在体外实验中，探索雾化高渗盐水对人支气管上皮的作用
2018/08/16
摘要：
雾化吸入高渗盐水（HS）是黏液阻塞性肺病的有效疗法。然而，与HS治疗相关的作用机理和原则仍不清楚。在体外将HS雾化至上皮细胞，其速率与体内条件相当。通过共聚焦显微镜分别测量气道表面液体（ASL）在正常和高浓度粘液状态下的体积和细胞高度。雾化HS使得ASL高度快速增加，同时细胞高度降低。雾化终止后，ASL体积迅速下降，然而细胞高度在相同的时间范围内没有恢复。重复使用雾化HS后ASL的体积应答减弱，但可通过在重复使用雾化HS之间加入低渗盐水来恢复。 HS诱导的ASL水合作用随着气道表面高浓度粘液的增加而延长，伴随更少的细胞体积减少量。气雾化HS产生渗透性诱导使得ASL高度增加，这受到活性钠吸收和细胞体积诱导的细胞水渗透性降低的限制。气道表面的粘液通过粘液依赖性渗透力延长了HS的作用，表明高浓度粘液患者的HS作用持续时间增加。
The in vitro effect of nebulised hypertonic saline on human bronchial epithelium
Goralski, J. L. et al.
Eur Respir J. 2018 May 17.
Abstract
Inhaled hypertonic saline (HS) is an effective therapy for muco-obstructive lung diseases. However, the mechanism of action and principles pertinent to HS administration remain unclear. An in vitro system aerosolised HS to epithelial cells at rates comparable to in vivo conditions. Airway surface liquid (ASL) volume and cell height responses were measured by confocal microscopy under normal and hyperconcentrated mucus states.Aerosolised HS produced a rapid increase in ASL height and decrease in cell height. Added ASL volume was quickly reabsorbed following termination of nebulisation, although cell height did not recover within the same time frame. ASL volume responses to repeated HS administrations were blunted, but could be restored by a hypotonic saline bolus interposed between HS administrations. HS-induced ASL hydration was prolonged with hyperconcentrated mucus on the airway surface, with more modest reductions in cell volume.Aerosolised HS produced osmotically induced increases in ASL height that were limited by active sodium absorption and cell volume-induced reductions in cell water permeability. Mucus on airway surfaces prolonged the effect of HS via mucus-dependent osmotic forces, suggesting that the duration of action of HS is increased in patients with hyperconcentrated mucus.
雾化吸入高渗盐水（HS）是黏液阻塞性肺病的有效疗法。然而，与HS治疗相关的作用机理和原则仍不清楚。在体外将HS雾化至上皮细胞，其速率与体内条件相当。通过共聚焦显微镜分别测量气道表面液体（ASL）在正常和高浓度粘液状态下的体积和细胞高度。雾化HS使得ASL高度快速增加，同时细胞高度降低。雾化终止后，ASL体积迅速下降，然而细胞高度在相同的时间范围内没有恢复。重复使用雾化HS后ASL的体积应答减弱，但可通过在重复使用雾化HS之间加入低渗盐水来恢复。 HS诱导的ASL水合作用随着气道表面高浓度粘液的增加而延长，伴随更少的细胞体积减少量。气雾化HS产生渗透性诱导使得ASL高度增加，这受到活性钠吸收和细胞体积诱导的细胞水渗透性降低的限制。气道表面的粘液通过粘液依赖性渗透力延长了HS的作用，表明高浓度粘液患者的HS作用持续时间增加。
（复旦大学附属中山医院呼吸内科 罗锦龙 摘译 杨冬 审校）
（Eur Respir J. 2018 May 17.）
（Eur Respir J. 2018 May 17.）
The in vitro effect of nebulised hypertonic saline on human bronchial epithelium
Goralski, J. L. et al.
Eur Respir J. 2018 May 17.
Abstract
Inhaled hypertonic saline (HS) is an effective therapy for muco-obstructive lung diseases. However, the mechanism of action and principles pertinent to HS administration remain unclear. An in vitro system aerosolised HS to epithelial cells at rates comparable to in vivo conditions. Airway surface liquid (ASL) volume and cell height responses were measured by confocal microscopy under normal and hyperconcentrated mucus states.Aerosolised HS produced a rapid increase in ASL height and decrease in cell height. Added ASL volume was quickly reabsorbed following termination of nebulisation, although cell height did not recover within the same time frame. ASL volume responses to repeated HS administrations were blunted, but could be restored by a hypotonic saline bolus interposed between HS administrations. HS-induced ASL hydration was prolonged with hyperconcentrated mucus on the airway surface, with more modest reductions in cell volume.Aerosolised HS produced osmotically induced increases in ASL height that were limited by active sodium absorption and cell volume-induced reductions in cell water permeability. Mucus on airway surfaces prolonged the effect of HS via mucus-dependent osmotic forces, suggesting that the duration of action of HS is increased in patients with hyperconcentrated mucus.
