Endotoxin-induced acute lung injury in rats. Role of insulin

Reduced inflammatory responses are frequently associated with diabetes mellitus. In order to investigate the influence of diabetes mellitus on the activation of bronchoalveolar cells, diabetic Wistar rats (alloxan, 40 mg/kg, iv, 30 days) and matched controls were exposed to an aerosol of endotoxin (lipopolysaccharide, LPS) or saline. Bronchoalveolar lavage (BAL) was performed 4 h thereafter. Compared with saline, aerosol administration of LPS significantly increased the number of neutrophils in the BAL fluid of control and diabetic rats. Number of mononuclear cells did not change and eosinophils were absent. A marked increase in luminol-dependent chemiluminescence (LDCL) was observed in control group after stimulation of the cells in vitro with zymosan. In contrast, tests performed with cells from diabetic rats showed a 50% reduction in LDCL generation. Full recovery of cell behaviour to match control values was observed after treatment of diabetic animals with insulin, administered before LPS exposure. Furthermore, relative to controls, level of TNF-alpha in the BAL supernatant of diabetic rats was significantly reduced. Values returned to control levels after treatment of diabetic rats with insulin, prior exposure to LPS. In conclusion, data presented suggest that insulin might regulate superoxide generation and TNF-alpha release by leukocytes upon exposure to LPS in vivo.