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首页> 外文期刊>Journal of vascular surgery >Endotoxemia during supraceliac aortic crossclamping is associated with suppression of the monocyte CD14 mechanism: possible role of transforming growth factor-beta1.
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Endotoxemia during supraceliac aortic crossclamping is associated with suppression of the monocyte CD14 mechanism: possible role of transforming growth factor-beta1.

机译：race上主动脉钳夹术中的内毒素血症与单核细胞CD14机制的抑制有关：转化生长因子-β1的可能作用。

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PURPOSE: Monocyte CD14 and its soluble form (sCD14) mediate the proinflammatory response to endotoxemia. The aim of this study was to measure the changes to these factors after major aortic surgery and the possible inhibitory role of transforming growth factor-beta(1) (TGF-beta(1)) during these procedures. METHODS: Twenty-four patients with supraceliac aortic crossclamping during thoracoabdominal aortic aneurysm (TAAA) repair and 12 patients with infrarenal aortic crossclamping as part of infrarenal aneurysm repair (AAA) were studied. Blood was collected at incision, aortic clamping, and reperfusion and at 1, 8, and 24 hours after reperfusion. Samples were assayed for endotoxin, peripheral blood monocyte CD14 expression, sCD14, tumor necrosis factor-alpha, and TGF-beta(1). RESULTS: Although there was significant endotoxemia on reperfusion in both groups of patients, peak plasma endotoxin levels were significantly higher in patients with TAAA (P =.001). Monocyte CD14 and plasma sCD14 were significantly decreased in patients with TAAA at reperfusion and 1 hour after reperfusion (P <.01, both points). In patients with AAA, a significant upregulation of CD14 was observed at 24 hours after reperfusion (P <.01), but no significant changes in sCD14 were observed. TNF-alpha showed no significant changes during the study period in both groups. In patients with TAAA, TGF-beta(1) showed significant elevation at all time points (P <.01); whereas in patients with AAA, TGF-beta(1) showed no significant changes. CONCLUSION: Splanchnic ischemia reperfusion in patients who undergo supraceliac aortic clamping is associated with peripheral blood monocyte CD14 suppression and significant elevation of TGF-beta(1). TGF-beta(1) may play an important role in modulating the immune response to endotoxemia during major aortic aneurysm surgery.
机译：目的：单核细胞CD14及其可溶性形式（sCD14）介导对内毒素血症的促炎反应。这项研究的目的是测量主动脉手术后这些因素的变化以及在这些手术过程中转化生长因子-β（1）（TGF-β（1））的可能抑制作用。方法：研究了24例胸腹主动脉瘤（TAAA）修复过程中的race上主动脉交叉钳夹术和12例作为肾下动脉瘤修复（AAA）的肾下主动脉夹钳患者。在切口，主动脉夹钳和再灌注以及再灌注后1、8和24小时收集血液。分析样品的内毒素，外周血单核细胞CD14表达，sCD14，肿瘤坏死因子-α和TGF-β（1）。结果：尽管两组患者的再灌注均具有明显的内毒素血症，但TAAA患者的血浆内毒素峰值明显更高（P = .001）。 TAAA患者在再灌注时和再灌注后1小时，单核细胞CD14和血浆sCD14显着降低（P <.01，两个点）。在AAA患者中，再灌注后24小时观察到CD14显着上调（P <.01），但未观察到sCD14的显着变化。在研究期间，两组的TNF-α均无明显变化。在患有TAAA的患者中，TGF-beta（1）在所有时间点均显示出明显升高（P <.01）;而在AAA患者中，TGF-beta（1）没有明显变化。结论：race上主动脉钳夹患者的内脏缺血再灌注与外周血单核细胞CD14抑制和TGF-beta（1）明显升高有关。 TGF-beta（1）可能在调节主动脉瘤手术中对内毒素血症的免疫反应中起重要作用。

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