1.Department of Burn and Plastic Surgery, Air Force Medical Center of Chinese PLA, Beijing 100142, China
2.Department of Respiratory and Critical Care Medicine, Air Force Medical Center of Chinese PLA, Beijing 100142, China
* zoubai185@163.com;
huxirenzhangb@163.com
纸质出版:2022-02
Scan QR Code
Simulated aeromedical evacuation exacerbates burn induced lung injury: targeting mitochondrial DNA for reversal[J]. 解放军医学杂志(英文版), 2022,9(1):32-39.
Xiao et al.: Simulated aeromedical evacuation exacerbates burn induced lung injury: targeting mitochondrial DNA for reversal. Mil Med Res, 2021, 8: 30.
Simulated aeromedical evacuation exacerbates burn induced lung injury: targeting mitochondrial DNA for reversal[J]. 解放军医学杂志(英文版), 2022,9(1):32-39. DOI: 10.1186/s40779-021-00320-9.
Xiao et al.: Simulated aeromedical evacuation exacerbates burn induced lung injury: targeting mitochondrial DNA for reversal. Mil Med Res, 2021, 8: 30. DOI: 10.1186/s40779-021-00320-9.
Background:
2
Aeromedical evacuation of patients with burn trauma is an important transport method in times of peace and war
during which patients are exposed to prolonged periods of hypobaric hypoxia; however
the effects of such exposure on burn injuries
particularly on burn-induced lung injuries
are largely unexplored. This study aimed to determine the effects of hypobaric hypoxia on burn-induced lung injuries and to investigate the underlying mechanism using a rat burn model.
Methods:
2
A total of 40 male Wistar rats were randomly divided into four groups (10 in each group): sham burn (SB) group
burn in normoxia condition (BN) group
burn in hypoxia condition (BH) group
and burn in hypoxia condition with treatment intervention (BHD) group. Rats with 30% total body surface area burns were exposed to hypobaric hypoxia (2000 m altitude simulation) or normoxia conditions for 4 h. Deoxyribonuclease I (DNase I) was administered systemically as a treatment intervention. Systemic inflammatory mediator and mitochondrial deoxyribonucleic acid (mtDNA) levels were determined. A histopathological evaluation was performed and the acute lung injury (ALI) score was determined. Malonaldehyde (MDA) content
myeloperoxidase (MPO) activity
and the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome level were determined in lung tissues. Data among groups were compared using analysis of variance followed by Tukey’s test post hoc analysis.
Results:
2
Burns resulted in a remarkably higher level of systemic inflammatory cytokines and mtDNA release
which was further heightened by hypobaric hypoxia exposure (
P
<
0.01). Moreover
hypobaric hypoxia exposure gave rise to increased NLRP3 inflammasome expression
MDA content
and MPO activity in the lung (
P
<
0.05 or
P
<
0.01). Burn-induced lung injuries were exacerbated
as shown by the histopathological evaluation and ALI score (
P
<
0.01). Administration of DNase I markedly reduced mtDNA release and systemic inflammatory cytokine production. Furthermore
the NLRP3 inflammasome level in lung tissues was decreased and burn-induced lung injury was ameliorated (
P
<
0.01).
Conclusions:
2
Our results suggested that simulated aeromedical evacuation further increased burn-induced mtDNA release and exacerbated burn-induced inflammation and lung injury. DNase I reduced the release of mtDNA
limited mtDNA-induced systemic inflammation
and ameliorated burn-induced ALI. The intervening mtDNA level is thus a potential target to protect from burn-induced lung injury during aeromedical conditions and provides safer air evacuations for severely burned patients.
Sine CR , Belenkiy SM , Buel AR , Waters JA , Lundy JB , Henderson JL , et al . Acute respiratory distress syndrome in burn patients: a comparison of the Berlin and American-European definitions . J Burn Care Res . 2016 ; 37 ( 5 ): e461 - 9 .
Enkhbaatar P , Traber DL . Pathophysiology of acute lung injury in combined burn and smoke inhalation injury . Clin Sci (Lond) . 2004 ; 107 ( 2 ): 137 - 43 .
Perl M , Lomas-Neira J , Venet F , Chung CS , Ayala A . Pathogenesis of indirect (secondary) acute lung injury . Expert Rev Respir Med . 2011 ; 5 ( 1 ): 115 - 26 .
Bhatia M , Zemans RL , Jeyaseelan S . Role of chemokines in the pathogenesis of acute lung injury . Am J Respir Cell Mol Biol . 2012 ; 46 ( 5 ): 566 - 72 .
Lupfer C , Kanneganti TD . The expanding role of NLRs in antiviral immunity . Immunol Rev . 2013 ; 255 ( 1 ): 13 - 24 .
Di Virgilio F . The therapeutic potential of modifying inflammasomes and NOD-like receptors . Pharmacol Rev . 2013 ; 65 ( 3 ): 872 - 905 .
Thomas CJ , Schroder K . Pattern recognition receptor function in neutrophils . Trends Immunol . 2013 ; 34 ( 7 ): 317 - 28 .
Bianchi ME . DAMPs, PAMPs and alarmins: all we need to know about danger . J Leukoc Biol . 2007 ; 81 ( 1 ): 1 - 5 .
Hirsiger S , Simmen HP , Werner CM , Wanner GA , Rittirsch D . Danger signals activating the immune response after trauma . Mediat Inflamm . 2012 : 315941 .
West AP , Shadel GS . Mitochondrial DNA in innate immune responses and inflammatory pathology . Nat Rev Immunol . 2017 ; 17 ( 6 ): 363 - 75 .
Grazioli S , Pugin J . Mitochondrial damage-associated molecular patterns: from inflammatory signaling to human diseases . Front Immunol . 2018 ; 9 : 832 .
Stanojcic M , Abdullahi A , Rehou S , Parousis A , Jeschke MG . Pathophysiological response to burn injury in adults . Ann Surg . 2018 ; 267 ( 3 ): 576 - 84 .
Liu R , Xu F , Bi S , Zhao X , Jia B , Cen Y . Mitochondrial DNA-induced inflammatory responses and lung injury in thermal injury murine model: protective effect of cyclosporine-a . J Burn Care Res . 2019 ; 40 ( 3 ): 355 - 60 .
Carter DW , Prudovsky I , Kacer D , Soul T , Kumpel C , Pyburn K , et al . Tranexamic acid suppresses the release of mitochondrial DAMPs and reduces lung inflammation in a murine burn model . J Trauma Acute Care Surg . 2019 ; 86 ( 4 ): 617 - 24 .
Eltzschig HK , Carmeliet P . Hypoxia and inflammation . N Engl J Med . 2011 ; 364 ( 7 ): 656 - 65 .
Cummins EP , Keogh CE , Crean D , Taylor CT . The role of HIF in immunity and inflammation . Mol Aspects Med . 2016 ; 47–48 : 24 - 34 .
Bowser JL , Lee JW , Yuan X , Eltzschig HK . The hypoxia-adenosine link during inflammation . J Appl Physiol (1985) . 2017 ; 123 ( 5 ): 1303 - 20 .
Fröhlich S , Boylan J , Mcloughlin P . Hypoxia-induced inflammation in the lung: a potential therapeutic target in acute lung injury? Am J Respir Cell Mol Biol . 2013 ; 48 ( 3 ): 271 - 9 .
Gonzalez NC , Wood JG . Alveolar hypoxia-induced systemic inflammation: what low PO2 does and does not do . Adv Exp Med Biol . 2010 ; 662 : 27 - 32 .
Chitra L , Boopathy R . Altered mitochondrial biogenesis and its fusion gene expression is involved in the high-altitude adaptation of rat lung . Respir Physiol Neurobiol . 2014 ; 192 : 74 - 84 .
Sliter DA , Martinez J , Hao L , Chen X , Sun N , Fischer TD , et al . Parkin and PINK1 mitigate STING-induced inflammation . Nature . 2018 ; 561 ( 7722 ): 258 - 62 .
Xiao M , Li L , Li C , Liu L , Yu Y , Ma L . 3,4-Methylenedioxy-beta-nitrostyrene ameliorates experimental burn wound progression by inhibiting the NLRP3 inflammasome activation . Plast Reconstr Surg . 2016 ; 137 ( 3 ): 566e - 75e .
Faller S , Hausler F , Goeft A , von Itter MNA , Gyllenram V , Hoetzel A , et al . Hydrogen sulfide limits neutrophil transmigration, inflammation, and oxidative burst in lipopolysaccharide-induced acute lung injury . Sci Rep . 2018 ; 8 ( 1 ): 14676 .
Xiao M , Li L , Li C , Zhang P , Hu Q , Ma L , et al . Role of autophagy and apoptosis in wound tissue of deep second-degree burn in rats . Acad Emerg Med . 2014 ; 21 ( 4 ): 383 - 91 .
Han S , Cai W , Yang X , Jia Y , Zheng Z , Wang H , et al . ROS-mediated NLRP3 inflammasome activity is essential for burn-induced acute lung injury . Mediat Inflamm . 2015 : 720457 .
Dayani Y , Stierwalt J , White A , Chen Y , Arnaud F , Jefferson MA , et al . Hypobaria during aeromedical evacuation exacerbates histopathological injury and modifies inflammatory response in rats exposed to blast overpressure injury . J Trauma Acute Care Surg . 2019 ; 87 ( 1 ): 205 - 13 .
Zhao J , You G , Yin Y , Zhang Y , Wang Y , Chen G , et al . Acute high-altitude exposure shortens survival after uncontrolled hemorrhagic shock in rats . J Surg Res . 2018 ; 226 : 150 - 6 .
Proctor JL , Mello KT , Fang R , Puche AC , Rosenthal RE , Fourney WL , et al . Aeromedical evacuation-relevant hypobaria worsens axonal and neurologic injury in rats after underbody blast-induced hyperacceleration . J Trauma Acute Care Surg . 2017 ; 83 ( 1 Suppl 1 ): S35 - 42 .
Skovira JW , Kabadi SV , Wu J , Zhao Z , Dubose J , Rosenthal R , et al . Simulated aeromedical evacuation exacerbates experimental brain injury . J Neurotrauma . 2016 ; 33 ( 14 ): 1292 - 302 .
Scultetus AH , Haque A , Chun SJ , Hazzard B , Mahon RT , Harssema MJ , et al . Brain hypoxia is exacerbated in hypobaria during aeromedical evacuation in swine with traumatic brain injury . J Trauma Acute Care Surg . 2016 ; 81 ( 1 ): 101 - 7 .
Santos FX , Mayoral E , Gabriel S , Hamann C . Air evacuation of critically burned patients . Mil Med . 1995 ; 160 ( 11 ): 593 - 6 .
Goodman MD , Makley AT , Huber NL , Clarke CN , Friend LAW , Schuster RM , et al . Hypobaric hypoxia exacerbates the neuroinflammatory response to traumatic brain injury . J Surg Res . 2011 ; 165 ( 1 ): 30 - 7 .
Liu Y , Yan W , Tohme S , Chen M , Fu Y , Tian D , et al . Hypoxia induced HMGB1 and mitochondrial DNA interactions mediate tumor growth in hepatocellular carcinoma through toll-like receptor 9 . J Hepatol . 2015 ; 63 ( 1 ): 114 - 21 .
Luo Y , Yang X , Gao Y . Mitochondrial DNA response to high altitude: a new perspective on high-altitude adaptation . Mitochondrial DNA . 2013 ; 24 ( 4 ): 313 - 9 .
Simmons JD , Freno DR , Muscat CA , Obiako B , Lee YLL , Pastukh VM , et al . Mitochondrial DNA damage associated molecular patterns in ventilator-Xiao et al . Military Medical Research (2021) 8:30 Page 7 of 8 associated pneumonia: prevention and reversal by intratracheal DNase I . J Trauma Acute Care Surg . 2017 ; 82 ( 1 ): 120 - 5 .
Fuchs HJ , Borowitz DS , Christiansen DH , Morris EM , Nash ML , Ramsey BW , et al . Effect of aerosolized recombinant human DNase on exacerbations of respiratory symptoms and on pulmonary function in patients with cystic fibrosis. The Pulmozyme study group . N Engl J Med . 1994 ; 331 ( 10 ): 637 - 42 .
0
浏览量
0
Downloads
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621