1
|
Xu Y, Zhang Y, Zhang J, Liang W, Wang Y, Zeng Z, Liang Z, Ling Z, Chen Y, Deng X, Huang Y, Liu X, Zhang H, Li Y. High driving pressure ventilation induces pulmonary hypertension in a rabbit model of acute lung injury. J Intensive Care 2023; 11:42. [PMID: 37749622 PMCID: PMC10518953 DOI: 10.1186/s40560-023-00689-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/04/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Mechanical ventilation may cause pulmonary hypertension in patients with acute lung injury (ALI), but the underlying mechanism remains elucidated. METHODS ALI was induced in rabbits by a two-hit injury, i.e., hydrochloric acid aspiration followed by mechanical ventilation for 1 h. Rabbits were then ventilated with driving pressure of 10, 15, 20, or 25 cmH2O for 7 h. Clinicopathological parameters were measured at baseline and different timepoints of ventilation. RNA sequencing was conducted to identify the differentially expressed genes in high driving pressure ventilated lung tissue. RESULTS The two-hit injury induced ALI in rabbits was evidenced by dramatically decreased PaO2/FiO2 in the ALI group compared with that in the control group (144.5 ± 23.8 mmHg vs. 391.6 ± 26.6 mmHg, P < 0.001). High driving pressure ventilation (20 and 25 cmH2O) significantly elevated the parameters of acute pulmonary hypertension at different timepoints compared with low driving pressure (10 and 15 cmH2O), along with significant increases in lung wet/dry ratios, total protein contents in bronchoalveolar lavage fluid, and lung injury scores. The high driving pressure groups showed more pronounced histopathological abnormalities in the lung compared with the low driving pressure groups, accompanied by significant increases in the cross-sectional areas of myocytes, right ventricular weight/body weight value, and Fulton's index. Furthermore, the expression of the genes related to ferroptosis induction was generally upregulated in high driving pressure groups compared with those in low driving pressure groups. CONCLUSIONS A rabbit model of ventilation-induced pulmonary hypertension in ALI was successfully established. Our results open a new research direction investigating the exact role of ferroptosis in ventilation-induced pulmonary hypertension in ALI.
Collapse
Affiliation(s)
- Yonghao Xu
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Yu Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Jie Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Weibo Liang
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Ya Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Zitao Zeng
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Zhenting Liang
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Zhaoyi Ling
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Yubiao Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Xiumei Deng
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Yongbo Huang
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Xiaoqing Liu
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China
| | - Haibo Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China.
- The Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, M5B1W8, Canada.
- Department of Anesthesia, University of Toronto, Toronto, ON, Canada.
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
| | - Yimin Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory and Health, Medical Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China.
| |
Collapse
|
2
|
Wang Y, Zheng J, Wang X, Yang P, Zhao D. Alveolar macrophages and airway hyperresponsiveness associated with respiratory syncytial virus infection. Front Immunol 2022; 13:1012048. [PMID: 36341376 PMCID: PMC9630648 DOI: 10.3389/fimmu.2022.1012048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
Respiratory syncytial virus (RSV) is a ubiquitous pathogen of viral bronchiolitis and pneumonia in children younger than 2 years of age, which is closely associated with recurrent wheezing and airway hyperresponsiveness (AHR). Alveolar macrophages (AMs) located on the surface of the alveoli cavity are the important innate immune barrier in the respiratory tract. AMs are recognized as recruited airspace macrophages (RecAMs) and resident airspace macrophages (RAMs) based on their origins and roaming traits. AMs are polarized in the case of RSV infection, forming two macrophage phenotypes termed as M1-like and M2-like macrophages. Both M1 macrophages and M2 macrophages are involved in the modulation of inflammatory responses, among which M1 macrophages are capable of pro-inflammatory responses and M2 macrophages are capable of anti-proinflammatory responses and repair damaged tissues in the acute and convalescent phases of RSV infection. Polarized AMs affect disease progression through the alteration of immune cell surface phenotypes as well as participate in the regulation of T lymphocyte differentiation and the type of inflammatory response, which are closely associated with long-term AHR. In recent years, some progress have been made in the regulatory mechanism of AM polarization caused by RSV infection, which participates in acute respiratory inflammatory response and mediating AHR in infants. Here we summarized the role of RSV-infection-mediated AM polarization associated with AHR in infants.
Collapse
Affiliation(s)
- Yuxin Wang
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Junwen Zheng
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xia Wang
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Pu Yang
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
- Children’s Digital Health and Data Center of Wuhan University, Wuhan, China
- *Correspondence: Dongchi Zhao, ; Pu Yang,
| | - Dongchi Zhao
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
- Children’s Digital Health and Data Center of Wuhan University, Wuhan, China
- *Correspondence: Dongchi Zhao, ; Pu Yang,
| |
Collapse
|
3
|
Zhou L, Xue C, Chen Z, Jiang W, He S, Zhang X. c-Fos is a mechanosensor that regulates inflammatory responses and lung barrier dysfunction during ventilator-induced acute lung injury. BMC Pulm Med 2022; 22:9. [PMID: 34986829 PMCID: PMC8734268 DOI: 10.1186/s12890-021-01801-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/13/2021] [Indexed: 12/05/2022] Open
Abstract
Background As one of the basic treatments performed in the intensive care unit, mechanical ventilation can cause ventilator-induced acute lung injury (VILI). The typical features of VILI are an uncontrolled inflammatory response and impaired lung barrier function; however, its pathogenesis is not fully understood, and c-Fos protein is activated under mechanical stress. c-Fos/activating protein-1 (AP-1) plays a role by binding to AP-1 within the promoter region, which promotes inflammation and apoptosis. T-5224 is a specific inhibitor of c-Fos/AP-1, that controls the gene expression of many proinflammatory cytokines. This study investigated whether T-5224 attenuates VILI in rats by inhibiting inflammation and apoptosis. Methods The SD rats were divided into six groups: a control group, low tidal volume group, high tidal volume group, DMSO group, T-5224 group (low concentration), and T-5224 group (high concentration). After 3 h, the pathological damage, c-Fos protein expression, inflammatory reaction and apoptosis degree of lung tissue in each group were detected. Results c-Fos protein expression was increased within the lung tissue of VILI rats, and the pathological damage degree, inflammatory reaction and apoptosis in the lung tissue of VILI rats were significantly increased; T-5224 inhibited c-Fos protein expression in lung tissues, and T-5224 inhibit the inflammatory reaction and apoptosis of lung tissue by regulating the Fas/Fasl pathway. Conclusions c-Fos is a regulatory factor during ventilator-induced acute lung injury, and the inhibition of its expression has a protective effect. Which is associated with the antiinflammatory and antiapoptotic effects of T-5224.
Collapse
Affiliation(s)
- Leilei Zhou
- School of Clinical Medicine, Guizhou Medical University, 550004, Guiyang, China
| | - Chunju Xue
- School of Clinical Medicine, Guizhou Medical University, 550004, Guiyang, China
| | - Zongyu Chen
- School of Clinical Medicine, Guizhou Medical University, 550004, Guiyang, China
| | - Wenqing Jiang
- School of Clinical Medicine, Guizhou Medical University, 550004, Guiyang, China
| | - Shuang He
- School of Clinical Medicine, Guizhou Medical University, 550004, Guiyang, China
| | - Xianming Zhang
- School of Clinical Medicine, Guizhou Medical University, 550004, Guiyang, China. .,Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, 550004, Guiyang, China.
| |
Collapse
|
4
|
Different Tidal Volumes May Jeopardize Pulmonary Redox and Inflammatory Status in Healthy Rats Undergoing Mechanical Ventilation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:5196896. [PMID: 34745417 PMCID: PMC8570858 DOI: 10.1155/2021/5196896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022]
Abstract
Mechanical ventilation (MV) is essential for the treatment of critical patients since it may provide a desired gas exchange. However, MV itself can trigger ventilator-associated lung injury in patients. We hypothesized that the mechanisms of lung injury through redox imbalance might also be associated with pulmonary inflammatory status, which has not been so far described. We tested it by delivering different tidal volumes to normal lungs undergoing MV. Healthy Wistar rats were divided into spontaneously breathing animals (control group, CG), and rats were submitted to MV (controlled ventilation mode) with tidal volumes of 4 mL/kg (MVG4), 8 mL/kg (MVG8), or 12 mL/kg (MVG12), zero end-expiratory pressure (ZEEP), and normoxia (FiO2 = 21%) for 1 hour. After ventilation and euthanasia, arterial blood, bronchoalveolar lavage fluid (BALF), and lungs were collected for subsequent analysis. MVG12 presented lower PaCO2 and bicarbonate content in the arterial blood than CG, MVG4, and MVG8. Neutrophil influx in BALF and MPO activity in lung tissue homogenate were significantly higher in MVG12 than in CG. The levels of CCL5, TNF-α, IL-1, and IL-6 in lung tissue homogenate were higher in MVG12 than in CG and MVG4. In the lung parenchyma, the lipid peroxidation was more important in MVG12 than in CG, MVG4, and MVG8, while there was more protein oxidation in MVG12 than in CG and MVG4. The stereological analysis confirmed the histological pulmonary changes in MVG12. The association of controlled mode ventilation and high tidal volume, without PEEP and normoxia, impaired pulmonary histoarchitecture and triggered redox imbalance and lung inflammation in healthy adult rats.
Collapse
|
5
|
Jia L, Liu K, Fei T, Liu Q, Zhao X, Hou L, Zhang W. Programmed cell death-1/programmed cell death-ligand 1 inhibitors exert antiapoptosis and antiinflammatory activity in lipopolysaccharide stimulated murine alveolar macrophages. Exp Ther Med 2021; 21:400. [PMID: 33680122 PMCID: PMC7918472 DOI: 10.3892/etm.2021.9831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 06/17/2020] [Indexed: 12/23/2022] Open
Abstract
Acute lung injury caused by sepsis remains one of the most difficult challenges faced by patients in intensive care units and is associated with a high mortality rate. The aim of the present study was to investigate whether programmed cell death (PD)-1/programmed cell death-ligand 1 (PD-L1) inhibitors reduce alveolar macrophage apoptosis, reduce inflammatory factor release and relieve inflammation. For this purpose, murine alveolar macrophages, MH-S, were cultured and divided into control, lipopolysaccharide (LPS) and LPS+BMS-1 (PD-1/PD-L1 inhibitors) groups. LPS (10 ng/ml) was added to the LPS and LPS+BMS-1 groups for 24 h and PD-1/PD-L1 inhibitor BMS-1 (1 µmol/l) was added to the LPS+BMS-1 group for 72 h. PD-1 mRNA expression was detected using reverse transcription-quantitative PCR and PD-1 protein expression was detected using western blotting in the control, LPS and LPS+BMS-1 groups of macrophages. MH-S apoptosis was detected using flow cytometry with Annexin V/PI staining. The levels of the inflammatory factors interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α and IL-10 were detected by ELISA. Murine alveolar macrophages expressed PD-1 at both the molecular and protein levels and PD-1 expression was increased in MH-S cells stimulated with LPS. Compared with the LPS group, the expression of PD-1 in the LPS+BMS-1 group was significantly decreased. Flow cytometry demonstrated that there was increased apoptosis of alveolar macrophages in the LPS group compared with the control group, whereas, alveolar macrophages notably decreased apoptosis in the LPS+BMS-1 group compared with the LPS group. There was no statistical difference between the control group and the LPS+BMS-1 group. IL-1β, IL-6, TNF-α and IL-10 were increased in the LPS group compared with the control group. The levels of IL-1β, IL-6 and TNF-α in the LPS+BMS-1 group were lower compared with those in the LPS group whereas IL-10 was further increased. In vitro, the PD-1/PD-L1 inhibitor, BMS-1, decreases alveolar macrophage apoptosis compared with the LPS group to maintain effective immune clearance and reduce inflammatory factor release. This decreased the inflammatory response and reduced acute lung injury caused by sepsis. Therefore, PD-1/PD-L1 inhibitors may be a potential therapeutic target for acute lung injury in patients with sepsis.
Collapse
Affiliation(s)
- Lingling Jia
- Department of Thoracic Surgery, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Kai Liu
- Department of Thoracic Surgery, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Teng Fei
- Department of Thoracic Surgery, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Qian Liu
- Department of Thoracic Surgery, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Xiwei Zhao
- Department of Thoracic Surgery, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Linyi Hou
- Department of Intensive Care Unit, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Wenkai Zhang
- Department of Intensive Care Unit, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| |
Collapse
|