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Published in: Inflammation 3/2014

01-06-2014

Treatment of Low Molecular Weight Heparin Inhibits Systemic Inflammation and Prevents Endotoxin-Induced Acute Lung Injury in Rats

Authors: Zheng-Gang Luan, Mendsaikhan Naranpurev, Xiao-Chun Ma

Published in: Inflammation | Issue 3/2014

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Abstract

To determine whether low molecular weight heparin (LMWH) is able to reduce pulmonary inflammation and improve the survival in rats with endotoxin-induced acute lung injury (ALI). Rat ALI model was reproduced by injection of lipopolysaccharide (LPS) into tail vein. Rats were divided randomly into three groups: control group, ALI group, LMWH-treated group. Blood was collected and lung tissue was harvested at the designated time points for analysis. The lung specimens were harvested for morphological studies, streptavidin-peroxidase immunohistochemistry examination. Lung tissue edema was evaluated by tissue water content. The levels of lung tissue myeloperoxidase (MPO) were determined. Meanwhile, the nuclear factor-kappa B (NF-κB) activation, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) levels and high mobility group box 1 (HMGB1) and intercellular adhesion molecule-1 (ICAM-1) protein levels in the lung were studied. In survival studies, a separate group of rats were treated with LMWH or sterile saline after LPS administration. Then, the mortality was recorded. Treatment with LMWH after ALI was associated with a reduction in the severity of LPS-induced lung injury. Treatment with LMWH significantly decreased the expression of TNF-α, IL-1β, HMGB1 and ICAM-1 in the lung of ALI rats. Similarly, treatment with LMWH dramatically diminished LPS-induced neutrophil sequestration and markedly reduced the enhanced lung permeability. In the present study, LMWH administration inhibited the nuclear translocation of NF-κB in the lung. Survival was significantly higher among the LMWH-treated group compared with the ALI group. These data suggest that LMWH attenuates inflammation and prevents lethality in endotoxemic rats.
Literature
1.
go back to reference Dreyfuss, D., and G. Saumon. 1998. Ventilator-induced lung injury: lessons from experimental studies. American Journal of Respiratory and Critical Care Medicine 157: 294–323.PubMedCrossRef Dreyfuss, D., and G. Saumon. 1998. Ventilator-induced lung injury: lessons from experimental studies. American Journal of Respiratory and Critical Care Medicine 157: 294–323.PubMedCrossRef
2.
go back to reference Ware, L.B., and M.A. Matthay. 2000. The acute respiratory distress syndrome. New England Journal of Medicine 342: 1334–1349.PubMedCrossRef Ware, L.B., and M.A. Matthay. 2000. The acute respiratory distress syndrome. New England Journal of Medicine 342: 1334–1349.PubMedCrossRef
3.
go back to reference Bhatia, M., and S. Moochhala. 2004. Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome. Journal of Pathology 202: 145–156.PubMedCrossRef Bhatia, M., and S. Moochhala. 2004. Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome. Journal of Pathology 202: 145–156.PubMedCrossRef
4.
go back to reference Ghosh, S., R.D. Latimer, B.M. Gray, et al. 1993. Endotoxin-induced organ injury. Critical Care Medicine 21: S19–S24.PubMedCrossRef Ghosh, S., R.D. Latimer, B.M. Gray, et al. 1993. Endotoxin-induced organ injury. Critical Care Medicine 21: S19–S24.PubMedCrossRef
5.
go back to reference Xu, H., X. Ye, H. Steinberg, et al. 2010. Selective blockade of endothelial NF-kappaB pathway differentially affects systemic inflammation and multiple organ dysfunction and injury in septic mice. Journal of Pathology 220: 490–498.PubMed Xu, H., X. Ye, H. Steinberg, et al. 2010. Selective blockade of endothelial NF-kappaB pathway differentially affects systemic inflammation and multiple organ dysfunction and injury in septic mice. Journal of Pathology 220: 490–498.PubMed
6.
go back to reference Bustin, M. 1999. Regulation of DNA-dependent activities by the functional motifs of the high-mobility-group chromosomal proteins. Molecular and Cellular Biology 19: 5237–5246.PubMedCentralPubMed Bustin, M. 1999. Regulation of DNA-dependent activities by the functional motifs of the high-mobility-group chromosomal proteins. Molecular and Cellular Biology 19: 5237–5246.PubMedCentralPubMed
7.
go back to reference Wang, H., O. Bloom, M. Zhang, et al. 1999. HMG-1 as a late mediator of endotoxin lethality in mice. Science 285: 248–251.PubMedCrossRef Wang, H., O. Bloom, M. Zhang, et al. 1999. HMG-1 as a late mediator of endotoxin lethality in mice. Science 285: 248–251.PubMedCrossRef
8.
go back to reference Reiss, L.K., U. Uhlig, and S. Uhlig. 2012. Models and mechanisms of acute lung injury caused by direct insults. European Journal of Cell Biology 91: 590–601.PubMedCrossRef Reiss, L.K., U. Uhlig, and S. Uhlig. 2012. Models and mechanisms of acute lung injury caused by direct insults. European Journal of Cell Biology 91: 590–601.PubMedCrossRef
9.
go back to reference Kim, J.Y., J.S. Park, D. Strassheim, et al. 2005. HMGB1 contributes to the development of acute lung injury after hemorrhage. American Journal of Physiology—Lung Cellular and Molecular Physiology 288: L958–L965.PubMedCrossRef Kim, J.Y., J.S. Park, D. Strassheim, et al. 2005. HMGB1 contributes to the development of acute lung injury after hemorrhage. American Journal of Physiology—Lung Cellular and Molecular Physiology 288: L958–L965.PubMedCrossRef
10.
go back to reference Scaffidi, P., T. Misteli, and M.E. Bianchi. 2002. Release of chromatin protein HMGB1 by necrotic cells triggers inflammation. Nature 418: 191–195.PubMedCrossRef Scaffidi, P., T. Misteli, and M.E. Bianchi. 2002. Release of chromatin protein HMGB1 by necrotic cells triggers inflammation. Nature 418: 191–195.PubMedCrossRef
11.
go back to reference Andersson, U., H. Wang, K. Palmblad, et al. 2000. High mobility group 1 protein (HMG-1) stimulates proinflammatory cytokine synthesis in human monocytes. Journal of Experimental Medicine 192: 565–570.PubMedCentralPubMedCrossRef Andersson, U., H. Wang, K. Palmblad, et al. 2000. High mobility group 1 protein (HMG-1) stimulates proinflammatory cytokine synthesis in human monocytes. Journal of Experimental Medicine 192: 565–570.PubMedCentralPubMedCrossRef
12.
go back to reference Barsness, K.A., J. Arcaroli, A.H. Harken, et al. 2004. Hemorrhage-induced acute lung injury is TLR-4 dependent. American Journal of Physiology—Regulatory, Integrative and Comparative Physiology 287: R592–R599.PubMedCrossRef Barsness, K.A., J. Arcaroli, A.H. Harken, et al. 2004. Hemorrhage-induced acute lung injury is TLR-4 dependent. American Journal of Physiology—Regulatory, Integrative and Comparative Physiology 287: R592–R599.PubMedCrossRef
13.
go back to reference Xie, K., Y. Yu, Y. Huang, et al. 2012. Molecular hydrogen ameliorates lipopolysaccharide-induced acute lung injury in mice through reducing inflammation and apoptosis. Shock 37: 548–555.PubMed Xie, K., Y. Yu, Y. Huang, et al. 2012. Molecular hydrogen ameliorates lipopolysaccharide-induced acute lung injury in mice through reducing inflammation and apoptosis. Shock 37: 548–555.PubMed
14.
go back to reference Gong, Q., J.F. Xu, H. Yin, et al. 2009. Protective effect of antagonist of high-mobility group box 1 on lipopolysaccharide-induced acute lung injury in mice. Scandinavian Journal of Immunology 69: 29–35.PubMedCrossRef Gong, Q., J.F. Xu, H. Yin, et al. 2009. Protective effect of antagonist of high-mobility group box 1 on lipopolysaccharide-induced acute lung injury in mice. Scandinavian Journal of Immunology 69: 29–35.PubMedCrossRef
15.
go back to reference Wang, H., J.M. Vishnubhakat, O. Bloom, et al. 1999. Proinflammatory cytokines (tumor necrosis factor and interleukin 1) stimulate release of high mobility group protein-1 by pituicytes. Surgery 126: 389–392.PubMedCrossRef Wang, H., J.M. Vishnubhakat, O. Bloom, et al. 1999. Proinflammatory cytokines (tumor necrosis factor and interleukin 1) stimulate release of high mobility group protein-1 by pituicytes. Surgery 126: 389–392.PubMedCrossRef
16.
go back to reference Fiuza, C., M. Bustin, S. Talwar, et al. 2003. Inflammation-promoting activity of HMGB1 on human micro vascular endothelial cells. Blood 101: 2652–2660.PubMedCrossRef Fiuza, C., M. Bustin, S. Talwar, et al. 2003. Inflammation-promoting activity of HMGB1 on human micro vascular endothelial cells. Blood 101: 2652–2660.PubMedCrossRef
17.
go back to reference Park, J.S., F. Gamboni-Robertson, Q. He, et al. 2006. High Mobility Group Box 1 protein (HMGB1) interacts with multiple toll like receptors. American Journal of Physiology—Cellular Physiology 290: 917–924.CrossRef Park, J.S., F. Gamboni-Robertson, Q. He, et al. 2006. High Mobility Group Box 1 protein (HMGB1) interacts with multiple toll like receptors. American Journal of Physiology—Cellular Physiology 290: 917–924.CrossRef
18.
go back to reference Kokkola, R., A. Andersson, G. Mullins, et al. 2005. RAGE is the major receptor for the proinflammatory activity of HMGB1 in rodent macrophages. Scandinavian Journal of Immunology 61: 1–9.PubMedCrossRef Kokkola, R., A. Andersson, G. Mullins, et al. 2005. RAGE is the major receptor for the proinflammatory activity of HMGB1 in rodent macrophages. Scandinavian Journal of Immunology 61: 1–9.PubMedCrossRef
19.
go back to reference Iba, T., A. Kidokoro, and Y. Yagi. 1998. The role of the endothelium in changes in procoagulant activity. Journal of the American College of Surgeons 87: 321–329.CrossRef Iba, T., A. Kidokoro, and Y. Yagi. 1998. The role of the endothelium in changes in procoagulant activity. Journal of the American College of Surgeons 87: 321–329.CrossRef
20.
go back to reference Macfarlane, S.R., M.J. Seatter, T. Kanke, et al. 2001. Proteinase-activated receptors. Pharmacological Reviews 53: 245–282.PubMed Macfarlane, S.R., M.J. Seatter, T. Kanke, et al. 2001. Proteinase-activated receptors. Pharmacological Reviews 53: 245–282.PubMed
21.
go back to reference Freeman, B.D., B.A. Zehnbauer, and T.G. Buchman. 2003. A meta-analysis of controlled trials of anticoagulant therapies in patients with sepsis. Shock 20: 5–9.PubMedCrossRef Freeman, B.D., B.A. Zehnbauer, and T.G. Buchman. 2003. A meta-analysis of controlled trials of anticoagulant therapies in patients with sepsis. Shock 20: 5–9.PubMedCrossRef
22.
go back to reference Matthay, M.A. 2001. Severe sepsis: a new treatment with both anticoagulant and anti-inflammatory properties. New England Journal of Medicine 344: 759–762.PubMedCrossRef Matthay, M.A. 2001. Severe sepsis: a new treatment with both anticoagulant and anti-inflammatory properties. New England Journal of Medicine 344: 759–762.PubMedCrossRef
23.
go back to reference Al-Ansari, E., H.K. Du, L. Yu, et al. 2007. Low molecular-weight heparin inhibits hypoxic pulmonary hypertension and vascular remodeling in guinea pigs. Chest 132: 1898–1905.PubMedCrossRef Al-Ansari, E., H.K. Du, L. Yu, et al. 2007. Low molecular-weight heparin inhibits hypoxic pulmonary hypertension and vascular remodeling in guinea pigs. Chest 132: 1898–1905.PubMedCrossRef
24.
go back to reference Li, L.F., C.C. Huang, H.C. Lin, et al. 2009. Unfractionated heparin and enoxaparin reduce high stretch ventilation-augmented lung injury-a prospective, controlled animal experiment. Critical Care 13: R108.PubMedCentralPubMedCrossRef Li, L.F., C.C. Huang, H.C. Lin, et al. 2009. Unfractionated heparin and enoxaparin reduce high stretch ventilation-augmented lung injury-a prospective, controlled animal experiment. Critical Care 13: R108.PubMedCentralPubMedCrossRef
25.
go back to reference Darien, B.J., J. Fareed, K.S. Centgraf, et al. 1998. Low molecular weight heparin prevents the pulmonary hemodynamic and pathomorphologic effects of endotoxin in a porcine acute lung injury model. Shock 9: 274–281.PubMedCrossRef Darien, B.J., J. Fareed, K.S. Centgraf, et al. 1998. Low molecular weight heparin prevents the pulmonary hemodynamic and pathomorphologic effects of endotoxin in a porcine acute lung injury model. Shock 9: 274–281.PubMedCrossRef
26.
go back to reference Chen, C.M., H.C. Chou, L.F. Wang, et al. 2008. Captopril decreases plasminogen activator inhibitor-1 in rats with ventilatorinduced lung injury. Critical Care Medicine 36: 1880–1885.PubMedCrossRef Chen, C.M., H.C. Chou, L.F. Wang, et al. 2008. Captopril decreases plasminogen activator inhibitor-1 in rats with ventilatorinduced lung injury. Critical Care Medicine 36: 1880–1885.PubMedCrossRef
27.
go back to reference Takahashi, H., S. Ebihara, T. Okazaki, et al. 2005. A comparison of the effects of unfractionated heparin, dalteparin and danaparoid on vascular endothelial growth factor-induced tumour angiogenesis and heparinase activity. British Journal of Pharmacology 146: 333–343.PubMedCentralPubMedCrossRef Takahashi, H., S. Ebihara, T. Okazaki, et al. 2005. A comparison of the effects of unfractionated heparin, dalteparin and danaparoid on vascular endothelial growth factor-induced tumour angiogenesis and heparinase activity. British Journal of Pharmacology 146: 333–343.PubMedCentralPubMedCrossRef
28.
go back to reference Murakami, K., R. McGuire, R.A. Cox, et al. 2002. Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep. Shock 18: 236–241.PubMedCrossRef Murakami, K., R. McGuire, R.A. Cox, et al. 2002. Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep. Shock 18: 236–241.PubMedCrossRef
29.
go back to reference Ogawa, Y., K. Yamakawa, H. Ogura, et al. 2012. Recombinant human soluble thrombomodulin improves mortality and respiratory dysfunction in patients with severe sepsis. Journal of Trauma and Acute Care Surgery 72: 1150–1157.PubMed Ogawa, Y., K. Yamakawa, H. Ogura, et al. 2012. Recombinant human soluble thrombomodulin improves mortality and respiratory dysfunction in patients with severe sepsis. Journal of Trauma and Acute Care Surgery 72: 1150–1157.PubMed
30.
go back to reference McMaken, S., M.C. Exline, P. Mehta, et al. 2011. Thrombospondin-1 contributes to mortality in murine sepsis through effects on innate immunity. PLoS One 6: e19654.PubMedCentralPubMedCrossRef McMaken, S., M.C. Exline, P. Mehta, et al. 2011. Thrombospondin-1 contributes to mortality in murine sepsis through effects on innate immunity. PLoS One 6: e19654.PubMedCentralPubMedCrossRef
31.
go back to reference Levi, Marcel, and Tom van der Poll. 2010. Inflammation and coagulation. Critical Care Medicine 38: S26–S34.PubMedCrossRef Levi, Marcel, and Tom van der Poll. 2010. Inflammation and coagulation. Critical Care Medicine 38: S26–S34.PubMedCrossRef
32.
go back to reference Krzyzaniak, M., G. Cheadle, C. Peterson, et al. 2011. Burn-induced acute lung injury requires a functional toll-like receptor 4. Shock 36: 24–29.PubMedCrossRef Krzyzaniak, M., G. Cheadle, C. Peterson, et al. 2011. Burn-induced acute lung injury requires a functional toll-like receptor 4. Shock 36: 24–29.PubMedCrossRef
33.
go back to reference Wang, M., T. Liu, D. Wang, et al. 2011. Therapeutic effects of pyrrolidine dithiocarbamate on acute lung injury in rabbits. Journal of Translational Medicine 9: 61.PubMedCentralPubMedCrossRef Wang, M., T. Liu, D. Wang, et al. 2011. Therapeutic effects of pyrrolidine dithiocarbamate on acute lung injury in rabbits. Journal of Translational Medicine 9: 61.PubMedCentralPubMedCrossRef
34.
go back to reference Wolfson, R.K., E.T. Chiang, and J.G. Garcia. 2011. HMGB1 induces human lung endothelial cell cytoskeletal rearrangement and barrier disruption. Microvascular Research 81: 189–197.PubMedCentralPubMedCrossRef Wolfson, R.K., E.T. Chiang, and J.G. Garcia. 2011. HMGB1 induces human lung endothelial cell cytoskeletal rearrangement and barrier disruption. Microvascular Research 81: 189–197.PubMedCentralPubMedCrossRef
35.
go back to reference Ueno, H., T. Matsuda, S. Hashimoto, et al. 2004. Contributions of high mobility group box protein in experimental and clinical acute lung injury. American Journal of Respiratory and Critical Care Medicine 170: 1310–1316.PubMedCrossRef Ueno, H., T. Matsuda, S. Hashimoto, et al. 2004. Contributions of high mobility group box protein in experimental and clinical acute lung injury. American Journal of Respiratory and Critical Care Medicine 170: 1310–1316.PubMedCrossRef
36.
go back to reference Angus, D.C., L. Yang, L. Kong, et al. 2007. Circulating high-mobility group box 1 (HMGB1) concentrations are elevated in both uncomplicated pneumonia and pneumonia with severe sepsis. Critical Care Medicine 35: 1061–1067.PubMedCrossRef Angus, D.C., L. Yang, L. Kong, et al. 2007. Circulating high-mobility group box 1 (HMGB1) concentrations are elevated in both uncomplicated pneumonia and pneumonia with severe sepsis. Critical Care Medicine 35: 1061–1067.PubMedCrossRef
37.
39.
go back to reference Kim, B.H., E. Roh, H.Y. Lee, et al. 2008. Benzoxathiole derivative blocks lipopolysaccharide-induced nuclear factor-kappaB activation and nuclear factor-kappaB-regulated gene transcription through inactivating inhibitory kappaB kinase beta. Molecular Pharmacology 73: 1309–1318.PubMedCrossRef Kim, B.H., E. Roh, H.Y. Lee, et al. 2008. Benzoxathiole derivative blocks lipopolysaccharide-induced nuclear factor-kappaB activation and nuclear factor-kappaB-regulated gene transcription through inactivating inhibitory kappaB kinase beta. Molecular Pharmacology 73: 1309–1318.PubMedCrossRef
40.
go back to reference Ha, T., Y. Xia, X. Liu, et al. 2011. Glucan phosphate attenuates myocardial HMGB1 translocation in severe sepsis through inhibiting NF-κB activation. American Journal of Physiology—Heart and Circulatory Physiology 301: H848–H855.PubMedCentralPubMedCrossRef Ha, T., Y. Xia, X. Liu, et al. 2011. Glucan phosphate attenuates myocardial HMGB1 translocation in severe sepsis through inhibiting NF-κB activation. American Journal of Physiology—Heart and Circulatory Physiology 301: H848–H855.PubMedCentralPubMedCrossRef
41.
go back to reference Esmon, C.T. 2001. Role of coagulation inhibitors in inflammation. Thrombosis and Haemostasis 86: 51–56.PubMed Esmon, C.T. 2001. Role of coagulation inhibitors in inflammation. Thrombosis and Haemostasis 86: 51–56.PubMed
42.
go back to reference Riewald, M., V.V. Kravchenko, R.J. Petrovan, et al. 2001. Gene induction by coagulation factor Xa is mediated by activation of protease-activated receptor 1. Blood 97: 3109–3116.PubMedCrossRef Riewald, M., V.V. Kravchenko, R.J. Petrovan, et al. 2001. Gene induction by coagulation factor Xa is mediated by activation of protease-activated receptor 1. Blood 97: 3109–3116.PubMedCrossRef
43.
go back to reference Skoutakis, V.A. 1997. Danaparoid in the prevention of thromboembolic complications. Annals of Pharmacotherapy 31: 876–887.PubMed Skoutakis, V.A. 1997. Danaparoid in the prevention of thromboembolic complications. Annals of Pharmacotherapy 31: 876–887.PubMed
44.
go back to reference Kwak, H.J., J.S. Song, J.Y. Heo, et al. 2005. Roflumilast inhibits lipopolysaccharide-induced inflammatory mediators via suppression of nuclear factor-kappaB, p38 mitogen-activated protein kinase, and c-Jun NH2-terminal kinase activation. Journal of Pharmacology and Experimental Therapeutics 315: 1188–1195.PubMedCrossRef Kwak, H.J., J.S. Song, J.Y. Heo, et al. 2005. Roflumilast inhibits lipopolysaccharide-induced inflammatory mediators via suppression of nuclear factor-kappaB, p38 mitogen-activated protein kinase, and c-Jun NH2-terminal kinase activation. Journal of Pharmacology and Experimental Therapeutics 315: 1188–1195.PubMedCrossRef
45.
go back to reference Schottelius, A.J., M.W. Mayo, R.B. Sartor, et al. 1999. Interleukin-10 signaling blocks inhibitor of kappaB kinase activity and nuclear factor kappaB DNA binding. Journal of Biological Chemistry 274: 31868–31874.PubMedCrossRef Schottelius, A.J., M.W. Mayo, R.B. Sartor, et al. 1999. Interleukin-10 signaling blocks inhibitor of kappaB kinase activity and nuclear factor kappaB DNA binding. Journal of Biological Chemistry 274: 31868–31874.PubMedCrossRef
46.
go back to reference Cavaillon, J.M., C. Marie, M. Caroff, et al. 1996. CD14/LPS receptor exhibits lectin-like properties. Journal of Endotoxin Research 3: 471–480. Cavaillon, J.M., C. Marie, M. Caroff, et al. 1996. CD14/LPS receptor exhibits lectin-like properties. Journal of Endotoxin Research 3: 471–480.
47.
go back to reference Anastase-Ravion, S., C. Blondin, B. Cholley, et al. 2003. Heparin inhibits lipopolysaccharide (LPS) binding to leukocytes and LPS-induced cytokine production. Journal of Biomedical Materials Research. Part A 66: 376–384.PubMedCrossRef Anastase-Ravion, S., C. Blondin, B. Cholley, et al. 2003. Heparin inhibits lipopolysaccharide (LPS) binding to leukocytes and LPS-induced cytokine production. Journal of Biomedical Materials Research. Part A 66: 376–384.PubMedCrossRef
Metadata
Title
Treatment of Low Molecular Weight Heparin Inhibits Systemic Inflammation and Prevents Endotoxin-Induced Acute Lung Injury in Rats
Authors
Zheng-Gang Luan
Mendsaikhan Naranpurev
Xiao-Chun Ma
Publication date
01-06-2014
Publisher
Springer US
Published in
Inflammation / Issue 3/2014
Print ISSN: 0360-3997
Electronic ISSN: 1573-2576
DOI
https://doi.org/10.1007/s10753-014-9812-6

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