The efficacy of spironolactone and surfactant treatment on HMGB1, CRP, IL- 1ß and TNF-α levels in acute lung injury

Muhammet Emin Naldan; Canan Atalay; Ayşenur Coşkun; Muhammet Karaca; Yener Aydın; Emrullah Dorman; Ferah Daloğlu; Hüsnü Kürşad; Ömer Araz

doi:10.5606/tgkdc.dergisi.2015.10395

Muhammet Emin Naldan¹, Canan Atalay², Ayşenur Coşkun³, Muhammet Karaca², Yener Aydın⁴, Emrullah Dorman⁵, Ferah Daloğlu⁶, Hüsnü Kürşad², Ömer Araz⁷

¹Department of Anesthesia and Reanimation, Erzurum Training and Research Hospital, Erzurum, Turkey
²Department of Anesthesia and Reanimation, Medical Faculty of Atatürk University, Erzurum, Turkey
³Department of Anesthesia and Reanimation, Denizli Sarayköy State Hospital, Denizli, Turkey
⁴Department of Thoracic Surgery, Medical Faculty of Atatürk University, Erzurum, Turkey
⁵ Department of Biochemistry, Medical Faculty of Atatürk University, Erzurum, Turkey
⁶Department of Pathology, Medical Faculty of Atatürk University, Erzurum, Turkey
⁷Department of Chest Diseases, Medical Faculty of Atatürk University, Erzurum, Turkey

DOI : 10.5606/tgkdc.dergisi.2015.10395

Background: This study aims to compare high-mobility group box-1 (HMGB1), interleukin-1 beta (IL-1ß), tumor necrosis factor alpha (TNF-α), and C reactive protein (CRP) levels with spironolactone and surfactant treatment, investigate if spironolactone and surfactant treatment is effective, and evaluate the effect of this treatment on histopathologic changes in the lungs in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).

Methods: Forty rabbits were randomized into five groups to include eight rabbits in each group: group N: normal group, group T: tracheotomized group, group A: ARDS group, group S1: spironolactone group, group S2: surfactant group. Lungs of the rabbits were dissected and examined histopathologically.

Results: HMGB1, CRP, IL-1ß and TNF-α levels were statistically significantly increased in group A. There was a statistically significant decrease in HMGB1, CRP, IL-1ß and TNF-α levels in S1 and S2 groups (p<0.05). While PO₂, SpO₂, pH and PO₂/FIO₂ levels were statistically significantly decreased in group A, they were increased in the treatment groups (p<0.05).

Conclusion: As in many studies, our study suggests that surfactant is effective in the treatment of ALI and ARDS, and spironolactone also has a similar effect as surfactant. Spironolactone may be used as a cost effective and efficient agent in ALI and ARDS. Further comprehensive studies are required regarding this subject.

Keywords : Acute lung injury; acute respiratory distress syndrome; spironolactone; surfactant

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