Effects Of Mechanical Ventialation On The Expression Of Muscle Genes And Ubiquitin-Related Protein In COPD Patients

Objective:Effects of noninvasive positive pressure ventilation (NIPPV) on chronic obstructive pulmonary disease exacerbations (AECOPD) respiratory pump failure and on the pulmonary function by inhibiting the ubiquitin-proteasome pathway (UPP) was investigated. It provides new ideas for improvement of the prognosis of patients with chronic obstructive pulmonary disease (COPD) patients. Subjects:16 cases of AECOPD patients by diagnosed by systemic investigation were collected. After exclusion of NIPPV contraindications, the test patients were randomly divided into 10 cases of non-invasive mechanical ventilation in the treatment group and control group of 6 cases. Methods:We established an uniform standard for clinical data recording sheet, recording AECOPD age, sex, primary disease, lung function, previous diseases. Recycling parameters and blood gas analysis were performed 2-4 hours after the start of treatment and,14 days to review the index after treatment begins. Tissue samples were collected by biopsy needle (size:14Ga, BARD) after 14 days of treatment. Replicates of 100 mg muscle tissue samples were collected for each treatment, were immediately frozen in liquid nitrogen tank, and were refrigerated at-80 ℃ refrigerator. mRNA level of encoding genes for skeletal muscle ribosomal protein S21 (RPS21), ubiquitin, E2, E3 was detected by RT-PCR experiment. Western blotting was performed to measure the expression of ACO2, C3, SLC16 expression. Results:After NIPPV treatment, PaCO2, PaO2 improved significantly (p<0.05), while HR and MBP show no significant difference (P> 0.05) between the samples of control and NIPPV treatment; mRNA expression level of S21 (RPS21), ubiquitin, E2, E3 in NIPPV treatment group are significantly lower than the control group; Protein level of C3 and ACO2 in NIPPV treatment group increased significantly compared with the control group, while SLC16 protein level was decreased. Conclusinos:1. mRNA level of S21 (RPS21), ubiquitin, E2, E3 and their products C3 and ACO2 in AECOPD patients increased significantly compared with the control group, while SLC16 protein level was decreased.2. NIPPV treatment could down-regulate skeletal muscle, ubiquitin, E2, E3 mRNA and their protein products ACO2, C3 expression, while up-regulate SLC16 expression of AECOPD patients.3. NIPPV alleviate the symptoms of AECOPD respiratory pump failure and pulmonary function by inhibiting the ubiquitin-proteasome pathway, providing a new way for the treatment of COPD.