及肺组织损伤评分均明显低于CLP组(P＜0.05).IL-10水平24h时在各组动物比较结果差异无统计学意义(P＞0.05).结论:人参皂苷Rg5可以改善脓毒血症引起ALI时炎症反应从而发挥肺保护作用.     

富氢液对大鼠脓毒血症引起急性肺损伤的影响

目的:探讨富氢液对大鼠脓毒血症引起急性肺损伤的影响。方法:24只大鼠建立盲肠结扎穿孔法(CLP)脓毒症模型,随机均分为以下3组(n=8):假手术组(Sham组)、CLP组及CLP+富氢液组。CLP+富氢液组于CLP后即时、6及18 h腹腔分别注射富氢液5 ml/kg,CLP组及假手术组于上述相应时间点腹腔注射富氢液5 ml/kg。CLP或假手术24 h后检测肺组织TNF-α、IL-6、HMGB1、IL-10、MDA、SOD、MPO活性及干湿重比(W/D)并采用HE染色法进行肺组织学评分。结果:与Sham组比较,CLP组及CLP+富氢液组肺组织TNF-α、IL-6、HMGB1、IL-10、MDA、SOD、MPO活性、W/D及肺组织学评分明显升高而SOD活性明显降低(P<0.05);与CLP组相比,CLP+富氢液组IL-6、HMGB1、MDA、MPO明显降低及肺组织学评分明显降低而SOD明显升高(P<0.05)。结论:富氢液降低脓毒血症的炎性反应和氧化应激,从而改善ALI时的肺功能。     

电针对脓毒症大鼠肺炎症反应和高迁移率族蛋白B1的影响

摘要 目的：研究电针足三里对脓毒症大鼠肺脏炎症反应和病理损伤的调节,为脓毒症的临床治疗提供新的理论依据。方法：成年雄性SD大鼠40只,按照随机数字表法分为假手术组（sham组）、脓毒症（盲肠结扎穿刺术( Cecal ligation and puncture, CLP)组）、脓毒症+假电针组（非经非穴组）和脓毒症+电针足三里组（足三里组）,每组10只。除第一组外,其余大鼠均采用盲肠结扎穿孔术（CLP）制备脓毒症大鼠模型;造模前,脓毒症+假电针组选择非经非穴处电针刺激,脓毒症+电针足三里组给予足三里穴位电针处理,电针参数为疏密波,2 Hz,1 mA,持续30 min,连续5天。术后24 h,先取支气管肺泡灌洗液, 再取右肺测湿干重比,取左肺下叶观察病理学改变,取左肺上叶检测炎症因子肿瘤坏死因子-α(Tumor necrosis factor, TNF-α)、白介素-1(interleukin -1, IL-1β)、白介素-6(interleukin-6, IL-6)和HMGB1。结果：与sham组比较,CLP组大鼠肺组织出现明显病理损伤（均P＜0.05）,炎症因子明显升高（均P＜0.01）,高迁移率族蛋白1（High mobility group 1 protein, HMGB1）明显升高(P＜0.05);经过电针足三里处理,脓毒症大鼠肺组织病理损伤明显减轻（P＜0.05）,炎症因子明显降低（均P＜0.01）,HMGB1明显减少(P＜0.05)。CLP组与非经非穴组大鼠生存率、肺组织病理损伤、炎症因子和HMGB1无明显差异,差异无统计学意义（均P＞0.05）。结论：电针足三里可以减轻脓毒症大鼠肺的炎症反应和组织损伤,降低其肺脏HMGB1水平。     

饱和氢气生理盐水对盲肠结扎穿孔大鼠肺损伤的干预作用*

目的: 观察饱和氢气生理盐水对盲肠结扎穿孔(CLP)大鼠肺组织的作用。方法: 将24只健康雄性SD大鼠(体重250~300 g)随机分成4组(每组6只):①假手术对照组(Sham组)+生理盐水组:盲肠根部穿过丝线,不行结扎和穿孔,手术前10 min腹腔注射生理盐水(10 mg/kg);②CLP组+生理盐水组:结扎盲肠根部并用18号针头穿刺2个孔,2个孔相距约1cm,手术前10 min腹腔注射生理盐水(10 mg/kg);③Sham+H₂组:手术前10 min腹腔注射饱和氢气生理盐水(10 mg/kg); ④CLP+ H₂组:手术前腹腔注射饱和氢气生理盐水(10 mg/kg)。各组于手术后8 h进行观察:采用生物化学和RT-PCR的方法分别检测大鼠肺组织中CSE/H₂S体系的变化。采用H₂S供体硫氢化钠(NaHS)诱导的肺组织损伤动物模型,另取32只健康雄性SD大鼠(体重250~300 g),随机分为4组(每组8只):①生理盐水组:腹腔注射生理盐水(10 mg/kg);②H₂S组:腹腔注射H₂S供体NaHS(56 μmol/kg);③H₂S+H₂组:腹腔注射NaHS前10 min注射饱和氢气生理盐水(10 mg/kg);④H₂组:腹腔注射生理盐水前10 min注射饱和氢气生理盐水(10 mg/kg)。于给药后8 h测定肺系数,检测肺组织中MDA含量、MPO活性及细胞因子TNF-α、IL-6和IL-10含量,观察肺组织形态学变化。结果: 饱和氢气生理盐水可抑制CLP大鼠肺组织中CSE/H₂S体系:减少CLP大鼠肺组织中H₂S的生成,抑制H₂S的合成酶CSE的活性及mRNA表达 (P均＜0.05);外源性给予H₂S(NaHS)可造成肺组织损伤,饱和氢气生理盐水可明显减轻H₂S所致的肺组织损伤:大鼠肺系数明显减小(P＜ 0.05),MDA含量下降(P＜0.05);肺组织MPO活性下降(P＜0.05);大鼠肺间质和肺泡中PMN的浸润程度明显减轻,肺组织形态及IQA接近正常(P＜0.05)。结论: 饱和氢气生理盐水可通过抑制CLP大鼠肺组织中CSE/H₂S体系,发挥其改善CLP大鼠肺组织损伤的作用。     

苹果多酚对野百合碱诱导的肺动脉高压大鼠肺血管重构的作用和机制

目的:探讨苹果多酚抑制肺动脉高压大鼠肺动脉血管重构的作用及其机制。方法:雄性SD大鼠随机分为对照组(Con),野百合碱(MCT)组,苹果多酚(APP)组,野百合碱+苹果多酚(MCT+APP)组,每组9只。Con组:每天皮下注射1ml生理盐水;APP组:隔天按20mg/kg的剂量腹腔注射苹果多酚;MCT组:按60mg/kg剂量一次性皮下注射MCT;MCT+APP组:一次性皮下注射60mg/kg剂量MCT,隔天按20mg/kg剂量腹腔注射APP,所有处理持续3周。建模完成后,检测各组大鼠平均肺动脉压(mPAP),肺血管阻力(PVR),右心室肥厚指数(RVHI),肺动脉血管环外周长比值(WT%),肺小血管管壁面积和管总面积比值(WA%)。检测肺组织中的白细胞介素1(IL-1),白细胞介素6(IL-6),肿瘤坏死因子α(TNF-α),环氧化酶2(COX-2),髓过氧化物酶(MPO)等炎症通路相关指标,及肺动脉平滑肌细胞内Ca2+和内皮细胞eNOS,NO含量。结果:MCT组大鼠与对照组比较,在动物水平的指标mPAP、PVR、RVHI、WA%、WT%和肺动脉组织内IL-1,IL-6,TNF-α,COX-2,MPO表达量以及肺动脉平滑肌细胞内的Ca2+浓度明显升高(P<0.05),而内皮细胞中的eNOS,NO含量明显下降(P<0.05);苹果多酚治疗组与MCT组大鼠相比上述情况得到改善,其中COX-2和Ca2+指标明显下降,且具有统计学意义(P<0.05)。结论:苹果多酚可通过抑制MCT引起的肺组织内IL-1,IL-6,TNF-α,COX-2升高和肺动脉平滑肌细胞内Ca2+升高以及内皮细胞中eNOS,NO降低,抑制平滑肌细胞增殖,逆转肺血管重构,缓解肺动脉高压。     

雌孕激素对ALI大鼠α-ENaC、BNP、TNF-α表达的影响

目的:研究雌孕激素对ALI大鼠II型肺泡上皮细胞钠通道(epithelial Na+channel,ENaC)α亚基,血清脑钠肽(brain natriuretic peptide,BNP)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达的影响,探讨肺泡内液体清除的机制。方法:雌性未成年SD大鼠30只,随机分为3组:对照组(静脉注入生理盐水8 mL/kg)、ALI模型组(静脉注入油酸0.1 mL/kg)、雌孕激素联合组(在油酸注入前12 h、36 h皮下注射1∶1 000雌孕激素混合液0.1 mL)。建模后6 h处死大鼠,观察肺组织病理改变,测定肺湿重/干重比值、肺系数,肺组织匀浆中α-ENaC mRNA及蛋白的表达及血清BNP、TNF-α的表达。结果:与对照组比较,模型组出现明显肺水肿、出血及炎性细胞浸润,肺湿重/干重比值、肺系数及血清中BNP、TNF-α表达增加,而α-ENaC mRNA及蛋白明显降低(P<0.01);雌孕激素联合组与ALI模型组比较,肺水肿、出血及炎性细胞浸润要轻,肺湿重/干重比值、肺系数、BNP下降,α-ENaC mRNA及蛋白增加(P<0.05)。结论:雌孕激素联合治疗可上调α-ENaC mRNA及蛋白的表达,减少BNP表达,促进肺泡内液体的清除,为ALI/急性呼吸窘迫综合症(ARDS)的治疗和监控提供新的方法。     

姜黄素干预油酸诱导的ALI/ARDS大鼠模型对NF-κB、TNF-α和IL-6的影响

急性肺损伤(acute lung injury,ALI)/急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)发病机制的大量研究表明核因子κB(nuclear factor kappa B,NF-κB)激活是其发生、发展的中心环节.姜黄素作为治疗ALI/ARDS的可能潜在性药物的作用和机制尚不明晰.该研究将大鼠随机分为正常组(C组)、模型组(M组)、二甲基亚砜(D组)和姜黄素治疗组(T组),通过大鼠ALI/ARDS模型,利用光镜H.E.染色观察肺部组织形态学变化,比较肺湿/干重(W/D),酶联免疫吸附法(ELISA)测定支气管肺泡灌洗液(bronchoalveolarlavage fluid,BALF)中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白细胞介素-6(interleukin-6,IL-6)含量动态变化,以及间接免疫荧光染色和免疫印记(Western blot)检测肺组织NF-κB蛋白水平变化,分析姜黄素对ALI的保护作用以及NF-κB、TNF-α和IL-6水平的影响.研究发现造模后4 h,M组BALF中TNF-α、IL-6升高并达高峰(P<0.05);姜黄素干预后,T组肺组织病理学改变减轻,BALF中蛋白渗出、TNF-α和IL-6明显减少(P<0.05).间接免疫荧光检测和Western blot结果显示C组大鼠肺组织蛋白抽提物中存在少量NF-κB蛋白,而M组明显升高,在4 h时达高峰,这一峰值出现时间与造模后肺内炎性损伤因子TNF-α、IL-6释放的高峰时间相吻合.姜黄素治疗后T组肺组织提取物NF-κB水平显著低于M组,且在12 h达高峰(P<0.05).D组与M组各检测指标未见差异(P>0.05).结果表明姜黄素能明显抑制ALI/ARDS后的NF-κB的表达,抑制炎性反应,对ARDS可能具有潜在治疗价值.     

淫羊藿苷及宝藿苷Ⅰ对气管切开模型大鼠肺组织病理学及炎症因子的影响

目的探讨淫羊藿苷及其代谢产物宝藿苷I对气管切开模型大鼠肺组织病理及炎症的影响。方法将72只SPF级雄性SD大鼠随机分成四组,正常对照组(A)、模型非用药组(B)、模型+宝藿苷I组(C)、模型+淫羊藿苷组(D),每组18只。制备大鼠气管切开插管留置模型。模型成功6h后给予C组宝藿苷I,D组淫羊藿苷干预,A、B组给与等量0.9%生理盐水。分别在24、72、168h取肺组织及肺泡灌洗液。肺组织用苏木精-伊红染色(HE染色),光镜下观察分析肺组织的病理学改变;ELISA检测肺泡灌洗液白细胞介素6(IL-6),肿瘤坏死因子α(TNF-α)表达。结果1)肺组织病理结果显示:气管切开后B组大鼠肺损伤程度随时间延长逐渐加重,明显高于A组(P<0.05)。C、D组肺损伤程度均明显轻于B组,且D组在24、168h均明显轻于C组(P<0.05)。D组在168h病理评分明显降低(与24h比较P<0.01)。(2)肺泡灌洗液IL-6、TNF-α含量:气管切开插管后大鼠肺泡灌洗液IL-6和TNF-α含量在三个时段均明显高于A组(P<0.05)。用宝藿苷I和淫羊藿苷干预后,C、D组IL-6、TNF-α含量在72、168h明显低于B组(P<0.05);且C、D组组内IL-6和TNF-α含量在72、168h明显低于24h(P<0.05);D组与C组相比,IL-6含量无明显统计学差异(P>0.05)。D组TNF-α在72h、168h均明显低于C(P<0.05)。结论宝藿苷I和淫羊藿苷对气管切开术后早期肺部炎症有一定疗效,其机制与抑制肺泡灌洗液炎症因子IL-6、TNF-α的表达,减轻肺组织损伤有关,且淫羊藿苷效果更佳。     

脓毒症致大鼠急性肾损伤中炎症介质的变化及机制探讨

目的观察脓毒症致大鼠急性肾损伤(AKI)中血清和肾脏组织中炎症介质的变化及肾脏组织中核因子-κB(NF-κB)的表达,探讨脓毒症致大鼠急性肾损伤的可能机制。方法雄性SD大鼠随机分为假手术组(Sham组)和盲肠结扎穿孔组(CLP组)。CLP组大鼠采用盲肠结扎穿孔法建立脓毒症动物模型,Sham组除不结扎穿孔盲肠外,其余处理同脓毒症组。分别于造模后6h、12h和24h观察各组大鼠血清肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平,肾脏组织中Toll样受体4(TLR4)和高迁移率族蛋白B1(HMGB1)mRNA表达;免疫组化法检测肾小管中NF-κB p65的表达,分析NF-κB p65核阳性率。结果与相同时间点Sham组比较,CLP组6h~12h大鼠血清TNF-α和IL-6水平明显升高(P0.01),CLP组6h~24h大鼠肾脏组织中TLR4mRNA表达明显升高(P0.01),CLP组12h~24h大鼠肾脏组织中HMGB1mRNA表达明显升高(P0.01),CLP组6h~24h大鼠肾小管中NF-κB p65核阳性率升高(P0.05~P0.01)。结论随脓毒症致AKI病程的延长,大鼠肾脏组织中TLR4和HMGB1mRNA表达和NF-κB p65核阳性率明显升高,其机制可能与TLR4介导的炎症通路密切相关。     

褪黑素对PM 2.5暴露大鼠肺部炎症反应和氧化应激的影响

为探讨褪黑素对大气细颗粒物(PM 2.5)暴露大鼠肺部炎症反应和氧化应激的影响及其机制,本实验将48只清洁级SD大鼠随机(随机数字法)分成4组:空白对照组、NS对照组、PM 2.5组及褪黑素(MT)组,通过气管向肺内注入PM 2.5悬液构建大鼠肺组织PM 2.5染毒模型,并通过灌胃MT溶液,采用肺组织HE染色、ELISA法及蛋白印迹等方法分别检测肺组织病理改变、TNF-α、IL-6、IL-1、MPO、SOD及MDA表达以及NF-κBp65蛋白表达。结果显示:(1)与空白对照组及NS对照组比较,PM 2.5组大鼠肺组织出现明显损伤改变,MT组大鼠肺组织损伤较PM 2.5组明显减轻;(2)PM 2.5组大鼠肺组织TNF-α、IL-6、IL-1表达出现明显增加(p0.05),MT组较PM 2.5组TNF-α、IL-6、IL-1表达明显下降(p0.05);(3)PM 2.5组大鼠肺组织SOD表达较空白对照组及NS对照组明显下降(p0.05),而MPO及MDA表达明显增加(p0.05),而与PM 2.5组比较,MT组大鼠肺组织SOD表达出现增加,MPO及MDA表达下降(p0.05);(4)PM 2.5组P65蛋白表达出现明显上调(p0.05),而MT组较PM 2.5组P65蛋白表达出现明显下降(p0.05)。由此得出结论,PM 2.5能通过介导肺组织炎性反应及氧化应激导致肺组织损伤,且与活化NF-κB相关,褪黑素能显著抑制PM 2.5所致NF-κB活化,减轻炎性反应及氧化应激,改善PM 2.5暴露大鼠肺损伤。     

Effect of penehyclidine hydrochloride on expressions of MAPK in mice with CLP-induced acute lung injury

Penehyclidine hydrochloride (PHC) is a new anticholinergic drug. PHC has been shown to have a good curative effect for sepsis. Mitogen-activated protein kinase (MAPK) has recently been considered to play an important role in sepsis. In this study, the role of MAPK signal pathways in protective effects of PHC preconditioning on acute lung injury in cecal ligation and puncture (CLP)-induced sepsis was investigated. Healthy female mice were randomly divided into 4 groups: sham control, CLP, and 0.3 or 0.45 mg/kg PHC. At 12 h after surgery, arterial blood was drawn for blood gas analysis, and lung tissue samples were collected to examine pulmonary microvascular permeability, IL-6 levels and myeloperoxidase (MPO) activity. MAPK protein expressions were measured using western blot technique. Compared with sham control mice, acute lung injury was induced in CLP group, which was indicated by decreased PaO₂/FiO₂, increased pulmonary microvascular permeability, IL-6 levels and MPO activity. Furthermore, mice’ exposure to CLP induced the increased protein levels of MAPK. Treatment of 0.45 mg/kg PHC markedly improved PaO₂/FiO₂, decreased pulmonary microvascular permeability, IL-6 levels and MPO activity, and inhibited expressions of extracellular signal-regulated kinase (ERK1/2) and p38 MAPK. Taken together, these results suggest that PHC ameliorated acute lung injury through the inhibition of extracellular signal-regulated kinase (ERK1/2) and p38 MAPK activation in septic mice.     

脓毒症患者血清HMGB1、IGF-1水平变化及与T淋巴细胞亚群、预后的关系研究

目的:探讨脓毒症患者血清高迁移率族蛋白1(HMGB1)、胰岛素样生长因子-1(IGF-1)水平变化及与T淋巴细胞亚群、预后的关系。方法:选取2016年2月～2018年12月期间我院收治的脓毒症患者139例,根据Sepsis 3.0定义,将脓毒症患者分成一般脓毒症组(n=73)及脓毒症休克组(n=66),根据患者进入重症监护室28d后的转归资料,将其分为存活组和死亡组。比较不同预后、不同病情严重程度的脓毒症患者血清IGF-1、HMGB1水平、急性病生理与慢性健康评价系统Ⅱ(APACHEⅡ)评分以及T淋巴细胞亚群;采用Pearson相关分析血清HMGB1、IGF-1水平与T淋巴细胞亚群、APACHEⅡ评分的关系。结果:一般脓毒症组CD3~+、CD4~+、CD4~+/CD8~+高于脓毒症休克组,CD8~+低于脓毒症休克组(P0.05)。脓毒症休克组血清HMGB1水平、APACHEⅡ评分均高于一般脓毒症组,血清IGF-1水平则低于一般脓毒症组(P0.05)。存活组CD8~+低于死亡组,CD3~+、CD4~+、CD4~+/CD8~+高于死亡组(P0.05)。存活组血清HMGB1水平、APACHEⅡ评分低于死亡组,血清IGF-1水平高于死亡组(P0.05)。Pearson相关分析显示,脓毒症患者血清HMGB1水平与CD8~+、APACHEⅡ评分呈正相关,与CD3~+、CD4~+、CD4~+/CD8~+呈负相关(P0.05);血清IGF-1水平与CD8~+、APACHEⅡ评分呈负相关,与CD3~+、CD4~+、CD4~+/CD8~+呈正相关(P0.05)。结论:脓毒症血清HMGB1、T淋巴细胞亚群、IGF-1均存在异常变化,可用于评估脓毒症患者的病情和预后。     

脓毒症小鼠心肌损伤与中性粒细胞浸润的关系

目的:探讨脓毒症小鼠心肌损伤与中性粒细胞浸润的关系。方法:复制脓毒症动物模型,分对照组、假手术组、造模组,并设不同的时间点(2h、4h、8h、12h)。采用双抗夹心酶联免疫法(ELISA)检测血清肌钙蛋白(IcTnI),并测心肌组织髓过氧化物酶(MPO)活性。结果:正常组与假手术组各时间点血清cTnI、心肌组织MPO活性均无显著性差异。造模组心肌组织MPO活性较正常组和假手术组均有明显升高(P<0.05),且随着时间进展而增加;造模组血清cTnI浓度随着时间进展而增加,2小时与正常组及假手术组无显著性差异(P>0.05),4小时后显著高于正常组和假手术组(P<0.05);血清cTnI浓度与心肌组织MPO活性呈显著正相关(r=0.700,P=0.000)。结论:脓毒症心肌损伤时,心肌组织存在中性粒细胞浸润,中性粒细胞浸润程度与心肌损伤显著正相关。     

α2A-AR antagonism by BRL-44408 maleate attenuates acute lung injury in rats with downregulation of ERK1/2, p38MAPK,and p65 pathway

Acute respiratory distress syndrome (ARDS), characterized by acute hypoxic respiratory dysfunction or failure, is a manifestation of multiple organ failure in the lung, and the most common risk factor is sepsis. We previously showed that blocking α₂-adrenoceptor (α₂-AR) could attenuate lung injury induced by endotoxin in rats. α_2A-adrenoceptor (α_2A-AR), a subtype of α₂-AR plays a key role in inflammatory diseases, but the mechanism remains unknown. Here, we explored the effect of BRL-44408 maleate (BRL), a specific α_2A-AR antagonist, on cecal ligation puncture (CLP)-induced ARDS in rats and the underlying mechanism. Preadministration of BRL-44408 maleate significantly alleviated CLP-induced histological injury, macrophage infiltration, inflammatory response, and wet/dry ratio in lung tissue. However, there was no statistical difference in survival rate between the CLP and CLP+BRL groups. Extracellular regulated protein kinase (ERK1/2), p38MAPK, and p65 were activated in the CLP group, and BRL-44408 maleate inhibited the activation of these signal molecules, c-Jun N-terminal kinase (JNK) and protein kinase A (PKA) showed no changes in activation between these two groups. BRL-44408 maleate decreased lipopolysaccharide (LPS)-induced expression of cytokines in NR8383 rat alveolar macrophages and reduced phosphorylation of ERK1/2, p38MAPK, and p65. JNK and PKA were not influenced by LPS. Together, these findings suggest that antagonism of α_2A-AR improves CLP-induced acute lung injury and involves the downregulation of ERK1/2, p38MAPK, and p65 pathway independent of the activation of JNK and PKA.     

IL-27 和PCT 联合检测在不同分型的脓毒症危重患者中的诊断价值

目的：探讨白细胞介素-27（Interleukin 27,IL-27）对成人全身炎症反应综合征（systemic inflammatory response syndrome, SIRS）和脓毒症的诊断价值。方法：214 例SIRS患者按入院诊断结果及感染源不同分为非脓毒症组（n＝80）、肺源性脓毒症组（n＝ 73）和非肺源性脓毒症组（n＝ 61）。采用酶联免疫吸附试验（ELISA）检测各组患者血清IL-27 和降钙素原（PCT）水平;绘制受试者 工作特征曲线（ROC）,判断各指标的诊断价值,分析各生物标志物的性能,判断潜在的预测变量。结果：肺源性脓毒症患者体温符 合SIRS 标准的比例为65.8%,明显高于非脓毒症患者（45.0%）及非肺源性脓毒症患者（45.9%）（P ＜ 0.05）;非肺源性脓毒症患者白 细胞数符合SIRS标准的比例为68.9%,明显高于非脓毒症患者42.5%,（P ＜ 0.05）。确诊脓毒症后的患者血清IL-27 的AUC 为 0.655,PCT的AUC 为0.649。根据不同感染源进一步分析,肺源性和非肺源性脓毒症患者血清IL-27 水平明显高于非脓毒症患 者,肺源性和非肺源性脓毒症患者PCT 水平明显高于非脓毒症患者（P＜0.01）。ROC曲线分析发现,肺源性和非肺源性脓毒症患 者血清IL-27 的AUC分别为0.657 和0.652,肺源性和非肺源性脓毒症患者PCT 的AUC 为0.667 和0.629。分别联合检测三组患 者的血清IL-27 和PCT值,肺源性脓毒症患者的AUC为0.728,非肺源性脓毒症患者的AUC 为0.703。对肺源性脓毒症患者与非 肺源性脓毒症患者诊断的准确性均有所提升。结论：肺源性和非肺源性脓毒症患者较非脓毒症患者更加符合SIRS 标准。IL-27 作 为脓毒症诊断的生物标志物,对病情变化的反应不敏感,而IL-27 和PCT 结合可以使诊断的准确性提高。     

Short-term high fat feeding increases organ injury and mortality after polymicrobial sepsis

The purpose of this study was to examine the effect of short-term high fat feeding on the inflammatory response in polymicrobial sepsis. Male C57BL/6 mice at 6 weeks of age were randomized to a high-fat diet (HFD) (60% kcal fat) or control diet (CD) (16% kcal fat) for 3 weeks. After 3 weeks of feeding, sepsis was induced by cecal ligation and puncture (CLP) and animals were monitored for survival. In a separate experiment, after 3 weeks of feeding mice underwent CLP and were sacrificed at various time points thereafter. Tissue was collected for biochemical studies. Mice fed a HFD gained more weight and had a greater fat mass compared to CD-fed mice. Mice on a HFD had a lower probability of survival and more severe lung injury compared with CD-fed mice following sepsis. Myeloperoxidase (MPO) activity, an indicator of neutrophil infiltration, was increased in the lung and liver after CLP in HFD-fed mice compared with CD (P < 0.05). The plasma cytokines tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 were increased in both groups after CLP, however, TNF-α and IL-6 levels were lower in HFD mice at 3 h after CLP compared with CD and consistent with lung, but not liver, messenger RNA (mRNA) expression. Leptin levels were higher in HFD-fed mice at 18 h after sepsis compared to baseline levels (P < 0.05). Polymicrobial sepsis increased hepatic nuclear factor-κB (NF-κB) activation in HFD-fed mice after CLP vs. CD-fed mice. Short duration high fat feeding increases mortality and organ injury following polymicrobial sepsis. These effects correspond to changes in NF-κB.     

Adipose-derived mesenchymal stem cells ameliorate the inflammatory reaction in CLP-induced septic acute lung injury rats via sTNFR1

We hypothesized that the adipose-derived mesenchymal stem cells (ADMSCs), which secrete high amounts of soluble molecules, such as soluble tumor necrosis factor receptor 1 (sTNFR1), may ameliorate sepsis-induced acute lung injury (ALI). A total of 120 male adult Sprague–Dawley rats were separated into four groups: the sham control (SC), sepsis induced by cecal ligation and puncture (CLP), CLP–ADMSCs, and CLP–sTNFR1 small interfering RNA (siRNA) groups; CLP groups underwent CLP and then received 1 × 10⁶ ADMSCs with or without knockdown of sTNFR1 intravenously at 1 hr after surgery. Rats were killed at 3, 6, 24, and 48 hr after the SC or CLP procedures. 5-Ethynyl-2′-deoxyuridine-labeled ADMSCs extensively colonized the lungs at 6, 24, and 72 hr after injection. The lung wet/dry (W/D) weight ratios in the CLP group were higher than those in SC group; however, ADMSCs ameliorated the W/D weight ratios following CLP, and this effect was abolished by sTNFR1 siRNA treatment. The levels of serum sTNFR1 and interleukin-10 (IL-10) were higher in the CLP–ADMSCs group and lower in the SC group than in other groups; interestingly, these levels were higher in CLP and CLP–sTNFR1 siRNA groups than in SC group. Tumor necrosis factor-α and IL-6 levels increased significantly after CLP, and ADMSCs could alleviate these changes, but the effect was weakened by sTNFR1 siRNA treatment. The lung cell apoptosis and edema levels were consistent with IL-6 levels among all groups. Therapeutically administered ADMSCs secrete sTNFR1, which most likely protects against ALI in septic rats by ameliorating inflammation and lung edema.     

Plasma HMGB-1 Levels in Subjects with Obesity and Type 2 Diabetes: A Cross-Sectional Study in China

Object

To detect the levels of plasma High-Mobility Group Box-1(HMGB1) in Chinese subject with obesity and type 2 diabetes mellitus (T2DM), and to investigate the correlations between plasma HMGB1 concentration and parameters of body fat, insulin resistance (IR) metabolism and inflammation.

Methods

This study recruited 79 normal glucose tolerance (NGT) subjects and 76 newly diagnosed T2DM patients. NGT and T2DM groups were divided into normal weight (NW) and obese (OB)subgroups respectively. Anthropometric parameters such as height, weight, waist circumference, hip circumference and blood pressure were measured. Plasma concentrations of HMGB1, IL-6, fasting plasma glucose (FPG), 2 hours post challenge plasma glucose (2hPG), serum lipid, glycated hemoglobin (HbA_1C) and fasting insulin (FINS) were examined. The homeostasis model assessment (HOMA) was performed to assess IR status.

Results

Plasma HMGB1 levels were higher in T2DM group than that in NGT group. The concentrations of serum HMGB1 were also higher in subjects with OB than those in subjects with NW both in NGT and T2DM groups. Plasma levels of HMGB1 were positively correlated with waist hip ratio (WHR), blood pressure, FPG, FINS, HOMA-IR, TG, IL-6 and negatively correlated with HOMA-βand high-density lipoprotein-cholesterol (HDL-c) independent of age, gender and BMI. Plasma levels of HMGB1 were significantly correlated with diabetes in fully adjusted models.

Conclusion

Plasma HMGB1 levels were increased in Chinese subjects with pure T2DM, which might be caused by IR. Serum HMGB1 participated in the pathological process of obesity and T2DM via its proinflammatory effect.     

HMGB1 Mediates Cognitive Impairment in Sepsis Survivors

Severe sepsis, a syndrome that complicates infection and injury, affects 750,000 annually in the United States. The acute mortality rate is approximately 30%, but, strikingly, sepsis survivors have a significant disability burden: up to 25% of survivors are cognitively and physically impaired. To investigate the mechanisms underlying persistent cognitive impairment in sepsis survivors, here we developed a murine model of severe sepsis survivors following cecal ligation and puncture (CLP) to study cognitive impairments. We observed that serum levels of high mobility group box 1 (HMGB1), a critical mediator of acute sepsis pathophysiology, are increased in sepsis survivors. Significantly, these levels remain elevated for at least 4 wks after CLP. Sepsis survivors develop significant, persistent impairments in learning and memory, and anatomic changes in the hippocampus associated with a loss of synaptic plasticity. Administration of neutralizing anti-HMGB1 antibody to survivors, beginning 1 wk after onset of peritonitis, significantly improved memory impairments and brain pathology. Administration of recombinant HMGB1 to naïve mice recapitulated the memory impairments. Together, these findings indicate that elevated HMGB1 levels mediate cognitive decline in sepsis survivors, and suggest that it may be possible to prevent or reverse cognitive impairments in sepsis survivors by administration of anti-HMGB1 antibodies.     

Glucan phosphate attenuates myocardial HMGB1 translocation in severe sepsis through inhibiting NF-κB activation

Myocardial dysfunction is a major consequence of septic shock and contributes to the high mortality of sepsis. High-mobility group box 1 (HMGB1) serves as a late mediator of lethality in sepsis. We have reported that glucan phosphate (GP) attenuates cardiac dysfunction and increases survival in cecal ligation and puncture (CLP)-induced septic mice. In the present study, we examined the effect of GP on HMGB1 translocation from the nucleus to the cytoplasm in the myocardium of septic mice. GP was administered to mice 1 h before induction of CLP. Sham-operated mice served as control. The levels of HMGB1, Toll-like receptor 4 (TLR4), and NF-κB binding activity were examined. In an in vitro study, H9C2 cardiomyoblasts were treated with lipopolysaccharide (LPS) in the presence or absence of GP. H9C2 cells were also transfected with Ad5-IκBα mutant, a super repressor of NF-κB activity, before LPS stimulation. CLP significantly increased the levels of HMGB1, TLR4, and NF-κB binding activity in the myocardium. In contrast, GP administration attenuated CLP-induced HMGB1 translocation from the nucleus to the cytoplasm and reduced CLP-induced increases in TLR4 and NF-κB activity in the myocardium. In vitro studies showed that GP prevented LPS-induced HMGB1 translocation and NF-κB binding activity. Blocking NF-κB binding activity by Ad5-IκBα attenuated LPS-induced HMGB1 translocation. GP administration also reduced the LPS-stimulated interaction of HMGB1 with TLR4. These data suggest that attenuation of HMGB1 translocation by GP is mediated through inhibition of NF-κB activation in CLP-induced sepsis and that activation of NF-κB is required for HMGB1 translocation.