Assuntos
Animais , Masculino , Ratos , NF-kappa B/metabolismo , Poli(ADP-Ribose) Polimerases/metabolismo , Surfactantes Pulmonares/farmacologia , Síndrome do Desconforto Respiratório/tratamento farmacológico , /farmacologia , /uso terapêutico , Líquido da Lavagem Broncoalveolar/química , Líquido da Lavagem Broncoalveolar/citologia , Citrulina/metabolismo , Combinação de Medicamentos , Ativação Enzimática , Álcoois Graxos/farmacologia , Álcoois Graxos/uso terapêutico , Concentração de Íons de Hidrogênio , Quinase I-kappa B/metabolismo , Lipopolissacarídeos , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Pulmão/patologia , NF-kappa B/antagonistas & inibidores , Óxido Nítrico Sintase Tipo II/metabolismo , Nitritos/metabolismo , Células Epiteliais Alveolares/efeitos dos fármacos , Células Epiteliais Alveolares/metabolismo , Poli(ADP-Ribose) Polimerases/antagonistas & inibidores , Polietilenoglicóis/farmacologia , Polietilenoglicóis/uso terapêutico , Surfactantes Pulmonares/uso terapêutico , Ratos Sprague-Dawley , Síndrome do Desconforto Respiratório/induzido quimicamente , Síndrome do Desconforto Respiratório/metabolismo , SuínosRESUMO
Acute lung injury (ALI) or its severe form, acute respiratory distress syndrome (ARDS) is an important cause of mortality in the human population. Despite significant advances made, the mortality associated with ALI remains unchanged. The objective of the present study was to evaluate the role of oxidative stress, alveolar antioxidant status and multiple organ injury in ARDS induced by lipopolysaccharide (LPS) in rats. Rats were divided into 4 groups, group I control rats were given saline intraperitoneally, whereas groups II, III and IV (LPS-treated) rats received an intraperitoneal injection of LPS (10 mg/kg body weight) and sacrificed after various time intervals. In LPS-treated rats, we observed increased levels of oxidative products, decreased levels of antioxidants in lung tissues and increased levels of serum marker enzymes, suggesting multiple organ injury. Bronchoalveolar lavage fluid (BALF) neutrophil content and protein concentration in LPS-treated rats were significantly elevated in a time-dependent manner. Histological studies revealed neutrophil influx and diffused alveolar damage in LPS-administered rats. These results clearly suggested that increased oxidant levels led to oxidative stress, antioxidant deficiency attenuating lung inflammation and tissue damage. LPS administration resulted in multiple organ failure, leading to increased mortality.
Assuntos
Animais , Antioxidantes/metabolismo , Humanos , Lipopolissacarídeos , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Masculino , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Wistar , Síndrome do Desconforto Respiratório/induzido quimicamente , Síndrome do Desconforto Respiratório/metabolismoRESUMO
BACKGROUND & OBJECTIVES: The decrease in surfactant protein-A (SP-A level) has recently been implicated in the pathophysiology of acute respiratory distress syndrome (ARDS). Mechanical ventilation is the main modality of treatment of ARDS. But information on the SP-A levels after mechanical ventilation is scanty. We therefore studied the effect of mechanical ventilation on SP-A levels in patients with ARDS. METHODS: In a prospective, observational study conducted in the Respiratory Intensive Care Unit of a tertiary care hospital in north India, 13 patients with ARDS requiring mechanical ventilation were included. SP-A levels in the bronchial aspirates were serially estimated by ELISA at the start of mechanical ventilation and after 24 and after 48 h. RESULTS: The SP-A level at the start of mechanical ventilation was 3.06 +/- 2.56 microg/ml. The levels gradually increased to 3.99 +/- 2.39 and 6.64 +/- 2.72 microg/ml, at 24 and 48 h respectively, and this increase was statistically significant (P < 0.05). Patients having an infectious etiology had lower SP-A levels compared to those with non-infections causes. Neither the initial SP-A level nor the increase in SP-A level correlated with the improvement in lung function or duration of ventilation. INTERPRETAION & CONCLUSION: The present study showed a progressive increase in the SP-A levels in patients with ARDS on mechanical ventilation. Further studies are required to confirm that the increase in SP-A levels may be one of the contributors for recovery in ARDS.
Assuntos
Doença Aguda , Adolescente , Adulto , Brônquios , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Pulmão/metabolismo , Masculino , Pessoa de Meia-Idade , Pneumonia/genética , Estudos Prospectivos , Proteína A Associada a Surfactante Pulmonar/metabolismo , Síndrome do Desconforto Respiratório/metabolismoRESUMO
Las especies reactivas del oxígeno intervienen en un sinnúmero de enfermedades y producen daño directo o indirecto a diferentes órganos. En el paciente críticamente enfermo se observa un conjunto de afecciones entre las que se tomaron como ejemplo el síndrome de distrés respiratorio del adulto, el infarto agudo del miocardio y los accidentes cerebrovasculares isquémicos. El síndrome de distrés respiratorio es una afección inflamatoria aguda donde se altera el endotelio vascular pulmonar con acúmulo excesivo de polimorfonucleares en los espacios intersticiales y alveolares, proceso favorecido por las especies reactivas del oxígeno que ocasionan el daño tisular. El síndrome de distrés respiratorio se produce por múltiples afecciones: politrauma, sepsis, estados de choque, politransfundidos, etc. y siempre con una elevada mortalidad. El infarto agudo de miocardio y los infartos cerebrales son un ejemplo de enfermedades donde está presente el síndrome de isquemia-reperfusión y se produce el daño tisular lo que provoca una lesión isquémica que compromete la capacidad para controlar el metabolismo de oxígeno. En la fase de reperfusión hay una liberación excesiva de especies reactivas del oxígeno que al interactuar con la membrana celular desencadenan el llamado proceso de peroxidación lipídica, destrucción y muerte celular