title: Effects of serum of the rats ventilated with high tidal volume on endothelial cell permeability and therapeutic effects of ulinastatin.
abstract: BACKGROUND
  With the widespread use of ventilators in treating critically ill patients, the morbidity of ventilator-induced lung injury (VILI) is increasing accordingly. VILI is characterized by a considerable increase in microvascular leakiness and activation of inflammatory processes. In this study we investigated the effects of inflammatory mediators in VILI rat serum on endothelial cytoskeleton and monolayer cellular permeability, as well as the therapeutic effect of ulinastatin, to explore the pathogenesis and the relationship between biotrauma and lung oedema induced by VILI.
  
  
  METHODS
  Thirty healthy male Sprague-Dawley rats were randomly divided into three groups: group A (normal tidal volume ventilation), group B (high tidal volume ventilation) and group C (high tidal volume ventilation plus ulinastatin). The serum of each rat after ventilation was added to endothelial cell line ECV-304 medium for two hours to observe the effects of serum and/or ulinastatin on endothelial fibrous actin and permeability.
  
  
  RESULTS
  Compared to rats ventilated with normal tidal volume, serum of rats ventilated with high tidal volume caused a striking reorganization of actin cytoskeleton with a weakening of fluorescent intensity at the peripheral filament bands and formation of the long and thick stress fibres in the centre resulting in endothelial contraction and higher permeability. Prior treatment with ulinastatin lessened the above changes significantly. The changes of permeability coefficient of endothelial permeability after group A, B or C rats serum stimulation were (6.95 +/- 1.66)%, (27.50 +/- 7.77)% and (17.71 +/- 4.66)% respectively with statistically significant differences (P < 0.05) among the three groups.
  
  
  CONCLUSIONS
  The proinflammatory mediators in the serum of the rats given high tidal volume ventilation increases endothelial permeability by reorganizing actin cytoskeleton, and pretreatment with ulinastatin lessens the permeability by inhibiting of proinflammatory mediators.
authors.affiliation: Department of Respiration, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
authors.forename: Guo-dong
authors.initials: GD
authors.lastname: Hu
authors.forename: Guo-dong
authors.initials: GD
authors.lastname: Huo
authors.forename: Shao-xi
authors.initials: SX
authors.lastname: Cai
authors.forename: Bo
authors.initials: B
authors.lastname: Chen
authors.forename: Ying-hua
authors.initials: YH
authors.lastname: Chen
mesh_terms: D000199:Actins / Q000032:analysis / Q000378:metabolism; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002463:Cell Membrane Permeability / Q000187:drug effects; D002478:Cells, Cultured; D042783:Endothelial Cells / Q000187:drug effects / Q000378:metabolism* / Q000502:physiology; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000378:metabolism; D008171:Lung Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D055370:Lung Injury; D008297:Male; D008856:Microscopy, Fluorescence / Q000379:methods; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012121:Respiration, Artificial / Q000009:adverse effects*; D013990:Tidal Volume / Q000187:drug effects; D012122:Ventilators, Mechanical / Q000009:adverse effects
chemical_list: D000199:Actins; D000893:Anti-Inflammatory Agents; D006023:Glycoproteins; C028665:urinastatin