rhGH预治疗对烧伤后并发脓毒症大鼠早期免疫反应的影响

Effect of pretreatment with rhGH on earlier immune response in septic rats after burn

目的研究重组人生长激素(rhGH)预治疗对烧伤后并发脓毒症大鼠免疫和炎症反应的影响。方法64只SD大鼠根据烧伤和(或)脓毒症模型建立及预治疗情况进行随机分组。ELISA法测定大鼠血清致炎因子(IL-1、IL-6、TNF-α)和抑炎因子(IL-4、IL-10)水平;制备大鼠脾脏组织标本,HE染色计数中性粒细胞,免疫组化染色检测淋巴细胞HLA-DR的表达。结果与烧伤并发脓毒症未预治疗组比较,相应rhGH预治疗组血清IL-1、IL-6和TNF-α水平显著降低(0.0064±0.0022vs 0.0139±0.0018、0.0058±0.0010vs0.0128±0.0014、0.0055±0.0030 vs 0.0145±0.0020)(P<0.05),而血清IL-4和IL-10水平则明显上升(0.0178±0.0045vs 0.0082±±0.0026、0.0251±0.0104vs0.0143±0.0029)(P<0.05);脾脏中性粒细胞浸润减少(0.38±0.52vs 1.73±1.49)(P<0.05),淋巴细胞HLA-DR表达下降(0.0280±0.0167vs0.0594±0.0336),仍明显高于烧伤对照组(P<0.05)。rhGH预治疗对未烧伤脓毒症大鼠的炎性细胞浸润和HLA-DR表达无明显影响。结论在有创伤因素存在时,rhGH在降低致炎因子表达同时提高抑炎因子表达;在烧伤或烧伤并发脓毒症时,rhGH不但可以显著降低炎症反应,还可显著减少炎症细胞在外周的浸润,有效调控外周淋巴细胞HLA-DR的表达。

Objective To investigate the effect of recombinant human growth hormone （rhGH） on immune and inflammatory response in septic rats after burn. Methods Sixty-four SD rats were randomly divided into groups according to the conditions of burn, sepsis and pretreatment with rhGH. The serum levels of pro-inflamatory cytokines （IL-1, IL-6 and TNF-α） and anti-inflammatory cytokines（IL-4 and IL-10）were detected by ELISA. The spleen specimens were prepared, neutrophil count was performed with HE staining, and expression of HLA-DR in lymphocytes was detected with immunohistochemical staining. Results Compared with burn and sepsis without pretreatment group, the serum levels of IL-1, IL-6 and TNF-α in burn and sepsis with pretreatment group significantly decreased （0. 0064± 0. 0022 vs 0. 0139 ± 0.0018, 0.0058±0. 0010 vs 0. 0128 ±0. 0014 and 0. 0055 ±0. 0030 vs 0. 0145 ±0. 0020, respectively） （P 〈0.05）, while serum IL-4 and IL-10 significantly increased （ 0. 0178 ±0. 0045 vs 0. 0082 ±0. 0026 and 0. 0251 ±0. 0104 vs 0. 0143 ± 0. 0029, respectively） （ P 〈 0.05）. The neutrophil count in spleen specimens was decreased （0.38 ± 0.52 vs 1.73 ±1.49） （P 〈 0.05） , and expression of HLA-DR in lymphocytes decreased（0. 0280± 0. 0167 vs 0. 0594 ± 0. 0336） , but still higher than that of burn control group （P 〈 0.05）. Pretreatment with rhGH has no significant effect on the inflammatory cytokines infiltration and expression of HLA-DR in septic rats without brun. Conclusion rhGH can decrease the level of pro- inflamatory cytokines and increase the level of anti-inflammatory cytokines in the existence of traumatic factors. In the presence of burn or burn with sepsis, rhGH can significantly decrease the inflammatory response and peripheral infiltration of inflammatory cells, and effectively regulate the expression of HLA-DR in peripheral lymphocytes.