Altered Profile of Circulating Endothelial-Derived Microparticles in Ventilator-Induced Lung Injury.
Crit Care Med
; 43(12): e551-9, 2015 Dec.
Article
em En
| MEDLINE
| ID: mdl-26308427
ABSTRACT
OBJECTIVES:
Pulmonary endothelial cell injury is central to the pathophysiology of acute lung injury. Mechanical ventilation can cause endothelial disruption and injury, even in the absence of preexisting inflammation. Platelet-endothelial cell adhesion molecule-1 is a transmembrane protein connecting adjacent endothelial cells. We hypothesized that injurious mechanical ventilation will increase circulating lung endothelial-derived microparticles, defined as microparticles positive for platelet-endothelial cell adhesion molecule-1, which could serve as potential biomarkers and mediators of ventilator-induced lung injury.DESIGN:
Prospective randomized, controlled, animal investigation.SETTING:
A hospital preclinical animal laboratory.SUBJECTS:
Forty-eight Sprague-Dawley rats.INTERVENTIONS:
Animals were randomly allocated to one of the three following ventilatory protocols for 4 hours spontaneous breathing (control group), mechanical ventilation with low tidal volume (6 mL/kg), and mechanical ventilation with high tidal volume (20 mL/kg). In both mechanical ventilation groups, positive end-expiratory pressure of 2 cm H2O was applied. MEASUREMENTS AND MAINRESULTS:
We analyzed histologic lung damage, gas exchange, wet-to-dry lung weight ratio, serum cytokines levels, circulating endothelial-derived microparticles, platelet-endothelial cell adhesion molecule-1 lung protein content, and immunohistochemistry. When compared with low-tidal volume mechanical ventilation, high-tidal volume ventilation increased lung edema score and caused gas-exchange deterioration. These changes were associated with a marked increased of circulating endothelial-derived microparticles and a reduction of platelet-endothelial cell adhesion molecule-1 protein levels in the high-tidal volume lungs (p < 0.0001).CONCLUSIONS:
There is an endothelial-derived microparticle profile associated with disease-specific features of ventilator-induced lung injury. This profile could serve both as a biomarker of acute lung injury and, potentially, as a mediator of systemic propagation of pulmonary inflammatory response.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Moléculas de Adesão Celular
/
Células Endoteliais
/
Micropartículas Derivadas de Células
/
Lesão Pulmonar Induzida por Ventilação Mecânica
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Animals
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article