Severe Burns To Stimulate Neutrophils On Endothelial Cell Function And Shenmai Injection For Its Protection Role

ObjectiveMajor cutaneous burns result in not only localized tissue damage but broad systemic inflammation causing organ system damage distal to the burn site. It is well recognized that many problems result from the release of inflammatory mediators that target vascular endothelial cells, causing organ dysfunction. PMN-EC adhesion is the foundation of chemotaxis,migration,phagolysis of leukocytes. PMN adhesion to the vascular surface could be found in Endotoxemia,exsanguine shock,multiorgans dysfunction syndrome(MODS), and organ system damage at the early time of severely burned patients. Reports refer to micro-circulation disorder has been widely issued, but infrequence when it refer to vascular endothelial cells and neutrophils with severely burned patients cocultured in vitro.Traditional therapeutic intervention is quite often ineffective in treating PMN-EC adhesion, it is make sense to research thus therapy. We study the protect effect of Shenmai injection to the vascular endothelial cell injuried by neutrophils drawn from severely burned patients, and discuss the mechanism of Shenmai injection in abating neutrophil-mediated endothelial cell injury at the early time of severely burned.MethodsVascular endothelial cells(ECV304) and neutrophils in patients with severely burned were cocultured in vitro. Observe the morphology of vascular endothelial cells by means of light microscopy. Cell energy were measured by MTT colorimetric assay. The content of ET,NO,and MDA ecreted by endothelial cells were measured by radioimmunoassay (RIA),Griess,LDH released and TBA methods.Results Neutrophils drawn at postburn 6h could arose morphologic change of vascular endothelial cells, descend cell energy and ascend the content of ET(P<0.01). Postburn 24h reached crest. The difference between 48h and 24h was not significant(P>0.05). The content of NO reached highest at postburn 6h(P<0.01), but among healthy people,postburn 24h and 48h was not significant(P>0.05). The content of LDH reached highest at postburn 24h, and descend remarkably at 48h(P<0.01). While the content of MDA ascend gradually, and postburn 48h still ascend remarkably compared 24h(P<0.01). Shenmai injection with middle or high concentration could ascend cell energy and the content of NO, descend the content of ET. The difference between middle and high concentration was not significant(P>0.05). The content of LDH and MDA descend remarkably with high concentration Shenmai injection compared middle concentration(P<0.01).ConclusionsActivated neutrophils in patients with severely burned enhanced endothelial cell injury by arosing morphologic change, descending cell energy, ascending ET/NO, attacking membrane, arosing lipid peroxidation by oxygen specieson. Postburn 24h reached crest. Abated at postburn 48h except lipid peroxidation by O2-. Shenmai injection could optimize the ratio of ET/NO, protect the function of vascular endothelial cells injuried severely burned by adjust the compound and secretion of ET,NO, protect cell membrane and anti-lipid peroxidation.