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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock

Abstract: Objective: To investigate the effects of resuscitation with normal saline (NS), hypertonic saline (HTS), and hydroxyethyl starch (HES) on regulatory T cells (Tregs), helper T 1 (Th1)/Th2 and cytotoxic T 1 (Tc1)/Tc2 profiles in the treatment of hemorrhagic shock. Methods: Rats subjected to severe hemorrhagic shock were resuscitated for 30 min with NS (n=8), HTS (n=8), or HES (n=8); sham (n=8) and naive control (n=8) groups were used for comparison. Following fluid resuscitation, the whole shed blood was reinfused for 30 min, and the rats were observed with continuous hemodynamic monitoring for 120 min. CD4+CD25+Foxp3+ Treg proportions, Th1/Th2 and Tc1/Tc2 profiles in spleen were analyzed by three-color flow cytometry. Results: The proportion of CD4+CD25+Foxp3+ Tregs and ratios of Th1/Th2 and Tc1/Tc2 did not differ among control, sham, and HTS groups, but were significantly lower in NS and HES groups (both P<0.05 vs. sham); NS and HES levels were similar. The level of Tc1 was significantly increased in HTS (P<0.05 vs. sham), and levels of Tc2 were increased in NS, HES, and HTS groups compared to sham (all P<0.05), but did not differ from each other. Conclusions: HTS resuscitation has a greater impact on immune system recovery than NS or HES by preserving the proportion of Tregs and maintaining the balance between Th1/Th2 and Tc1/Tc2 cells in the spleen. Thus, HTS resuscitation provides potential immunomodulatory activity in the early stage after hemorrhagic shock.

Key words: Regulatory T cells; Helper T cells; Cytotoxic T cells; Hemorrhagic shock

Chinese Summary  <23> 严重失血性休克大鼠液体复苏后的免疫修复

目的:严重失血性休克大鼠模型早期阶段使用不同的液体复苏,比较脾脏组织中调节性T细胞(Tregs)、辅助性T细胞1(Th1)/Th2以及细胞毒性T细胞1(Tc1)/Tc2的不同变化,初步探讨其免疫修复机制。
创新点:(1)脾脏为机体重要免疫器官,检测其中的免疫细胞变化,比外周血更具敏感性和特异性;(2)将免疫反应中多环节的免疫细胞变化进行协同分析,结果更具创新性和科学性,为临床上形成规范的救治方案提供了科学的实践资料。
方法:将SD雄性大鼠随机分成5组,其中对照组和Sham组(假手术)仅作为比较,其余三组在建立严重失血性休克大鼠模型后,采用不同的液体复苏:等渗盐水(NS组)、高渗盐水(HTS组)和羟乙基淀粉(HES组)。然后再灌注30分钟,并持续监测血液动力学120分钟,最后心脏穿刺,取脾脏组织,通过三色荧光标记流式细胞术进一步分析CD4+CD25+Foxp3+ Treg细胞含量,以及Th1/Th2和Tc1/Tc2的比值。
结论:液体复苏后大鼠脾脏中CD4+CD25+Foxp3+ Tregs细胞含量、Th1/Th2和Tc1/Tc2的比值在对照组、Sham组和HTS组中无差异,并都显著高于NS组和HES组。与Sham组比较,HTS组中Tc1水平明显升高,而NS组、HES组和HTS组中Tc2水平均有升高,且三组之间Tc2水平无差别。因此,对于维持脾脏中Treg细胞含量、Th1/Th2和Tc1/Tc2平衡的作用上,HTS液体复苏对免疫系统的影响大于NS和HES。综上所述,在失血性休克后的早期阶段HTS复苏可提供潜在的免疫修复作用。

关键词组:调节性T细胞;辅助性T细胞;细胞毒性T细胞;失血性休克


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DOI:

10.1631/jzus.B1600370

CLC number:

R605.971

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On-line Access:

2017-05-04

Received:

2016-08-23

Revision Accepted:

2016-10-17

Crosschecked:

2017-04-10

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