by Li-Fu Li, Bao-Xiang Chen, Ying-Huang Tsai, Winston W.-Y. Kao, Cheng-Ta Yang, Pao-Hsien Chu
Diaphragmatic dysfunction found in the patients with acute lung injury required prolonged mechanical ventilation. Mechanical ventilation can induce production of inflammatory cytokines and excess deposition of extracellular matrix proteins via up-regulation of transforming growth factor (TGF)-ß1. Lumican is known to participate in TGF-ß1 signaling during wound healing. The mechanisms regulating interactions between mechanical ventilation and diaphragmatic injury are unclear. We hypothesized that diaphragmatic damage by short duration of mechanical stretch caused up-regulation of lumican that modulated TGF-ß1 signaling. Methods
Male C57BL/6 mice, either wild-type or lumican-null, aged 3 months, weighing between 25 and 30 g, were exposed to normal tidal volume (10 ml/kg) or high tidal volume (30 ml/kg) mechanical ventilation with room air for 2 to 8 hours. Nonventilated mice served as control groups. Results
High tidal volume mechanical ventilation induced interfibrillar disassembly of diaphragmatic collagen fiber, lumican activation, type I and III procollagen, fibronectin, and a-smooth muscle actin (a-SMA) mRNA, production of free radical and TGF-ß1 protein, and positive staining of lumican in diaphragmatic fiber. Mechanical ventilation of lumican deficient mice attenuated diaphragmatic injury, type I and III procollagen, fibronectin, and a-SMA mRNA, and production of free radical and TGF-ß1 protein. No significant diaphragmatic injury was found in mice subjected to normal tidal volume mechanical ventilation. Conclusion
Our data showed that high tidal volume mechanical ventilation induced TGF-ß1 production, TGF-ß1-inducible genes, e.g., collagen, and diaphragmatic dysfunction through activation of the lumican.