多种因素参与了脂多糖诱导兔肺动脉反应性的变化

为探讨内毒素休克时肺动脉高压的发生机制,实验观察了N-乙酰半胱氨酸(N-acetylcysteine,NAC)、NO及CO在脂多糖(lipopolysaccharide,LPS)诱导的肺动脉反应性变化中的作用.用雄性家兔24只,制备约3 mm宽的肺动脉环.实验结果显示LPS孵育7 h后,肺动脉对1 μmol/L乙酰胆碱介导的内皮依赖性舒张反应降低,但对非内皮依赖性舒张剂硝普钠的反应性无明显改变.自由基清除剂(NAC)、L-精氨酸(NO供体)和氯化血红素(CO供体)可分别减轻LPS的上述作用.而应用血红素氧合酶-1(heme oxygenase-1,HO-1)阻断剂锌原卟啉抑制CO产生后则增强LPS的上述作用.N-硝基-L-精氨酸甲酯(L-NAME,一氧化氮合酶抑制剂)抑制NO的产生后使各组肺动脉对乙酰胆碱的反应由舒张变为收缩,对1 μmol/L苯肾上腺素的收缩反应显著增强,说明NO和CO在肺动脉反应性改变中发挥重要作用.上述结果提示抗氧化或给予NO、CO可显著改善LPS引起的内皮依赖性舒张反应减弱.周此,多种因素参与了本实验中内毒素引起的肺动脉高压的发生.     

内源性过氧亚硝基阴离子介导脂多糖导致肺动脉内皮细胞损伤

在培养的牛肺动脉内皮细胞(bovine pulmonary artery endothelial cells,BPAECs)水平上,观察脂多糖(lipopolysaccharide,LPS)对BPAECs诱生过氧亚硝基阴离子(peroxynitrite,ONOO~-)能力及内皮源性ONOO~-在LPS致BPAECs损伤中的作用。结果显示:(1)LPS剂量依赖性地引起BPAECs诱生ONOO~-生成标志物硝基酪氨酸(nitrotyrosine,NT)的荧光强度(即ONOO~-)明显增多,NT阳性细胞数和百分率也明显增多或增高(P<0.05);iNOS选择性抑制剂氨基胍(AG)明显抑制LPS诱生ONOO~-增多(P<0.05),而NT阳性细胞数和百分率分别减少或降低,但无明显差异。(2)在LPS作用下BPAECs培养上清中的MDA含量和LDH活性明显增多和增高,呈现剂量依赖性效应。加AG后MDA含量明显降低(P<0.001),LDH活性呈降低趋势。(3)LPS可诱导BPAECs凋亡明显增多,用EB荧光染色后可见细胞染色质浓集、核变小等凋亡征象。AG可导致LPS引起的BPAECs凋亡明显减少,但仍明显高于溶剂组。LPS可导致BPAECs线粒体呼吸抑制及膜电位下降。上述结果表明,LPS可引起BPAECs生成ONOO~-增多,ONOO~-参与介导LPS所致BPAECs过氧化损伤与细胞凋亡。     

N-乙酰半胱氨酸对脂多糖诱导的急性肺损伤大鼠肺组织病理形态及TGF-β1表达的作用

目的:观察N-乙酰半胱氨酸(NAC)对脂多糖诱导的急性肺损伤大鼠肺组织形态及转化生长因子-β1表达的作用.方法:将30只SD大鼠随机分为正常对照组、模型组和NAC干预组3组,每组10只.模型组经舌下静脉注射5 mg/kg脂多糖制备大鼠急性肺损伤模型,NAC干预组在注射脂多糖后1h腹腔注射NAC(200 mg/kg),注入脂多糖后12h处死大鼠,取左叶肺组织,观察各组大鼠肺组织病理形态和TGF-β1的表达变化.结果:模型组肺泡间隔增宽,腔内有少许出血,渗出及炎性细胞浸润,肺间质充血水肿,有大量炎性细胞浸润,NAC干预组肺部炎性细胞浸润、渗出、出血较模型组明显减轻.模型组肺组织TGF-β1的表达较正常对照组明显增加(P＜0.05),NAC干预组TGF-β1的表达较模型组显著降低(P＜0.05),但与正常对照组比较差异无统计学意义.结论:NAC可显著减轻脂多糖诱导的大鼠急性肺损伤,这可能与其降低肺组织中TGF-β1的表达有关.     

褪黑素对脂多糖诱导血管内皮细胞损伤的保护机制研究

目的：研究褪黑素（melatonin,MLT）对人脐静脉内皮细胞（HUVECs）损伤的保护作用及其机制探讨。方法：不同浓度的褪黑素作用于体外培养的内皮细胞脂质过氧化损伤模型,实验分为5组,即正常对照组（Ctrl）,脂多糖（LPS）氧化损伤组：在培养基中加入2mmol／L的LPS诱导损伤4h;LPS加MLT低剂量（200t~mol／L）组、中剂量（400ixmol／L）组、高剂量（600txmol／L）gai。采用MTT法观察MET对HUVECs活性的影响;用双波长荧光分光光度法测定HUVECs细胞内游离钙离子浓度;检测各组内皮细胞匀浆中丙二醛（MDA）含量及超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH·Px）活性;用ELISA法测定培养的细胞上清液中白细胞介素6（IL．6）表达的变化;并测定细胞凋亡率。结果：①LPS作用后血管内皮细胞损伤明显,细胞增殖减少,细胞培养上清液和细胞匀浆中MDA含量、细胞内钙离子浓度和IL．6均升高,SOD、GSH-Px活性下降,凋亡率可达38．9±1．1％,均与正常对照组有统计学差异（P〈0．01）;②加入MET可明显减轻LPS对抗氧化酶SOD、GSH—Px的影响,同时MDA含量、细胞内钙离子浓度和几一6均明显下降,并显著减少凋亡细胞数量,各指标差异有统计学意义（P〈0．01）。结论：褪黑素可保护和修复LPS引起的血管内皮细胞损伤,其作用途径可能与保护细胞的线粒体,提高了该细胞的抗氧化酶活性,降低细胞内钙离子浓度作用有关。     

N-乙酰-L-半胱氨酸的合成及其在医药上的应用

概述了近几十年来国内外关于Ｎ－乙酰－Ｌ－半胱氨酸的合成方法及其在医药上的应用。     

N-乙酰半胱氨酸对犬心房快速起搏电重构的影响

目的:探讨N-乙酰半胱氨酸(NAC)对犬心房快速起搏电重构的影响。方法:取16只犬,随机分为对照组和NAC干预组。NAC组按照15mg/kg/d剂量给予NAC口服6周时间。在犬右房置入电极,快速起搏右心房,诱发房颤并维持2小时。在起搏前后分别测定有效不应期(AERP)。结果:房颤后对照组AERP显著缩短,AERP频率适应性下降(P<0.05);而NAC组房颤前后AERP和AERP频率适应性均无明显变化。结论:在心房快速起搏致房颤2h的模型中,NAC对心房电重构具有明显的保护作用。     

电渗析法分离提纯N-乙酰-L-半胱氨酸研究

使用我校由辐射法制备的高性能离子交换膜ＨＦ—１及ＨＦ—２,采用电渗析技术对合成所得的Ｎ－乙酰－Ｌ－半胱氨酸进行了分离提纯,脱盐率＞１５％,损失率＜１５％,为工业化应用提供了依据。     

N-乙酰半胱氨酸对犬心房快速起搏电重构的影响

目的：探讨N-乙酰半胱氨酸（NAC）对犬心房快速起搏电重构的影响。方法：取16只犬,随机分为对照组和NAC干预组。NAC组按照15mg／kg／d剂量给予NAC口服6周时间。在犬右房置入电极,快速起搏右心房,诱发房颤并维持2小时。在起搏前后分别测定有效不应期（AERP）。结果：房颤后对照组AERP显著缩短,AERP频率适应性下降（P〈0．05）;而NAC组房颤前后AERP和AERP频率适应性均无明显变化。结论：在心房快速起搏致房颤2h的模型中,NAC对心房电重构具有明显的保护作用。     

内毒诱导肺动脉内皮细胞生成过氧亚硝基阴离子的意义

目的：探讨牛肺动脉内皮细胞（BPAEC）产生过氧亚硝基阴离子（ONOO^-）的能力及其作用。方法：用流式细胞免疫荧光技术,定量检测内毒素主要成分脂多糖（LPS）诱导培养的BPAEC中ONOO^-生成标志物硝基酪氨酸（NT）的含量,观察ONOO^-对BPAEC形态变化的影响。结果：LPS可剂量依赖性诱导BPAEC产生ONOO^-明显增多,并为氮基胍部分翻转;ONOO^-可导致BPAEC明显回缩,胞体变小,细胞间隙增宽。结论：LPS诱导BPAEC产生增多的ONOO^-可能参与介导LPS对BPAEC本身的损伤效应。     

脂多糖直接损伤血管内皮细胞后内皮细胞膜脂的修饰

我们前期的研究显示,脂多糖（lipopolysaccharide,LPS）直接损伤人脐静脉血管内皮细胞（human umbilical vein endothelial cell,HUVEC）后,HUVEC膜粘度随LPS浓度的增加而增大,这暗示LPS可能改变HUVEC的膜结构和组成。本文旨在研究LPS直接损伤HUVEC后内皮细胞膜脂的修饰。用高效毛细管电泳（high performance capillary electrophoresis,HPCE)污测定HUVEC膜磷脂组成,HUVEC用不同浓度（O、0.3125、0.625、1.25、2.5、5、7、8.5、9、10μg/ml）的LPS无血清培养液直接损伤3h;用含LPS（0.625μg/ml）的无血清培养液直接损伤1、3、6、12、24、48h。结果显示：在3h LPS的作用下,HUVEC的总磷脂含量随LPS浓度的增加而增加,在0.625μg/ml LPS的浓度条件下,HUVEC的总磷脂含量随LPS作用时间的延长而降低;LPS的作用浓度和作用时间对磷脂酰鞘磷脂（SM）、磷脂酰乙醇胺（PE）以及磷脂酰丝氨酸（PS）的含量影响不大。LPS激活膜磷脂代谢的反应特性表现出典型的酶促动力学特性。实验结果表明,LPS可直接激活血管内皮细胞膜磷脂代谢,诱导HUVEC膜磷脂的修饰,提示LPS直接损伤血管内皮细胞HUVEC的途径可能与膜结构组成及膜脂代谢有关。     

Prophylactic protection by N-acetylcysteine against the pulmonary injury induced by 2-chloroethyl ethyl sulfide,a mustard analogue

Mustard gas exposure causes adult respiratory distress syndrome associated with lung injury. The purpose of this study was to investigate whether an antioxidant, such as N-acetylcysteine (NAC), has any protective effect. Guinea pigs were given single exposure (0.5-6 mg/kg body weight) of 2-chloroethyl ethyl sulfide (CEES) as a mustard analogue intratracheally and maintained for various lengths of time (1 h to 21 days). Within 1 h of CEES infusion at 4 mg/kg, high levels of tumor necrosis factor alpha (TNF-alpha), ceramides, and nuclear factor kappaB accumulated in lung and alveolar macrophages. Both acid and neutral sphingomyelinases were activated within 4 h. These signal transduction events were associated with alteration in the oxygen defense system. Within 1 h of exposure to CEES (6 mg/kg body weight), there was 10-fold increase in the (125)I-BSA leakage into lung tissue, indicating severe lung injury. Although low level of CEES exposure (0.5 mg/kg body weight) produced symptoms of chemical burn in lung as early as 1 h after exposure, the severity of edema, congestion, hemorrhage, and inflammation increased progressively with time (1 h to 21 days). Feeding of single dose of NAC (0.5 g) by gavage just before the CEES infusion was ineffective to counteract these effects. However, consumption of the antioxidant in drinking water for 3 or 30 days prior to CEES exposure significantly inhibited the induction of TNF-alpha, activation of neutral and acid sphingomyelinases, production of ceramides, activation of caspases, leakage of (125)I-bovine serum albumin ((125)I-BSA) into lung tissue, and histological alterations in lung. Pretreatment with NAC for 3 and 30 days protected against 69-76% of the acute lung injury. Therefore, NAC may be an antidote for CEES-induced lung injury.     

L-Arg对LPS诱导的急性肺损伤大鼠肺表面活性物质和肺泡巨噬细胞功能的影响

目的:探讨L-精氨酸(L-Arg)对脂多糖(LPS)诱导的急性肺损伤大鼠肺表面活性物质和肺泡巨噬细胞功能的影响。方法:舌下静脉注射脂多糖(LPS)复制肺损伤模型。健康雄性SD大鼠48只,随机分为对照组、模型组(LPS组)和L-Arg治疗组(L-Arg组)(n=16)。分别于给予LPS 3 h或6 h后给予生理盐水(对照组及LPS组,ip)和L-Arg(500 mg/kg ip)(L-Arg治疗组),治疗3 h。原位杂交法(ISH)检测肺组织中肺表面活性蛋白A(SP-A)mRNA的表达;测定肺泡灌洗液(BALF)中的总蛋白(TP)。体外分离培养大鼠肺泡巨噬细胞,以LPS(终浓度10 mg/L)处理巨噬细胞,观察L-Arg对肺泡巨噬细胞的影响。结果:与对照组比较,大鼠肺损伤后SP-A mRNA表达减弱,BALF中TP增多(P<0.01)。肺损伤3 h用L-Arg治疗3 h后,SP-A mRNA阳性细胞表达明显增强,BALF中TP较LPS组相同时间点明显降低(P<0.05,P<0.01),肺损伤减轻。体外实验中,与正常对照组相比,LPS组细胞培养上清中乳酸脱氢酶(LDH)、一氧化氮(NO)、肿瘤坏死因子-α(TNFα-)和白细胞介素-6(IL-6)浓度明显增高(P<0.01);L-Arg明显减少LPS所致的LDH的释放,降低TNFα-和IL-6浓度。结论:L-Arg可减轻内毒素性肺损伤,此机制可能与增强SP-AmRNA表达有关;LPS可刺激巨噬细胞分泌促炎因子和NO,L-Arg可抑制LPS对巨噬细胞的作用。     

Alkaline stress-induced apoptosis in human pulmonary artery endothelial cells

The effect of alkaline stress, or an increase in extracellular pH (pHext), on cell viability is poorly defined. Human pulmonary artery endothelial cells (HPAEC) were subjected to alkaline stress using different methods of increasing pHext. Viability and mode of cell death following alkaline stress were determined by assessing nuclear morphology, ultrastructural features, and caspase-3 activity. Incubation of monolayers in media set to different pHext values (7.4–8.4) for 24-h induced morphological changes suggesting apoptosis (35–45% apoptotic cells) following severe alkaline stress. The magnitude of apoptosis was related to the severity of alkaline stress. These findings were confirmed with an assessment of ultrastructural changes and caspase-3 activation. While there was no difference in the intracellular calcium level ([Ca²⁺]_i) in monolayers set to pHext 7.4 versus 8.4 following the first hour of alkaline stress, blockade of calcium uptake with the chelator, EGTA, potentiated the magnitude of apoptosis under these conditions. Potentiation of apoptosis was reduced by calcium supplementation of the media. Finally, alkaline stress was associated with an increase in intracellular pH. This is the first report of apoptosis following alkaline stress in endothelial cells in the absence of other cell death stimuli.     

内源性一氧化氮在内毒素引起的肺动脉高压和肺损伤中的作用

本实验观察了家兔静脉内注入内毒素的主要成分脂多糖(LPS)后平均动脉血压(MAP)、肺动脉压(PAP)及入、出肺血NO含量的变化,并观察了静脉内预注入NO生成抑制剂Nω-硝基-L-精氨酸(L-NNA)及诱生型NO生成抑制剂氨基胍(AG)后PAP和肺损伤的变化.结果观察到:家兔LPS注入后,MAP均明显下降,LPS注入后0.5、1、1.5、2h PAP明显增高(P<0.05).LPS注入后PAP的高峰期(1h)入肺血NO含量明显降低,出肺血NO无明显变化.与对照组相比,LPS注入后3h出肺血NO含量和5h入、出肺血NO含量均明显增多.相关分析表明,兔LPS注入前和LPS注入后1h PAP与入肺血NO含量呈明显的负相关,而LPS注入后 3h和5h两者相关不明显.静脉预注入L-NNA后,LPS处理组的动物PAP明显增高,入、出肺血丙二醛(MDA)含量也明显增高,动物生存率明显降低.肺组织光镜下可见肺萎陷和小血管淤血加重,白细胞明显增加.静脉预注入AG后,LPS处理组的动物MAP在3～5h明显增高,此时PAP无明显改变,但5h时血中MDA含量明显减低,5h时与LPS组相比肺萎陷和小血管淤血减轻,白细胞也明显减少.以上结果提示,内毒素入血后较早期阶段可出现PAP的升高,此时入肺血NO的减少是参与肺动脉压增高(PAH)的机制之一.家兔内毒素进入血后较早期阶段NO对减轻内毒素引起的PAH和肺损伤起重要作用,而较晚的时期当诱生型NO合酶(iNOS)诱生后释放的NO则参与内毒素引起的肺组织炎症反应和肺损伤.     

Improved pulmonary artery buffering function during phenylephrine-induced pulmonary hypertension

The goal of this study was to determine the in vivo pulmonary arterial buffering function (BF) during acute and moderate pulmonary hypertension achieved by phenylephrine-induced smooth muscle activation.Pulmonary pressure (Konigsberg P7) and diameter (sonomicrometry) were measured in nine anesthetized sheep. Transit pulmonary arterial hypertension was induced by mechanical occlusion of the pulmonary artery (HP) and by phenylephrine infusion (5 g/kg/min) (PHE). A viscoelastic Kelvin-Voigt model was used. By increasing the values of the viscous modulus, the pressure-diameter hysteresis area was reduced to a minimum in order to obtain the purely elastic pressure-diameter relationship. The elastic index (E) was calculated as the first derivative of the exponential model of the purely elastic pressure-diameter relationship at the mean pressure point.Systolic, diastolic, mean and pulse pressures were similar during HP and PHE, but significantly higher with regard to control steady state. In HP, E and arterial diameter (both its minimum and maximum values) increased significantly. In contrast, when pulmonary hypertension was induced by VSM activation, E was maintained concomitantly with pulmonary artery vasoconstriction.Pulmonary hypertension produced by occlusion of the pulmonary artery increases elasticity. Smooth muscle activation may offset the deleterious effect of pulmonary hypertension on arterial wall elasticity by reducing E and impeding arterial dilatation and collagen recruitment, maintaining BF during pulmonary hypertension.     

八肽胆囊收缩素对家兔内毒素休克时肺动脉张力的影响

为探讨八肽胆囊收缩素(CCK-8)缓解内毒素休克(ES)时肺动脉血压(PAP)增高的机制,观察了CCK-8对脂多糖(LPS)引起家兔ES时PAP变化以及离体肺动脉环(PARs)张力改变的影响。实验用新西兰大耳白雄性家兔40只,分为颈静脉注入LPS(8mg／kg i．v.)复制的家兔ES模型、LPS注入前15min给CCK-8(15μg/kg,i.v.)、LPS注入前15min给CCK受体拮抗剂丙谷胺(Pro 1mg／kg,i.v.)、单独注入CCK-8(15μg/kg,i.v.)和注射生理盐水(对照)共5组。用生理记录仪监测平均动脉压(MAP)和PAP的变化;5h后制备PARs,应用血管张力测定技术,检测各组PARs张力。结果为：(1)ES时MAP降低、PAP升高,CCK-8可完全翻转ES时PAP的增高,而Pro加剧ES时PAP的增高;(2)LPS组的PARs对苯肾上腺素(PE)的收缩反应增强,对ACh内皮依赖性舒张反应降低,而CCK-8可逆转LP5的上述作用。上述结果提示CCK—8可缓解ES时的PAP升高,这可能与其调节肺动脉张力改变有关。     

过氧亚硝基阴离子介导内毒素致肺血管损伤及胆囊收缩素的保护作用

本文探讨过氧亚硝基阴离子（ONOO^-）在内毒素致肺血管损伤中的介导作用和八肽胆囊收缩素（CCK）的保护作用及其机制。结果发现,内毒素主要成分脂多糖（LPS）可诱导大鼠肺组织生成ONOO^-1,ONOO^-能导致肺微血管壁通透性明显增加和肺脏严重病理变化;ONOO^-可引起离体肺动脉反应性异常改变,LPS也可产生类似变化;ONOO^-有较弱的舒血管作用并受到内皮细胞的抑制性调节;LPS诱导培养的牛肺动脉内皮细胞（BPAEC）产生增多的ONOO^-参与介导内皮细胞本身的损伤;CCK能拮抗LPS对BPAEC的损伤效应,此作用由CCK受体介导,并与抑制ONOO^-生成有关。结果提示,清除ONOO^-或减少ONOO^-生成可为防治内毒素引起的急性肺损伤等病理过程提供新对策;CCK是一种有应用前景的细胞保护因子。     

低氧对人肺动脉平滑肌和人肺动脉内皮细胞中HMGB1及相关炎症因子表达的影响*

目的:探讨低氧时人肺动脉平滑肌细胞(HPASMC)和人肺动脉内皮细胞(HPAEC)的高迁移率族蛋白1(HMGB1)及相关受体和炎症因子表达,并检测HMGB1对两种细胞增殖、迁移活性的影响。方法:低氧(1%氧浓度,Hypoxia组)及常氧(Control组)条件下培养HPASMC和HPAEC,RealTime-PCR检测两种细胞HMGB1、TLR2、TLR4、TLR9、RAGE、CD24、IL-6 、TNF-a和CXCL8 mRNA等受体和炎性因子的表达。MTS法观察不同浓度HMGB1对HPASMC和HPAEC增殖的影响;划痕法观察HMGB1对HPASMC和HPAEC迁移的影响。结果:Hypoxia组HPASMC、HPAEC中HMGB1及RAGE mRNA表达量较Control 组明显升高(P＜0.05及0.01);Hypoxia组HPAEC中CD24及HPASMC中IL-6 mRNA表达明显增高(P均＜0.05)。MTS结果显示在345 pmol/L 剂量下 HMGB1明显抑制HPAEC的增殖(P＜0.01),而对HPASMC增殖无影响。划痕实验示HMGB1对HPASMC和HPAEC迁移无明显影响。结论:低氧诱导HPAEC、HPASMC 产生HMGB1;HMGB1通过抑制HPAEC增殖引起内皮屏障功能障碍;而低氧进一步刺激HPASMC产生炎症因子。     

急性低氧条件下大鼠循环血中内皮细胞及肺小动脉内皮细胞的改变

目的:探讨急性低氧对血管内皮细胞(VEC)和循环血液中内皮细胞(CEC)的影响.方法:用光镜观察急性低氧情况下血中CEC的形态并记数,用组织化学染色和显微分光光度计对血中年轻型CEC及肺小动脉VEC的乳酸脱氢酶(LDH)活性进行定量分析.结果:与低氧前相比,低氧后各组VEC的LDH活性均下降,且随低氧时间延长,LDH活性下降越明显.而低氧前后各组年轻型CEC的LDH活性是一致的,且明显低于各组VEC的LDH活性.低氧前CEC多为衰老型,低氧后CEC数量增多且多为年轻型,随低氧时间延长年轻型CEC增多越明显.结论:CEC的形态和数量的变化可以反映血管的损伤情况;VEC的LDH活性可以反映VEC向CEC转化的进程;年轻型CEC的LDH活性可以反映VEC脱落时的损伤程度.