Abstract
Introduction . The relevance of the problem of high mortality in acute lung edema (ALE) is associated with the insufficient effectiveness of treatment methods for extreme rapidly occurring lung pathology. The goal is a comprehensive study of the role of lymph flow stimulation using a lymph-stimulating peptide in the pathogenesis of ALE under conditions of lung biomicroscopy. Materials and methods . Biomicroscopy of the lungs using an implanted chamber and mesentery of the rat small intestine, laser Doppler lung flowmetry, morphological and histological examination of the lungs. Registration of contractile activity of the wall, valves of the lymphatic microvessels of the mesentery by photometry and the rate of lymph flow; determination of the diameter of microvessels, solids and pulmonary coefficient in the lungs. photo and video registration of the lungs. Results . The direct peptidic lymphostimulant caused activation of lymphatic flow in the lymphatic microvessels of the mesentery and lungs in patients with ALE, followed by restoration of microcirculation in the lungs. The reduction and elimination of edema of the interstitial space in the lungs was associated with the restoration of the diameter of the lymphatic and venous microvessels. Prophylactic use of the peptide was accompanied by an increase in animal survival by 3 times. The use of the peptide after the ALE did not affect survival, however, it increased the life expectancy of rapidly dying animals during the first 10 min up to a day from 16 to 46 %. Conclusions . Activation of motility of the lymphatic microvessels and lymph flow in ALE with the help of a peptidic lymphostimulator, an agonist of the delta opiate receptors, helps to eliminate edema as a result of removing excess interstitial fluid through the lymphatic vessels of the lungs to the main venous collectors and then to the right atrium, than reduces the load on the left half of the heart with cardiogenic ALE. The restoration of microlymph- and microhemocirculation in the lungs contributed to the restoration of the structure of the lung tissue and a 3-fold increase in the survival and longevity of animals. Activation of the lymphatic system is an effective, but unused reserve of the body playing an important role in the pathogenesis of ALE.
Highlights
The reduction and elimination of edema of the interstitial space in the lungs was associated with the restoration of the diameter of the lymphatic and venous microvessels
Prophylactic use of the peptide was accompanied by an increase in animal survival by 3 times
The restoration of microlymph- and microhemocirculation in the lungs contributed to the restoration of the structure of the lung tissue and a 3-fold increase in the survival and longevity of animals
Summary
Цель – комплексное изучение роли стимуляции лимфотока с помощью лимфостимулирующего пептида в патогенезе ООЛ в условиях биомикроскопии легких. Лимфостимулятор прямого действия пептидной природы вызывал активацию лимфотока в ЛМ брыжейки и ткани легких при ООЛ с последующим восстановлением микрогемоциркуляции в легких. Использование пептида после развития ООЛ не влияло на выживаемость, однако увеличивало продолжительность жизни быстро погибающих животных в течение первых 10 мин до суток с 16 до 46 %. Активация моторики ЛМ и лимфотока при ООЛ с помощью лимфостимулятора пептидной природы – агониста дельта опиатных рецепторов – способствует устранению отека в результате выведения избытка интерстициальной жидкости через лимфатические сосуды легких в магистральные венозные коллекторы и далее в правое предсердие, чем снижает нагрузку на левую половину сердца при кардиогенном ООЛ. Ключевые слова: острый отек легких, биомикроскопия, микроциркуляция, активация лимфатических микрососудов, опиоидный пептид, морфология, выживаемость, крысы.
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