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| Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock |
| Feng Yao, Yuan-qiang Lu, Jiu-kun Jiang, Lin-hui Gu, Han-zhou Mou |
| Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; Cancer Institute, Zhejiang Tumor Hospital, Hangzhou 310022, China |
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Abstract Objective: To investigate the effects of resuscitation with normal saline (NS), hypertonic saline (HTS), and hydroxyethyl starch (HES) on regulatory T cells (Tregs), helper T 1 (Th1)/Th2 and cytotoxic T 1 (Tc1)/Tc2 profiles in the treatment of hemorrhagic shock. Methods: Rats subjected to severe hemorrhagic shock were resuscitated for 30 min with NS (n=8), HTS (n=8), or HES (n=8); sham (n=8) and naive control (n=8) groups were used for comparison. Following fluid resuscitation, the whole shed blood was reinfused for 30 min, and the rats were observed with continuous hemodynamic monitoring for 120 min. CD4+CD25+Foxp3+ Treg proportions, Th1/Th2 and Tc1/Tc2 profiles in spleen were analyzed by three-color flow cytometry. Results: The proportion of CD4+CD25+Foxp3+ Tregs and ratios of Th1/Th2 and Tc1/Tc2 did not differ among control, sham, and HTS groups, but were significantly lower in NS and HES groups (both P<0.05 vs. sham); NS and HES levels were similar. The level of Tc1 was significantly increased in HTS (P<0.05 vs. sham), and levels of Tc2 were increased in NS, HES, and HTS groups compared to sham (all P<0.05), but did not differ from each other. Conclusions: HTS resuscitation has a greater impact on immune system recovery than NS or HES by preserving the proportion of Tregs and maintaining the balance between Th1/Th2 and Tc1/Tc2 cells in the spleen. Thus, HTS resuscitation provides potential immunomodulatory activity in the early stage after hemorrhagic shock.
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Received: 23 August 2016
Published: 04 May 2017
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严重失血性休克大鼠液体复苏后的免疫修复
目的：严重失血性休克大鼠模型早期阶段使用不同的液体复苏，比较脾脏组织中调节性T细胞（Tregs）、辅助性T细胞1（Th1）/Th2以及细胞毒性T细胞1（Tc1）/Tc2的不同变化，初步探讨其免疫修复机制。
创新点：（1）脾脏为机体重要免疫器官，检测其中的免疫细胞变化，比外周血更具敏感性和特异性；（2）将免疫反应中多环节的免疫细胞变化进行协同分析，结果更具创新性和科学性，为临床上形成规范的救治方案提供了科学的实践资料。
方法：将SD雄性大鼠随机分成5组，其中对照组和Sham组(假手术)仅作为比较，其余三组在建立严重失血性休克大鼠模型后，采用不同的液体复苏:等渗盐水(NS组)、高渗盐水(HTS组)和羟乙基淀粉(HES组)。然后再灌注30分钟，并持续监测血液动力学120分钟，最后心脏穿刺，取脾脏组织，通过三色荧光标记流式细胞术进一步分析CD4+CD25+Foxp3+ Treg细胞含量，以及Th1/Th2和Tc1/Tc2的比值。
结论：液体复苏后大鼠脾脏中CD4+CD25+Foxp3+ Tregs细胞含量、Th1/Th2和Tc1/Tc2的比值在对照组、Sham组和HTS组中无差异，并都显著高于NS组和HES组。与Sham组比较，HTS组中Tc1水平明显升高，而NS组、HES组和HTS组中Tc2水平均有升高，且三组之间Tc2水平无差别。因此，对于维持脾脏中Treg细胞含量、Th1/Th2和Tc1/Tc2平衡的作用上，HTS液体复苏对免疫系统的影响大于NS和HES。综上所述，在失血性休克后的早期阶段HTS复苏可提供潜在的免疫修复作用。
关键词：
调节性T细胞,
辅助性T细胞,
细胞毒性T细胞,
失血性休克
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