- 作者: Chia-Chih Lin, Pei-Hsin Liu, Shang Kao, Hsing I Chen
- 作者服務機構: 1Department of Physical Education and Kinesiology, National Dong Hwa University, Hualien, Taiwan., R.O.C.
- 中文摘要: --
- 英文摘要:
Background: Fat embolism syndrome (FES) associated with acute lung injury (ALI) is a clinical condition following
long bone fracture. We have reported 14 victims due to ALI with FES. Our laboratory has developed an animal
model that produced fat emboli (FE). The major purpose of this study was to test whether neutrophil activation
with phorbol myristate acetate (PMA) and inhibition with sivelestat (SVT) exert protection on the lung.
Methods: The lungs of Sprague-Dawley rats were isolated and perfused. FE was produced by addition of corn oil
micelles into the lung perfusate. PMA and SVT were given simultaneously with FE. Parameters such as lung
weight/body weight ratio, LW gain, exhaled nitric oxide (NO), protein concentration in bronchoalveolar lavage
relating to ALI were measured. The neutrophil elastase (NE), myeloperoxidase, malondialdehyde and phopholipase
A2 activity were determined. We also measured the nitrate/nitrite, methyl guanidine (MG), and cytokines.
Pulmonary arterial pressure and microvascular permeability were assessed. Lung pathology was examined and
scored. The inducible and endothelial NO synthase (iNOS and eNOS) were detected.
Results: FE caused ALI and increased biochemical factors. The challenge also resulted in pulmonary hypertension and
increased microvascular permeability. The NE appeared to be the first to reach its peak at 1 hr, followed by other
factors. Coadministration with PMA exacerbated the FE-induced changes, while SVT attenuated the effects of FE.
Conclusions: The FE-induced lung changes were enhanced by PMA, while SVT had the opposite effect. Sivelestat,
a neutrophil inhibitor may be a therapeutic choice for patients with acute respiratory distress syndrome (ARDS)
following fat embolism. - 中文關鍵字: --
- 英文關鍵字: Fat embolism, Acute lung injury, Neutrophil elastase, Phorbol myristate acetate, Sivelestat