Ketamine Promotes LPS-Induced Pulmonary Autophagy and Reduces Apoptosis through the AMPK/mTOR Pathway

To explore the protective effect of ketamine on acute lung injury (ALI) in sepsis mice regarding the autophagy and apoptosis, lipopolysaccharide (LPS) was used to construct a sepsis-induced ALI model. In in vivo experiments, ketamine at a concentration of 20 mg/kg was injected before modeling. The serum levels of inflammatory factors IL-1β, IL-6, and TNF-α were detected by enzyme-linked immunosorbent assay (ELISA) kit. At the same time, quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect apoptosis-related factors Bax and Bcl-2 and autophagy-related factors Beclin-1 and P62. In in vitro experiment, firstly, Cell Counting Kit-8 (CCK8) assay was used to detect the cell viability and identify optimal concentration of ketamine. TUNEL staining, Western blotting (WB), and qRT-PCR were used to detect alveolar type II epithelial cells (AEC II) AEC II cell apoptosis. The content of inflammatory factors in the cell supernatant was detected by kits and the autophagy intensity of AEC II cells was detected by PCR and WB. At the same time, the expression changes of AMPK/mTOR pathway were detected by WB technology. Compared with the Sham group, the dry-wet ratio of the lung tissue in the LPS group was obviously increased, the expression of inflammatory factors in the serum was upregulated, and apoptosis and autophagy activation occurred. In the LPS + ketamine group, ketamine significantly promoted autophagy intensity and inhibited inflammatory response, thereby reducing apoptosis. In vitro, 1 mmol/L ketamine can effectively improve the viability of AEC II cells after LPS treatment, promote autophagy, and decrease cell apoptosis. And we found that the above-mentioned effect of ketamine was by regulating the activation of AMPK/mTOR pathway. In this study, we demonstrated that LPS treatment can induce inflammation and autophagy and induce apoptosis in lung cells. In contrast, AMPK expression was activated after ketamine treatment, inhibiting the mTOR pathway and promoting autophagy, thereby alleviating the apoptosis of AEC II cells.