| Objective:To evaluate the protective effect of ulinastatin,dexamethasone and ambroxol on smoke inhalation injury using rat model.To provide a new clinical therapy to protect lung from damage and systemic inflammatory reaction during treatment of inhalation injury.Methods:Fifty rats were randomly divided into five groups labeled C,A,U,D,and M.Each group containing ten members.The rats in control group(group C) were not exposed to smoke.The remaining four groups(groupA,D,U,M) were exposed to smoke and then after half an hour,they were treated with ambrioxl(30 mg·kg-1),dexamethasone(5 mg·kg-1),ulinastatin(100 ku·kg-1),and normal saline respectively.After a period of six hours from exposure,all rats were killed.The lungs were removed for general observation.Arterial blood was then collected from the rats and the levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) were determined.Lung homogenate was checked for superoxide dismutase(SOD), malondialdehyde(MDA),nitric oxide(NO) and inducible nitric oxide synthase(iNOS). The pathological changes in lungs were also examined under an optical microscope.Results:1:General observation:All rats survived the exposure to smoke inhalation and the drug therapy.There was no statistically significant difference among the weights of rats in all groups.The rats that had suffered from inhalation injury appeared dysphoric,had tachypnea and tachycardia.The rats in control group appeared to have stable respiration.The lungs of rats from group C on visual inspection had normal color and no congestion and edema.Group M was found to have severe diffused and passive lung congestion.The lung tissues of group A were found to have ecchymosis and edema.Punctate hemorrhage and ecchymosis of lungs were observed in group U. There was no obvious sign of edema or spot bleeding of lungs in group D.2:Pathological section:Group C and group M were compared under the microscope.The lungs of rats in group M were found to have infiltrating inflammatory granulocytes,diffused alveolar septum thickening and spotty hemorrhage.The histopathological change in group U and D were minimal in comparison to group M.The lung tissues from group A were only found to have bronchial wall thickening,margination of leukocyte and telangiectasia.3:When compared with group C,the levels of TNF-αand IL-6 were found to be significantly higher in group M(P＜0.01).Between group M and group U,the levels were again higher in group M(P＜0.05).There was a statistically significant difference in the levels of TNF-αand IL-6 between group D and group M(P＜0.01). When compared with group U,the levels of TNF-αand IL-6 were found to be significantly lower in group D(P＜0.05,P＜0.01).There was no statistically significant difference between group A and group M(P＞0.05).4:When compared with group M,the level of SOD activity was found to be significantly higher in group U,group D and group A(P＜0.05).The level of MDA in group U and group D was found to be significantly lower when compared to group M (P＜0.01).There was no statistically significant difference between group A and group M when the levels of MDA(P＞0.05) were compared.5:Between group U and group A,the level of NO in lung homogenate was higher in group A(P＜0.01).When groups A and D were compared,group A was again found to have higher levels of NO.There were significant improvements in the levels of NO and iNOS in group A and group M when compared with group C(P＜0.01). However,When group D and U were separately compared with group C,there was no statistically difference found in the level of iNOS(P＞0.05).Conclusion:1:Ulinastatin may have anti-inflammatory effect and provide some degree of protection against smoke inhalation injury in rats by reducing inflammatory mediators and free oxygen radicals.2:Dexamethasone can definitely reduce systemic inflammatory response and decrease inflammatory exudation and hemorrhage in lungs of exposed rats if given soon after exposure in high dosage.3:The effects on anti-free oxygen radicals and anti-inflammation are not obvious when exposed rats were treated with ambroxol.
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