title: Recombinant human soluble tumor necrosis factor-alpha receptor fusion protein partly attenuates ventilator-induced lung injury.
abstract: Ventilator-induced lung injury is mediated, at least in part, by TNF-alpha. We determined the effect of a recombinant human soluble TNF receptor fusion protein (etanercept) on mechanical ventilation (MV)-induced changes in a murine ventilator-induced lung injury model. After pretreatment with etanercept or placebo, C57Bl/6 mice were anesthetized and randomized to MV with either low tidal volumes (VT, approximately 7.5 mL/kg) or high VT ( approximately 15 mL/kg) for 5 h. Instrumented but spontaneously breathing mice served as controls. End points were lung wet-to-dry ratios, lung histopathology scores, protein levels, neutrophil cell counts and thrombin-antithrombin complex levels in bronchoalveolar lavage fluid (BALF), and cytokine levels in lung homogenates. The number of caspase 3-positive cells was used as a measure for apoptosis. Etanercept treatment attenuated MV-induced changes, in particular, in MV with high VT. Compared with placebo, etanercept reduced the number of neutrophils in BALF and thrombin-antithrombin complex levels in BALF and cytokine levels in lung homogenates. Lung wet-to-dry ratios, histopathology scores, and local protein levels in BALF, however, were not influenced by etanercept treatment. The number of caspase 3-positive cells was significantly higher in etanercept-treated animals. Inhibition of TNF by etanercept attenuates, in part, MV-induced changes.
authors.affiliation: Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, C3-423, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. e.k.wolthuis@amc.uva.nl
authors.forename: Esther K
authors.initials: EK
authors.lastname: Wolthuis
authors.forename: Alexander P J
authors.initials: AP
authors.lastname: Vlaar
authors.forename: Goda
authors.initials: G
authors.lastname: Choi
authors.forename: Joris J T H
authors.initials: JJ
authors.lastname: Roelofs
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Haitsma
authors.forename: Tom
authors.initials: T
authors.lastname: van der Poll
authors.forename: Nicole P
authors.initials: NP
authors.lastname: Juffermans
authors.forename: Machteld M
authors.initials: MM
authors.lastname: Zweers
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Schultz
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology; D053148:Caspase 3 / Q000276:immunology; D004195:Disease Models, Animal; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000494:pharmacology*; D008168:Lung / Q000276:immunology* / Q000473:pathology; D051379:Mice; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins / Q000494:pharmacology*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*; D055397:Ventilator-Induced Lung Injury / Q000276:immunology / Q000473:pathology / Q000517:prevention & control*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D014409:Tumor Necrosis Factor-alpha; C505409:Casp3 protein, mouse; D053148:Caspase 3; D000068800:Etanercept