Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1 (5-Year IF – 2.0)
Journal Citation Indicator (JCI) (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker – 4.0)
Index Copernicus  – 171.00; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 7, July, p. 813–817

doi: 10.17219/acem/121936

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Ketamine alleviates HMGB1-induced acute lung injury through TLR4 signaling pathway

Dong Xu1,B,C, Xang Sun2,A,B, Yang Zhang3,E,F, Li Cao1,C,D

1 Department of Anesthesiology, Jinan Central Hospital Affiliated to Shandong University, China

2 Department of Intensive Care Unit, Jinan Central Hospital Affiliated to Shandong University, China

3 Department of Anesthesiology, Binzhou People’s Hospital, China

Abstract

Background. Acute lung injury (ALI) is a common critical respiratory disease that seriously threatens human health. Ketamine has good anti-inflammatory and immune-regulating properties that can delay the lung injury process.
Objectives. High mobility group box protein 1 (HMGB1) plays an important role in the occurrence, development and treatment of ALI. Toll-like receptor 4 (TLR4) is the receptor for HMGB1. The aim of this study was to determine the role of the HMGB1 TLR4 signaling pathway in the treatment of ALI using ketamine.
Material and Methods. A total of 30 healthy, male, 8-week-old Sprague-Dawley rats were randomly, equally divided into a control group, an lipopolysaccharide (LPS) group and a ketamine group. In order to establish a rat ALI model, 15 mg/kg of LPS was injected into the femoral veins. Ketamine was intravenously injected (10 mg/kg) into the experimental group rats. The rats were euthanized 24 h after modeling and lung tissue samples were collected. Western blot was used to test TLR4, MyD88, TRAF-6, LOX-1, and HMGB1 protein expression in the lung tissue. Real-time polymerase chain reaction (RT-PCR) was performed to detect TLR4, MyD88, TRAF-6, LOX-1, and HMGB1 mRNA levels.
Results. Compared with the controls, the LPS group had significantly higher TLR4, MyD88, TRAF-6, LOX-1, and HMGB1 mRNA and protein levels (p < 0.05). These levels were significantly lower after ketamine intervention in comparison with the LPS group (p < 0.05). A positive correlation was found between TLR4 and HMGB1 expression in the LPS and ketamine groups (r = 0.952, p < 0.001; r = 0.941, p < 0.001).
Conclusion. Ketamine attenuates HMGB1-induced ALI, possibly by regulating the TLR4 signaling pathway.

Key words

ketamine, acute lung injury, TLR4, HMGB1

References (26)

  1. Kao RL, Xu X, Xenocostas A, et al. Induction of acute lung inflammation in mice with hemorrhagic shock and resuscitation: Role of HMGB1. J Inflamm (Lond). 2014;11(1):30.
  2. Luh SP, Chiang CH. Acute lung injury/acute respiratory distress syndrome (ALI/ARDS): The mechanism, present strategies and future perspectives of therapies. J Zhejiang Univ Sci B. 2007;8(1):60–69.
  3. Villar J, Sulemanji D, Kacmarek RM. The acute respiratory distress syndrome: Incidence and mortality, has it changed? Curr Opin Crit Care. 2014;20(1):3–9.
  4. Berger MM, Pitzer B, Zugel S, et al. Alveolar but not intravenous S-ketamine inhibits alveolar sodium transport and lung fluid clearance in rats. Anesth Analg. 2010;111(1):164–170.
  5. Yang CL, Chen CH, Tsai PS, Wang TY, Huang CJ. Protective effects of dexmedetomidine-ketamine combination against ventilator-induced lung injury in endotoxemia rats. J Surg Res. 2011;167(2):e273–e281.
  6. Yang CH, Tsai PS, Wang TY, Huang CJ. Dexmedetomidine-ketamine combination mitigates acute lung injury in haemorrhagic shock rats. Resuscitation. 2009;80(10):1204–1210.
  7. Shen H, Jin L, Zhuang X, Zhou Y. A single small dose of ketamine prevents lung injury following hepatic ischemia-reperfusion in rabbits. J Chin Med Assoc. 2011;74(8):350–356.
  8. Erdem MK, Yurdakan G, Yilmaz-Sipahi E. The effects of ketamine, midazolam and ketamine/xylazine on acute lung injury induced by alpha-naphthylthiourea in rats. Adv Clin Exp Med. 2014;23(3):343–351.
  9. Wang WF, Liu S, Xu B. A study of the protective effect and mechanism of ketamine on acute lung injury induced by mechanical ventilation. Eur Rev Med Pharmacol Sci. 2017;21(6):1362–1367.
  10. Dange RB, Agarwal D, Teruyama R, Francis J. Toll-like receptor 4 inhibition within the paraventricular nucleus attenuates blood pressure and inflammatory response in a genetic model of hypertension. J Neuroinflammation. 2015;12:31.
  11. Wang H, Bloom O, Zhang M, et al. HMG-1 as a late mediator of endotoxin lethality in mice. Science. 1999;285(5425):248–251.
  12. Zhou M, Zhang Y, Chen X, et al. PTEN-Foxo1 signaling triggers HMGB1-mediated innate immune responses in acute lung injury. Immunol Res. 2015;62(1):95–105.
  13. Entezari M, Javdan M, Antoine DJ, et al. Inhibition of extracellular HMGB1 attenuates hyperoxia-induced inflammatory acute lung injury. Redox Biol. 2014;2:314–322.
  14. Haitsma JJ, Lachmann B, Papadakos PJ. Additives in intravenous anesthesia modulate pulmonary inflammation in a model of LPS-induced respiratory distress. Acta Anaesthesiol Scand. 2009;53(2):176–182.
  15. Liu XX, Yu DD, Chen MJ, et al. Hesperidin ameliorates lipopolysaccharide-induced acute lung injury in mice by inhibiting HMGB1 release. Int Immunopharmacol. 2015;25(2):370–376.
  16. Chen Y, Huang XJ, Yu N, et al. HMGB1 contributes to the expression of P-glycoprotein in mouse epileptic brain through toll-like receptor 4 and receptor for advanced glycation end products. PLoS One. 2015;10(10):e0140918.
  17. Li G, Wu X, Yang L, et al. TLR4-mediated NF-kappaB signaling pathway mediates HMGB1-induced pancreatic injury in mice with severe acute pancreatitis. Int J Mol Med. 2016;37(1):99–107.
  18. Lai CH, Wang KC, Lee FT, et al. Toll-like receptor 4 is essential in the development of abdominal aortic aneurysm. PLoS One. 2016;11(1):e0146565.
  19. Gokcinar D, Ergin V, Cumaoglu A, Menevse A, Aricioglu A. Effects of ketamine, propofol, and ketofol on pro-inflammatory cytokines and markers of oxidative stress in a rat model of endotoxemia-induced acute lung injury. Acta Biochim Pol. 2013;60(3):451–456.
  20. Lange M, Broking K, van Aken H, Hucklenbruch C, Bone HG, Westphal M. Role of ketamine in sepsis and systemic inflammatory response syndrome [in German]. Anaesthesist. 2006;55(8):883–891.
  21. Wu Y, Li W, Zhou C, et al. Ketamine inhibits lipopolysaccharide-induced astrocytes activation by suppressing TLR4/NF-kB pathway. Cell Physiol Biochem. 2012;30(3):609–617.
  22. Yu M, Shao D, Yang R, Feng X, Zhu S, Xu J. Effects of ketamine on pulmonary inflammatory responses and survival in rats exposed to polymicrobial sepsis. J Pharm Pharm Sci. 2007;10(4):434–442.
  23. Tianzhu Z, Shumin W. Esculin inhibits the inflammation of LPS-induced acute lung injury in mice via regulation of TLR/NF-kappaB pathways. Inflammation. 2015;38(4):1529–1536.
  24. Wang SY, Li ZJ, Wang X, Li WF, Lin ZF. Effect of ulinastatin on HMGB1 expression in rats with acute lung injury induced by sepsis. Genet Mol Res. 2015;14(2):4344–4353.
  25. Abdelmageed ME, El-Awady MS, Suddek GM. Apocynin ameliorates endotoxin-induced acute lung injury in rats. Int Immunopharmacol. 2016;30:163–170.
  26. Qin MZ, Gu QH, Tao J, et al. Ketamine effect on HMGB1 and TLR4 expression in rats with acute lung injury. Int J Clin Exp Pathol. 2015;8(10):12943–12948.