The role of neutrophilic granulocytes in the development of acute lung injury in experimental diabetes mellitus

L. Zaiats, Y. Fedorchenko
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Abstract

Diabetes mellitus takes one of the first places in the structure of endocrine diseases. Among the complications of diabetes are sufficiently described nephro- and retinopathy, neuropathy, damage to the cardiovascular system. However, changes in the respiratory system and, in particular, the state of the endothelium of the pulmonary hemocapillaries and the morphofunctional state of neutrophilic granulocytes remain poorly understood. The aim of this study was to determine the role of neutrophilic granulocytes in the pathogenesis of acute lung injury in experimental diabetes mellitus. The experiments were performed on 88 white male Wistar rats weighing 170-210 g. The animals were divided into three groups: 1 – intact (n=10); 2 – control (n=40); 3 – experimental (n=38) with a model of diabetes mellitus, which was reproduced by intraperitoneal administration of streptozotocin company “Sigma” (USA), diluted in 0.1 M citrate buffer with pH 4.5, at a rate of 60 mg/kg body weight. An equivalent dose of 0.1 M citrate buffer solution with a pH of 4.5 was intraperitoneally administered to the control group of animals. Pulmonary tissue collection for electron microscopic examination was performed under thiopental anesthesia 14, 28, 42, 70 days after streptozotocin administration. Pieces of lung tissue were fixed in 2.5 % glutaraldehyde solution, followed by fixation in 1 % osmium tetroxide solution. After dehydration, the material was poured into epon-araldite. Sections obtained on an ultramicrotome “Tesla BS-490” were studied in an electron microscope “PEM-125K”. It was found that in the early stages of diabetes mellitus (14-28 days) there is a violation of the rheological properties of blood, as evidenced by erythrocyte aggregates, excessive accumulation of neutrophils, their adhesion and aggregation in the hemocapillaries of the alveolar wall. With the extension of the experiment (42-70 days) there is a progressive violation of the ultrastructural organization of hemocapillaries of the alveolar wall and pronounced changes in the rheological properties of blood. Erythrocyte sludges and leuco-platelet aggregates are determined in the lumen of microvessels. Increased permeability of hemocapillaries of the alveolar wall leads to the emigration of neutrophilic granulocytes into the interstitium and the lumen of the alveoli with the development of interstitial and intraalveolar edema. Thus, streptozotocin-induced diabetes is accompanied by the development of acute lung damage in the pathogenesis of which the leading role belongs to neutrophilic granulocytes. The nature and severity of changes in the lungs depends on the duration of exposure to hyperglycemia.
中性粒细胞在实验性糖尿病急性肺损伤发生中的作用
糖尿病在内分泌疾病的结构中居于首位。糖尿病的并发症包括肾脏和视网膜病变、神经病变、心血管系统损伤。然而,呼吸系统的变化,特别是肺毛细血管内皮的状态和中性粒细胞的形态功能状态仍然知之甚少。本研究旨在探讨中性粒细胞在实验性糖尿病急性肺损伤发病机制中的作用。实验选用体重170 ~ 210 g的雄性Wistar大鼠88只。动物分为三组:1 -完整(n=10);2 -对照组(n=40);3 -糖尿病模型实验(n=38),采用Sigma公司(美国)腹腔注射链脲佐菌素,以0.1 M pH为4.5的柠檬酸缓冲液稀释,剂量为60 mg/kg体重。对照组动物腹腔注射等量的0.1 M柠檬酸盐缓冲溶液,pH为4.5。给予链脲佐菌素后14、28、42、70天,在硫喷妥钠麻醉下采集肺组织进行电镜检查。肺组织片在2.5%戊二醛溶液中固定,然后在1%四氧化锇溶液中固定。脱水后,将物料倒入epon- aralite中。在“Tesla BS-490”超微切片上获得的切片在“PEM-125K”电子显微镜下进行研究。我们发现,在糖尿病早期(14-28天),血液流变学特性受到破坏,红细胞聚集,中性粒细胞过度积聚,它们在肺泡壁的毛细血管中粘附和聚集。随着实验时间的延长(42 ~ 70天),肺泡壁毛细血管超微结构组织逐渐破坏,血液流变学特性明显改变。在微血管腔内测定红细胞污泥和白细胞聚集物。肺泡壁毛细血管通透性增加,导致嗜中性粒细胞向肺泡间质和腔内迁移,发生间质水肿和肺泡内水肿。因此,链脲佐菌素诱导的糖尿病伴随着急性肺损伤的发展,其发病机制属于中性粒细胞的主导作用。肺部变化的性质和严重程度取决于暴露于高血糖的持续时间。
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