The effect of methylene blue treatment on aspiration pneumonia

J Surg Res. 2015 Feb;193(2):909-19. doi: 10.1016/j.jss.2014.08.039. Epub 2014 Aug 27.

Abstract

Background: The study aimed to examine whether methylene blue (MB) prevents different pulmonary aspiration materials-induced lung injury in rats.

Methods: The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250-300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + MB treated, BIO + MB treated, and HCl + MB treated. Saline, BIO, and HCl were injected into the lungs in a volume of 2 mL/kg. After surgical procedure, MB was administered intraperitoneally for 7 days at a daily dose of 2 mg/kg per day. Seven days later, rats were killed, and both lungs in all groups were examined biochemically and histopathologically.

Results: Our findings show that MB inhibits the inflammatory response reducing significantly (P < 0.05) peribronchial inflammatory cell infiltration, alveolar septal infiltration, alveolar edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonary aspiration significantly increased the tissue hydroxyproline content, malondialdehyde levels, and decreased (P < 0.05) the antioxidant enzyme (superoxide dismutase and glutathione peroxidase) activities. MB treatment significantly (P < 0.05) decreased the elevated tissue hydroxyproline content and malondialdehyde levels and prevented the inhibition of superoxide dismutase and glutathione peroxidase (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase (iNOS), terminal deoxynucleotidyl transferase dUTP nick end labeling, and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with MB therapy.

Conclusions: MB treatment might be beneficial in lung injury and therefore shows potential for clinical use.

Keywords: Methylene blue; Pulmonary aspiration; Surfactant protein D; TUNEL; iNOS.

MeSH terms

  • Acute Lung Injury / etiology
  • Acute Lung Injury / pathology
  • Acute Lung Injury / prevention & control*
  • Animals
  • Drug Evaluation, Preclinical
  • Enzyme Inhibitors / therapeutic use*
  • Immunohistochemistry
  • In Situ Nick-End Labeling
  • Lung / pathology
  • Methylene Blue / therapeutic use*
  • Pneumonia, Aspiration / complications*
  • Pneumonia, Aspiration / drug therapy
  • Pneumonia, Aspiration / pathology
  • Random Allocation
  • Rats, Sprague-Dawley

Substances

  • Enzyme Inhibitors
  • Methylene Blue