Pulmonary vascular clearance of harmful endogenous macromolecules in a porcine model of acute liver failure
| Autor: | Kjetil Elvevold, Bård Smedsrød, Lars M. Ytrebø, Marcio F. Chedid, Rajiv Jalan, Arthur Revhaug, Geir I. Nedredal, Sambit Sen, Christopher F. Rose |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Pathology Time Factors Hyaluronic acid Sus scrofa Specialties of internal medicine Tissue plasminogen activator 03 medical and health sciences Liver disease chemistry.chemical_compound 0302 clinical medicine Internal medicine Macrophages Alveolar medicine Animals Liver sinusoidal endothelial cells Receptor Lung Serum Albumin Pulmonary intravascular macrophages Leukopenia Hepatology business.industry Albumin Endothelial Cells Biological Transport Lung Injury General Medicine Liver Failure Acute medicine.disease Systemic inflammatory response syndrome Disease Models Animal 030104 developmental biology Endocrinology medicine.anatomical_structure chemistry RC581-951 030211 gastroenterology & hepatology Tumor necrosis factor alpha Inflammation Mediators medicine.symptom business Fluorescein-5-isothiocyanate medicine.drug |
| Zdroj: | Annals of Hepatology, Vol 15, Iss 3, Pp 427-435 (2016) |
| ISSN: | 1665-2681 |
| Popis: | Background. Pulmonary complications are common in acute liver failure (ALF). The role of the lungs in the uptake of harmful soluble endogenous macromolecules was evaluated in a porcine model of ALF induced by hepatic devascularization (n = 8) vs. controls (n = 8). In additional experiments, pulmonary uptake was investigated in healthy pigs. Fluorochrome-labeled modified albumin (MA) was applied to investigate the cellular uptake. Results. As compared to controls, the ALF group displayed a 4-fold net increased lung uptake of hyaluronan, and 5-fold net increased uptake of both tissue plasminogen activator and lysosomal enzymes. Anatomical distribution experiments in healthy animals revealed that radiolabeled MA uptake (taken up by the same receptor as hyaluronan) was 53% by the liver, and 24% by the lungs. The lung uptake of LPS was 14% whereas 60% remained in the blood. Both fluorescence and electron microscopy revealed initial uptake of MA by pulmonary endothelial cells (PECs) with later translocation to pulmonary intravascular macrophages (PIMs). Moreover, the presence of PIMs was evident 10 min after injection. Systemic inflammatory markers such as leukopenia and increased serum TNF-α levels were evident after 20 min in the MA and LPS groups. Conclusion. Significant lung uptake of harmful soluble macromolecules compensated for the defect liver scavenger function in the ALF-group. Infusion of MA induced increased TNF-α serum levels and leukopenia, similar to the effect of the known inflammatory mediator LPS. These observations suggest a potential mechanism that may contribute to lung damage secondary to liver disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|