在小鼠左肺切除术后,直接的血栓激素抑制剂无法逆转肝素对肺生长和功能的负面影响
Savas T Tsikis1,2, Thomas I Hirsch1,2, Timothy Klouda3
1Vascular Biology Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States.
American journal of physiology. Lung cellular and molecular physiology
|December 19, 2023
概括
直接血栓抑制剂 (DTI) 不能逆转肝素的作用.
科学领域:
- 肺部医学 肺部医学
- 血管生物学 血管生物学
- 新生儿生理学 新生儿生理学
背景情况:
- 患有先天性隔膜 (CDH) 的新生儿通常需要心肺旁路和抗凝治疗.
- 以前的研究表明,在小鼠补偿性肺生长 (CLG) 模型中,亚治疗性肝素会损害肺生长和功能.
- 直接血栓抑制剂 (DTI),如比瓦利鲁丁和阿斯拉特罗班,在CLG模型中先前保留了生长.
研究的目的:
- 评估DTI是否可以逆转亚治疗性肝素对肺生长和功能的负面影响.
- 为了研究肝素和DTI对肺内皮细胞增殖和细胞亡的联合作用,在体外.
- 在CLG模型中评估低剂量肝素与或没有DTI对肺生长和肺功能的体内影响.
主要方法:
- 在实验室中评估肺内皮细胞增殖和亡,单独使用肝素或与比瓦利鲁丁/阿加特罗班联合使用.
- 在体内研究使用C57BL/6J小鼠进行左肺切除术以补偿肺生长 (CLG).
- 小鼠接受了用盐水,比瓦利鲁丁或阿格拉特罗班的透,以及每天低剂量肝素;分析了肺体积,功能和组织学.
主要成果:
- 在体外,仅仅氨酸可降低内皮细胞增殖和增加细胞亡;DTI可逆转细胞增殖效应,但不能逆转细胞亡.
- 在体内,低剂量氨酸显著降低了肺体积,肺功能和运动表现,与对照组相比.
- 氨酸暴露导致降低了膜化,血管化,血管生成信号和基因表达,DTI无法逆转这些效应.
结论:
- 比瓦利鲁丁和阿格拉斯罗班不能抵消亚治疗性肝素对肺部发育和功能的有害影响.
- 在小鼠CLG模型中,氨酸和DTI的联合使用会损害肺生长和功能.
- 需要进行临床研究来检查同时使用氨酸和DTI对CDH患者结局的影响.
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