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Mechanical ventilation with moderate tidal volumes synergistically increases lung cytokine response to systemic endotoxin.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Altemeier, William A. Matute-Bello, Gustavo Frevert, Charles W. Kawata, Yasunobu Kajikawa, Osamu Martin, Thomas R. Glenny, Robb W. |
| Copyright Year | 2004 |
| Abstract | Previous animal studies have identified a role for activation of innate immunity in the pathogenesis of ventilator-associated lung injury. These studies have used large tidal volume ventilation to study the effect of alveolar overdistension on induction of inflammatory pathways. We hypothesized an alternative mechanism for the pathogenesis of lung injury in which moderate tidal volume ventilation does not independently cause clinical inflammation but rather interacts with innate immune activation by bacterial products, resulting in an enhanced inflammatory response. We measured cytokine expression and lung injury in normal and lipopolysaccharide (LPS)-treated anesthetized rabbits randomized to either spontaneous respiration or mechanical ventilation. Outcome parameters were analyzed by two-way factorial analysis of variance to identify synergism between ventilation and systemic LPS. Mechanical ventilation alone resulted in minimal cytokine expression in the lung but did enhance LPS-induced expression of tumor necrosis factor-alpha, the CXC chemokines interleukin-8 and growth-related protein-alpha, and the CC chemokine monocyte chemoattractant protein-1. Increased mRNA expression and activation of the transcription factors nuclear factor-kappaB and activator protein-1 accompanied the cytokine responses. We conclude that moderate volume ventilation strategies augment the innate immune response to bacterial products in the lung and may play a role in the development of acute lung injury in patients with sepsis. |
| Starting Page | 22 |
| Ending Page | 32 |
| Page Count | 11 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://ajplung.physiology.org/content/ajplung/287/3/L533.full.pdf |
| Alternate Webpage(s) | http://ajplung.physiology.org/content/early/2004/05/14/ajplung.00004.2004.full.pdf |
| PubMed reference number | 15145786v1 |
| Volume Number | 287 |
| Issue Number | 3 |
| Journal | American journal of physiology. Lung cellular and molecular physiology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Acute Lung Injury Bronchioloalveolar Adenocarcinoma Chemokine CCL22 Chemokine CXCL11 Chemotactic Factors Clomiphene Immunity, Innate Lipopolysaccharides Mechanical ventilation Patients Respiration Sample Variance Sepsis Structure of parenchyma of lung Transcription Factor AP-1 Tumor Necrosis Factors Ventilator - respiratory equipment cytokine inflammatory response |
| Content Type | Text |
| Resource Type | Article |
