Relationship between the burden of pneumocystis carinii, the inflammatory reaction and lung injury in pneumocystis carinii pneumonia
Obiective To study the relationship between the burden of Pneumocystis carinii (P.cadninii) and the inflammatory reaction and biochemical markers in bronchoalveotar lavage fluids (BAL.F)in a rat model of p. carirnii pneumonia (PCP).Methods Clean grade 50 male Sprague-Dawley rats were immunosuppressed by a subcutaneous injection of 25mg cortisone acetate twice a week for 8-12 weeks; the PCP model was successfully induced in 14 rats. The inflammatory reaction and biochemical markers of the activity of lactate dehydrogenass (LDH), alknline phosphatase(ALP) end type Ⅳ collagenase(matrix metalloproteinases, MMP-2,MMP-9) as well as the values of total protein (TP) and albumin (ALB) in BALF between the mild burden group of P. caninii (involved alveoli<25% per 100 alveoli,Group A) and the moderate to severe burden group (involved alveoli≥25% per 100 alveoli, Group B)were measured. The other six clean grade SD rata served es normal control group (Group C).Results The total white cell count in BALF=was higher in Group B [(6.8±1.7)×106/L] than in Group A [(3.8±1.2)×106/L] (P<0.01);however, there were no differences in white cell differentiation.Assays of biochemical markers showed that ALB in BALF in Group B (0.893±0.469 g/L) was increased in companison with Group A (0.262±0.169 g/L); it was only 0.026±0.021 g/L in Group C. The contents of TP and activities of LDH were higher in Group B (TP 1.756±0.706 g/L, LDH 2580±550 U/L) than inGroup A (TP 0.784±0.553 g/L, LDH 1410±620 U/L); the values of TP and LDH were 0.063±0.020 g/L and 370±250 U/L respectively in Group C.The activity of Type IV collagenase, including MMP-2 and MMP-9, was higher in Group B than in Group A ( P<0.01) (MMP-2: 1102±169 grey value vs 459±274 grey valce; MMP-9: 1218±257 grey value vs 449±225 grey value).There was no activity of Type IV cellagenase in BALF of Group C. No statistically significant difference was obselved in ALP between the groups B and A.Conclusions These results indicate that there is a significant correlation between the burden of P. carinii in lung tissues and the irlflammatory reaction as well as biochemical markers of the rasultant aotivity of lung injury.
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