中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2010年
9期
921-926
,共6页
张克君%宋彩霞%焦学龙%刘世松%孙传东%李春伟%王培戈%周长勇
張剋君%宋綵霞%焦學龍%劉世鬆%孫傳東%李春偉%王培戈%週長勇
장극군%송채하%초학룡%류세송%손전동%리춘위%왕배과%주장용
重症胰腺炎%急性肺损伤%凋亡%核因子-κB%P53正向凋亡调节因子
重癥胰腺炎%急性肺損傷%凋亡%覈因子-κB%P53正嚮凋亡調節因子
중증이선염%급성폐손상%조망%핵인자-κB%P53정향조망조절인자
Severe pancreatitis%Acute lung injury%Apoptosis%Nuclear factor-κB%p53 upregulated modulator of apoptosis
目的 探讨NF-κB(核因子-κB)与PUMA(P53正向凋亡调节因子)表达在大鼠重症急性胰腺炎致急性肺损伤(SAP-ALI)的作用及脯氨酸二硫代氨基甲酸酯(PDTC)的影响.方法 SD大鼠随机(随机数字法)分为假手术组、SAP-ALI组、PDTC组,每组18只.各组再按6,12,24 h时间点分为三个亚组,每个亚组6只.假手术组开腹后翻动胰腺数次;SAP-ALI组采用胰胆管逆行注入5%牛磺胆酸钠(1 mL/kg)诱导SAP-ALI模型;PDTC组在SAP-ALI组的基础于术前1h给予PDTC(15 mg/kg),各组按时间点处死大鼠.观察胰腺和肺脏病理变化.Western-blot法检测肺组织NF-κB p65,PUMA表达,采用RT-PCR法测量各组bax,bcl-2和Caspase-3 mRNA,通过荧光检测试剂检测Caspase-3活性.投射电镜下观察各组肺泡Ⅱ型上皮细胞超微结构的变化,TUNEL检测肺泡上皮细胞的凋亡指数.结果 成功建立了大鼠SAP-ALI模型,Western-blotting结果显示,SAP-ALI组肺组织NF-κB p65和PUMA蛋白表达在6h后增加,24 h增加最明显,NF-κB p65与PUMA显著正相关;SAP-ALI组肺组织bax mRNA和Caspase-3mRNA在6 h后增加,24 h增加最明显,bcl-2 mRNA在6 h后下降,24 h下降最明显,Caspase-3活性在24h增加最明显.PDTC组肺组织NF-κB p65和PUMA蛋白表达明显降低;bax mRNA和caspase-3 mRNA表达及Caspase-3活性明显降低,bcl-2 mRNA表达明显增加.假手术组肺组织各组蛋白的表达与PDTC组比无显著改变.PDTC组肺损伤病理组织学评分在术后各时间点较SAP-ALI组显著降低,PDTC组细胞凋亡指数较SAP-ALI组明显降低.SAP-ALI组24h市泡Ⅱ型上皮细胞微绒毛消失.结论 NF-κB活化激活PUMA与肺泡上皮细胞凋亡有关,PDTC通过抑制NF-κB活化,下调NF-κB活化后引起的PUMA表达,抑制肺泡Ⅱ型上皮细胞凋亡,减轻SAP-ALI.
目的 探討NF-κB(覈因子-κB)與PUMA(P53正嚮凋亡調節因子)錶達在大鼠重癥急性胰腺炎緻急性肺損傷(SAP-ALI)的作用及脯氨痠二硫代氨基甲痠酯(PDTC)的影響.方法 SD大鼠隨機(隨機數字法)分為假手術組、SAP-ALI組、PDTC組,每組18隻.各組再按6,12,24 h時間點分為三箇亞組,每箇亞組6隻.假手術組開腹後翻動胰腺數次;SAP-ALI組採用胰膽管逆行註入5%牛磺膽痠鈉(1 mL/kg)誘導SAP-ALI模型;PDTC組在SAP-ALI組的基礎于術前1h給予PDTC(15 mg/kg),各組按時間點處死大鼠.觀察胰腺和肺髒病理變化.Western-blot法檢測肺組織NF-κB p65,PUMA錶達,採用RT-PCR法測量各組bax,bcl-2和Caspase-3 mRNA,通過熒光檢測試劑檢測Caspase-3活性.投射電鏡下觀察各組肺泡Ⅱ型上皮細胞超微結構的變化,TUNEL檢測肺泡上皮細胞的凋亡指數.結果 成功建立瞭大鼠SAP-ALI模型,Western-blotting結果顯示,SAP-ALI組肺組織NF-κB p65和PUMA蛋白錶達在6h後增加,24 h增加最明顯,NF-κB p65與PUMA顯著正相關;SAP-ALI組肺組織bax mRNA和Caspase-3mRNA在6 h後增加,24 h增加最明顯,bcl-2 mRNA在6 h後下降,24 h下降最明顯,Caspase-3活性在24h增加最明顯.PDTC組肺組織NF-κB p65和PUMA蛋白錶達明顯降低;bax mRNA和caspase-3 mRNA錶達及Caspase-3活性明顯降低,bcl-2 mRNA錶達明顯增加.假手術組肺組織各組蛋白的錶達與PDTC組比無顯著改變.PDTC組肺損傷病理組織學評分在術後各時間點較SAP-ALI組顯著降低,PDTC組細胞凋亡指數較SAP-ALI組明顯降低.SAP-ALI組24h市泡Ⅱ型上皮細胞微絨毛消失.結論 NF-κB活化激活PUMA與肺泡上皮細胞凋亡有關,PDTC通過抑製NF-κB活化,下調NF-κB活化後引起的PUMA錶達,抑製肺泡Ⅱ型上皮細胞凋亡,減輕SAP-ALI.
목적 탐토NF-κB(핵인자-κB)여PUMA(P53정향조망조절인자)표체재대서중증급성이선염치급성폐손상(SAP-ALI)적작용급포안산이류대안기갑산지(PDTC)적영향.방법 SD대서수궤(수궤수자법)분위가수술조、SAP-ALI조、PDTC조,매조18지.각조재안6,12,24 h시간점분위삼개아조,매개아조6지.가수술조개복후번동이선수차;SAP-ALI조채용이담관역행주입5%우광담산납(1 mL/kg)유도SAP-ALI모형;PDTC조재SAP-ALI조적기출우술전1h급여PDTC(15 mg/kg),각조안시간점처사대서.관찰이선화폐장병리변화.Western-blot법검측폐조직NF-κB p65,PUMA표체,채용RT-PCR법측량각조bax,bcl-2화Caspase-3 mRNA,통과형광검측시제검측Caspase-3활성.투사전경하관찰각조폐포Ⅱ형상피세포초미결구적변화,TUNEL검측폐포상피세포적조망지수.결과 성공건립료대서SAP-ALI모형,Western-blotting결과현시,SAP-ALI조폐조직NF-κB p65화PUMA단백표체재6h후증가,24 h증가최명현,NF-κB p65여PUMA현저정상관;SAP-ALI조폐조직bax mRNA화Caspase-3mRNA재6 h후증가,24 h증가최명현,bcl-2 mRNA재6 h후하강,24 h하강최명현,Caspase-3활성재24h증가최명현.PDTC조폐조직NF-κB p65화PUMA단백표체명현강저;bax mRNA화caspase-3 mRNA표체급Caspase-3활성명현강저,bcl-2 mRNA표체명현증가.가수술조폐조직각조단백적표체여PDTC조비무현저개변.PDTC조폐손상병리조직학평분재술후각시간점교SAP-ALI조현저강저,PDTC조세포조망지수교SAP-ALI조명현강저.SAP-ALI조24h시포Ⅱ형상피세포미융모소실.결론 NF-κB활화격활PUMA여폐포상피세포조망유관,PDTC통과억제NF-κB활화,하조NF-κB활화후인기적PUMA표체,억제폐포Ⅱ형상피세포조망,감경SAP-ALI.
Objective To investigate the expression of nuclear factor-κB (NF-κB) and p53 up-regulated modulator of apoptosis (PUMA) in acute lung injury (ALI) induced by severe acute pancreatitis (SAP), and the therapeutic role of proline dithiocarbamate (PDTC). Method SD rats weighed 200~ 250 g were randomly(random number) divided into sham operation group (A group, n = 18), ALI group (B group, n = 18) and PDTC treatment group (C group, n = 18). The model of SAP was eastablished by injecting 1 mL/kg of sodium tauarocholate into the pancreatic capsule of the rats in B group and C group. The model rats in C group were treated with PDTC one hour after modeling. Six rats of each group were sacrificed 6 h,12 h, and 24 hours after modeling. The histopathological changes in lung and pancreas were observed. The levels of NF-κB p65 and PUMA in lung were detected by using Western blotting, and the expressions of bcl-2, bax and caspase-3 mRNA in the lung were detected by using RT-PCR. The lung tissue was taken for examination under transmission electron microscope. TUNEL was used for detection of apoptotic alveolar epithelial cells. Results Six to 24 hours after modeling, the pathological scores in lung of ALI group were significantly higher than those of control group and PDTC group after sodium taurocholate injection ( P < 0.05). The levels of NF-κB p65 and PUMA, and the expressions of bax and caspase3 mRNA in ALI group at different intervals were higher than those in control group and PDTC group ( P < 0.05),whereas the expression of bcl-2 mRNA in ALI group was lower than that in control group and PDTC group ( P <0.05). The NF-κB p65 was correlated closely and positively with PUMA ( r= 0.987, P < 0.01). Higher activity of caspase-3 acrtive units was seen in ALI group than that in control group and PDTC group ( P < 0.05). The microvilli disappeared in ALI group 24 hours later. The apoptosis index in ALI group was higher than that in control group and PDTC group ( P < 0.05). Conclusions The apoptosis of alveolar epithelial cells of rats in ALI group is caused by PUMA activated by NF-κB. PDTC treatment can inhibit apoptosis of alveolar epithelial cells of rats in ALI group by inhibiting the activation of NF-κB.