油酸致兔ARDS模型长期效果的多因素析评

目的:研究油酸致ARDS模型对疾病的长期模拟效果,并探讨内在机制。方法:选择健康新西兰大白兔30只,经左侧耳缘静脉按油酸0.1 ml/kg的剂量缓慢注入,观察动物呼吸、心率变化,测定氧合指数(PaO2/FiO2)、动脉氧分压、二氧化碳分压。分别于注射油酸后6小时、24小时、48小时以及72小时处死动物,收集静脉血及肺泡灌洗液(BALF),ELISA法检测肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)变化。H-E染色镜下观察肺部病理改变,计算肺组织含水量以判断肺损伤程度。结果:①所有模型动物在6小时内均出现ARDS表现。②6h组、24h组以及48h组氧合指数(PaO2/FiO2)与正常对照组相比均明显降低(P<0.05),且符合ARDS诊断标准。72h组氧合指数(PaO2/FiO2)虽然也明显降低,但未达到ARDS的诊断标准。③血浆中TNF-α与IL-6明显升高(P<0.05),于致伤后72小时后有所恢复,但仍高于正常。BALF中TNF-α也出现相同变化趋势,而IL-6则在试验期间持续高表达。④镜下可见两肺充血、出血,肺泡及肺间质水肿,透明膜形成,大量中性粒细胞浸润,终末支气管上皮细胞变性坏死,双肺含水...     

Interplay between intra- and extracellular calcium ions

Two, well characterized cationic channels, the ryanodine receptor (RyR) and the canonical transient receptor potential cation channel (TRPC) are briefly reviewed with a particular attention on recent developments related to the interplay between the two channel families.     

Inhibition of pulmonary surfactant by oleic acid: mechanisms and characteristics.

The inhibitory effects of oleic acid (OA) on the surface activity of pulmonary surfactant were characterized by use of the oscillating bubble surfactometer, the Wilhelmy balance, and excised rat lungs. Oscillating bubble studies showed that OA prevented lavaged calf surfactant [0.5 mM phospholipid (PL)] from lowering surface tension below 15 mN/m at or above a molar ratio of OA/PL = 0.5. In contrast to inhibition of surfactant by plasma proteins, increasing the surfactant concentration did not eliminate inhibition by oleic acid, which occurred at OA/PL greater than 0.67 on the oscillating bubble even at surfactant concentrations of 1.5 and 12 mM PL. Studies of surfactant adsorption showed that preformed films of OA had little effect on the adsorption of pulmonary surfactant. Wilhelmy balance studies showed that OA did interfere with the ability of spread films of surfactant to reach low surface tensions during dynamic compression. Further balance experiments with binary films of OA and dipalmitoyl phosphatidylcholine showed that these compounds were miscible in surface films. Together these findings suggested that OA inhibited pulmonary surfactant activity by disrupting the rigid interfacial film responsible for the generation of very low surface tension during dynamic compression. Mechanical studies in excised rat lungs showed that instillation of OA gave altered deflation pressure-volume characteristics with decreased quasi-static compliance, indicating disruption of pulmonary surfactant function in situ. This alteration of mechanics occurred without major changes in the composition of lavaged PLs or in the tissue compliance of the lungs defined by mechanical measurements during inflation-deflation with saline.(ABSTRACT TRUNCATED AT 250 WORDS)     

Metabolic precursors of surfactant disaturated-phosphatidylcholine in preterms with respiratory distress

Our objective was to study the metabolic precursors of surfactant disaturated-phosphatidylcholine (DSPC) in preterm infants with respiratory distress syndrome (RDS) on mechanical ventilation. We performed 46 DSPC kinetic studies in 23 preterms on fat-free parenteral nutrition and mechanical ventilation (birth weight = 1167 ± 451 g, gestational age = 28.5 ± 2.0 weeks). Eight infants received a simultaneous intravenous infusion of U¹³C-glucose and [16,16,16]²H-palmitate, eight infants received U¹³C-glucose and ²H₂O, and seven received U¹³C-palmitate and ²H₂O. Surfactant DSPC kinetics were calculated from the isotopic enrichments of DSPC-palmitate from sequential tracheal aspirates and its metabolic precursors in plasma or urine. DSPC fractional synthesis rate (FSR) was 17 ± 11, 21 ± 16, and 15 ± 6%/day from glucose, palmitate, and body water, respectively (P = 0.36). DSPC-FSR from U¹³C-glucose and ²H₂O were significantly correlated and yielded similar estimates (difference of –0.1 ± 3%) (P = 0.91). The difference in the 15 infants receiving palmitate versus ²H₂O or palmitate versus glucose was +6.0 ± 12%/day (P = 0.21). There was a significant correlation between DSPC-FSRs from plasma glucose and plasma FFA. The contribution of glucose versus palmitate to DSPC-FSR was 49 ± 20% versus 51 ± 20%, respectively. Plasma glucose and FFA showed similar contributions to DSPC-FSR in infants with RDS and fat-free parenteral nutrition. FSRs from ²H₂O or glucose were highly correlated.     

The effect of BW775C on respiratory distress in the rat induced by arachidonic acid

BW775C, an inhibitor of the lipoxygenase and cyclo-oxygenase pathways, inhibits the respiratory distress induced by arachidonic acid in rats. The degree of respiratory distress was measured in terms of respiratory rate using electrodes implanted at each side of the thorax. Indomethacin, an inhibitor of the cyclooxygenase pathway, failed to influence the respiratory distress induced by arachidonic acid. The results implicate the lipoxygenase pathway, i.e. the leukotrienes synthesis inhibition, in the respiratory distress induced by arachidonic acid.     

Structural changes of alpha-lactalbumin induced by low pH and oleic acid

The effects of low pH and oleic acid on conformation and association state of Ca2+-depleted bovine alpha-lactalbumin (apo-BLA) have been studied by electrospray ionization mass spectrometry, fluorescence spectroscopy, and circular dichroism. The experimental results demonstrate that two structurally distinct species exist in the conformational transition of apo-BLA induced by low pH. One species populates at pH 3.0 characterized as a monomeric molten globule state and the other accumulates at pH 4.0-4.5 which is a partially folded dimer. Oleic acid promotes the formation of the dimeric intermediate at pH 4.0 and 7.0, but increases the content of molten globule state remarkably at pH 3.0 compared with that in the absence of oleic acid, indicating that oleic acid at pH 3.0 plays a different role from those at pH 4.0 and 7.0. Our data provide insight into the mechanism of pH-dependent and oleic acid-dependent structural changes and oligomerization of alpha-lactalbumin, and will be helpful to the understanding of the apoptosis-inducing function of multimeric alpha-lactalbumin in which oleic acid is a necessary cofactor.     

NMR studies of exchange between intra- and extracellular glutathione in human erythrocytes

Glutathione is the main source of intracellular antioxidant protection in the human erythrocyte and its redox status has frequently been used as a measure of oxidative stress. Extracellular glutathione has been shown to enhance intracellular reduced glutathione levels in some cell types. However, there are conflicting reports in the literature and it remains unclear as to whether erythrocytes can utilise extracellular glutathione to enhance the intracellular free glutathione pool. We have resolved this issue using a 13C-NMR approach. The novel use of L-gamma-glutamyl-L-cysteinyl-[2-13C]glycine allowed the intra- and extracellular glutathione pools to be distinguished unequivocally, enabling the direct and non-invasive observation over time of the glutathione redox status in both compartments. The intracellular glutathione redox status was measured using 1H spin-echo NMR, while 13C[1H-decoupled] NMR experiments were used to measure the extracellular status. Extracellular glutathione was not oxidised in the incubations, and did not affect the intracellular glutathione redox status. Extracellular glutathione also did not affect erythrocyte glucose metabolism, as measured from the lactate-to-pyruvate ratio. The results reported here refute the previously attractive hypothesis that, in glucose-starved erythrocytes, extracellular GSH can increase intracellular GSH concentrations by releasing bound glutathione from mixed disulfides with membrane proteins.     

Peptide-based synthetic pulmonary surfactant for the treatment of respiratory distress disorders

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Modulation of TRPV4 gating by intra- and extracellular Ca

We have studied the modulation of gating properties of the Ca²⁺-permeable, cation channel TRPV4 transiently expressed in HEK293 cells. The phorbol ester 4αPDD transiently activated a current through TRPV4 in the presence of extracellular Ca²⁺. Increasing the concentration of extracellular Ca²⁺ ([Ca²⁺]_e) reduced the current amplitude and accelerated its decay. This decay was dramatically delayed in the absence of [Ca²⁺]_e. It was also much slower in the presence of [Ca²⁺]_e in a mutant channel, obtained by a point mutation in the 6th transmembrane domain, F707A. Mutant channels, containing a single mutation in the C-terminus of TRPV4 (E797), were constitutively open. In conclusion, gating of the 4αPDD-activated TRPV4 channel depends on both extra- and intracellular Ca²⁺, and is modulated by mutations of single amino acid residues in the 6th transmembrane domain and the C-terminus of the TRPV4 protein.     

The breakdown of myelin-bound proteins by intra- and extracellular proteases

Changes in protein components of purified myelin were measured following incubation in vitro with purified intra- and extracellular enzymes. Incubation with calf brain cathepsin D did not result in a significant relese of acid-soluble peptides as measured by ninhydrin analysis but was accompanied by a large loss of myelin proteins as determined on SDS-acrylamide gels. After 5 hr at 37°C there was a loss of about 25% for fast and slow basic proteins and the Agrawal proteolipid, but only a 5–10% loss for the Folch-Lees and Wolfgram components. Rat brain cathepsin D prepared by affinity chromatography gave a 30–60% breakdown of basic proteins and proteolipids. In general, breakdown using lyophilized myelin was increased over two-fold as compared to experiments with fresh myelin. Breakdown induced by cathepsin D was completely inhibited by the pentapeptide pepstatin. Incubation of myelin at physiological pH resulted in an endogenous breakdown of about 12% for basic proteins in freshly prepared, and 50% for lyophilized material. Addition of a soluble neutral proteinase that splits hemoglobin did not induce additional breakdown except for a small change in the Folch-Lees component. The extracellular enzymes pepsin and TPCK-treated trypsin resulted in a larger breakdown of all components as compared to brain enzymes. Present results demonstrate that all protein components of myelin are accessible to hydrolases and vulnerable to breakdown to varying extents by brain enzymes. These facts are consistent with the known rates for myelin protein turnover and may have a bearing on changes associated with demyelinating diseases     

Experimental neonatal respiratory failure induced by lysophosphatidylcholine: effect of surfactant treatment

The purpose of this study was to characterize the toxic effectsof lysophosphatidylcholine (lyso-PC) on neonatal lung function. Variousdoses of lyso-PC (from 0 to 40 mg/kg) were administered to near-termnewborn rabbits. Lung-thorax compliance during mechanical ventilationwas significantly decreased by doses 10 mg/kg, and static lungvolumes during deflation were decreased by doses 20 mg/kg. Using thesame experimental model, we investigated the effects of modifiedporcine surfactant (Curosurf, 200 mg/kg). Animals exposed to lyso-PC atbirth and treated simultaneously with surfactant showed a satisfactorytherapeutic response, whereas those treated after 30 min failed torespond. These animals also had a much larger leak of albumin into theair spaces and an elevated minimum surface tension of the lavage fluidin a pulsating bubble surfactometer, suggesting inactivation of theexogenous surfactant. Timing of surfactant administration may thus beessential for the therapeutic effect in this experimental model ofacute lung injury.     

The role of the intra- and extracellular protons in the photosynthetic response induced by the variation potential in pea seedlings

Local burning induces generation and propagation of variation potential (VP) in higher plants. VP induces transient inactivation of photosynthesis, which is possibly connected with proton signal in plant cell. Analysis of the role of changes in intracellular and extracellular pH in the VP-induced photosynthetic response in pea seedlings was the aim of this work. It was shown that local burning induced VP propagation, which was accompanied with a decrease of intracellular pH and increase of extracellular pH. VP induced photosynthesis inactivation that included an increase in the nonphotochemical fluorescence quenching and a decrease in the CO₂ assimilation rate. Analysis of photosynthetic responses under control and low external CO₂ concentration and changes in pH showed that there were two components in the responses. The first component appeared as a fast decrease of the CO₂ assimilation and increase of nonphotochemical quenching. It depended on the activity of the dark stage of photosynthesis and was connected with apoplast alkalization. The second component was presented as a slow increase of nonphotochemical quenching. It weakly depended on a dark stage and was connected with a decrease of intracellular pH.     

Altered molecular specificity of surfactant phosphatidycholine synthesis in patients with acute respiratory distress syndrome

Background

Acute respiratory distress syndrome (ARDS) is a life-threatening critical illness, characterised by qualitative and quantitative surfactant compositional changes associated with premature airway collapse, gas-exchange abnormalities and acute hypoxic respiratory failure. The underlying mechanisms for this dysregulation in surfactant metabolisms are not fully explored. Lack of therapeutic benefits from clinical trials, highlight the importance of detailed in-vivo analysis and characterisation of ARDS patients according to patterns of surfactant synthesis and metabolism.

Methods

Ten patients with moderate to severe ARDS were recruited. Most (90%) suffered from pneumonia. They had an infusion of methyl-D₉-choline chloride and small volume bronchoalveolar lavage fluid (BALF) was obtained at 0,6,12,24,48,72 and 96 hours. Controls were healthy volunteers, who had BALF at 24 and 48 hours after methyl-D₉-choline infusion. Compositional analysis and enrichment patterns of stable isotope labelling of surfactant phosphatidylcholine (PC) was determined by electrospray ionisation mass spectrometry.

Results

BALF of patients with ARDS consisted of diminished total PC and fractional PC16:0/16:0 concentrations compared to healthy controls. Compositional analysis revealed, reductions in fractional compositions of saturated PC species with elevated levels of longer acyl chain unsaturated PC species. Molecular specificity of newly synthesised PC fraction showed time course variation, with lower PC16:0/16:0 composition at earlier time points, but achieved near equilibrium with endogenous composition at 48 hours after methyl-D₉-choline infusion. The enrichment of methyl-D₉-choline into surfactant total PC is nearly doubled in patients, with considerable variation between individuals.

Conclusions

This study demonstrate significant alterations in composition and kinetics of surfactant PC extracted from ARDS patients. This novel approach may facilitate biochemical phenotyping of ARDS patients according to surfactant synthesis and metabolism, enabling individualised treatment approaches for the management of ARDS patients in the future.     

The role of intra- and extracellular Ca in the activation of contraction of pulmonary artery smooth muscles induced by serotonin

In Ca-free EGTA-containing solution serotonin induced a transient contraction of rabbit pulmonary artery smooth muscle which decayed to nearly steady-state level accounted for 17.7 +/- 1.6% of original contraction in Krebs solution. Both phasic and tonic components of this contraction were effectively inhibited by verapamil and Cd2+. Caffeine induced no contraction of muscle strips if it was applied after withdrawal of serotonin. But when the sequence of these drugs application was reversed, serotonin still evoked contraction with reduced phasic component. The results obtained in these experiments suggest, that serotonin-induced contraction of pulmonary artery smooth muscle is partly (less than 20%) due to mobilization of bound calcium from at least two stores located on the opposite sides of the cell membrane. Calcium released from external store site enters the cell via receptor-operated calcium channels.