Establishing a rat model of sepsis by combining seawater immersion with Vibrio vulnificus infection after burns
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摘要:
目的 建立烫伤后海水浸泡合并创伤弧菌感染脓毒症大鼠模型,为海洋烧创伤脓毒症研究提供实验基础。 方法 该研究采用析因设计,为实验研究。取115只8周龄雄性SD大鼠,按照随机数字表法（分组方法下同）分为模型组（45只）、单纯烫伤组（40只）和假伤组（30只）,前2组大鼠背部均先行烫伤处理,然后分别行人工海水浸泡30 min+创伤弧菌注射、生理盐水注射；后1组大鼠背部先浸入温水做假伤处理,然后注射生理盐水。建模后1、3、5 d,采用苏木精-伊红染色法检测3组大鼠肝、肾、肺、心脏的病理变化,采用半定量评分体系评估前述脏器病理损伤情况；按照试剂盒说明书,采用酶标仪检测3组大鼠血清中天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、尿素氮、肌酐、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）及髓过氧化物酶（MPO）的含量；通过称量3组大鼠新鲜肺组织及其烘干后重量,计算肺湿干比重；采用流式细胞仪检测单纯烫伤组和模型组大鼠外周血中辅助性T细胞、B细胞和细胞毒性T细胞的占比；采用酶联免疫吸附测定法检测3组大鼠血清中白细胞介素（IL）-6、IL-10、IL-1β、肿瘤坏死因子-α（TNF-α）等炎症因子表达水平。另取70只8周龄雄性SD大鼠,随机分为假伤组、单纯烫伤组、烫伤+淡水浸泡组、烫伤+海水浸泡组、烫伤+感染组、单纯感染组、模型组,每组10只。模型组、单纯烫伤组和假伤组大鼠做同前处理；烫伤+淡水浸泡组、烫伤+海水浸泡组大鼠背部先行烫伤处理,然后分别行淡水、人工海水浸泡30 min；单纯感染组大鼠背部经皮下注射创伤弧菌；烫伤+感染组大鼠背部先行烫伤处理,伤后30 min再注射创伤弧菌。建模后7 d内,每天观察大鼠生存情况并计算其生存比例。 结果 建模后1、3、5 d,假伤组大鼠肝、肾、肺、心脏的组织结构基本正常,未见明显病理性损伤；单纯烫伤组大鼠前述脏器组织均存在轻至中度炎症反应,胞质疏松,呈现明显的细胞水肿,但整体结构基本正常；模型组大鼠前述脏器组织均出现明显病理改变,其中建模后3 d最为严重,主要表现为严重的炎症反应、组织损伤,甚至坏死。与假伤组相比,模型组大鼠建模后1、3、5 d肝、肾、肺、心脏病理损伤情况评分均明显升高（P<0.05）；与单纯烫伤组相比,模型组大鼠建模后1 d肝、肾、肺、心脏病理损伤情况评分均明显升高（P<0.05）,建模后3、5 d肝、肾、肺病理损伤情况评分均明显升高（P<0.05）。与假伤组相比,模型组大鼠建模后1 d血清中AST、ALT、尿素氮、肌酐、CK-MB、LDH、MPO含量及肺湿干比重均明显升高（P<0.05）,建模后3、5 d血清中AST、ALT、尿素氮、肌酐、LDH、MPO含量及肺湿干比重均明显升高（P<0.05）。与单纯烫伤组相比,模型组大鼠建模后1 d血清中AST、ALT、尿素氮、肌酐、CK-MB、LDH、MPO含量及肺湿干比重均明显升高（P<0.05）,建模后3 d血清中AST、ALT、肌酐、LDH含量均明显升高（P<0.05）,建模后5 d血清中AST、ALT、肌酐、LDH、MPO含量均明显升高（P<0.05）。建模后1、3、5 d,与假伤组相比,模型组大鼠外周血中辅助性T细胞、B细胞、细胞毒性T细胞占比均明显降低（P<0.05）。建模后1、3、5 d,模型组大鼠血清中IL-6、IL-10、IL-1β、TNF-α表达水平均明显高于假伤组和单纯烫伤组（P<0.05）。建模后7 d,模型组大鼠的生存比例仅为5/10,而假伤组和单纯感染组大鼠的生存比例均为10/10。建模后7 d内,模型组大鼠生存比例显著低于假伤组、单纯烫伤组、烫伤+淡水浸泡组、烫伤+海水浸泡组及单纯感染组（χ2值分别为19.31、12.11、12.33、9.01、17.61,P值均<0.05）,而与烫伤+感染组接近（P>0.05）。 结论 采用烫伤后海水浸泡合并创伤弧菌感染处理可建立脓毒症大鼠模型,该模型大鼠的主要脏器均出现明显病理改变,炎症因子表达水平均显著升高,辅助性T细胞、B细胞、细胞毒性T细胞等免疫细胞占比均明显降低,生存比例显著降低,是可靠的实验动物模型。 Abstract:Objective To establish a rat model of sepsis induced by combining seawater immersion with Vibrio vulnificus infection after burns, providing an experimental basis for research on marine burn wound-associated sepsis. Methods This study was conducted using an experimental animal model. A total of 115 eight-week-old male Sprague Dawley rats were randomly allocated using a random number table (grouping method was the same as below) into three groups: burn+seawater immersion+infection group (model group for short, n=45), burn-only group (n=40), and sham injury group (n=30). Rats in the first two groups received standardized dorsal burn injury, followed by either artificial seawater immersion for 30 min+subcutaneous injection of Vibrio vulnificus or injection of an equal volume of normal saline, respectively. In sham injury group, the dorsal region was immersed in warm water to induce sham injury, followed by injection of an equal volume of normal saline. On 1, 3, and 5 days after modeling, hematoxylin-eosin staining was performed to evaluate histopathological changes in the liver, kidney, lung, and heart in the three groups of rats, the pathological damage of the aforementioned organs was evaluated using a semi-quantitative scoring system. According to the instructions of the kit, an enzyme-linked immunosorbent assay reader was used to detect the contents of aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen, creatinine, creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), and myeloperoxidase (MPO) in the serum of the three groups of rats, to reflect the degree of liver, kidney and heart injury. Fresh lung tissues in the three groups of rats were weighed and then dried to a constant weight to calculate the lung wet-to-dry weight ratio. In addition, the proportions of helper T cells, B cells, and cytotoxic T cells in peripheral blood of rats in sham and model groups were determined by flow cytometry. Serum levels of inflammatory cytokines in the three groups of rats, including IL-6, IL-10, IL-1β, and TNF-α, were measured using enzyme-linked immunosorbent assay. An additional 70 eight-week-old male Sprague Dawley rats were randomly assigned to seven groups (with each group of 10 rats): sham, burn-only, burn+freshwater immersion, burn+seawater immersion, burn+infection, infection-only, and model groups. The rats in model, burn-only group and sham injury groups were treated as before. The rats in burn+freshwater immersion and burn+seawater immersion groups were first received dorsal burn injury, followed by 30 min immersion in freshwater or artificial seawater, respectively. Rats in infection-only group received subcutaneous injection of the same dose of Vibrio vulnificus at the corresponding dorsal site. Rats in burn+infection group first received dorsal burn injury and then injected with the same dose of Vibrio vulnificus 30 min after injury. Within 7 days after modeling, the survival status of the rats was observed every day and their survival rate was calculated. Results On 1, 3, and 5 days after modeling, the tissue structures of the liver, kidney, lung, and heart of rats in sham injury group were basically normal, and no obvious pathological damage was observed; the tissues of the aforementioned organs of rats in burn-only group had mild to moderate inflammatory reactions, with loose cytoplasm and obvious cellular edema, but the overall structure was basically normal; the tissues of the aforementioned organs of rats in model group showed obvious pathological changes, with the most severe changes on 3 days after modeling, mainly manifested as severe inflammatory reactions, tissue damage, and even necrosis. Compared with that in sham injury group, histopathological injury scores for the liver, kidney, lung, and heart of rats in model group were significantly increased on 1, 3, and 5 day after modeling (P<0.05). Compared with that in burn-only group, histopathological injury scores for the liver, kidney, lung, and heart of rats in model group were significantly increased on 1 day after modeling (P<0.05), and histopathological injury scores for the liver, kidney, and lung were significantly increased on 3 and 5 days after modeling (P<0.05). Compared with that in sham injury group, the serum levels of AST, ALT, blood urea nitrogen, creatinine, CK-MB, LDH, and MPO, as well as the lung wet-to-dry weight ratio of rats in model group were significantly increased on 1 day after modeling (P<0.05), and the serum levels of AST, ALT, blood urea nitrogen, creatinine, LDH, and MPO, as well as the lung wet-to-dry weight ratio were significantly increased on 3 and 5 days after modeling (P<0.05). Compared with that in burn-only group, the serum levels of AST, ALT, blood urea nitrogen, creatinine, CK-MB, LDH, and MPO, as well as the lung wet-to-dry weight ratio of rats in model group were significantly increased on 1 day after modeling (P<0.05), the serum levels of AST, ALT, creatinine, and LDH were significantly increased on 3 days after modeling (P<0.05),and the serum levels of AST, ALT, creatinine, LDH, and MPO on 5 days after modeling (P<0.05). On 1, 3, and 5 days after modeling, compared with that in sham injury group, the proportions of helper T cells, B cells, and cytotoxic T cells in peripheral blood of rats in model group were significantly increased (P<0.05). On 1, 3, and 5 days after modeling, the serum levels of IL-6, IL-10, IL-1β, and TNF-α of rats in model group were significantly higher than those in both sham injury and burn-only groups (P values all <0.05). on 7 days after modeling, the survival rate of rats in model group was only 50%, whereas it was 100% in both sham injury and infection-only groups. Within 7 days after modeling, the survival rate of rats in model group was significantly lower than that in sham, burn-only, burn+freshwater immersion, burn+seawater immersion, and infection-only groups (with χ2 values of 19.31, 12.11, 12.33, 9.01, and 17.61, respectively, P values all <0.05), but was comparable to that in burn+infection group (χ2=1.75, P>0.05). Conclusions Combining seawater immersion with Vibrio vulnificus infection after burns successfully established a rat model of sepsis. This model exhibited marked pathological alterations in major organs, significantly elevated inflammatory cytokine levels, increased proportions of immune cells including helper T cells, B cells, and cytotoxic T cells, and a markedly reduced survival rate, indicating that it is a reliable experimental animal model. -
Key words:
- Burns /
- Sepsis /
- Vibrio vulnificus /
- Infections /
- Models, animal /
- Seawater immersion
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参考文献
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图 1 3组大鼠建模后各时间点肺组织病理变化 苏木精-伊红 ×400。1A、1B、1C.分别为假伤组、单纯烫伤组、模型组建模后1 d肺的病理情况；1D、1E、1F.分别为假伤组、单纯烫伤组、模型组建模后3 d肺的病理情况,可见图1F中肺结构被破坏、肺泡间隔显著增厚（红色圆圈内区域所示）；1G、1H、1I.分别为假伤组、单纯烫伤组、模型组建模后5 d肺的病理情况
注：烫伤+海水浸泡+感染组（简称模型组）、单纯烫伤组大鼠背部均先行烫伤处理,然后分别行人工海水浸泡30 min+创伤弧菌注射处理以及注射生理盐水；假伤组大鼠背部先浸入温水做假伤处理,然后注射生理盐水
图 2 7组大鼠建模后7 d内的生存比例比较（样本数为10）
注：烫伤+海水浸泡+感染组（简称模型组）、单纯烫伤组大鼠背部均先行烫伤处理,然后分别行人工海水浸泡30 min+创伤弧菌注射处理以及注射生理盐水；假伤组大鼠背部先浸入温水做假伤处理,然后注射生理盐水；烫伤+淡水浸泡组、烫伤+海水浸泡组大鼠先行烫伤处理,然后分别行淡水、人工海水浸泡30 min；单纯感染组大鼠背部注射创伤弧菌；烫伤+感染组大鼠先行烫伤处理,伤后30 min再注射创伤弧菌；假伤组大鼠生存比例与单纯感染组重合,单纯烫伤组大鼠生存比例折线与烫伤+淡水浸泡组大部分重合；与模型组比较,aP<0.05
Table 1. 3组大鼠建模后各时间点主要脏器的病理损伤情况评分比较（分,
组别与时间点 样本数 肝 肾 肺 心脏 假伤组 建模后1 d 9 0.50±0.21 0.30±0.08 0.32±0.15 0.33±0.10 建模后3 d 9 0.63±0.14 0.37±0.14 0.27±0.12 0.42±0.21 建模后5 d 9 0.48±0.21 0.42±0.15 0.30±0.15 0.38±0.15 单纯烫伤组 建模后1 d 9 2.47±0.16 1.53±0.12 1.67±0.22 1.52±0.19 建模后3 d 9 3.83±0.17 2.31±0.17 2.37±0.30 2.32±0.37 建模后5 d 9 3.15±0.32 1.65±0.10 1.35±0.41 2.55±0.33 模型组 建模后1 d 9 3.97±0.48 2.33±0.23 2.18±0.24 2.40±0.37 建模后3 d 9 5.83±0.37 3.38±0.25 2.85±0.19 2.58±0.32 建模后5 d 9 4.87±0.39 2.88±0.19 2.17±0.26 2.55±0.23 P1值 <0.001 <0.001 <0.001 <0.001 P2值 <0.001 <0.001 <0.001 <0.001 P3值 <0.001 <0.001 <0.001 <0.001 P4值 <0.001 <0.001 0.002 <0.001 P5值 <0.001 <0.001 0.003 0.245 P6值 <0.001 <0.001 <0.001 0.999 注：烫伤+海水浸泡+感染组（简称模型组）、单纯烫伤组大鼠背部均先行烫伤处理,然后分别行人工海水浸泡30 min+创伤弧菌注射处理以及注射生理盐水；假伤组大鼠背部先浸入温水做假伤处理,然后注射生理盐水；肝、肾、肺、心脏病理损伤情况评分的处理因素主效应,F值分别为989.80、996.80、363.30、329.07,P值均<0.001；时间因素主效应,F值分别为65.11、63.69、26.53、12.78,P值均<0.001；两者交互作用,F值分别为13.73、16.13、8.54、6.66,P值均<0.001；P₁值、P2值、P3值分别为模型组建模后1、3、5 d各指标与假伤组各指标比较所得；P4值、P5值、P₆值分别为模型组建模后1、3、5 d各指标与单纯烫伤组各指标比较所得 
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Table 2. 3组大鼠建模后各时间点血清中各指标含量及肺湿干比重比例（
组别与时间点 样本数 ALT（U/L） AST（U/L） 尿素氮（mmol/L） 肌酐（μmol/L） CK-MB（U/L） LDH（U/L） MPO（U/L） 肺湿干比重 假伤组 建模后1 d 9 35±4 35±5 9.8±1.7 18.9±1.4 924±105 881±89 7.5±0.8 3.34±0.12 建模后3 d 9 36±4 36±6 10.0±1.3 18.1±1.6 947±82 890±121 7.7±1.0 3.36±0.20 建模后5 d 9 33±5 33±5 9.8±1.2 18.3±1.5 891±144 867±115 7.4±0.8 3.43±0.17 单纯烫伤组 建模后1 d 9 88±6 94±8 14.0±2.4 24.8±4.9 1 038±99 1 102±14 10.4±1.1 3.75±0.18 建模后3 d 9 52±8 66±6 21.7±2.8 25.8±4.5 984±173 1 355±208 13.8±1.7 4.30±0.22 建模后5 d 9 38±5 41±9 22.18±3.0 21.9±2.4 853±144 1 209±89 12.3±2.6 4.02±0.14 模型组 建模后1 d 9 175±9 214±14 26.4±3.4 28.5±1.5 1 199±159 2 750±721 18.3±1.7 5.01±0.49 建模后3 d 9 119±13 195±19 24.7±3.1 30.2±4.0 1 056±153 2 494±560 15.9±1.5 4.50±0.25 建模后5 d 9 86±8 171±16 22.8±5.2 25.6±3.4 917±150 2 375±401 14.7±2.2 4.21±0.23 P1值 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 P2值 <0.001 <0.001 <0.001 <0.001 0.220 <0.001 <0.001 <0.001 P3值 <0.001 <0.001 <0.001 <0.001 0.913 <0.001 <0.001 <0.001 P4值 <0.001 <0.001 <0.001 0.031 <0.001 <0.001 <0.001 <0.001 P5值 <0.001 <0.001 0.083 0.012 0.514 <0.001 0.156 0.205 P6值 <0.001 <0.001 0.889 0.032 0.582 <0.001 0.005 0.231 注：AST为天冬氨酸氨基转移酶,ALT为丙氨酸氨基转移酶,CK-MB为肌酸激酶同工酶,LDH为乳酸脱氢酶,MPO为髓过氧化物酶；烫伤+海水浸泡+感染组（简称模型组）、单纯烫伤组大鼠背部均先行烫伤处理,然后分别行人工海水浸泡30 min+创伤弧菌注射处理以及注射生理盐水；假伤组大鼠背部先浸入温水做假伤处理,然后注射生理盐水；AST、ALT、尿素氮、肌酐、CK-MB、LDH、MPO及肺湿干比重的处理因素主效应,F值分别为1 066.00、1 572.00、177.30、65.90、10.30、169.64、205.10、164.40,P值均<0.001；时间因素主效应,F值分别为265.80、60.61、3.66、5.71、5.88、0.67、2.42、3.79,P值分别为<0.001、<0.001、0.031、0.005、0.004、0.517、0.096、0.027；二者交互作用,F值分别为77.48、14.17、11.14、1.69、2.95、1.62、9.85、16.46,P值分别为<0.001、<0.001、<0.001、0.161、0.026、0.180、<0.001、<0.001；P1值、P2值、P3值分别为为模型组建模后1、3、5 d各指标与假伤组各指标比较所得；P4值、P5值、P6值分别为为模型组建模后1、3、5 d各指标与单纯烫伤组各指标比较所得
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Table 3. 2组大鼠建模后各时间点外周血中各类免疫细胞占比比较（%,
组别与时间点 样本数 辅助性T细胞 B细胞 细胞毒性T细胞 假伤组 建模后1 d 3 30.12±0.66 8.44±0.25 5.84±0.39 建模后3 d 3 31.57±1.58 9.05±0.32 5.48±0.53 建模后5 d 3 30.93±1.95 8.52±0.13 5.42±0.28 模型组 建模后1 d 3 7.63±0.90 1.74±0.09 1.62±0.66 建模后3 d 3 8.95±0.43 2.36±0.27 2.03±0.10 建模后5 d 3 7.50±0.13 2.51±0.09 1.77±0.68 P1值 <0.001 <0.001 <0.001 P2值 <0.001 <0.001 <0.001 P3值 <0.001 <0.001 <0.001 注：烫伤+海水浸泡+感染组（简称模型组）大鼠背部先行烫伤处理,然后行人工海水浸泡+创伤弧菌注射处理；假伤组大鼠背部先浸入温水做假伤处理,然后注射生理盐水；辅助T细胞、B细胞及细胞毒性T细胞占比的处理因素主效应,F值分别为1 827.52、4 230.00、269.98,P值均<0.001；时间因素主效应,F值分别为2.42、13.27、0.19,P值分别为0.131、<0.001、0.832；二者交互作用,F值分别为0.30、5.40、1.00,P值分别为0.745、0.021、0.400；P₁值、P2值、P3值分别为模型组建模后1、3、5 d各指标与假伤组建模后1、3、5 d各指标比较所得
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Table 4. 3组大鼠建模后各时间点血清中各炎症因子表达水平比较（pg/mL,
组别与时间点 样本数 IL-6 IL-10 IL-1β TNF-α 假伤组 建模后1 d 9 16±4 28±5 23±3 40±6 建模后3 d 9 20±5 27±6 23±3 42±5 建模后5 d 9 20±5 28±4 21±4 41±5 单纯烫伤组 建模后1 d 9 33±4 37±3 87±14 115±37 建模后3 d 9 53±4 49±7 56±13 71±14 建模后5 d 9 40±4 129±29 46±19 61±8 模型组 建模后1 d 9 178±10 223±25 512±72 211±7 建模后3 d 9 138±12 324±50 245±21 181±13 建模后5 d 9 116±8 184±20 178±8 100±15 P1值 <0.001 <0.001 <0.001 <0.001 P2值 <0.001 <0.001 <0.001 <0.001 P3值 <0.001 <0.001 <0.001 <0.001 P4值 <0.001 <0.001 <0.001 <0.001 P5值 <0.001 <0.001 <0.001 <0.001 P6值 <0.001 <0.001 <0.001 <0.001 注：烫伤+海水浸泡+感染组（简称模型组）、单纯烫伤组大鼠背部均先行烫伤处理,然后分别行人工海水浸泡30 min+创伤弧菌注射处理以及注射生理盐水；假伤组大鼠背部先浸入温水做假伤处理,然后注射生理盐水；白细胞介素（IL）-6、IL-10、IL-1β、肿瘤坏死因子-α（TNF-α）的处理因素主效应,F值分别为2 643.00、707.80、973.40、440.10,P值均<0.001；时间因素主效应,F值分别为45.28、18.83、173.80、85.70,P值均<0.001；二者交互作用,F值分别为87.53、60.26、122.70、35.03,P值均<0.001；P₁值、P2值、P3值分别为模型组建模后1、3、5 d各指标与假伤组各指标比较所得；P4值、P5值、P₆值为模型组建模后1、3、5 d各指标与单纯烫伤组各指标比较所得
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