外源性粒-巨噬细胞集落刺激因子对脓毒症树突状细胞的生物效应  

The biological effect of exogenetic GM-CSF to dentritic cells in spesis

作　　者：章德文[1] 何建[1] 

机构地区：[1]第二军医大学附属长海医院急诊科,上海200433

出　　处：《中华急诊医学杂志》2012年第2期137-140,共4页Chinese Journal of Emergency Medicine

基　　金：基金项目：上海市公共卫生优秀学科带头人培养基金（08GWD25）

摘　　要：目的 探讨粒-巨噬细胞集落刺激因子（GM-CSF）用于重度脓毒症治疗对于脾脏树突状细胞（DCs）的生物学效应及对预后影响.方法 选取160只雄性昆明鼠,随机（随机数字法）分为4组：健康对照组（n=50,不予特殊处理,正常喂养）,CLP组（n=42,盲肠结扎穿孔）,常规治疗组（n=34,CLP术后12、24、36、48、60、72、84h腹腔注射头孢曲松5 mg/kg）,GM-CSF治疗组（n=34,CLP术后除常规治疗外另于12、36、60、84h皮下注射GM-CSF 20 μg/kg）.于CLP术后0、12、24、48、72 h分批处死,用流式细胞仪测定各组脾脏DCs数量及凋亡率,用ELISA法检测各组血清IL-12质量浓度.并观察96h生存预后.结果 重度脓毒症时所有时间点脾脏DCs凋亡增加、数量明显减少（P＜0.05）,IL-12血清浓度单向曲线型增高（P＜0.05）；头孢曲松治疗可以加剧DCs的丢失（P＜0.05）,而对IL-12质量浓度无影响（P＞0.05）.GM-CSF治疗可增加DCs的数量（P＜0.05）,降低IL-12质量浓度（P＜0.05）.Logistic回归分析GM-CSF的OR值为0.079.结论 GM-CSF治疗重度脓毒症可以增加脾脏DCs数量,降低血清IL-12质量浓度,改善预后.Objective To investigate the biological effect of GM-CSF on splenic dentritic cells （DCs）when used to treat severe sepsis and the influence on the prognosis.Methods All 160 male Kunming mice were randomly（random number）divided into four groups：control group（n =50）,the mice didnt receive special treatment; CLP group（n =42）,the mice underwent cecal ligation and puncture;conventional treatment group（n =34）,the mice received intraperitoneal injection of 5 mg/kg ceftriaxone at 12,24,36,48,60,72 and 84 h after surgery; GM-CSF treatment group（n =34）,the mice received hypodermic injection of 20 μg/kg GM-CSF besides ceftriaxone at 12,36,60,and 84 h after surgery.The mice were sacrificed at 0,12,24,48 and 72 h after CLP by cervical dislocation.The amount of splenic DCs and apoptosis rate were measured by flow cytometry,and the serum concentrations of IL-12 were detected by ELISA in each group.Meanwhile the survival prognosis was observed at 96 h.Results At every time point,the apoptosis of splenic DCs increased and the amount markedly reduced in severe sepsis（P 〈0.05）,the serum concentration of IL-12 increased on an one-way curve type（P 〈0.05）.The treatment of cephalosporin exacerbated the loss of DCs（P 〈 0.05）,while hadnt any effect on IL-12（P 〉 0.05）.GMCSF treatment increased the amount of DCs（P 〈 0.05）,and decreased IL-12 concentrations（P 〈 0.05）.The OR of GM-CSF was 0.079 computed by Logist regression analysis.Conclusions GM-CSF treatment severe sepsis can increase the amount of splenic DCs,decrease serum levels of IL-12,and improve prognosis.

关 键 词：脓毒症 树突状细胞 凋亡 粒-巨噬细胞集落刺激因子 白介素12 

分 类 号：R457.7[医药卫生—治疗学]