The Change Of Th1/Th2 Balance In The Process Of Preventing And Treating Multiple Organ Dysfunction With High Volume Hemofiltration

[Abstract] Objective: To explore the pathogenesis of MODS and the role of HVHF in preventing and treating MODS.Methods: Double-hit method was used to establish the porcine MODS model. To observe the improvement of main organs function and the change of mobidity of MODS in group HVHF(H). Plasma levels of IFN- Y and IL-4 were detected by enzyme-linked immunosorbent assay(ELISA). Real-time PCR was used to detect the expression of IFN- Y and IL-4mRNA in main failure organs(including liver, lung and kidney) .T-bet and GATA-3mRNA levels in spleen, key transcription factors associated with Thl and Th2 responses respectively, were also measured by RT-PCR. Western blot was used to detect the plasma level of HMGB1.The plasma level of PGE2 was measured by ELISA. Results: The mobidity of MODS in group H was 20% (2/10),much lower than that in group M (88.9%,8/9) (P=0.005). Main organs function were improved by HVHF. The plasma levels oflFN- Y and IL-4 in group H were obviously lower than that in group M (P<0.05),and the ratio of IFN- γ / IL-4 preparatory to executing was higher than that in group M (P=0.003);In main f ai lure organs,the expression of IFN- Y and IL-4mRNA in group H was lower than that in group M;In spleen ,the expression of GATA3mRNA was obviously lower than that in group M (P=0.000) ,but the descent of T-betmRNAwas not obvious (P=0.334). the ratio of T-bet/GATA3 was higher than that in group M (P=0.000) . The plasma level of PGE2 obviously dropped after HVHF (P<0.01),and the level of HMGB1 in group H was lower than that in group M after the endotoxin injection.Conclusion: The shift from Thl to Th2 maybe is the improtant pathogenesis of MODS,and to some extent, HVHF can hold back the shift to Th2.