Alleviation of acute pancreatitis-associated lung injury by inhibiting the p38 mitogen-activated protein kinase pathway in pulmonary microvascular endothelial cells

BACKGROUND Previous reports have suggested that the p38 mitogen-activated protein kinase signaling pathway is involved in the development of severe acute pancreatitis(SAP)-related acute lung injury(ALI).Inhibition of p38 by SB203580 blocked the inflammatory responses in SAP-ALI.However,the precise mechanism associated with p38 is unclear,particularly in pulmonary microvascular endothelial cell(PMVEC)injury.AIM To determine its role in the tumor necrosis factor-alpha(TNF-α)-induced inflammation and apoptosis of PMVECs in vitro.We then conducted in vivo experiments to confirm the effect of SB203580-mediated p38 inhibition on SAP-ALI.METHODS In vitro,PMVEC were transfected with mitogen-activated protein kinase kinase 6(Glu),which constitutively activates p38,and then stimulated with TNF-α.Flow cytometry and western blotting were performed to detect the cell apoptosis and inflammatory cytokine levels,respectively.In vivo,SAP-ALI was induced by 5%sodium taurocholate and three different doses of SB203580(2.5,5.0 or 10.0 mg/kg)were intraperitoneally injected prior to SAP induction.SAP-ALI was assessed by performing pulmonary histopathology assays,measuring myeloperoxidase activity,conducting arterial blood gas analyses and measuring TNF-α,interleukin(IL)-1βand IL-6 levels.Lung microvascular permeability was measured by determining bronchoalveolar lavage fluid protein concentration,Evans blue pulmonary cells was confirmed by performing a terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling analysis and examining the Bcl2,Bax,Bim and cle-caspase3 levels.The proteins levels of P-p38,NFκB,IκB,P-signal transducer and activator of transcription-3,nuclear factor erythroid 2-related factor 2,HO-1 and Myd88 were detected in the lungs to further evaluate the potential mechanism underlying the protective effect of SB203580.RESULTS In vitro,mitogen-activated protein kinase(Glu)transfection resulted in higher apoptotic rates and cytokine(IL-1βand IL-6)levels in TNF-α-treated PMVECs.In vivo,SB2035080 attenuated lung histopathological injury,decreased inflammatory activity(TNF-α,IL-1β,IL-6 and myeloperoxidase)and preserved pulmonary function.Furthermore,SB203580 significantly reversed changes in the bronchoalveolar lavage fluid protein concentration,Evans blue accumulation,terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling-positive cell numbers,apoptosis-related proteins(cle-caspase3,Bim and Bax)and endothelial microstructure.Moreover,SB203580 significantly reduced the pulmonary P-p38,NFκB,P-signal transducer and activator of transcription-3 and Myd88 levels but increased the IκB and HO-1 levels.CONCLUSION p38 inhibition may protect against SAP-ALI by alleviating inflammation and the apoptotic death of PMVECs.

Hypoxia Down-regulates Secretion of MMP-2, MMP-9 in Porcine Pulmonary Artery Endothelial and Smooth Muscle Cells and the Role of HIF-1

Summary： Primary cell culture, techniques of gene transfection, gelatin zymography, and Western blot were used to investigate the effect of hypoxia on the secretion of MMP 2 and MMP-9 in pulmonary artery endothelial cells （PAEC） and smooth muscle cells （PASMC）, and the role of HIF-1. Our results showed that （1） after exposure to hypoxia for 24 h, the protein content and activity of MMP-2 in the PAEC medium as well as these of MMP-2 and MMP-9 in PASMC medium （P〈0. 01 ） decreased significantly in contrast to those in normoxic group （P（0.05） ; （2） after transfection of wild type EPO3＇ enhancer, a HIF-1 decoy, the content and activity of MMP 2 and MMP-9 in hypoxic mediums became higher than those in normoxic group （P〈0. 01）, while transfection of mutant EPO3＇-enhancer didn＇t affect the hypoxia-induced down-regulation. It is concluded that hypoxia could inhibit the secretion and activity of MMP 2 and MMP-9 in PAEC and PASMC, which could he mitigated by the transfection of EPO3 ＇-enhancer and that H1F-1 pathway might contribute to hypoxia-induced down regulation of MMP-2 and MMP-9.

Baicalin Induces IFN-α/β and IFN-γ Expressions in Cultured Mouse Pulmonary Microvascular Endothelial Cells

We studied the effect of baicalin,an extract from Radix Scutellariae（a traditional Chinese medicine） in inducing mouse pulmonary microvascular endothelial cells（MPMVECs） to produce interferons（IFNs）.MPMVECs were cultured in vitro in the presence of different concentrations of baicalin（10,20,and 30 μg mL-1）,and the cells and the culture media were harvested at various time intervals.The proteins and mRNA levels（relative to β-actin） of IFN-α/β and IFN-γ were analyzed by RT-PCR and enzyme-linked immunosorbent assay（ELISA）.It was observed that baicalin substantially up-regulated the expression of IFN-α/β and IFN-γ.In all baicalin-treated groups,the relative levels of IFN-α/β and IFN-γ mRNAs peaked after 12 h of culturing,and IFN-α/β and IFN-γ proteins peaked after 24 h of culturing.These results suggest that baicalin can effectively induce the expression of IFNs in pulmonary microvascular endothelial cells,and thus potentially act as an antiviral compound.This study may provide background information for developing new antiviral drugs based on baicalin.

Prevalence of Anti-endothelial Cell Antibodies in Patients with Pulmonary Arterial Hypertension Associated with Connective Tissue Diseases

Objective To investigate the prevalence of anti-endothelial cell antibodies (AECAs) in the sera of connective tissue diseases (CTD) patients with pulmonary arterial hypertension (PAH) and its correlation with clinical manifestations. Methods AECAs in sera of 39 CTD patients with PAH,22 CTD patients without PAH,and 10 healthy donors as controls were detected with Western blotting. The prevalence of different AECAs in different groups was compared and its correlation with clinical manifestations was also investigated. Results The prevalence of AECAs was 82.1% in CTD patients with PAH,72.7% in CTD patients without PAH,and 20.0% in healthy donors. Anti-22 kD AECA was only detected in CTD patients with PAH (15.4%). Anti-75 kD AECA was more frequently detected in CTD patients with PAH than in those without PAH (51.3% vs. 22.7%,P<0.05). In CTD patients with PAH,anti-75 kD AECA was more frequently detected in those with Raynaud’s phenomenon or with positive anti-RNP antibody. Conclusion AECAs could be frequently detected in CTD patients with or without PAH,while anti-22 kD and anti-75 kD AECA might be specific in CTD patients with PAH.

Effects of Sirt1 on proliferation,migration,and apoptosis of endothelial progenitor cells in peripheral blood of SD rats with chronic obstructive pulmonary disease

Objective:To explore the effect of Sirt1 on the function of endothelial progenitor cells(EPCs)in rats with chronic obstructive pulmonary disease(COPD).Methods:A rat COPD model was established via smoking and endotoxin administration for three months.The peripheral circulating EPCs were isolated by gradient centrifugation,and their functions,cell cycle distribution,apoptosis,and Sirt1 expression were examined.The function changes of EPCs in the presence or absence of Sirt1 agonist and inhibitor were estimated;meanwhile,the expressions of Sirt1,FOXO3a,NF-κB,and p53 were also evaluated.Results:The proliferation,adhesion,and migration of EPCs decreased while the apoptosis rate was increased in the COPD rats.The expression of Sirt1 protein in EPCs of the COPD group was significantly lower than that in the control group(P<0.01).The overexpression of the Sirt1 gene using a gene transfection technique or Sirt1 agonists(SRT1720)improved the proliferation,migration,and adhesion,and decreased the apoptosis of EPC.However,Sirt1 inhibitor(EX527)decreased EPC functions in the COPD group.The effect of Sirt1 expression on EPC function may be related to reduction of FOXO3a and increase of NF-κB and p53 activity.Conclusions:Increased expression of Sirt1 can improve the proliferation and migration of EPCs and reduce their apoptosis in COPD rats.This change may be related to FOXO3a,NF-κB,and p53 signaling pathways.

Study of plasma effects during hypoxia and hemorrhagic shock on polymorphonuclear neutrophil－vascular endothelial cellinterac

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The effect of bone marrow mesenchymal stem cell transplantation on hypoxic pulmonary hypertension in rats

Objective:To study the influence of bone marrow mesenchymal stem cells(MSCs)transplantation on hypoxic pulmonary hypertension(HPH)in rats.Methods:MSCs in SD rats were separated,cultivated,identified in vitro,and labeled by the green fluorescence protein(GFP)adenovirus.Healthy male SD rats were randomly divided into four groups:normal control group(NC group)and HPH group,with eight rats in each group respectively;HPH+mesenchymal stem cell transplantation group(MSCs group)and HPH+vascular endothelial growth factor+mesenchymal stem cell transplantation group(VEGF+MSCs group),with twenty-four rats in each group respectively.In this experiment,intermittent normobaric hypoxia was employed to establish the pulmonary hypertension rat models,with stem cells transfected and transplanted.The mean pulmonary artery pressure(mPAP)was observed in rats to calculate the right ventricular hypertrophy index(RVHI);the morphological changes of pulmonary arterioles in each group of rats were observed under the microscope;the distribution and manifestation of MSCs fluorescently labeled by adenovirus transfection were observed in pulmonary arterioles under the fluorescence microscope at the set time points of 7 d,14 d and 28 d after the transplantation of stem cells.Results:For NC group,the mPAP(mmHg)was 15.5±1.5 at 28 d,while the mPAP in HPH,MSCs and VEGF+MSCs groups were 26.1±1.9,21.6±2.7 and 20.1±2.9 respectively which were apparently higher than that in NC group(p<.01).Compared with HPH group(p<.01),the mPAP was obviously decreased in MSCs and VEGF+MSCs groups.There was no significant difference between MSCs and VEGF+MSCs groups.At 28 d,RVHI for NC group was 0.28±0.02,while the RVHI in HPH,MSCs and VEGF+MSCs groups were 0.43±0.07,0.34±0.03 and 0.35±0.01 respectively which were apparently higher than that in NC group(p<.01).In comparison with HPH group,RVHI was significantly decreased in MSCs and VEGF+MSCs groups(p<.05).There was no significant difference between MSCs and VEGF+MSCs groups.For HPH group,at 28 d,pulmonary arterioles were apparently thickened,with luminal stenosis&obliteration and incomplete endothelial cells.Compared with HPH group,pulmonary arterioles in MSCs group became thinning,with the lumen unobstructed and the integrity of endothelial cells improved.The changes in the manifestation of MSCs and VEGF+MSCs groups were not significant.Conclusions:The transplantation of MSCs can improve the remodeling of pulmonary arterioles to partially reverse the progress of HPH;the combined transplantation of VEGF and MSCs doesn’t improve the effect of MSC transplantation.

硝化应激在肺动脉高压中的研究进展

肺动脉高压(pulmonary hypertension,PH)是一种进行性发展的肺血管疾病,病理基础包括内皮功能障碍、平滑肌细胞异常增生、炎症浸润以及肺纤维化。PH的发生机制尚不完全清楚,但硝化应激已经证实在PH中发挥了重要作用。该文综述了活性氮(reactive nitrogen species,RNS)的种类及肺循环中RNS的来源,以及由此引发的硝化应激在PH发生发展中的作用,以期为靶向抗硝化治疗的临床应用提供参考依据。

卡巴胆碱对失血性休克大鼠肺微血管内皮细胞功能的影响

目的 观察大鼠失血性休克时卡巴胆碱对肺微血管内皮细胞的作用。方法 将30只健康雄性SD大鼠(SPF级)按每组10只随机分为假休克组(SS组)、失血性休克组(HS组)、失血性休克+卡巴胆碱组(CBL组)。失血性休克动物模型按照Wiggers改良法制作,各组模型制备完毕后6 h,经右侧股动脉采血,检测肿瘤坏死因子-α(TNF-α)水平,取右肺下叶肺组织检测Src抑制的蛋白激酶C的底物(SSeCKS)、E-选择素蛋白质水平,取右肺下叶行透射电镜检查肺微血管内皮细胞超微结构。结果 SS组表达少量的TNF-α、SSeCKS、E-选择素,HS组和CBL组表达升高(P<0.05),与HS组相比,CBL组表达降低(P<0.05)。SS组肺微血管内皮细胞细胞膜表面光滑,细胞膜、细胞质、细胞核形态结构正常;HS组肺微血管内皮细胞出现细胞水肿、坏死和凋亡表现(细胞膜表面皱折、细胞膜表面凹凸不平、细胞器水肿、异染色质染色加深边集等);CBL组较SS组,细胞有所损伤,但好于HS组。结论 大鼠失血性休克时卡巴胆碱对肺微血管内皮细胞具有保护作用,也可通过抑制炎症细胞合成和释放炎症介质减轻对血管内皮细胞的损伤。

温石棉对内皮细胞Wnt5a、p16和p21表达的影响

目的探讨温石棉对人脐静脉内皮细胞(HUVECs)的影响。方法实验组以50、100、200 mg/L温石棉纤维液刺激HUVECs 24、48、72 h,对照组仅加RPMI 1640培养基培养细胞,观察细胞形态变化,β-半乳糖苷酶法分析细胞衰老情况,四甲基偶氮唑蓝法检测细胞存活率。采用实时荧光定量PCR法检测细胞中Wnt5a、p16和p21 mRNA的表达情况。结果实验组HUVECs多呈梭形,部分呈圆形或不规则形,出现裸核及空泡现象,可见死亡细胞。随温石棉质量浓度及暴露时间的增加,细胞活性逐渐降低,衰老细胞逐渐增多。100 mg/L温石棉处理HUVECs 24 h时,细胞生长较活跃。与对照组相比,实验组Wnt5a、p16和p21 mRNA表达水平均增高(P<0.05)。结论温石棉可促进HUVECs衰老,Wnt5a、p16和p21参与此过程。

靶向肺血管内皮功能障碍治疗肺动脉高压的研究进展

肺动脉高压(pulmonary hypertension, PH)是一种进行性、致命性疾病,肺动脉内皮细胞(pulmonary arterial endothelial cells, PAECs)功能障碍是其重要的致病因素之一。PAECs是单层扁平上皮细胞,在维持肺血管稳态调控中发挥重要作用。研究发现,在PH发生的早期,PAECs出现损伤及凋亡的现象,而在PH发展的晚期,PAECs则呈现抗凋亡的特征。缺氧、炎症因子诱导的PAECs向间充质细胞的转化,也参与了PH的发病过程。PAECs的癌样代谢和线粒体功能障碍、骨形态发生蛋白受体2突变、表观遗传学改变和炎症,是导致PH患者肺血管内皮功能障碍的主要发病机制。新的靶向PAECs功能障碍的治疗措施,有望在未来治疗PH中发挥重要作用。

GW501516对低氧致肺动脉内皮细胞损伤的影响及机制

目的探讨过氧化物酶体增殖物激活受体δ(PPARδ)激动剂GW501516对低氧诱导的肺动脉内皮细胞(PAECs)损伤的影响及机制。方法通过检测PAECs的相对存活率,观察GW501516的细胞毒性作用;采用Western blot法检测PPARδ蛋白的表达水平。建立低氧条件下PAECs损伤的细胞模型,以抗氧化剂N-乙酰半胱氨酸(NAC)为阳性对照,通过检测细胞凋亡率、细胞活力、乳酸脱氢酶(LDH)活性、活性氧(ROS)水平,考察GW501516对细胞损伤及ROS产生的影响。以核因子E2相关因子2(Nrf2)激活剂富马酸二甲酯(DMF)为阳性对照,在低氧条件下通过GW501516和(或)Nrf2抑制剂ML385孵育PAECs,以细胞损伤(细胞凋亡、细胞活力、LDH活性)及超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GPx)、过氧化氢酶(CAT)、丙二醛(MDA)、ROS水平及Nrf2、血红素加氧酶1(HO-1)、裂解型胱天蛋白酶3(C-caspase-3)蛋白的表达水平,探讨GW501516对低氧致PAECs损伤的作用机制。结果低氧刺激能够抑制PAECs内PPARδ蛋白的表达(P<0.05),而GW501516可在低氧条件下促进PPARδ蛋白的表达且无明显的细胞毒性作用。GW501516可抑制PAECs凋亡,提高细胞活力,降低LDH活性及ROS水平。GW501516可通过激活Nrf2通路,上调PAECs内HO-1蛋白表达水平及SOD、GPx、CAT水平,降低MDA、ROS水平(P<0.05),而Nrf2抑制剂ML385能够逆转GW501516的上述作用(P<0.05)。GW501516下调C-caspase-3蛋白表达,抑制低氧诱导的PAECs损伤的作用与Nrf2激活剂DMF相似(P<0.05),而Nrf2抑制剂ML385能够逆转GW501516抑制PAECs损伤的作用(P<0.05)。结论GW501516可通过抑制氧化应激来减轻低氧诱导的PAECs损伤,其机制与激活Nrf2有关。

黄连及其提取物防治肺部感染的研究进展

肺部感染已成为威胁人类健康的重大疾病,给数百万患者的身体健康造成严重威胁。黄连是典型清热药,主要活性成分包括黄连素(小檗碱)、黄连碱等,具有强效清热燥湿作用,可通过多种途径防治肺部感染。黄连及其提取物对肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌、肺炎链球菌、流感病毒、冠状病毒等多种肺部感染病原菌具有抗菌活性。黄连及其提取物还可增强抗生素的抗菌活性。黄连及其提取物可通过抑制多种炎症因子释放、阻止核因子κB(nuclear factor kappa-B,NF-κB)激活、抑制NOD样受体热蛋白结构域相关蛋白3(NOD-like receptor thermal protein domain associated protein 3, NLRP3)炎症小体活化、调节T细胞免疫反应、降低粘附分子的释放、抑制磷脂酶A2(Phospholipase A2,PLA2)的释放,降低病原菌引发的炎症反应。黄连及其提取物能降低肺部血管内皮损伤,抑制新血管形成,阻止肺纤维化,以降低肺部损伤。本研究通过文献整理,对黄连及其提取物防治肺部感染的作用机制进行了综述。

丹参酮ⅡA对脓毒症肺微血管内皮细胞损伤的保护作用

目的探寻丹参酮ⅡA对脓毒症肺血管内皮细胞损伤的保护作用。方法采用盲肠结扎穿孔术构建脓毒症肺损伤小鼠模型,分为6组:假手术组、模型组、丹参酮1组(10 mg/kg)、丹参酮2组(30 mg/kg)、丹参酮3组(50 mg/kg)、丹参酮4组(100 mg/kg)。药物干预24 h后检测肺组织病理变化、肺微血管通透性、肺组织湿/干重比、白细胞计数以及炎症因子等各项指标,假手术组仅行盲肠探查术。结果丹参酮各组较模型组小鼠肺组织损伤及评分均减轻(P<0.05)。与模型组比较,丹参酮各组小鼠肺组织Evans Blue含量、肺组织湿/干比明显降低(P<0.05),BALF白细胞计数、蛋白含量、炎症因子明显减少(均P<0.05),且呈剂量依赖性,其中丹参酮2组、丹参酮3组和丹参酮4组之间,肺组织病理损伤、Evans Blue含量、肺组织湿/干比以及肺泡灌洗液中白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)表达水平差异无统计学意义(均P>0.05)。结论丹参酮ⅡA能够剂量依赖性地降低脓毒症所致的肺微血管内皮细胞损伤,从而改善肺损伤;30 mg/kg剂量的丹参酮ⅡA即可达到最佳效果。

红景天苷调控NF-κB、Bcl-2信号通路对烟雾暴露大鼠氧化应激及肺血管内皮细胞凋亡的影响

目的探究红景天苷(SDS)通过调控B淋巴细胞瘤-2(Bcl-2)、核转录因子-κB(NF-κB)信号通路对烟雾暴露大鼠氧化应激及肺血管内皮细胞凋亡的机制。方法选取60只大鼠分为对照组、模型组、SDS 10 mg/kg、SDS 40 mg/kg、SDS 70 mg/kg、醋酸泼尼松(PNS)组,每组10只,除对照组外,其余均建立烟雾致肺损伤模型,对照组与模型组大鼠每日采用等量生理盐水灌胃;SDS高、中、低剂量组分别按70、40、10 mg/kg剂量给予SDS混悬液2 mL灌胃;PNS组给予PNS混悬液3.6 mg/kg灌胃,均每日1次,连续21 d。结果与对照组比较,模型组大鼠血清中丙二醛(MDA)、Bcl-2相关X因子(Bax)、NF-κB、p-NF-κB及细胞凋亡升高,超氧化物歧化酶(SOD)、Bcl-2降低(P<0.05);与模型组比较,SDS各剂量组MDA、Bax、NF-κB、p-NF-κB及细胞凋亡均有所降低,SOD、Bcl-2也有所升高(P<0.05),且模型组与SDS 10 mg/kg组比较无明显差异(P>0.05),SDS 40 mg/kg组与PNS组比较无明显差异(P>0.05)。对照组大鼠肺组织良好;模型组肺损伤严重;药物干预后各组肺损伤均减轻。结论SDS可改善烟雾暴露大鼠肺损伤、氧化应激及血管内皮细胞凋亡,其机制可能与调控Bax/Bcl-2及NF-κB相关。

支气管肺发育不良模型小鼠肺周细胞变化及对肺血管内皮细胞成管的影响

背景:肺周细胞位于肺血管连接凹陷处,与肺血管的形成和稳定有着密切关系。然而,在支气管肺发育不良发病过程中肺周细胞如何影响肺血管内皮细胞活动的研究较少。目的:分析支气管肺发育不良不同时期肺周细胞亚群与内皮细胞间数目变化关系,探讨血小板源性生长因子受体β、蛋白聚糖NG2、α-平滑肌肌动蛋白三阳性(PDGFR-β^(+)NG2^(+)α-SMA^(+))肺周细胞对肺血管内皮细胞早期成管活动的影响。方法:①动物实验:取新生C57BL/6小鼠12只,于出生24 h内采用随机数字表法分为常氧组及高氧组,每组6只,高氧组小鼠暴露于体积分数85%O_(2)环境下喂养,建立支气管肺发育不良动物模型;常氧组小鼠置于同一室内空气中喂养。出生后7,14 d取小鼠肺组织,苏木精-伊红染色观察肺组织病理改变,流式细胞术检测肺周细胞3种亚群与血管内皮细胞数量。②细胞实验:将小鼠第3代PDGFR-β^(+)NG2^(+)α-SMA^(+)肺周细胞与小鼠肺血管内皮细胞共培养(实验组),细胞比例为1∶4,以单独培养的小鼠肺血管内皮细胞为对照组。培养15 h后,分析两组血管内皮细胞成管差异。结果与结论:①动物实验:苏木精-伊红染色显示,7 d时,常氧组小鼠肺组织结构规则,存在明显肺泡结构,大小均匀;高氧组小鼠肺组织肺泡数量较少,肺泡形态不规则。14 d时,常氧组小鼠肺泡逐渐发育成熟,肺泡结构逐步规整,大小均匀,肺泡密度逐渐增加;高氧组小鼠肺组织结构相对紊乱,肺泡形成滞后体积逐渐增大,肺泡结构简单化。流式细胞术检测显示,与常氧组相比,高氧组7,14 d肺组织中的PDGFR-β^(+)NG2-α-SMA^(+)和PDGFR-β^(+)NG2^(+)α-SMA^(+)肺周细胞数量增加(P<0.01),PDGFR-β^(+)NG2^(+)α-SMA-肺周细胞与肺血管内皮细胞数量减少(P<0.01,P<0.05)。②细胞实验:对照组肺血管内皮细胞排列成条索状向四周延伸,部分区域中形成类似管腔样结构;实验组未观察到PDGFR-β^(+)NG2^(+)α-SMA^(+)肺周细胞及其伪足,肺血管内皮细胞形成的不规则网格状结构较对照组明显减少,内皮细胞以团块样聚集为主。③结果表明:支气管肺发育不良小鼠肺组织以α-SMA^(+)周细胞亚群为主,PDGFR-β^(+)NG2^(+)α-SMA^(+)肺周细胞则能直接抑制肺血管内皮细胞成管活动,可能参与了支气管肺发育不良发生过程中肺微血管发育异常的过程。

CXCR1、ESM-1及IGFBP-2与COPD合并肺部感染患者疾病严重程度、预后的关系

目的 分析血清趋化因子受体1(CXCR1)、内皮细胞特异性分子-1(ESM-1)、胰岛素样生长因子结合蛋白2(IGFBP-2)水平与慢性阻塞性肺疾病(COPD)合并肺部感染患者疾病严重程度、预后的关系。方法 选取2021年1月至2023年1月于阜阳市人民医院就诊的COPD患者325例,根据肺部感染情况分为感染组及未感染组。比较两组入院时的血清CXCR1、ESM-1、IGFBP-2水平及常规感染指标[C-反应蛋白(CRP)、降钙素原(PCT)]水平,采用Pearson相关分析感染组上述指标的关系。比较不同病情严重程度COPD合并肺部感染患者入院时的CXCR1、ESM-1、IGFBP-2水平。对感染组患者跟踪随访6个月或死亡止,根据预后情况分为存活亚组及死亡亚组,比较两亚组患者入院时的血清CXCR1、ESM-1、IGFBP-2水平;采用受试者工作曲线(ROC)分析上述指标对COPD合并肺部感染患者死亡的预测价值。结果 325例COPD患者包括感染组109例及未感染组216例。感染组患者入院时的血清CXCR1、ESM-1、IGFBP-2、CRP、PCT水平高于未感染组,差异有统计学意义(P<0.05)。不同病情严重程度COPD合并肺部感染患者入院时的血清CXCR1、ESM-1、IGFBP-2水平比较差异有统计学意义(P<0.05)。Pearson相关分析显示,感染组入院时的血清CRP水平与CXCR1、ESM-1水平呈正相关(P<0.05)。随访期间感染组死亡19例(17.43%),存活90例(82.57%),死亡亚组入院时的血清CXCR1、ESM-1、IGFBP-2水平高于存活亚组,差异有统计学意义(P<0.05)。ROC结果显示,血清CXCR1、IGFBP-2水平预测COPD合并肺部感染患者死亡具有一定局限性(AUC=0.636、0.769),ESM-1的预测效能较好(AUC=0.827),CXCR1+ESM-1+IGFBP-2三项联合诊断的预测效能最佳(AUC=0.904)。结论 血清CXCR1、ESM-1、IGFBP-2水平在COPD合并肺部感染患者的疾病严重程度及预后评估方面具有一定指导意义。

中性粒细胞胞外诱捕网通过激活NLRP3炎症小体诱导人肺微血管内皮细胞焦亡

目的探讨中性粒细胞胞外诱捕网作用于肺微血管内皮细胞并诱发内皮细胞死亡的具体机制。方法以200 ng/mL的体外分离的中性粒细胞胞外诱捕网刺激人肺微血管内皮细胞,碘化丙锭染色法检测细胞死亡情况,蛋白质印迹法和免疫荧光法检测焦亡标记物。结果与对照组相比,中性粒细胞胞外诱捕网刺激后的肺微血管内皮细胞死亡加剧,NLRP3炎症小体和焦亡相关标记物GSDMD、N-GSDMD表达明显升高,NLRP3抑制剂MCC950预处理可有效减弱NLRP3的激活,抑制细胞焦亡的发生。结论中性粒细胞胞外诱捕网可通过激活NLRP3炎症小体诱发人肺微血管内皮细胞焦亡。

腺苷A_(2B)受体激活减轻脓毒症诱导的急性肺损伤及肺微血管内皮炎症损伤

目的分析腺苷A_(2B)受体(A_(2B) R)激活对脓毒症诱导的急性肺损伤(ALI)的影响并探讨其在肺微血管内皮炎症损伤中的调控作用。方法(1)将24只SD大鼠随机分为假手术组(sham组)、ALI模型组(ALI组)、A_(2B) R激动剂BAY60-6583干预组(ALI+BAY组)和A_(2B) R抑制剂PSB1115干预组(ALI+PSB组),每组6只。制模后24 h处死大鼠取肺组织,光镜下行肺损伤评分(Smith评分),计算肺湿/干质量比值(W/D)。Evans Blue染色法测定肺水清除率(AFC)。酶联免疫吸附试验(ELISA)测定肺组织炎症因子肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)的水平。(2)采用TNF-α诱导人肺微血管内皮细胞(HPMECs)损伤模型,设立对照组、TNF-α组、BAY组、PSB组、BAY+TNF-α组和PSB+TNF-α组,各组细胞培养24 h后采用异硫氰酸荧光素(FITC)-白蛋白(albumin)法检测HPMECs单层通透性,Werstern blot法检测IL-1β、细胞间黏附分子-1(ICAM-1)、血管内皮钙黏连蛋白(VE-cadherin)、促血管生成素(ANGPT)的表达水平。结果与sham组比较,ALI组的Smith评分、肺W/D及肺组织TNF-α、IL-6、IL-1β水平均显著升高,AFC显著降低;与ALI组比较,ALI+BAY组的Smith评分、肺W/D及肺组织TNF-α、IL-6、IL-1β水平显著降低,AFC显著升高;而ALI+PSB组结果相反。TNF-α诱导HPMECs损伤模型中,与对照组比较,TNF-α组IL-1β、ICAM-1表达水平及HPMECs单层通透性升高,VE-cadherin、ANGPT表达水平降低。与TNF-α组比较,BAY+TNF-α组IL-1β、ICAM-1表达水平及HPMECs单层通透性降低,VE-cadherin、ANGPT表达水平升高,而PSB1115预处理可逆转上述现象。上述各组之间差异有统计学意义(均P<0.05)。结论腺苷A_(2B) R激活可减轻脓毒症诱导的ALI,并通过减轻肺微血管内皮炎症、降低通透性、促进血管生成等途径起保护作用。

血府逐瘀汤对肺动脉内皮细胞间质转化的影响及机制

目的 研究血府逐瘀汤对转化生长因子-β1(TGF-β1)诱导的大鼠肺微血管内皮细胞(pulmonary microvascular endothelial cells, PMVECs)内皮间质转化(endothelial-to-mesenchymal transition, EndMT)的影响,并从TGF-β1/Smad信号通路进一步分析其作用机制。方法 采用TGF-β1(5μg·L^(-1))建立EndMT细胞模型。实验分组为正常组,模型组(TGF-β1,5μg·L^(-1)),血府逐瘀汤低、中、高浓度组(3、10、30 mg·L^(-1)XFZYD+5μg·L^(-1)TGF-β1),SB 431542阳性药组(5μmol·L^(-1)SB 431542+5μg·L^(-1)TGF-β1)。观察细胞形态,鬼笔环肽染色观察细胞骨架,免疫荧光法观察内皮细胞标志物-血小板内皮细胞黏附分子1(CD31)和间质细胞标志物α-平滑肌肌动蛋白(α-SMA)的表达。蛋白免疫印迹法检测血府逐瘀汤对CD31、α-SMA、Snail、p-Smad2、p-Smad1/5蛋白表达的影响。结果 TGF-β1刺激后,细胞形态由鹅卵石形向梭形转变。CD31、p-Smad1/5表达明显减少,α-SMA、p-Smad2、Snail表达则显著升高。血府逐瘀汤干预后,与模型组相比,细胞形态不同程度的接近于正常组,CD31和p-Smad1/5表达呈上升趋势,α-SMA、p-Smad2、Snail表达呈下降趋势。结论 血府逐瘀汤可以减轻大鼠肺微血管内皮细胞发生内皮间质转化,其作用可能是通过影响TGF-β1/Smad信号通路实现的。