Effects of ulinastatin on serum IL-8, IL-10 and lung AQP1, AQP 4 expression in patients undergoing intraoperative one-lung ventilation

Objective To observe the changes of serum IL-8, IL-10 and the expression of lung aquaporin 1 (AQP1) and aquaporin 4 (AQP4) in patients who need lung radical resection with one-lung ventilation and the effects of clinical intervention by ulinastatin.Methods Thirty (ASA Ⅰ or Ⅱ) patients, scheduled for radical resection of lung cancer were randomly divided into three groups (n=10). The patients in the group A, B were given 5,000 U/kg or 10,000 U/kg of ulinastatin, which were mixed in 20 ml normal saline and at ministered intravenously via injection pump in 10 min before OLV; group C received the same volume of normal saline. Artrial blood samples were taken after the induction of anesthesia before ulinastatin at ministration (T1), at 30 min of OLV (T2), 60 min of OLV (T3), 90 min of OLV (T4), 120 min of OLV (T5), and 30 min after OLV (T6) for determination of plasma concentrations of IL-8, IL-10 by ELISA. The first piece of normal lung tissue was cut when we started OLV, and the second piece of lung tissue obtained immediately when lung lobe was resected. The expression of AQP1,AQP 4 of the first and the second lung tissue were measured by immunohistochemistry method.Results Compared with T1, the levels of IL-8 were increased significantly at T4-T6 in all the three groups (P0.05), as the levels of IL-10 were higher at T2-T6(P0.05). In group A and B, the levels of IL-8 were lower than group C at T3 and T4, and the levels of IL-10 were increased significantly from T2-T5(P0.05). Compared with group B, the levels of IL-8 in group A were higher at T4 and T5, whereas the levels of IL-10 were lower at T3-T5 (P0.05). Compared with the first piece of lung tissue, The AQP1 expression of group A and C were decreased significantly in the second piece of lung tissure (P0.05). Compared with group C, the expression of AQP1 in group B were significantly higher in the second piece of lung tissue (P0.05). Compared with group B, the level of AQP1 in the second piece of lung tissue was decreased in group A (P0.05); Compared with the first piece of lung tissue, the expression of AQP4 in the second piece of lung tissue were significantly lower in group C (P0.05), and the expression of AQP4 in group A and B were significantly higher than group C in the second piece of lung tissure (P0.05).Conclusion Ulinastatin can reduce the level of IL-8, increase the level of IL-10, and enhance the expression of AQP1and AQP4, and the effect was dose-dependent. So ulinastatin can reduced the injury induced by OLV.