Chest
Clinical Investigations in Critical CareExpression of Inducible Nitric Oxide Synthase and Inflammatory Cytokines in Alveolar Macrophages of ARDS Following Sepsis
Section snippets
Study Population
Patients with ARDS were identified prospectively. ARDS was defined according to the definition of Murray et al12 as follows: (1) lung injury score >2.5; (2) wedge pressure <18 mm Hg measured by pulmonary catheter, or no clinical evidence of congestive heart failure; and (3) no other explanation for the above findings.12
Eight patients with sepsis (six male, two female) whose lung injury score was >2.5 in the ICU (ARDS group), eight patients (three male, five female) in the operating room soon
Composition, Albumin, and Protein Levels in the BAL
The characteristics of the BALF from each group are summarized in Table 1. The number of WBCs in the BALF from the ARDS group increased significantly as compared with that of the control group. The percentage of AMs in the BALF from the ARDS group was significantly less as compared with that of the control group. The percentage of neutrophils in the BALF from the ARDS group increased significantly as compared with that of the control group. No statistical difference was observed in the
DISCUSSION
Using an immunofluorescent technique, our study identified the strong expression of iNOS in AMs of human lungs predominantly at the early stage of ARDS following sepsis. No expression of iNOS was observed in the AMs from the control group, or the LTV group. Although the patients in both the ARDS group and the LTV group were clinically diagnosed as having sepsis syndrome, only AMs of the ARDS group whose PaO2/FIo2 was <200 immunohistochemically expressed iNOS. The stronger expressions of IL-6
References (31)
- et al.
Adult respiratory distress syndrome (ARDS): the basics.
J Emerg Med
(1994) - et al.
Evaluation of nitrite production by human monocyte-derived macrophages.
Biochem Biophys Res Commun
(1992) - et al.
Expression of inducible nitric oxide in human lung epithelial cells.
Biochem Biophys Res Commun
(1994) - et al.
Induction of nitric oxide synthase in asthma.
Lancet
(1993) - et al.
Recovery from cryptococcemia and the adult respiratory distress syndrome in the acquired immunodeficiency syndrome.
Chest
(1988) A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding.
Anal Biochem
(1976)- et al.
Analysis of nitrate, nitrite, and [15N]nitrate in biological fluids.
Anal Biochem
(1982) - et al.
An enzyme-linked immunosorbent assay for the measurement of human interleukin-6.
J Immunol Methods
(1990) - et al.
A highly sensitive enzyme-linked immunosorbent assay for the measurement of interleukin-8 in biological fluids.
J Immunol Methods
(1992) - et al.
Transforming growth factor-beta 1, but not dexamethasone, down-regulates nitricoxide synthase mRNA after its induction by interleukin-1 beta in rat smooth muscle cells.
J Biol Chem
(1994)
Regulation of biosynthesis of nitric oxide.
J Biol Chem
Interleukin-8 and development of adult respiratory distress syndrome in at-risk patient groups.
Lancet
Interleukin 8 (IL-8) in the bronchoalveolar lavage fluid from patients with the adult respiratory distress syndrome (ARDS) and patients at risk for ARDS.
Cytokine
Evolution of bronchoalveolar cell populations in the adult respiratory distress syndrome.
Am J Respir Crit Care Med
Nitrogen oxide levels in patients after trauma and during sepsis.
Ann Surg
Cited by (94)
Lung nitroxidative stress in mechanically-ventilated septic patients: A pilot study
2019, Journal of Critical CareCitation Excerpt :Inflammatory stimulus from sepsis increases NOS expression further, as a result nitrite and nitrate concentrations in plasma and in BAL samples are higher in sepsis than in mechanical ventilation group. Sepsis-induced lung NOS expression together inflammatory cytokines have been described in the lungs of ARDS patients following sepsis [18]. Oxidative stress is an imbalance between oxidants and antioxidants on a cellular or individual level.
PET imaging approaches for inflammatory lung diseases: Current concepts and future directions
2017, European Journal of RadiologyCitation Excerpt :In addition, iNOS is specifically induced by inflammation. Its expression is increased in a number of chronic lower respiratory diseases that are characterized by inflammation, correlating with the severity and progression of asthma [23,24], COPD [25–27], and ARDS [28,29]. Preclinical studies further suggest that iNOS may cause lung tissue destruction and remodeling that leads to fibrosis [30]. (
Asiaticoside attenuates lipopolysaccharide-induced acute lung injury via down-regulation of NF-κB signaling pathway
2015, International ImmunopharmacologyPrime-O-glucosylcimifugin attenuates lipopolysaccharide-induced acute lung injury in mice
2013, International ImmunopharmacologyCitation Excerpt :High levels of pro-inflammatory cytokines, such as TNF-α, IL-1β and IL-6, perform a central role in the initiation and propagation of the inflammatory cascade in LPS-induced ALI [36]. Cytokines, such as TNF-α, IL-1β, IL-6, IL-8, and IL-10, that are secreted by alveolar macrophages stimulate more chemotaxis and attract more neutrophils to injured lungs [37–39]. In our study, the levels of TNF-α, IL-1β and IL-6 in BALF were lower in the Prime-O-glucosylcimifugin group than in the LPS group.
Funded by Japanese Ministry of Education grant 200207407045 (Dr. Hashimoto).
Reprint requests: Atsuko Kobayashi, MD, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602, Japan