烟雾暴露所致肺气肿小鼠模型的建立与评价

目的探讨单纯烟雾暴露所致肺气肿小鼠模型建立及病理学、气道炎症及肺功能评价,并进行支气管肺泡灌洗(bronchoalveolar lavage,BAL)技术的改进。方法 20只C57BL/6J小鼠随机分为正常对照及烟雾暴露组,烟雾暴露90d并观察30d后行小鼠肺功能检查、应用改进方法留取BALF行细胞计数及行肺组织病理切片观察,并与正常对照组进行比较。结果烟雾暴露组小鼠气道阻力(Raw)较正常对照组增高,动态肺顺应性(Cdyn)降低;BALF中细胞总数高于正常对照组,巨噬细胞数(AM)、中性粒细胞数(N)、中性粒细胞所占比例(N%)也高于对照组,差异均有统计学意义;病理学观察示烟雾暴露组肺泡腔扩大、部分肺泡间隔断裂、肺泡腔融合、肺气肿形成,气道上皮排列紊乱、部分气道上皮增生、周围炎症细胞浸润并伴有平滑肌增生;形态学计量分析示烟雾暴露组平均内衬间隔(MLI)及肺泡破坏指数(DI)较正常对照组增加。应用改进技术行BAL成功率100%,回收率高达90%。结论单纯烟雾暴露可以成功建立小鼠肺气肿模型且稳定可靠,与人类慢性阻塞性肺病相似性好,经BAL技术改进后该模型可行性高。     

通过烟熏和间歇低氧构建大鼠COPD-OSAHS重叠综合征模型

目的构建大鼠COPD-OSAHS重叠综合征(OS)模型,为开展OS基础研究提供可行手段及实验平台。方法将14只SPF级雌性6周龄SD大鼠随机分为实验组和对照组,其中实验组(8只)予烟熏和间歇低氧暴露,对照组(6只)予假烟熏和正常氧暴露。8周后计算实验组大鼠的存活率,并对比两组大鼠的一般情况、血气分析、右心室肥厚指数、平均肺泡数、平均肺泡间隔、肺组织病理改变。结果间歇低氧箱氧浓度-时间变化曲线显示氧浓度均周期性降低及恢复正常,成功模拟出间歇低氧气体环境;实验组最终存活6只,存活率为75%,对照组6只大鼠全部存活。与对照组相比,实验组6只存活的SD大鼠一般情况较差,存在酸中毒、低氧血症、二氧化碳潴留、右心室肥厚、平均肺泡截距明显增大、平均肺泡数明显减少(P<0.05),差异有统计学意义;肺组织病理观察显示肺间质炎症浸润、支气管壁淋巴细胞增生、细支气管管壁平滑肌增生、管壁平滑肌部分断裂、杯状细胞增生及肺气肿。结论采用烟熏联合间歇低氧暴露方法成功建立了大鼠OS模型,更加有意义及客观的模型评价指标有待研究发现。     

PRMT6过表达在NF-κB/p65介导小鼠肺气肿炎症反应中的作用

[目的]观察蛋白精氨酸甲基转移酶6(PRMT6)过表达在NF-κB/p65介导小鼠肺气肿模型炎症反应中的作用及机制。[方法]80只Balb/c小鼠暴露于香烟烟雾建立肺气肿模型,随机分为阴性对照组、模型组、阳性对照组(空白慢病毒载体气管内滴注)和PRMT6过表达组(PRMT6慢病毒载体气管内滴注)各20只。HE法观察肺组织形态学,Western Blot测定肺组织PRMT6表达。ELISA测定肺泡灌洗液(BALF)和肺组织匀浆中肿瘤坏死因子-α(TNF-α)和白细胞介素-8(IL-8)水平。[结果]与阴性对照组比较,模型组和阳性对照组小鼠气道阻力、BALF和肺组织匀浆TNF-α及IL-8水平、肺组织NF-κB/p65表达均升高,动态肺顺应性、肺组织PRMT6相对表达量降低(P<0.05);与模型组和阳性对照组比较,PRMT6过表达组小鼠气道阻力、BALF和肺组织匀浆TNF-α及IL-8水平、肺组织NF-κB/p65表达降低,动态肺顺应性、肺组织PRMT6相对表达水平升高(P<0.05)。[结论]PRMT6过表达可能通过抑制肺气肿小鼠肺组织NF-κB/p65核转位,发挥抗炎作用,改善肺功能。     

川芎嗪、丹参和地塞米松对大鼠肺气肿碱性成纤维细胞生长因子mRNA表达的影响

采用免疫细胞化学及原位杂交方法观察川芎嗪、丹参和地塞米松对木瓜蛋白酶所致大鼠肺气肿形成中肺组织碱性成纤维细胞生长因子 (b FGF) m RNA表达和肺泡 型上皮细胞增殖细胞核抗原 (PCNA )表达的影响。 Wistar大鼠随机分为正常对照、肺气肿 7天、 15天、 30天、川芎嗪、丹参和地塞米松治疗组 ,共 7个组。用一次气管内注入木瓜蛋白酶复制大鼠肺气肿模型 ,取肺组织作 b FGF m RNA原位杂交 ,分离肺泡 型上皮细胞作 PCNA免疫组织化学染色 ,用图像分析定量。结果显示注药后第 7天大鼠肺组织 b FGF m RNA表达至高峰 ,第 15天后表达逐渐减少 ,川芎嗪、丹参和地塞米松治疗 30天组 b FGF m RNA表达减少 ,但仍高于正常对照组 (P<0 .0 1)。肺泡 型上皮细胞 PCNA表达与肺组织 b FGFm RNA表达呈正相关 (r=0 .78,P<0 .0 1)。川芎嗪治疗组 PCNA表达明显降低 ,但仍高于正常对照组。结果表明川芎嗪在肺气肿发病过程中有一定治疗作用     

基质金属蛋白酶-9及其抑制剂mRNA在吸烟大鼠肺组织中的表达

目的 研究吸烟大鼠肺组织和肺泡巨噬细胞中基质金属蛋白酶9(MMP-9)和金属蛋白酶组织抑制剂-1(TIMP-1)基因的表达,探讨其在细胞外基质重塑中的作用。方法 建立吸烟大鼠模型,随机分为对照组和吸烟1、2、3、4、5及6月组(每组10只),用原位杂交技术检测肺组织和肺泡巨噬细胞MMP-9和TIMP-1 mRNA表达,用免疫组织化学技术观察Ⅳ型胶原在肺内的表达。结果 吸烟组肺组织和肺泡巨噬细胞MMP-9 mRNA的表达逐渐上升,至吸烟6月时均达高峰;而TIMP-1 mRNA的表达渐上升,至吸烟3～4月时达高峰,后逐步下降;肺组织Ⅳ型胶原的表达在吸烟3月时达高峰,然后渐降。结论 MMP-9／TIMP-1的动态平衡在吸烟大鼠肺气肿模型肺组织的细胞外基质重塑中有重要作用。     

β2-微球蛋白在肺气肿发病过程中的作用

目的探讨β2-微球蛋白(β2-microglobulin,β2m)通过巨噬细胞在肺气肿发病过程中的可能作用。方法小鼠分别烟雾暴露8、16、24周建立肺气肿模型,有创小鼠肺功能仪测定肺功能参数;收集肺泡灌洗液(bronchoalveolar lavage fluid, BALF)进行细胞计数;取肺组织进行苏木精-伊红(hematoxylin-eosin, HE)染色、免疫组织化学染色和免疫荧光共染,分析肺泡结构破坏、β2m表达及其靶细胞情况。佛波酯(phorbol 12-myristate 13-acetate, PMA)体外诱导人单核细胞系THP-1分化为巨噬细胞,以不同质量浓度的人重组β2m刺激48 h,ELISA检测细胞培养上清中炎症因子的改变。结果与对照组小鼠相比,烟雾暴露所致肺气肿模型组小鼠肺泡腔明显扩大,肺总量(total lung capacity, TLC)、肺泡弦长(mean linear intercept, Lm)和肺泡破坏指数(destructive index, DI)均明显增加(P<0.05);BALF细胞总数明显增多,以巨噬细胞为主。免疫组织化学染色及免疫荧光共染显示肺气肿组小鼠肺组织β2m表达上调(P<0.05),且可与巨噬细胞共定位。体外用人重组β2m刺激THP-1巨噬细胞可促进炎症因子IL-1β、IL-6、IL-8的产生(P<0.05)。结论上述数据表明β2m可能通过上调巨噬细胞炎症因子产生从而参与肺气肿的发病过程。研究为未来肺气肿的治疗提供了一个新的潜在干预靶点。     

吸烟对大鼠肺组织MCP-1和TGF-β表达的影响

目的研究吸烟大鼠肺气肿模型肺组织中单核细胞趋化蛋白-1(MCP-1)和转化细胞生长因子-β(TGF-β)的表达.方法建立吸烟肺气肿大鼠模型.72只雄性Wistar大鼠,随机分为对照组1至6月组,吸烟组1至6月组,每组均6只,共12组别.用免疫组化法观察MCP-1 和TGF-β在肺内的表达,用酶联免疫吸附测定法(ELISA)观察MCP-1在肺泡灌洗液(BALF)中的含量,及测定各组肺组织中溶胶原活性和总羟脯氨酸的含量.结果与对照组相比,吸烟组肺组织MCP-1和TGF-β的表达均明显上升,至吸烟4月时达高峰;MCP-1在BALF各组中差异不显著,无统计学意义;溶胶原活性各组各时段激活活性均比自发活性高,总活性逐渐上升.结论 MCP-1和TGF-β在吸烟大鼠肺气肿模型细胞外基质重塑中产生重要作用.     

吸烟大鼠肺脏AQP4 和MUC5AC 的表达及其与 一氧化氮的关系

目的:研究烟草烟雾吸入对大鼠肺组织水通道蛋白4(AQP4)和粘蛋白5AC(MUC5AC)表达的影响及其与支气管肺泡灌洗液内一氧化氮代谢物水平的关系,探讨氧化应激对肺部水转运和粘液分泌的影响。方法:免疫组化法观察AQP4在肺组织内的表达,平均光密度法比较模型组和空白组大鼠AQP4的表达差异;半定量RT-PCR法检测肺组织内AQP4及MUC5AC mRNA的表达水平;硝酸还原酶法测定各组大鼠支气管肺泡灌洗液内一氧化氮代谢产物的浓度,分析模型组AQP4、MUC5AC mRNA的表达水平与支气管肺泡灌洗液内一氧化氮代谢物浓度之间的相关关系。结果:AQP4在空白对照组呈强阳性染色,在模型组呈弱阳性染色,两者平均光密度值有显著差异(P<0.05)。模型组动物肺组织AQP4 mRNA的表达降低,MUC5AC mRNA的表达升高,与空白组比较均有显著差异(P<0.05),模型组动物支气管肺泡灌洗液内一氧化氮代谢产物的浓度与肺组织AQP4 mRNA表达水平呈负相关,相关系数r=-0.798(,P<0.05),与MUC5AC mRNA的表达水平呈正相关,相关系数r=0.857(,P<0.05)。结论:吸烟可导致肺组织AQP4表达下降进而影响气道内水的转运。一氧化氮可能参与了烟雾吸入动物模型中AQP4与MUC5AC基因表达的调控。     

葡萄籽原花青素对大鼠烟雾吸入性肺损伤的保护作用

目的:探讨葡萄籽原花青素(grape seed proanthocyanidin extract,GSPE)对大鼠烟雾吸入性肺损伤的保护作用。方法:将48只大鼠随机分为正常对照组、烟雾吸入性肺损伤模型组、GSPE治疗组(500mg/kg),分别于致伤后2、4、12、24h监测动脉血气分析,分批处死大鼠,分别进行肺组织湿/干重测定,制备组织匀浆测超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、一氧化氮合酶(NOS)活性及一氧化氮(NO)、丙二醛(MDA)含量和HE染色。结果:与模型组比较,GSPE治疗组各时间点动脉血氧分压均显著升高(P<0.01),肺组织含水量显著降低(P<0.05),肺组织中SOD活性均明显升高(P<0.01),GSH-Px活性均明显升高(P<0.05),NOS活性及NO、MDA含量均明显降低(P<0.05)。肺组织病理学观察GSPE治疗组较模型组肺间质水肿减轻,炎性细胞浸润减少。结论:GSPE可能通过其显著增加组织的抗氧化能力而对烟雾吸入性肺损伤起到一定保护作用。     

MMP-9、ICAM-1、TNF-α在自发性高血压大鼠烟熏肺损伤中的变化分析

探讨MMP-9、ICAM-1和TNF-α在自发性高血压大鼠烟熏肺损伤中的表达变化及其作用机制。选取健康、雄性Wister大鼠12只(对照组),自发性高血压雄性Wister大鼠24只随机分为烟熏组和SH对照组各12只,对照组和烟熏组均每天进行烟熏2次、每周6 d,连续8周对比3组大鼠肺功能变化、肺组织中细胞粘附分子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)蛋白及mRNA的表达情况。对照组、烟熏组的气道阻力、平滑肌指数、胶原指数均显著的高于SH对照组(p0.05),对照组、烟熏组的最大呼气流量、平均肺泡个数均低于SH对照组(p0.05);烟熏组的气道阻力、平滑肌指数、胶原指数均显著的高于对照组(p0.05),烟熏组的最大呼气流量、平均肺泡个数均低于对照组(p0.05);对照组、烟熏组的ICAM-1、TNF-α、MMP-9蛋白、mRNA表达程度均显著的高于SH对照组(p0.05);烟熏组的ICAM-1、TNF-α、MMP-9蛋白、mRNA表达程度均显著的高于对照组(p0.05)。烟熏对自发性高血压大鼠肺功能的损伤十分明显,破坏肺泡结构,影响大鼠的肺部功能,该过程可能与上调ICAM-1、TNF-α、MMP-9表达有关。     

Reversal of elastase-induced pulmonary emphysema and promotion of alveolar epithelial cell proliferation by simvastatin in mice

Besides lowering cholesterol, statins exert multiple effects, such as anti-inflammatory activity and improvement of endothelial cell function. We examined whether simvastatin (SS) protects against the development of elastase-induced pulmonary emphysema in mice by using mean linear intercepts of alveoli (Lm) as a morphometric parameter of emphysema. After injection of intratracheal elastase on day 0, C57BL/6 mice were treated daily with SS (SS+ group) or PBS (SS- group) for 2 wk. A 21% decrease in Lm on day 7 was observed in the SS+ group vs. the SS- group. Anti-inflammatory effects of SS were observed as a decrease in percentage of neutrophils up to day 3, and in hydroxyproline concentration on day 3, in bronchoalveolar lavage fluid (BALF). SS also increased the number of proliferating cell nuclear antigen (PCNA)-positive alveolar epithelial cells between days 3 and 14. To confirm the role of statins in promoting proliferation of alveolar cells, mice were treated with SS (SS+) vs. PBS (SS-) for 12 days, starting 3 wk after elastase administration. After SS treatment, Lm decreased by 52% and PCNA-positive alveolar epithelial cells increased compared with the SS- group. Concentrations of vascular endothelial growth factor in BALF and endothelial nitric oxide synthase protein expression in pulmonary vessels tended to be higher in the SS+ group vs. the SS- group in this protocol. In conclusion, SS inhibited the development of elastase-induced pulmonary emphysema in mice. This therapeutic effect was due not only to anti-inflammation but also to the promotion of alveolar epithelial cell regeneration, partly mediated by restoring endothelial cell functions.     

地塞米松联合缬沙坦对慢性阻塞性肺疾病小鼠保护作用及机制探讨*

目的: 评估地塞米松联合缬沙坦对香烟所致慢性阻塞性肺疾病(COPD)小鼠的保护作用。方法: 40只C57BL/6小鼠随机分为(n=8):对照组、COPD组、地塞米松组、缬沙坦组和地塞米松+缬沙坦联合处理组。COPD组小鼠持续8周进行香烟暴露;在香烟暴露基础上,地塞米松组小鼠在5~8周香烟暴露前腹腔注射地塞米松(2 mg/kg);缬沙坦组小鼠在1~8周香烟暴露前腹腔注射缬沙坦(30 mg/kg);地塞米松+缬沙坦联合处理组小鼠腹腔注射地塞米松(2 mg/kg)和缬沙坦(30 mg/kg)。8周后收集各组小鼠肺组织及支气管肺泡灌洗液(BALF),评估肺组织病理学评分及BALF中超氧化物歧化酶(SOD)和基质金属蛋白酶9(MMP-9)活性,以及丙二醛(MDA)、细胞内黏附分子1(ICAM-1)、C反应蛋白(CRP)和一氧化氮(NO)含量。结果: 与对照组相比,COPD组小鼠存在肺气肿和肺泡充血,BALF中MDA、ICAM-1、MMP-9、CRP和淋巴细胞升高,SOD、巨噬细胞和NO降低(P均＜0.05)。与COPD组相比,地塞米松或缬沙坦组小鼠肺气肿和肺泡充血无明显改善,BALF中SOD 和NO升高,MDA、淋巴细胞和巨噬细胞降低(P均＜0.05)。与地塞米松或缬沙坦组相比较,地塞米松+缬沙坦联合处理组能更有效预防香烟引起的肺气肿和肺泡充血,降低BALF中MDA、ICAM-1、MMP-9、CRP和淋巴细胞,升高SOD、巨噬细胞和NO(P均＜ 0.05)。结论: 地塞米松联合缬沙坦通过抑制氧化应激和炎症,可以更有效在COPD小鼠中发挥保护作用。     

慢性阻塞性肺疾病不同表型患者CAT评分与肺功能及预后的相关性分析

摘要 目的：探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）不同表型评估测试问卷（COPD assessment test,CAT）评分与肺功能及预后的关系。方法：收集361例COPD患者临床资料、CAT评分、肺功能检查结果及肺外合并症、肺内并发症等情况,按临床表型分为肺气肿组（n=200）和支气管炎组（n=161）,分析肺气肿组200例和支气管炎组161例COPD患者CAT评分与肺功能及预后的关系。结果：肺气肿组CAT评分高于支气管炎组（P<0.05）,一秒用力呼气容积（FEV₁）占预计值百分比（FEV₁%）、FEV₁/用力肺活量（FVC）低于支气管炎组（P<0.05）,吸气分数（IC/TLC）低于支气管炎组,残总比（RV/TLC）高于支气管炎组（P<0.05）;肺气肿组肺间质性病变、肺动脉高压发生率均高于支气管炎组（P<0.05）;支气管炎、肺气肿组CAT评分均与FEV₁%、FEV₁/FVC、IC/TLC呈负相关（P<0.05）,与RV/TLC呈正相关（P<0.05）,肺气肿各参数相关度更高（P<0.05）;肺气肿组不同CAT评分患者肺间质性病变、肺动脉高压发生率比较差异有统计学意义（P<0.05）,支气管炎组不同CAT评分肺动脉高压发生率比较差异有统计学意义（P<0.05）,随CAT评分的升高,肺气肿组肺间质性病变、肺动脉高压发生率上升,支气管炎组肺动脉高压发生率上升。结论： COPD肺气肿表型CAT评分较支气管炎表型高,肺功能降低更明显,呈现肺过度通气,气流受限特点,更易并发肺间质纤维化、肺动脉高压,且与CAT评分变化密切相关。     

The effect of hyaluronan on elastic fiber injury in vitro and elastase-induced airspace enlargement in vivo

This laboratory has previously described a method of preventing air-space enlargement in experimental pulmonary emphysema using aerosolized hyaluronan (HA). Although it was found that HA preferentially binds to elastic fibers (which undergo breakdown by elastases in emphysema), it remains to be shown that such attachment actually prevents damage to the fibers. In the current study, cell-free radiolabeled extracellular matrices, derived from rat pleural mesothelial cells, were used to test the ability of low molecular weight ( approximately 100 kDa) streptococcal HA to prevent elastolysis. Coating the matrices with HA significantly decreased elastolysis (P<0.05) induced by porcine pancreatic elastase (43%), human neutrophil elastase (53%), and human macrophage metalloelastase (80%). Concomitant in vivo studies examined the ability of an aerosol preparation of the streptococcal HA to prevent experimental emphysema induced by intratracheal administration of porcine pancreatic elastase. As seen with earlier studies involving bovine tracheal HA, a single aerosol exposure significantly decreased elastase-induced airspace enlargement, as measured by the mean linear intercept (107.5 vs 89.6 microm; P < 0. 05). Furthermore, repeated exposure to the HA aerosol for 1 month did not reveal any morphological changes in the lung. The results provide further evidence that aerosolized HA may be an effective means of preventing pulmonary emphysema and perhaps other lung diseases that involve elastic fiber injury.     

无创正压通气联合纤维支气管镜肺泡灌洗对老年AECOPD合并Ⅱ型呼吸衰竭患者肺功能及血气指标的影响

目的:观察无创正压通气(NIPPV)联合纤维支气管镜(FB)肺泡灌洗对老年急性加重期慢性阻塞性肺疾病(AECOPD)合并Ⅱ型呼吸衰竭患者肺功能及血气指标的影响,为临床治疗方案的选择提供依据。方法:选取82例于2017年1月～2019年1月间在我院住院治疗的老年AECOPD合并II型呼吸衰竭患者。根据治疗方法将患者分为观察组(NIPPV联合FB肺泡灌洗治疗,n=42)与对照组(单独NIPPV治疗,n=40)。观察两组患者的住院时间及抗菌药静脉滴注时间,并比较治疗前及治疗后两组患者的血气指标[pH值(pH)、氧分压(PaO_2)、二氧化碳分压(PaCO_2)、血氧饱和度(SaO_2)]、肺功能指标[一秒钟用力呼气容积(FEV1)、肺活量(FVC)、呼气峰值流速(PEF)]的变化情况。记录两组患者治疗过程中的并发症发生情况。结果:观察组住院时间及抗菌药物静脉滴注时间均明显短于对照组(P0.05)。治疗后,两组pH、PaO_2、SaO_2明显上升,而PaCO_2明显下降(P0.05),且与对照组比较,观察组的pH、PaO_2、SaO_2明显较高,而PaCO_2明显较低(P0.05)。治疗后,对照组FEV1、FVC、PEF无明显变化(P0.05),观察组FEV1、FVC、PEF均明显升高且高于对照组(P0.05)。两组患者不良反应发生率比较差异无统计学意义(P0.05)。结论:NIPPV联合FB肺泡灌洗治疗对老年AECOPD合并II型呼吸衰竭患者血气指标及肺功能均有较好的改善效果,能明显缩短患者的住院时间及抗菌药静脉滴注时间,且安全性良好。     

AMPK调控内质网应激抵抗COPD大鼠肺泡上皮细胞凋亡的实验研究

目的:初步探讨AMPK在内质网应激所致COPD大鼠肺泡上皮细胞凋亡中所起的作用及机制。方法:实验分三组:对照组,COPD模型组,AICAR干预组,以香烟烟雾烟熏加气管内滴注脂多糖方法构建COPD大鼠模型,取大鼠肺组织行HE染色病理观察,免疫组化,western blot检测p-AMPK/AMPK,ORP150,caspase-3及CHOP表达,TUNEL法检测各组凋亡情况。结果:病理HE染色提示模型组大量炎症细胞浸润,肺大疱形成,支气管壁发生狭窄;AICAR干预组炎症细胞较模型组减少。与正常对照组相比,免疫组化及western blot均提示模型组中p-AMPK和ORP150蛋白表达含量增强,差异有统计学意义(P0.05)。而AICAR干预组中p-AMPK/AMPK及ORP150蛋白表达较模型组明显上升,差异有统计学意义(P0.05)。内质网应激相关凋亡指标CHOP及caspase-3的表达在模型组明显增强,较正常组比较差异有显著性(P0.05),而AICAR组中凋亡指标较模型组明显下调。结论:AMPK可以保护肺泡上皮细胞免于香烟烟雾所致内质网应激凋亡,且有可能通过增加ORP150来实现其保护作用。     

Successful establishment of primary small airway cell cultures in human lung transplantation

Background

Although both animal and human studies suggested the association between placenta growth factor (PlGF) and chronic obstructive pulmonary disease (COPD), especially lung emphysema, the role of PlGF in the pathogenesis of emphysema remains to be clarified. This study hypothesizes that blocking PlGF prevents the development of emphysema.

Methods

Pulmonary emphysema was induced in PlGF knock-out (KO) and wild type (WT) mice by intra-tracheal instillation of porcine pancreatic elastase (PPE). A group of KO mice was then treated with exogenous PlGF and WT mice with neutralizing anti-VEGFR1 antibody. Tumor necrosis factor alpha (TNF-α), matrix metalloproteinase-9 (MMP-9), and VEGF were quantified. Apoptosis measurement and immuno-histochemical staining for VEGF R1 and R2 were performed in emphysematous lung tissues.

Results

After 4 weeks of PPE instillation, lung airspaces enlarged more significantly in WT than in KO mice. The levels of TNF-α and MMP-9, but not VEGF, increased in the lungs of WT compared with those of KO mice. There was also increased in apoptosis of alveolar septal cells in WT mice. Instillation of exogenous PlGF in KO mice restored the emphysematous changes. The expression of both VEGF R1 and R2 decreased in the emphysematous lungs.

Conclusion

In this animal model, pulmonary emphysema is prevented by depleting PlGF. When exogenous PlGF is administered to PlGF KO mice, emphysema re-develops, implying that PlGF contributes to the pathogenesis of emphysema.     

Evaluation of emphysema severity and progression in a rabbit model: comparison of hyperpolarized 3He and 129Xe diffusion MRI with lung morphometry.

The apparent diffusion coefficients (ADCs) of hyperpolarized (3)He and (129)Xe gases were measured in the lungs of rabbits with elastase-induced emphysema and correlated against the mean chord length from lung histology. In vivo measurements were performed at baseline and 2, 4, 6, and 8 wk after instillation of elastase (mild and moderate emphysema groups) or saline (control group). ADCs were determined from acquisitions that used two b values. To investigate the effect of b value on the results, b-value pairs of 0 and 1.6 s/cm(2) and 0 and 4.0 s/cm(2) were used for (3)He, and b-value pairs of 0 and 5.0 s/cm(2) and 0 and 10.0 s/cm(2) were used for (129)Xe. At 8 wk after instillation, the rabbits were euthanized, and the lungs were analyzed histologically and morphometrically. ADCs for the rabbits in the control group did not change significantly from baseline to week 8, whereas ADCs for the rabbits in the emphysema groups increased significantly (P < 0.05) for all gas and b-value combinations except (129)Xe with the b-value pair of 0 and 5.0 s/cm(2). The largest percent change in mean ADC from baseline to week 8 (15.3%) occurred with (3)He and the b-value pair of 0 and 1.6 s/cm(2) for rabbits in the moderate emphysema group. ADCs (all b values) were strongly correlated (r = 0.62-0.80, P < 0.001) with mean chord lengths from histology. These results further support the ability of diffusion-weighted MRI with hyperpolarized gases to detect regional and global structural changes of emphysema within the lung.     

异丙托溴铵与布地奈德对COPD合并Ⅱ型呼吸衰竭患者MDA,SOD,GSH-Px水平及肺功能的影响

目的:探讨异丙托溴铵联合布地奈德对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者MDA、SOD、GSH-Px水平及肺功能的影响。方法:选取我院收治的慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者92例,分为对照组和实验组,每组各46例。对照组采用常规治疗,实验组在对照组基础上加用异丙托溴铵溶液联合布地奈德雾化吸入治疗。观察并比较两组患者治疗前后MDA、SOD及GSH-Px水平的变化情况以及肺功能和血气指标的改善情况。结果:与治疗前比较,两组患者治疗后SOD、GSH-Px、FEV1、VC、Pa O2明显升高,而MDA、RV、TLC、Pa CO2明显降低(P0.05);与对照组比较,实验组治疗后SOD、GSH-Px、FEV1、VC、Pa O2明显升高,而MDA、RV、TLC、Pa CO2明显降低(P0.05)。结论:异丙托溴铵联合布地奈德能够改善慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的肺功能参数、血气指标和MDA、SOD、GSH-Px水平,增强机体抗氧化功能,提高临床疗效。     

Keratinocyte growth factor protects against elastase-induced pulmonary emphysema in mice

Pulmonary emphysema is characterized by persistent inflammation and progressive alveolar destruction. The keratinocyte growth factor (KGF) favorably influences alveolar maintenance and repair and possesses anti-inflammatory properties. We aimed to determine whether exogenous KGF prevented or corrected elastase-induced pulmonary emphysema in vivo. Treatment with 5 mg x kg(-1) x day(-1) KGF before elastase instillation prevented pulmonary emphysema. This effect was associated with 1) a sharp reduction in bronchoalveolar lavage fluid total protein and inflammatory cell recruitment, 2) a reduction in the pulmonary expression of the chemokines CCL2 (or monocyte chemoattractant protein-1) and CXCL2 (or macrophage inflammatory protein-2alpha) and of the adhesion molecules ICAM-1 and VCAM-1, 3) a reduction in matrix metalloproteinase (MMP)-2 and MMP-9 activity at day 3, and 4) a major reduction in DNA damage detected by terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling (TUNEL) in alveolar cells at day 7. Treatment with KGF after elastase instillation had no effect on elastase-induced emphysema despite the conserved expression of the KGF receptor in the lungs of elastase-instilled animals as determined by immunohistochemistry. In vitro, KGF abolished the elastase-induced increase in CCL2, CXCL2, and ICAM-1 mRNA in the MLE-12 murine alveolar epithelial cell line. We conclude that KGF pretreatment protected against elastase-induced pulmonary inflammation, activation of MMPs, alveolar cell DNA damage, and subsequent emphysema in mice.