Department of Surgery, Denver Health Medical Center, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado 80045, USA.
Shock. 2013 Apr;39(4):366-72. doi: 10.1097/SHK.0b013e3182894016.
Firm neutrophil (PMN)-endothelial (EC) adhesion is crucial to the PMN-mediated hyperinflammation observed in acute lung injury. Hypertonic saline (HTS) used for resuscitation of hemorrhagic shock has been associated with a decreased incidence of PMN-mediated lung injury/acute respiratory distress syndrome. We hypothesize that physiologically accessible hypertonic incubation (170 vs. 140 mM, osmolarity ranging from 360 to 300 mOsm/L) inhibits proinflammatory activation of human pulmonary microvascular endothelial cells (HMVECs). Proinflammatory activation of HMVECs was investigated in response to tumor necrosis factor-α (TNF-α), including interleukin 8 (IL-8) release, intercellular adhesion molecule 1 (ICAM-1) surface expression, PMN adhesion, and signaling mechanisms under both isotonic (control) and hypertonic conditions. Hyperosmolarity alone had no effect on either basal IL-8 release or ICAM-1 surface expression but did lead to concentration-dependent decreases in TNF-α-induced IL-8 release, ICAM-1 surface expression, and PMN-HMVEC adhesion. Conversely, HTS activated p38 mitogen-activated protein kinase (MAPK) and enhanced TNF-α activation of p38 MAPK. Despite this basal activation, hyperosmolar incubation attenuated TNF-α-stimulated IL-8 release and ICAM-1 surface expression and subsequent PMN adherence, while p38 MAPK inhibition did not further influence the effects of hyperosmolar conditions on ICAM-1 surface expression. In addition, TNF-α induced nuclear factor-κB DNA binding, but HTS conditions attenuated this by 31% (P < 0.01). In conclusion, HTS reduces PMN-HMVEC adhesion and TNF-α-induced proinflammatory activation of primary HMVECs via attenuation of nuclear factor-κB signaling.
中性粒细胞(PMN)与内皮细胞(EC)的牢固黏附对于急性肺损伤中观察到的 PMN 介导的过度炎症反应至关重要。用于纠正失血性休克的高渗盐水(HTS)与 PMN 介导的肺损伤/急性呼吸窘迫综合征的发生率降低有关。我们假设生理上可获得的高渗孵育(170 与 140mM,渗透压范围为 360 至 300mOsm/L)可抑制人肺微血管内皮细胞(HMVEC)的促炎激活。研究了肿瘤坏死因子-α(TNF-α)诱导的 HMVEC 促炎激活,包括白细胞介素 8(IL-8)释放、细胞间黏附分子 1(ICAM-1)表面表达、PMN 黏附和在等渗(对照)和高渗条件下的信号转导机制。高渗单独作用对基础 IL-8 释放或 ICAM-1 表面表达均无影响,但确实导致 TNF-α 诱导的 IL-8 释放、ICAM-1 表面表达和 PMN-HMVEC 黏附呈浓度依赖性降低。相反,HTS 激活了丝裂原活化蛋白激酶 p38(p38MAPK)并增强了 TNF-α 对 p38MAPK 的激活。尽管存在这种基础激活,但高渗孵育可减弱 TNF-α 刺激的 IL-8 释放和 ICAM-1 表面表达以及随后的 PMN 黏附,而 p38MAPK 抑制并未进一步影响高渗条件对 ICAM-1 表面表达的影响。此外,TNF-α诱导核因子-κB DNA 结合,但 HTS 条件将其抑制了 31%(P<0.01)。总之,HTS 通过减弱核因子-κB 信号转导来减少 PMN-HMVEC 黏附和 TNF-α 诱导的原发性 HMVEC 的促炎激活。