Instilación intratraqueal de elastasa en la rata: cambios electroforéticos de la alfa1-AT-antitripsina en el lavado broncoalveolar / Intratracheal instillation of elastase in the rat: electrophoretical changes of alphal-antitrypsin in bronchoalveolar lavage fluid

Introduction: Endogenous alphal-antitrypsin alpha is the main inhibitor of the intratracheally instilled elastase in experimental animals. Objective: To evaluate by electrophoresis and immunodetection using western blot analysis, the different forms of alpha1-AT in bronchoalveolar lavage fluid (BALF) of Sprague Dawley rats after intratracheal instillation of elastase, with the hypothesis that the previously observed increment in antielastase activity is due to high levels of active alpha1-AT. Results: In the first hours after elastase instillation the concentration of alpha1-AT increases more than seven times due to an increase in alveolar-capillary permeability. Alpha 1-AT in BAIF is found as the native protein (~ 52 kDa), as complexes of different molecular sizes (> 75 kDa and > 100 kDa) and as a proteolytic product (< 40 kDa). Conclusion: In spite of a high proportion of alpha1-AT in the inactive form as part of different complexes, the increase in alveolar-capillary permeability after elastase treatment contributes to maintain high levels of active alpha. These results could be of importance in other inflammatory lung processes.

Introducción: la antiproteasa alfa 1-antitripsina alfa constituye el principal inhibidor endógeno de la elastasa instilada por vía intratraqueal en modelos experimentales. Objetivo: Evaluar mediante electroforesis e inmunodetección por western blot, las distintas formas en que se encuentra la alfa1-AT en el lavado broncoalveolar (IBA) de ratas Sprague Dawley después de la instilación de elastasa, con la hipótesis de que el aumento en la actividad antielastasa previamente encontrada se acompaña de niveles altos de alfa1-AT activa. Resultados: En las primeras horas post-elastasa la concentración de alfa1-AT en el IBA aumenta más de 7 veces, debido al aumento de la permeabilidad alvéolo-capilar, encontrándose tanto como proteína nativa (~ 52 kDa), como parte de complejos de mayor tamaño (> 75 kDa y > 100 kDa) y como producto de proteólisis (< 40 kDa). Conclusión: A pesar de existir una alta proporción de alfa1-AT inactiva formando complejos, el aumento de la permeabilidad alvéolo-capilar contribuye a mantener niveles altos de alfa1-AT activa. Estos resultados podrían ser extrapolables a distintos procesos inflamatorios pulmonares.

Distrés respiratorio. Nuevas perspectivas en el manejo del edema pulmonar / [Respiratory distress. New Perspectives to lung edema treatment]

Acute respiratory distress syndrome (ARDS) is a life threatening condition associated with great morbidity and mortality. it is characterized initially by accumulation of fluid in the alveolar space that impairs alveolar oxygen exchange. Eventually, this syndrome leads to multiorgan failure. Therefore, rapid edema clearance has generally been associated with better outcome in patients with acute respiratory distress syndrome. Clearance of alveolar fluid is driven predominantly by active Na+ transport out of the alveolar space, mediated by increased apical Na(+)-channel and Na-K-ATPase activity. It has been demonstrated that increases in Na-K-ATPase in response to catecholamines in the alveolar epithelium are associated with increased lung edema clearance. The cellular mechanisms involve the recruitment of new Na-K-ATPase molecules to the plasma membrane from intracellular organelles. It also appears that adenovirus-mediated Na-K-ATPase gene transfer and increased Na-K-ATPase expression may provide an alternative and efficient pathway for transient increase in alveolar fluid reabsorption and resolution of pulmonary edema.