The Protective Effect Of Albumin On Lung Injury In Trauma/hemorrhagic Shock Rats

Objective:As to ischemia reperfusion injury after trauma/hemmorhagic shock,shifts in paradigm have suggested that the majority of cellular injuries occur during resuscitation but not ischemic period,unsuitable treatment of fluid resuscitation can lead to a pathologic state even after the restoration of intravascular volume.Clinically,this can contribute to the development of adult respiratory distress syndrome(ARDS) and multiple organ dysfunction(MOD),which are important determinants of outcome in trauma.Recent data have suggested that the type of resuscitation fluid used to treat hemorrhagic shock can affect the physiologic response,and colloid versus crystalloid resuscitation in the acute trauma setting remains a controversial subject of debate. Despite the negative perception for resuscitation,recent studies showed that human albumin,as a broadly binding protein,has been characterized as a scavenger in addition to being an anti-apoptotic agent or antioxidant,and no increased mortality has been documented with albumin administration in the trauma population.Since lung prone to subject to I/R injury,all this led to our hypothesis that albumin would also protect lung epithelial from injury and apoptosis induced by T/HS.Methods:Using rat trauma/hemorrhagic shock model,the effects of albumin were evaluated by assessing lung damage,production of reactive oxygen species,expression of ICAM-1 and leukocyte-endothelial cell interactions.Furthermore,activation of mitogen-activated protein kinases(MAPKs) and NF -κB were also investigated for understanding of the potential mechanisms of apoptosis in alveolar epithelium.Results:Alveolar epithelium apoptosis and overproduction of reactive oxygen species were decreased by albumin treatment.Albumin also improved T/HS-induced lung damage and aggravated respiratory function,as evidenced by decreased numbers of rolling and adherent leukocytes(decrease the expressions of CD11b/CD18 and ICAM-1).I/R injury induced activation of p38-MAPKs and NF-κB was downregulated by albumin.Conclusion:In summary,the infusion of albumin during resuscitation period can protect lung from injury and decrease the expressions of CD11b/CD18 and ICAM-1,as well as inhibit T/HS-induced apoptosis in the lung via the p38 MAPK signal transduction pathway that functions to stimulate the activation of NF-κB.