SHOCK最新文献

{"title":"Plasma Constituents Promote Endothelial Thromboinflammatory Dysfunction After Hemorrhagic Shock.","authors":"Kelly E Sanders, Marissa D Pokharel, Baron K Osborn, Yao-Wei Wang, Charles E Wade, Lucy Z Kornblith, Mitchell J Cohen, Jessica C Cardenas","doi":"10.1097/SHK.0000000000002816","DOIUrl":"10.1097/SHK.0000000000002816","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhagic shock (HS) following traumatic injury is hallmarked by innate immune activation, hypercoagulability, and thromboinflammatory complications. To date, the direct link between HS, injury severity, and endothelial cell (EC) contributions to thromboinflammation remains poorly understood. The goals of this study were to determine the impact of injury severity and HS on endothelial-mediated thromboinflammation and examine whether these changes increase the propensity for thrombosis.</p><p><strong>Methods: </strong>Plasma from 89 male trauma patients, stratified by HS and injury severity, and 10 healthy subjects were assessed for inflammatory mediators by BioPlex. Human lung microvascular endothelial cells were exposed to patient plasma for 4 hours, after which surface thrombin generation was measured by calibrated automated thrombogram, and ribonucleic acid extracted for gene expression analysis. Plasma from mice that underwent sham or fixed-pressure HS was infused into naive mice, followed by inferior vena cava ligation to induce thrombosis. Thrombi were collected 24 hours later for histologic analysis.</p><p><strong>Results: </strong>Inflammatory mediators were highest in plasma from patients with severe injuries and HS. Human lung microvascular endothelial cells exposed to trauma patient plasma exhibited increased thrombin generation and thromboinflammatory gene expression, with a more pronounced effect in HS patients. Lastly, mice infused with HS plasma developed significantly larger thrombi with higher neutrophil infiltration and reduced EC thrombomodulin expression compared with that of those infused with sham plasma.</p><p><strong>Conclusions: </strong>HS plasma amplifies endothelial-mediated inflammation and coagulation, which is driven, in part, by the presence of inflammatory mediators. HS plasma also increases the development of thrombosis in vivo . This study highlights mechanistic links between ECs, thromboinflammation, and postinjury complications.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"876-886"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Early Prehospital Photoplethysmography Waveform Features and Subsequent Hemodynamic Changes in Trauma Patients.","authors":"Sabrina J Schmitz, Clifton W Callaway, Francis X Guyette, Christian Martin-Gill, Nina Lane, Dylan A Defilippi, Chase W Zikmund, David D Salcido","doi":"10.1097/SHK.0000000000002761","DOIUrl":"10.1097/SHK.0000000000002761","url":null,"abstract":"<p><strong>Introduction: </strong>Following an acute traumatic insult, compensatory physiological mechanisms maintain the delivery of oxygen while also influencing the shape of photoplethysmography (PPG) waveforms. Few studies have investigated the utility of PPG waveforms captured in clinical settings in identifying patients in compensated shock. We hypothesized that PPG waveform features measured early in the prehospital course in trauma patients with normal initial shock index (SI) would predict subsequent change in SI (ΔSI) and provision of life-saving interventions (LSIs).</p><p><strong>Materials and methods: </strong>We conducted a secondary analysis of adult trauma patients transported from the scene of injury by a critical care air medical transport service whose initial SI measurements (during the first 7 minutes of care) were normal (≤0.8). The primary outcome variable was defined as the change in SI (ΔSI max = mean SI in the first 7 minutes of care - maximum of all subsequent SI measurements). We performed stepwise multivariable linear regression to determine the association between PPG features (mean first 7 minutes) and ΔSI max . As an exploratory analysis, we examined the association between PPG waveform features and prehospital LSIs.</p><p><strong>Results: </strong>We identified 1,488 adult trauma patients with interpretable PPG waveform and vital sign data with normal initial SI calculations. In adjusted analysis, beat systolic amplitude, area under the curve, and back slope independently predicted ΔSI max . Area under the curve and systolic amplitude were predictive of prehospital LSI.</p><p><strong>Conclusions: </strong>These data suggest that early prehospital PPG waveform features can predict subsequent hemodynamic change and LSI. This information is clinically relevant as it may guide critical prehospital and emergency department triage and treatment decisions.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"838-846"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Antithrombin III Infusion in a Clinically Relevant Sepsis Model.","authors":"Naoki Hayase, Rohit R Chari, Alef A C Dos Santos, Yoshitaka Naito, Xuzhen Hu, Peter S T Yuen, Robert A Star","doi":"10.1097/SHK.0000000000002648","DOIUrl":"10.1097/SHK.0000000000002648","url":null,"abstract":"<p><strong>Background: </strong>Bolus antithrombin III (AT) improved sepsis/organ dysfunction and survival in lipopolysaccharide/monomicrobial infusion pretreatment animal models; however, AT failed in clinical trials. Because insults and drug administration schedules differed between preclinical and clinical settings, we re-examined AT using a clinically relevant polymicrobial insult (cecal ligation and puncture, CLP) and a new method to continuously infuse AT after animals became ill.</p><p><strong>Methods: </strong>Mice were catheterized with saline-filled osmotic minipumps. During CLP surgery we inserted AT- or saline-containing minipumps. We created and validated a ~6 h delay between sepsis induction and treatment. We compared delayed, continuous AT infusion with a conventional bolus AT injection using survival studies and 48-h studies.</p><p><strong>Results: </strong>6-h delayed, continuous AT infusion significantly improved 7-d survival versus saline infusion (65% vs. 29%, n = 21, P  = 0.018) and versus a single injection of AT (65% vs. 19%, n = 21, P  = 0.003). Delayed, continuous AT attenuated liver but not kidney or lung injury. Vascular leakage and inflammatory cytokines were suppressed only in liver. The highest accumulation of bacteria and thrombin at 48 h was in liver. AT did not change organ bacterial counts.</p><p><strong>Conclusions: </strong>Delayed, continuous AT infusion improved 7-d survival after CLP compared to single bolus AT injection or continuous vehicle. Liver may be critical in abdominal sepsis because of bacterial accumulation and subsequent thrombin generation. AT may be protective due to attenuation of thrombin-induced vascular leakage, inflammation, and liver injury during CLP sepsis. Because other organs were unprotected, AT may be combined with drugs protecting different organs.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"863-875"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil Transcriptomic Changes in Severe Sterile Vasoplegic Syndrome Resemble a Distinct Molecular Subtype of Septic Shock.","authors":"Anaar E Siletz, Kindra M Kelly-Scumpia, Phillip O Scumpia, Kelly Street, Vasileios Ragkousis, Roksana Shirazi, Yas Sanaiha, Tran H Do, Richard Shemin, Murray Kwon, Sara Crager, Peyman Benharash, H Gill Cryer, J Perren Cobb, Stephen T Smale","doi":"10.1097/SHK.0000000000002827","DOIUrl":"10.1097/SHK.0000000000002827","url":null,"abstract":"<p><strong>Background: </strong>Understanding early molecular events in systemic inflammation in sepsis is complicated by host-pathogen interactions and responses over time. Vasoplegic syndrome after cardiac surgery resembles septic shock but lacks pathogen-related variables and proceeds over a defined, reproducible time course. We hypothesized that human neutrophil transcriptomic changes in vasoplegic syndrome would resemble one or more molecular subtypes of septic shock.</p><p><strong>Methods: </strong>We compared dynamic human neutrophil transcriptomic changes during the development of vasoplegic syndrome to 1) dynamic changes in uncomplicated cardiac surgery and 2) static transcriptomic profiles in septic shock. Vasoplegic syndrome was defined as a vasopressor requirement to maintain mean arterial pressure >60 mmHg, cardiac index >2.2 L/min/m 2 , and systemic vascular resistance index <1,970 d·s/cm 5 ·m 2 lasting at least 24 hours postoperatively. Septic shock was defined as acute refractory organ dysfunction due to infection. Neutrophil transcriptomics were correlated with clinical course and plasma cytokine levels.</p><p><strong>Results: </strong>In principal component analysis, neutrophil transcriptomes from surgical patients demonstrated core gene expression changes in response to cardiac surgery independent of outcome. Additionally, among vasoplegic patients, two marked and consistent neutrophil transcriptomic phenotypes were observed and associated with distinct clinical phenotypes. A subset of dynamic expression changes in severe vasoplegic syndrome, which were not seen in surgical controls, instead resembled expression in patients with septic shock with increased matrix metalloproteinase 8 messenger RNA.</p><p><strong>Conclusions: </strong>Dynamic gene expression in neutrophils from patients with severe vasoplegic syndrome includes both changes in response to surgery and the development of a gene expression phenotype resembling septic shock with elevated matrix metalloproteinase 8 expression. Our findings suggest a common neutrophil molecular program associated with multiorgan failure, which may include common therapeutic targets for both sterile and septic systemic inflammatory states.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"801-811"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subphenotypes Of Infection In The Emergency Department: Clustering Analysis From Routine Parameters To Predict Early Deterioration.","authors":"Manon Dumolard, Anaëlle Nardot-Suchaud, Henri Hani Karam, Thomas Daix, Thomas Lafon","doi":"10.1097/SHK.0000000000002833","DOIUrl":"10.1097/SHK.0000000000002833","url":null,"abstract":"<p><p>Anticipating sepsis and infection-related deterioration in the emergency department (ED) remains challenging due to the limited accuracy of available individual scores and biomarkers. We performed an unsupervised hierarchical cluster analysis using routine variables to identify subphenotypes associated with early deterioration and described their clinical and prognostic features. This retrospective study included patients presented in ED with suspected infection, excluding those without confirmed infection or septic shock. Prognostic phenotypes were identified based on clinical deterioration within 72 hours of admission, as adjudicated by an independent committee. Deterioration was defined by a composite outcome, including an increase in sepsis-related sequential organ failure assessment score ≥ 2 points, subsequent shock requiring full fluid resuscitation, acute respiratory failure needing invasive support, or death. Cluster frequency, characteristics, prognostic performance, and 28- and 90-day mortality were assessed. Among 965 consecutive patients [635 infections; 330 sepsis; mean age = 70 (52-82) years; Charlson score = 4 (1-7); sepsis-related sequential organ failure assessment score = 1 (0-3); lactates = 1.4 (1.1-2.1) mM; D-90 mortality = 11%], deterioration occurred in 155 patients (16%). The clustering analysis identified three phenotypes with distinct clinical and prognostic profiles. Early deterioration occurred in 32% of C#1, 15% of C#2, and 6% of C#3 ( P < 0.001). Cluster 1 (19%) comprised the most severe cases with pronounced organ dysfunction and tissue hypoperfusion. Cluster 2 (56%) showed moderate dysfunction and intermediate outcomes. In contrast, C#3 (25% of patients) represented younger patients with fewer comorbidities and concomitant failures. Recognition of these phenotypes based on available criteria highlights the heterogeneity of sepsis in the ED and may support phenotype-driven risk stratification and clinical management.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"832-837"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histone Lactylation in Immune Cells and Its Predictive Role in Sepsis Progression: A Prospective Observational Study.","authors":"Yuqian Guo, Lihua Chu, Weiwei Shui, Huiyi Hu, Liman Hao, Dongdong Wang, Shengwen Song, Xiangming Fang, Guohao Xie","doi":"10.1097/SHK.0000000000002659","DOIUrl":"10.1097/SHK.0000000000002659","url":null,"abstract":"<p><strong>Background: </strong>Sepsis, a life-threatening condition caused by infection, induces dysregulated immune responses. Lactylation is a lactate-derived posttranslational modification with roles in various cellular processes. We investigated lactylation levels in the immune cells of patients with sepsis and evaluated their association with disease progression.</p><p><strong>Methods: </strong>In this prospective cohort study, blood samples were collected on days 1 and 3 from 58 intensive care unit patients, including critically ill controls and sepsis patients (survivors and nonsurvivors). Biochemical and clinical data were analyzed, and immune cells were isolated to measure pan-lysine lactylation (Pan Kla), H4K5la, and H3K56la levels using flow cytometry.</p><p><strong>Results: </strong>Patients with sepsis exhibited significantly elevated neutrophil H4K5la levels compared with critically ill controls on day 1 (231.6 [174.9-361.9] vs. 127.5 [69.4-168.9] mean fluorescence intensity [MFI], P  < 0.0001); similar trends were observed in monocytes, B cells, and T cells. Multivariate analysis identified neutrophil H4K5la levels as an independent predictor of sepsis. The combination of day 1 neutrophil H4K5la and C-reactive protein levels improved diagnostic performance (area under the receiver operating characteristic curve = 0.902 [95% confidence interval, 0.795-0.964]). On day 3, nonsurvivors showed lower lactylation levels than survivors (monocyte Pan Kla: 79.8 [54.9-106.1] vs. 133.2 [112.3-259.2] MFI, P  = 0.0334; T-cell H3K56la: 15.5 [8.2-28.1] vs. 37.2 [23.9-71.4] MFI, P  = 0.0143).</p><p><strong>Conclusions: </strong>Immune cell lactylation may serve as a biomarker for sepsis progression. The combination of neutrophil H4K5la and C-reactive protein enhances early diagnostic accuracy; reduced lactylation on day 3 may indicate poor prognosis.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"792-800"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative and Quantitative Analysis of Circulating Net-Derived Chromatin and Nucleosomes in Severe Thermal and Traumatically Injured Patients.","authors":"Ali Asiri, Jon Hazeldine, Naiem Moiemen, Miyuki Sakuma, Daniel Irimia, Paul Harrison","doi":"10.1097/SHK.0000000000002733","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002733","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the dynamic changes in the quantity and quality of neutrophil-derived cell-free DNA (cfDNA) in whole blood and plasma samples from severe thermal and traumatically injured patients.</p><p><strong>Background: </strong>Neutrophil-derived cfDNA, a component of neutrophil extracellular traps (NETs), is released during immune responses to injury and infection. Excessive NET formation mediates inflammation, tissue damage, and coagulopathy. Increased cfDNA levels in burn and trauma patients are reported to be associated with poor clinical outcomes, indicating their potential as biomarkers for predicting sepsis and MODS.</p><p><strong>Methods: </strong>Blood samples were obtained from two cohorts of burns (n = 96) and trauma (n = 147) patients. Neutrophil-derived cfDNA was quantified in plasma by SYTOX Green fluorescence and the size of extracted DNA was measured by electrophoresis. A microfluidic assay was also performed to capture NET-derived chromatin from burn patients' fresh whole blood samples. Captured NETs were stained with SYTOX green and anti-citrullinated histone antibodies. Stimulated whole blood or isolated neutrophils from healthy controls were used to generate NETs as positive controls.</p><p><strong>Results: </strong>Circulating cfDNA levels were significantly elevated in plasma from both burns (days 1-14 postinjury) and trauma patients (<1-72 hours) compared to healthy controls. Electrophoresis revealed a prominent nucleosome band (~150 base pairs) in both burns and trauma plasma, with nucleosome oligomers detected within ultra-early samples (<1-hour posttrauma). The density of nucleosome bands correlated with cfDNA concentrations. Microfluidic capture of circulating NET-derived chromatin demonstrated increased levels in whole blood from burns, particularly at day 1 postinjury.</p><p><strong>Conclusions: </strong>NET-derived chromatin, cfDNA, and nucleosomes are elevated following severe burns and trauma. The dynamic changes in cDNA support their contribution to inflammation and as a key biomarker.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":"65 5","pages":"821-831"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shock Synopsis May 2026.","authors":"Yong-Ming Yao","doi":"10.1097/SHK.0000000000002861","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002861","url":null,"abstract":"","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":"65 5","pages":"747-749"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myeloid-Derived Suppressor Cells in Sepsis: Pathophysiology, Duality, and Therapeutic Frontiers.","authors":"Shuang Qin, Zhaofeng Kang, Qiqi Wu, Chaoyao Hou, Siyuan Qi, Jing Cheng, Xijie Dong","doi":"10.1097/SHK.0000000000002817","DOIUrl":"10.1097/SHK.0000000000002817","url":null,"abstract":"<p><p>Sepsis-induced immunosuppression, one of the factors contributing to mortality, is closely mediated by myeloid-derived suppressor cells (MDSCs). This review first outlines MDSC biology, describing their origin from pathological emergency myelopoiesis and classification into polymorphonuclear and monocytic subsets. We then discuss their dual role: an early, protective modulation of cytokine storm that later evolves into harmful immunosuppression associated with secondary infections and death. The underlying mechanisms involve L-arginine depletion ( via arginase 1/inducible nitric oxide synthase), oxidative stress (reactive oxygen species), and induction of regulatory T cells. Therapeutic strategies are summarized, including interventions targeting MDSC differentiation (e.g., all-trans retinoic acid), metabolism (e.g., fatty acid oxidation inhibitors), precision depletion (e.g., anti-LOX-1), and microbiome modulation. Finally, we address challenges to clinical translation-phenotypic heterogeneity, metabolic ambiguity, and the \"double-edged sword\" of MDSC targeting. Deeper insights into MDSC biology may help develop strategies to improve outcomes in this severe syndrome.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"761-773"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular Vesicles Derived From Mesenchymal Stem Cells Ameliorate Bronchopulmonary Dysplasia in Mle-12 Cells and Neonatal Mice by Downregulating Mir-34A.","authors":"Qing Mu, Rong Zhu, Yuanyuan Shi, Jing Li","doi":"10.1097/SHK.0000000000002679","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002679","url":null,"abstract":"<p><strong>Background: </strong>Bronchopulmonary dysplasia (BPD) represents a multifaceted, chronic lung disorder caused by extensive oxygen exposure. Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) have been increasingly reported to impact cellular survival, apoptosis, and immune responses. This investigation aimed to delineate the roles and underlying mechanisms of MSC-EVs in hyperoxia-induced MLE-12 cells and BPD mouse model.</p><p><strong>Methods: </strong>MSC-EVs were characterized using scanning electron microscopy, nanoparticle tracking analysis, and Western blot assays. After a postnatal animal model of experimental murine BPD was induced by hyperoxia, the morphology of lung tissues was assessed by hematoxylin-eosin and Masson trichrome staining. Gene expression levels were detected using reverse transcription quantitative polymerase chain reaction and Western blot assays. The Cell Counting Kit 8 assay was used to detect cell viability, and the concentrations of caspase 3, caspase 6, collagen type I, and collagen type IV were evaluated through enzyme-linked immunosorbent assay. Gene expression in pulmonary tissues and cells was detected through immunofluorescence, immunohistochemistry, and fluorescence in situ hybridization techniques.</p><p><strong>Results: </strong>Exposure to MSC-EVs promoted the viability, reduced the apoptosis, altered the alveolar type II cell surface marker surfactant protein C expression, and decreased collagen levels in hyperoxia-induced MLE-12 cells in vitro. In vivo, MSC-EVs mitigated pulmonary damage in hyperoxia-treated mice. Intriguingly, our analyses revealed that MSC-EVs modulated the expression of miR-34a and its downstream gene, macrophage scavenger receptor 1 (MSR1), in murine lung tissues. MSC-EVs or inhibition of miR-34a might aggravate the effects of MSR1 overexpression on lung morphology in vivo.</p><p><strong>Conclusion: </strong>In summary, this research highlights the potential of MSC-EVs in improving pulmonary damage and function via the miR-34a/MSR1 signaling pathway. Thus, MSC-EVs-based therapy may possess great potential in BPD management.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":"65 5","pages":"855-862"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}