High pressure level in human airwayenhances the expression of 3 cytokines related to airway remodeling / 基础医学与临床

ABSTRACT

Objective To explore the relationship between different airway pressure and expression of related cytokines to airway remodeling.Methods Fourty-two chronic obstructive pulmonary disease cases (COPD group) and thirty-three control cases were collected.The above cases underwent mechanical ventilation in the period of general anesthesia.According to different levels of peak inspiratory pressure(PIP), above two groups, randomly and respectively, were divided into high PIP (HPIP, 24 cmH2O) group, moderate PIP (MPIP, 22 cmH2O) group, low PIP (LPIP, 20 cmH2O) group.All positive end expiratory pressure (PEEP) was set to 5 cmH2O.Then the collection of BALF was performed before and 3 hours after applying ventilator.The related factors to airway remodeling, such as fibroblast growth factor 2 (FGF-2), transforming growth factor β1 (TGF-β1) and matrix metalloproteinase-9 (MMP-9), were measured by enzyme-linked immunosorbent assay (ELISA) and Western blot.Results 1)Beforemechanical ventilation, the levels of FGF-2, TGF-β1 and MMP-9 in COPD group were higher than control group (P<0.01).2)3 hours after mechanical ventilation, we saw significant upregulated expression of FGF-2, TGF-β1, MMP-9 in HPIP subgroup in control group (P<0.05) and the 3 factors levels of COPD group were all increased (P<0.05).Moreover, HPIP subgroup was significantly higher than MPIP and LPIP subgroup in COPD group (P<0.05).3)The expression of FGF-2, TGF-β1, MMP-9 in BALF had a positive correlation with the airway pressure levels in COPD group(P<0.01).Conclusions Under mechanical ventilation, sustained high airway pressure may enhance the expression of FGF-2, TGF-β1 and MMP-9 which may result in airway remodeling by mechanosensitive cation channel in bronchial epithelial cells, especially in COPD patients.