TNF-alpha in smoke inhalation lung injury.
Adult respiratory distress syndrome is a major cause of morbidity in fire victims. Tumor necrosis factor-alpha(TNF-alpha) is edematogenic and has been associated with the etiology of other forms of adult respiratory distress syndrome. In the sheep lymph fistula model, we measured TNF-alpha after 48 (n = 7) or 128 (n = 3) breaths of cotton smoke and compared this with sham controls (n = 5) or controls in which left atrial pressure was elevated to 20 mmHg (n = 5) to increase lymph flow in the absence of inflammation. Smoke induced a rise in lymph flow and pulmonary arterial pressure with either no fall in lymph-to-plasma protein ratio (128 breaths) or a modest fall in lymph-to-plasma protein ratio (48 breaths), consistent with a change in microvascular permeability as well as a rise in microvascular pressure. Lymph concentration of TNF-alpha fell in both groups, although lymph flux (concentration x flow) transiently rose in both. In neither case did TNF-alpha flux exceed that induced by left atrial pressure elevation. TNF-alpha was detectable in only one out of five sheep in alveolar lavage. Thus, by utilizing a sensitive and specific radioimmunoassay, we were unable to demonstrate a role for TNF-alpha in smoke-induced microvascular lung injury in sheep.
Hales
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Department of Medicine, Massachusetts General Hospital, Shriners Burns Institute, Boston, USA.
Elsasser
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Ocampo
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Efimova
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D000818:Animals; D016275:Atrial Function / Q000502:physiology; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D004731:Endotoxins / Q000494:pharmacology; D008168:Lung / Q000737:chemistry* / Q000378:metabolism; D008196:Lymph / Q000737:chemistry / Q000502:physiology; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D012756:Sheep; D015208:Smoke Inhalation Injury / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism*
D004731:Endotoxins; D014409:Tumor Necrosis Factor-alpha