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Simvastatin attenuates ventilator-induced lung injury in mice 英文参考文献
Mülleretal.CriticalCare2010,14:R143
/content/14/4/R143
RESEARCH
OpenAccess
Simvastatinattenuatesventilator-inducedlung
injuryinmice
HolgerCMüller1*,KatharinaHellwig1,SimoneRosseau1,ThomasTschernig2,AndreasSchmiedl3,BirgittGutbier1,
BerndSchmeck1,4,StefanHippenstiel1,HarmPeters5,LarsMorawietz6,NorbertSuttorp1,MartinWitzenrath1
Abstract
Introduction:Mechanicalventilation(MV)isalifesavinginterventioninacuterespiratoryfailurewithout
alternative.However,particularlyinpre-injuredlungs,evenprotectiveventilationstrategiesmayevokeventilator-
inducedlunginjury(VILI),whichischaracterizedbypulmonaryinflammationandvascularleakage.Adjuvant
pharmacologicstrategiesinadditiontolungprotectiveventilationtoattenuateVILIarelacking.Simvastatin
exhibitedanti-inflammatoryandendothelialbarrierstabilizingpropertiesinvitroandinvivo.
Methods:Micewereventilated(12ml/kg;sixhours)andsubjectedtosimvastatin(20mg/kg)orshamtreatment.
Pulmonarymicrovascularleakage,oxygenation,pulmonaryandsystemicneutrophilandmonocytecountsand
cytokinereleaseinlungandbloodplasmawereassessed.Further,lungtissuewasanalyzedbyelectron
microscopy.
Results:MechanicalventilationinducedVILI,displayedbyincreasedpulmonarymicrovascularleakageand
endothelialinjury,pulmonaryrecruitmentofneutrophilsandGr-1high monocytes,andbyliberationofinflammatory
cytokinesinthelungs.Further,VILIassociatedsystemicinflammationcharacterizedbybloodleukocytosisand
elevatedplasmacytokineswasobserved.Simvastatintreatmentlimitedpulmonaryendothelialinjury,attenuated
pulmonaryhyperpermeability,preventedtherecruitmentofleukocytestothelung,reducedpulmonarycytokine
levelsandimprovedoxygenationinmechanicallyventilatedmice.
Conclusions:High-dosesimvastatinattenuatedVILIinmicebyreducingMV-inducedpulmonaryinflammationand
hyperpermeability.
Introduction
of pulmonary gas exchange [4]. Clinical studies of
Inacuterespiratoryfailure,mechanicalventilation(MV) Amatoetal.andtheARDSNetworkrevealedthatmini-
is a life saving treatment without alternatives, and MV
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