Activation of M1 macrophages in sepsis-induced acute kidney injury in response to heparin-binding protein.

BACKGROUND: In the early stage of sepsis, M1 macrophages result in the production of inflammatory mediators and AKI. Heparin-binding protein (HBP) have been shown to play important roles in sepsis-induced AKI. In this study, we investigate the association of HBP with M1 macrophages in sepsis-induced AKI. METHODS: Male C57BL6 mice were subjected to cecal ligation and puncture (CLP) or sham surgery. Biochemical and histological renal damage was assessed. Macrophage infiltration was assessed by immunohistochemistry. RT-PCR was used to investigate the expression of heparin-binding protein (HBP), the inducible nitric oxide synthase (iNOS) and arginase 1 (Arg-1) mRNAs. Western blots were performed to assay the tissue levels of HBP, tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6). RESULTS: High levels of HBP were obviously detected 24 h after sepsis-induced AKI. Heparin inhibited HBP expression during sepsis-induced AKI. The suppression of HBP expression by heparin injection after the establishment of sepsis-induced AKI resulted in a reduction in renal injury severity accompanied with a significant repression of M1 macrophage activation and expression of TNF-α and IL-6. CONCLUSIONS: HBP plays an important role in the initial inflammatory reaction associated with sepsis-induced AKI, presumably by activating M1 macrophages and suppressing TNF-α and IL-6 secretion.

Protective effect of esmolol on peritoneal macrophages in rats with sepsis / 中华急诊医学杂志

Objective To investigate the protective effects of esmolol on peritoneal macrophages in rats with sepsis.Methods Rat peritoneal macrophages were deprived of serum and divided into four groups,namely normal group,LPS stimulated group,esmolol group and LPS plus esmolol group.Quantitative real-time PCR and Western blot were performed to assay the expressions and protein levels of TNF-α,β1-AR and p65.The activation of NF-κB was determined by electrophoretic mobility shift assay.Results The expression of TNF-α mRNA and protein level was significantly increased in LPS-treated group than those in normal group (P ＜ 0.01),and those in LPS plus esmolol group was significantly lower than those in LPS stimulated group (P ＜ 0.01).The expression of β1-AR mRNA and protein level were significantly higher in LPS-treated group than those in normal group (P ＜ 0.01),The expression of β1-AR mRNA and protein level in the esmolol group was lower than those in normal group (P ＜ 0.01),and those in LPS plus esmolol group was lower than those in LPS stimulated group (P ＜ 0.01).Besides,compared with the normal group,the expression of p65 mRNA in the LPS stimulated group was noticeably higher (P ＜ 0.01).The expression of P65 mRNA in LPS plus esmolol group was significantly lower than that in LPS-treated group (P ＜ 0.01).The NF-κB/DNA binding force in the LPS stimulated group was significantly higher than that in normal group (P ＜0.01).Compared with the LPS stimulated group,the NF-κB/DNA binding force in the LPS plus esmolol group was significantly lower (P ＜ 0.01).Conclusions The expression of TNF-α mRNA induced by LPS was decreased by esmolol in rat peritoneal macrophages which might be achieved via inhibiting NF-κB pathway by the modulation role of β1 adrenergic receptor.

Analysis of characteristics of 144 casualties of tornado disaster in Yancheng / 中华急诊医学杂志

Objective To study the characteristics of the wounded injured from of a strong and spiraling up wind of tornado blowing in Yancheng on 23 June 2006.Methods The clinical data of 144 inpatients within 36 h after tornado disaster were collected and analyzed,including gender,age,time of visiting hospital,causes of injury,injury site,injury severity score,et al.Microsoft Excel for data input and SPSS 20.0 for statistical analysis were used.Results The majority of the patients with injury was over 60 years old (57.6％).The two peak periods for accepting patients were during the 6 h ～8 h (n =55) and the 21 h ～ 22 h (n =27) after tornado disaster.The patients during the first peak period had the higher injury severity score than that during the second peak period [(18.21 ± 7.13) vs.(14.65 ±4.86),P ＜ 0.05)].The most common causes of injuries for survivors were being hit by flying/falling object blown by the wind of tornado.The common kinds of injuries were soft-tissue (24.48％),chest (20.30％),head (17.61％),lower limb/pelvis (13.73％),upper limb (8.06％),spine (7.76％).And 41.0％,17.4％ and 13.9％ of patients were admitted to department of orthopedic,department of chest surgery and department of neurosurgery,respectively.Conclusions The destructive force of tornado was very strong leading to a large number of casualties.Therefore,medical aid agencies should have to develop a appropriate treatment process to improve their emergency response capabilities and rescue capacity.