Article(id=1239174992366203417, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239174986137661844, articleNumber=null, orderNo=null, doi=10.14109/j.cnki.xyylc.2024.04.10, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1663171200000, receivedDateStr=2022-09-15, revisedDate=null, revisedDateStr=null, acceptedDate=1702483200000, acceptedDateStr=2023-12-14, onlineDate=1773371940938, onlineDateStr=2026-03-13, pubDate=1713974400000, pubDateStr=2024-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773371940938, onlineIssueDateStr=2026-03-13, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773371940938, creator=13701087609, updateTime=1773371940938, updator=13701087609, issue=Issue{id=1239174986137661844, tenantId=1146029695717560320, journalId=1205117082300743687, year='2024', volume='43', issue='4', pageStart='241', pageEnd='320', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773371939453, creator=13701087609, updateTime=1773372128807, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1239175780396233704, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239174986137661844, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1239175780396233705, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239174986137661844, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=291, endPage=295, ext={EN=ArticleExt(id=1239174992638833196, articleId=1239174992366203417, tenantId=1146029695717560320, journalId=1205117082300743687, language=EN, title=Dexmedetomidine ameliorates ventilator-induced lung injury in rats via up-regulating NLRC3, columnId=1207314218647392369, journalTitle=Chinese Journal of New Drugs and Clinical Remedies, columnName=Original Article, runingTitle=null, highlight=null, articleAbstract=
AIM

To observe the effect of dexmedetomidine on the expression of NLR family CARD domain containing-3(NLRC3), a nucleotide oligomeric domain like receptor, in rats with ventilator-associated lung injury(VILI).

METHODS

A total of 36 SD rats were randomly divided into normal control group, model group, and dexmedetomidine group(n=12 in each group). VILI model were made by mechanical ventilation with a ventilator. The dexmedetomidine group was intravenously injected with dexmedetomidine 5 μg·kg-1 at 20 minutes before VILI, then maintain a dose of 5 μg·kg-1·h-1. The normal control group and model group received continuous intravenous infusion of 0.5 mL·kg-1·h-1 of physiological saline. The pathological results of lung tissue in each group of rats were observed under the light microscope and the wet dry weight ratio of lung tissue was detected. Western blot and qRT-PCR were used to detect of protein and mRNA expression of NLRC3, NLR family pyrin domain containing 3 protein(NLRP3), apoptosis associated speck-like protein containing a CARD domain(ASC), caspase-1, and NF-κB p65. The protein level of IL-1β、IL-18 and IL-33 in serum were detected by ELISA.

RESULTS

Compared with the normal control group, severe pathological damage in the lung tissue were showed in the model group, the wet to dry weight ratio and IQA of lung tissue increased significantly(P<0.05).NLRC3 protein and mRNA expression in lung tissue down regulated(P<0.05), NLRP3, ASC, caspase-1, and NF-κB p65 protein and mRNA upregulated significantly(P<0.05), and the concentration of IL-1β、 IL-18 and IL-33 in serum increased significantly(P<0.05). Compared with the model group, the pathological damage of lung tissue in the dexmedetomidine group showed reduced, and the wet to dry weight ratio and IQA of lung tissue decreased(P<0.05), the expression of NLRC3 protein and mRNA in lung tissue increased significantly(P<0.05), NLRP3, ASC, caspase-1, and NF-κB p65 protein and mRNA downregulated(P<0.05), the concentrations of IL-1β, IL-18 and IL-33 reduced significantly(P<0.05).

CONCLUSION

Dexmedetomidine improves VILI in rats by upregulating the expression of NLRC3 in lung tissue, and its mechanism may be related to the inhibition of NLRP3 inflammasome activation.

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目的

观察右美托咪定对机械通气相关性肺损伤(VILI)大鼠NLR家族含CARD结构域蛋白3(NLRC3)表达的影响。

方法

36只SD大鼠随机分为正常对照组、模型组和右美托咪定组,每组各12只。接呼吸机机械通气制备VILI模型,右美托咪定组于制模前20 min静脉注射右美托咪定5 μg·kg-1,随后以5 μg·kg-1·h-1的剂量维持。正常对照组和模型组于制模前20 min静脉持续输注生理盐水0.5 mL·kg-1·h-1。光镜下观察各组大鼠肺组织病理学结果,检测肺组织湿重-干重比。Western blot和qRT-PCR法分别检测肺组织中NLRC3、NLR家族热蛋白结构域包含蛋白3(NLRP3)、凋亡相关斑点蛋白(ASC)、caspase-1、NF-κB p65的蛋白和mRNA表达,ELISA法测定血清中白细胞介素(IL)-1β、IL-18和IL-33的浓度。

结果

与正常对照组相比,模型组肺组织病理损伤严重,肺损伤定量评价指标(IQA)和肺组织湿重-干重比显著增加(P<0.05);肺组织中NLRC3蛋白和mRNA表达显著下调(P<0.05),NLRP3、ASC、caspase-1和NF-κB p65蛋白及mRNA的表达显著上调(P<0.05),血清中IL-1β、IL-18和IL-33的浓度显著增加(P<0.05)。与模型组比较,右美托咪定组肺组织病理损伤减轻,肺组织湿重-干重比和IQA降低(P<0.05),肺组织中NLRC3蛋白及mRNA表达显著增加(P<0.05),NLRP3、ASC、caspase-1和NF-κB p65蛋白和mRNA的表达显著下调(P<0.05),血清中IL-1β、IL-18和IL-33的浓度显著降低(P<0.05)。

结论

右美托咪定通过上调肺组织中NLRC3的表达改善大鼠VILI,其机制可能与抑制NLRP3炎症小体的激活有关。

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李娜
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李娜,女,副主任医师,硕士生导师,博士,主要从事重症医学、妇产科麻醉方面的研究,E-mail:

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Immunity, 2018, 49(6): 1049-1061., articleTitle=The innate immune sensor NLRC3 acts as a rheostat that fine-tunes T cell responses in infection and autoimmunity, refAbstract=null), Reference(id=1239213765099582167, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, doi=null, pmid=null, pmcid=null, year=2017, volume=292, issue=30, pageStart=12691, pageEnd=12701, url=null, language=null, rfNumber=[10], rfOrder=10, authorNames=EREN E, BERBER M, OZOREN N, journalName=J Biol Chem, refType=null, unstructuredReference=EREN E, BERBER M, OZOREN N. NLRC3 protein inhibits inflammation by disrupting NALP3 inflammasome assembly via competition with the adaptor protein ASC for pro-caspase-1 binding[J]. J Biol Chem, 2017, 292(30): 12691-12701, articleTitle=NLRC3 protein inhibits inflammation by disrupting NALP3 inflammasome assembly via competition with the adaptor protein ASC for pro-caspase-1 binding, refAbstract=null), Reference(id=1239213765179273950, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, doi=null, pmid=null, pmcid=null, year=2020, volume=41, issue=4, pageStart=578, pageEnd=582, url=null, language=null, rfNumber=[11], rfOrder=11, authorNames=赵诗雯, 张宗泽, journalName=武汉大学学报:医学版, refType=null, unstructuredReference=赵诗雯, 张宗泽. 右美托咪定预处理抑制NLRP3炎性体活性减轻脂多糖诱导的大鼠急性肺损伤[J]. 武汉大学学报:医学版, 2020, 41(4): 578-582., articleTitle=右美托咪定预处理抑制NLRP3炎性体活性减轻脂多糖诱导的大鼠急性肺损伤, refAbstract=null)], funds=[Fund(id=1239213764000674461, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, awardId=WJ2019H278, language=CN, fundingSource=湖北省卫生健康委联合基金项目(WJ2019H278), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1239213759454048717, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, xref=null, ext=[AuthorCompanyExt(id=1239213759462437327, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, companyId=1239213759454048717, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Anesthesiology, Maternal and Child Health Hospital of Hubei Province, Wuhan HUBEI 430070, China), AuthorCompanyExt(id=1239213759470825935, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, companyId=1239213759454048717, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=湖北省妇幼保健院 麻醉科,湖北 武汉 430070)])], figs=[ArticleFig(id=1239213761375040082, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=EN, label=null, caption=null, figureFileSmall=txYI4Nf7a93p9l8e0YncJg==, figureFileBig=r7GbtGNN9TXiG1HU2dJnQQ==, tableContent=null), ArticleFig(id=1239213761492480603, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=CN, label=图1, caption=各组大鼠肺组织病理改变(HE染色,×400)

A:正常对照组,B:模型组,C:右美托咪定组

, figureFileSmall=txYI4Nf7a93p9l8e0YncJg==, figureFileBig=r7GbtGNN9TXiG1HU2dJnQQ==, tableContent=null), ArticleFig(id=1239213761626698342, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=EN, label=null, caption=null, figureFileSmall=ibw6A1+9sD2P5rkl57myfA==, figureFileBig=aJFApBfFuFcsBTXGhHTtsQ==, tableContent=null), ArticleFig(id=1239213763170202221, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=CN, label=图2, caption=各组大鼠肺组织中NLRP3、caspase-1、ASC、 NF-κB p65和NLRC3蛋白印迹图

A:正常对照组,B:模型组,C:右美托咪定组。NLRP3:NLR家族热蛋白结构域包含蛋白3,ASC:凋亡相关斑点蛋白,NLRC3:NLR家族含CARD结构域蛋白3

, figureFileSmall=ibw6A1+9sD2P5rkl57myfA==, figureFileBig=aJFApBfFuFcsBTXGhHTtsQ==, tableContent=null), ArticleFig(id=1239213763262476918, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别NLRP3ASCcaspase-1NF-κB p65NLRC3
正常对照1.04±0.121.03±0.100.63±0.111.15±0.122.05±0.17
模型7.53±0.36b9.16±0.36b9.43±0.37b8.87±0.32b1.68±0.13b
右美托咪定2.76±0.18e3.15±0.14e2.88±0.21e3.35±0.14e2.03±0.21e
), ArticleFig(id=1239213763367334525, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=CN, label=表1, caption=

各组肺组织中NLRP3ASCcaspase-1NF-κB p65NLRC3 mRNA的表达比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别NLRP3ASCcaspase-1NF-κB p65NLRC3
正常对照1.04±0.121.03±0.100.63±0.111.15±0.122.05±0.17
模型7.53±0.36b9.16±0.36b9.43±0.37b8.87±0.32b1.68±0.13b
右美托咪定2.76±0.18e3.15±0.14e2.88±0.21e3.35±0.14e2.03±0.21e
), ArticleFig(id=1239213763459609217, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别NLRP3ASCcaspase -1NF-κB p65NLRC3
正常对照0.24±0.010.23±0.020.19±0.020.25±0.040.65±0.05
模型0.53±0.04b0.48±0.05b0.47±0.06b0.57±0.05b0.31±0.03b
右美托咪定0.31±0.03e0.33±0.04e0.22±0.03e0.35±0.02e0.55±0.04e
), ArticleFig(id=1239213763547689606, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=CN, label=表2, caption=

各组大鼠肺组织中NLRP3、ASC、caspase-1、NF-κB p65和NLRC3蛋白表达比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别NLRP3ASCcaspase -1NF-κB p65NLRC3
正常对照0.24±0.010.23±0.020.19±0.020.25±0.040.65±0.05
模型0.53±0.04b0.48±0.05b0.47±0.06b0.57±0.05b0.31±0.03b
右美托咪定0.31±0.03e0.33±0.04e0.22±0.03e0.35±0.02e0.55±0.04e
), ArticleFig(id=1239213763644158604, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别IL-1βIL-18IL-33
正常对照20.31±5.1753.76±8.3689.53±9.78
模型129.68±29.23b153.21±58.37b210.15±75.35b
右美托咪定45.31±8.17e79.13±10.23e104.34±35.17e
), ArticleFig(id=1239213763761599121, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239174992366203417, language=CN, label=表3, caption=

各组大鼠血清中炎性细胞因子水平的比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别IL-1βIL-18IL-33
正常对照20.31±5.1753.76±8.3689.53±9.78
模型129.68±29.23b153.21±58.37b210.15±75.35b
右美托咪定45.31±8.17e79.13±10.23e104.34±35.17e
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右美托咪定上调NLRC3改善大鼠机械通气相关性肺损伤
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乐林莉 , 李娜
中国新药与临床杂志 | 论著 2024,43(4): 291-295
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中国新药与临床杂志 | 论著 2024, 43(4): 291-295
右美托咪定上调NLRC3改善大鼠机械通气相关性肺损伤
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乐林莉 , 李娜
作者信息
  • 湖北省妇幼保健院 麻醉科,湖北 武汉 430070
  • 乐林莉,女,副主任医师,硕士,主要从事重症医学、器官保护方面的研究,E-mail:

    李娜,女,副主任医师,硕士生导师,博士,主要从事重症医学、妇产科麻醉方面的研究,E-mail:

通讯作者:

李娜
Dexmedetomidine ameliorates ventilator-induced lung injury in rats via up-regulating NLRC3
Lin-li YUE , Na LI
Affiliations
  • Department of Anesthesiology, Maternal and Child Health Hospital of Hubei Province, Wuhan HUBEI 430070, China
出版时间: 2024-04-25 doi: 10.14109/j.cnki.xyylc.2024.04.10
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目的

观察右美托咪定对机械通气相关性肺损伤(VILI)大鼠NLR家族含CARD结构域蛋白3(NLRC3)表达的影响。

方法

36只SD大鼠随机分为正常对照组、模型组和右美托咪定组,每组各12只。接呼吸机机械通气制备VILI模型,右美托咪定组于制模前20 min静脉注射右美托咪定5 μg·kg-1,随后以5 μg·kg-1·h-1的剂量维持。正常对照组和模型组于制模前20 min静脉持续输注生理盐水0.5 mL·kg-1·h-1。光镜下观察各组大鼠肺组织病理学结果,检测肺组织湿重-干重比。Western blot和qRT-PCR法分别检测肺组织中NLRC3、NLR家族热蛋白结构域包含蛋白3(NLRP3)、凋亡相关斑点蛋白(ASC)、caspase-1、NF-κB p65的蛋白和mRNA表达,ELISA法测定血清中白细胞介素(IL)-1β、IL-18和IL-33的浓度。

结果

与正常对照组相比,模型组肺组织病理损伤严重,肺损伤定量评价指标(IQA)和肺组织湿重-干重比显著增加(P<0.05);肺组织中NLRC3蛋白和mRNA表达显著下调(P<0.05),NLRP3、ASC、caspase-1和NF-κB p65蛋白及mRNA的表达显著上调(P<0.05),血清中IL-1β、IL-18和IL-33的浓度显著增加(P<0.05)。与模型组比较,右美托咪定组肺组织病理损伤减轻,肺组织湿重-干重比和IQA降低(P<0.05),肺组织中NLRC3蛋白及mRNA表达显著增加(P<0.05),NLRP3、ASC、caspase-1和NF-κB p65蛋白和mRNA的表达显著下调(P<0.05),血清中IL-1β、IL-18和IL-33的浓度显著降低(P<0.05)。

结论

右美托咪定通过上调肺组织中NLRC3的表达改善大鼠VILI,其机制可能与抑制NLRP3炎症小体的激活有关。

右美托咪定  /  机械通气  /  呼吸机相关性肺损伤  /  炎症  /  NLR家族,热蛋白结构域包含蛋白3
AIM

To observe the effect of dexmedetomidine on the expression of NLR family CARD domain containing-3(NLRC3), a nucleotide oligomeric domain like receptor, in rats with ventilator-associated lung injury(VILI).

METHODS

A total of 36 SD rats were randomly divided into normal control group, model group, and dexmedetomidine group(n=12 in each group). VILI model were made by mechanical ventilation with a ventilator. The dexmedetomidine group was intravenously injected with dexmedetomidine 5 μg·kg-1 at 20 minutes before VILI, then maintain a dose of 5 μg·kg-1·h-1. The normal control group and model group received continuous intravenous infusion of 0.5 mL·kg-1·h-1 of physiological saline. The pathological results of lung tissue in each group of rats were observed under the light microscope and the wet dry weight ratio of lung tissue was detected. Western blot and qRT-PCR were used to detect of protein and mRNA expression of NLRC3, NLR family pyrin domain containing 3 protein(NLRP3), apoptosis associated speck-like protein containing a CARD domain(ASC), caspase-1, and NF-κB p65. The protein level of IL-1β、IL-18 and IL-33 in serum were detected by ELISA.

RESULTS

Compared with the normal control group, severe pathological damage in the lung tissue were showed in the model group, the wet to dry weight ratio and IQA of lung tissue increased significantly(P<0.05).NLRC3 protein and mRNA expression in lung tissue down regulated(P<0.05), NLRP3, ASC, caspase-1, and NF-κB p65 protein and mRNA upregulated significantly(P<0.05), and the concentration of IL-1β、 IL-18 and IL-33 in serum increased significantly(P<0.05). Compared with the model group, the pathological damage of lung tissue in the dexmedetomidine group showed reduced, and the wet to dry weight ratio and IQA of lung tissue decreased(P<0.05), the expression of NLRC3 protein and mRNA in lung tissue increased significantly(P<0.05), NLRP3, ASC, caspase-1, and NF-κB p65 protein and mRNA downregulated(P<0.05), the concentrations of IL-1β, IL-18 and IL-33 reduced significantly(P<0.05).

CONCLUSION

Dexmedetomidine improves VILI in rats by upregulating the expression of NLRC3 in lung tissue, and its mechanism may be related to the inhibition of NLRP3 inflammasome activation.

dexmedetomidine  /  mechanical ventilations  /  ventilator-induced lung injury  /  inflammation  /  NLR family,pyrin domain-containing 3 protein
乐林莉, 李娜. 右美托咪定上调NLRC3改善大鼠机械通气相关性肺损伤. 中国新药与临床杂志, 2024 , 43 (4) : 291 -295 . DOI: 10.14109/j.cnki.xyylc.2024.04.10
Lin-li YUE, Na LI. Dexmedetomidine ameliorates ventilator-induced lung injury in rats via up-regulating NLRC3[J]. Chinese Journal of New Drugs and Clinical Remedies, 2024 , 43 (4) : 291 -295 . DOI: 10.14109/j.cnki.xyylc.2024.04.10
机械通气常用于全身麻醉、急危重患者的呼吸支持。机械通气实施的是正压通气,这种反正常生理模式的呼吸方式使用不当可导致肺损伤,甚至加重原有的肺损伤,引起纵隔气肿、气胸以及肺部炎症、全身炎症反应等严重并发症,称为机械通气相关性肺损伤(ventilator induced lung injury, VILI)[1]。有研究表明,NLR家族含CARD结构域蛋白3(NLRC3)在LPS诱导的脓毒血症与急性肺损伤小鼠中表达降低,且NLRC3基因敲除小鼠的肺组织损伤较野生型更为严重[2]。右美托咪定(dexmedetomidine)是肾上腺素α2受体激动剂,具有镇静、镇痛、抗焦虑、催眠等作用而广泛应用于临床。随着研究的深入,研究者发现右美托咪定具有一定的肺保护作用[3] 。因此本研究拟观察右美托咪定对VILI大鼠NLRC3表达的影响,探讨右美托咪定的肺保护作用机制,为临床治疗肺损伤提供依据和方法。
右美托咪定(扬子江药业集团,规格为2 mL 200 μg,批号为19121931)。qRT-PCR试剂盒(美国FermentasLife Science公司);Bio-Rad蛋白定量试剂盒(北京索莱宝科技有限公司);兔多克隆抗体NLR、caspase-1、 NF-κB p65,鼠单克隆抗体家族热蛋白结构域包含蛋白3(NLRP3)、抗凋亡相关斑点蛋白(ASC)、NLRC3和荧光二抗均购自武汉贝茵莱生物科技有限公司;ECL化学发光试剂盒(武汉华联科生物);ELISA试剂盒(武汉贝茵莱生物科技有限公司)。小动物呼吸机(美国HarvardApparatus公司),qRT-PCR仪(Light Cyeler 480,美国Roche公司)。
本实验经湖北省妇幼保健院动物实验伦理委员会批准,选择4~6周龄清洁级健康雄性SD大鼠36只(购买自武汉市华联科生物工程有限公司),体重(220±20)g,将所有大鼠置入21~25 ℃的标准动物饲养间内,适应性饲养1周,饲养期间大鼠自由饮食水,将大鼠按照随机数字表法分为正常对照组、模型组和右美托咪定组(均n=12)。
所有动物实验前夜禁食12 h,自由饮水。正常对照组大鼠自主呼吸空气,其余2组大鼠腹腔注射体积分数3%戊巴比妥40 mg·kg-1,并建立尾静脉通道,麻醉维持采用尾静脉输注戊巴比妥2 mg·kg-1·h-1,将大鼠固定于仰卧位,依次备皮、消毒,钝性分离颈部组织,切开气管,插入自制的气管导管并固定,连接小动物呼吸机行机械通气。设置通气参数:潮气量为20 mL·kg-1,吸入氧浓度21%,呼吸频率为40次·min-1,吸呼比为1:1,呼气末正压(PEEP)为0。实验过程中保持室温26~28 ℃。机械通气前20 min,模型组静脉输注生理盐水0.5 mL·kg-1·h-1,右美托咪定组静脉泵注右美托咪定5 μg·kg-1(10 min内泵完),随后以5 μg·kg-1·h-1的剂量维持。正常对照组大鼠呼吸空气4 h,其余2组大鼠机械通气4 h,采集腹主动脉血10 mL,分离血清,取双肺组织。按实验动物伦理学要求进行实验操作。
将右肺中叶组织放置于4%多聚甲醛固定24 h,依次经脱水、透明、浸蜡、石蜡包埋、切片(厚度4 μm)处理,行HE染色。显微镜下观察各组大鼠肺组织病理学结果。在显微镜(×200)下,检测50个视野下的损伤肺泡数目,IQA=损伤肺泡数目/肺泡总数×100% [4]
分离大鼠右肺上叶组织,用滤纸立即吸干肺组织表面水分、残存血液,称取肺湿重,然后将肺组织放置于80 ℃恒温烘箱中烘烤24 h,再次称重为肺干重,计算各组大鼠肺组织湿重-干重比。
液氮研磨肺组织后Trizol法提取总RNA,肺组织中RNA浓度用紫外分光光度计测定。采用两步法qRT-PCR试剂盒进行扩增反应,将RNA逆转录成cDNA,严格按照试剂盒说明进行操作。NLRP3引物:(F)5'-CAGATTGGTAACAAAGGAGCCA-3',(R)5'-CGTTCGGTTTATCTTCAGAGCA-3';ASC引物:(F)5'-TGTGCTTAGAGACATGGGCATACAG-3',(R)5'-GCCA TACAGAGCATCCAGCAA-3';caspase-1引物:(F)5'-A CTCGTACACGTCTTGCCCTCA-3',(R)5'-CTGGGCAGGC AGCAAATTC-3';NF-κBp65引物:(F)5'-GGGAAACAG CGCATGAAGGA-3',(R)5'-CGCGTGATGGTGCTGGGT ACA-3':NLRC3引物:(F)5'-CAGATTGGTAACAAAGGA GCCA-3',(R)5'-CGTTCGGTTTATCTTCAGAGCA-3';GAPDH引物:(F)5'-CAAAGTTGTCATGGATGACC-3',(R)5'-CCATGGAGAAGGCTGGGGTA-3'。采用25 μL反应体系,扩增条件:95 ℃变性30 s,95 ℃变性,5 s,60 ℃退火34 s,共40个循环;72 ℃延伸10 min;4 ℃保存。使用qRT-PCR仪检测各样本的域值循环数(CT)值,采用2-△△CT法计算目的基因mRNA相对表达量。
取左肺组织0.1 g,采用BCA法提取细胞总蛋白。Bio-Rad蛋白定量试剂盒对总蛋白进行定量,取50 μg蛋白样品用10%分离胶行SDS-PAGE电泳,转膜后用5%脱脂牛奶封闭l h,分别加入NLRP3(1500)、ASC(1:500)、caspase-1(1:200)、NF-κB p65(1:1 000)和NLRC3(1:1 000)一抗4 ℃孵育过夜,洗涤后加入荧光二抗(1:10 000)室温孵育1 h,洗涤后用ECL化学发光试剂盒检测成像,通过TANONGIS软件读取相关条带灰度值并分析。
取大鼠腹主动脉血10 mL,4 ℃下高速离心15 min,取上层血清,保存于-80 ℃低温冰箱。采用ELISA法测定血清IL-1β、IL-18和IL-33水平,按照ELISA试剂盒说明书进行操作。
采用SPSS 19.0软件进行统计分析,符合正态分布的计量资料以表示,不同组间比较采用单因素方差分析,组间两两比较采用LSD-t检验,以P<0.05为有显著差异。
光镜下观察,正常对照组肺泡形态清晰,肺泡腔完整,肺泡间隔无水肿,未见炎性细胞浸润。模型组光镜下肺泡壁崩解,肺泡间隔肥厚、水肿、增生,间质内可见大量炎性细胞,肺泡腔内可见巨噬细胞及红细胞渗出。右美托咪定组肺泡组织结构尚存在,间隔稍增宽,淋巴细胞少量浸润,肺泡腔内少量巨噬细胞及红细胞渗出。见图1
模型组IQA显著高于正常对照组(42.5±4.10 vs.5.35±0.25, P<0.05),右美托咪定组IQA(7.26±0.31)显著低于模型组(P<0.05)。
模型组肺组织湿重-干重比显著高于正常对照组(6.29±0.32 vs. 4.35±0.25,P<0.05),右美托咪定组湿重-干重比(4.76±0.28)显著低于模型组(P<0.05)。
与正常对照组相比,模型组肺组织中NLRC3 mRNA表达显著下调(P<0.05),NLRP3caspase-1ASCNF-κB p65 mRNA表达上调(P<0.05)。与模型组相比,右美托咪定组肺组织中NLRC3 mRNA的表达显著上调(P<0.05),NLRP3caspase-1ASCNF-κB p65 mRNA的表达显著下调(P<0.05),见表1
与正常对照组相比,模型组肺组织中NLRC3蛋白表达显著下调(P<0.05),NLRP3、caspase-1、ASC和NF-κB p65蛋白表达显著上调(P<0.05)。与模型组比较,右美托咪定组肺组织中NLRC3的蛋白表达显著上调(P<0.05),NLRP3、caspase-1、ASC和NF-κB p65的表达显著下调(P<0.05),见图2表2
与正常对照组相比,模型组血清中IL-1β、IL-18和IL-33的浓度增加(P<0.05);与模型组相比,右美托咪定组血清中IL-1β、IL-18和IL-33的浓度显著降低(P<0.05),见表3
VILI早期是由于机械应力作用导致肺泡膜损伤以及间质结构破坏的机械性损伤,随后则是以炎性细胞因子的大量释放,相关信号转导通路被激活的炎症失衡性生物伤为主的病理生理过程[5]。细胞因子是急性肺损伤发展的关键介质,肺泡巨噬细胞在急性肺损伤病程中释放过多的IL-6和IL-1β等细胞因子,而IL-1β可以改变肺泡上皮和血管内皮通透性,诱发肺泡水肿,是肺损伤的关键因素[6]。与正常对照组比较,模型组IQA和肺组织湿重-干重比显著升高,血清中IL-1β、IL-18和IL-33浓度显著升高,表明机械通气导致了肺损伤。经过右美托咪定预处理,肺组织病理损伤减轻、IQA和肺组织湿重-干重比显著降低,血清中IL-1β、IL-18和IL-33的浓度显著降低,提示右美托咪定可以降低炎性细胞因子水平从而减轻VILI。
NLRP3属于NLR家族,主要表达在巨噬细胞、淋巴细胞、上皮细胞和其他免疫细胞中[4],正常状态下细胞内NLRP3的表达量极低,细胞在受到机械外力刺激后,NLRP3、pro-caspase-1以及ASC组成多蛋白复合体,即NLRP3炎症小体,炎症小体激活后将pro-caspase-1活化成caspase-1,并引起下游IL-1β、IL-18和IL-33等炎性细胞因子的活化释放,导致瀑布式炎症级联反应的激活,在炎症介质、细胞因子的共同作用下导致或加重肺部损伤[7]。本研究结果显示,模型组肺组织中NLRP3、ASC和caspase-1的表达明显增加,血清中IL-1β、IL-18以及IL-33的浓度增加,提示NLRP3炎症小体参与了机械通气引起的肺损伤。
在细胞水平,NLRC3可通过对固有免疫进行负调控,抑制TLR4/NF-κB信号通路的激活等多种途径减轻炎症反应[89]。此外,NLRC3还可通过与ASC竞争结合pro-caspase-1,从而影响NLRP3炎症小体的形成及其活性[10] 。NLRC3的CARD结构域可以抑制NLRP3炎症小体突变体诱导的IL-1β分泌和ASC形成,但目前关于NLRC3是否参与了VILI的研究较少。本研究结果显示,模型组肺组织中NLRC3的蛋白和mRNA表达较正常对照组显著降低,表明NLRC3也参与了VILI,NLRC3表达的下调或可加重大鼠VILI。右美托咪定是一种高度选择性肾上腺素α2受体激动剂,除用于麻醉辅助用药、ICU患者的镇静镇痛、门诊儿童镇静外,关于其肺保护作用的研究也逐渐增多,赵诗雯等[11]研究表明,右美托咪定通过抑制NLRP3炎症小体活性下调炎症反应,从而减轻LPS诱导的大鼠急性肺损伤。本研究结果显示,右美托咪定组肺组织病理损伤、IQA和肺组织湿重-干重比显著降低,肺组织NLRC3的蛋白及mRNA表达较模型组显著升高,而NLRP3、ASC和caspase-1蛋白的表达较模型组显著降低,血清中IL-1β、IL-18以及IL-33的浓度显著降低,表明右美托咪定可通过上调肺组织中NLRC3的表达减轻大鼠VILI,其机制可能与抑制NLRP3炎症小体的激活有关,但具体作用机制仍有待进一步研究。
综上所述,右美托咪定通过上调肺组织中NLRC3的表达减轻大鼠VILI,其机制可能与抑制NLRP3炎症小体的激活有关。
  • 湖北省卫生健康委联合基金项目(WJ2019H278)
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doi: 10.14109/j.cnki.xyylc.2024.04.10
  • 接收时间:2022-09-15
  • 首发时间:2026-03-13
  • 出版时间:2024-04-25
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  • 收稿日期:2022-09-15
  • 录用日期:2023-12-14
基金
湖北省卫生健康委联合基金项目(WJ2019H278)
作者信息
    湖北省妇幼保健院 麻醉科,湖北 武汉 430070

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李娜
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https://castjournals.cast.org.cn/joweb/zgxyylczz/CN/10.14109/j.cnki.xyylc.2024.04.10
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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