Influence of mast cells on leukocyte-independent plasma extravasation during endotoxemia

5-HT2a receptor antagonism reduces burn-induced macromolecular efflux in rats

BACKGROUND

Major thermal injuries lead to a systemic inflammatory response with systemic capillary leakage and multiple organ dysfunction. This systemic inflammatory response is induced by a variety of immunmodulative molecules including TNFα and serotonin. Unspecific serotonin antagonism leads to reduced macromolecular efflux in rat mesenteries after burn plasma transfer. The aim of the present study was to evaluate the effect of specific 5-HT2a antagonism on early burn edema.

METHODS

Donor rats (DR) underwent thermal injury (100 °C water, 30% BSA, 12 s) for positive controls. For negative controls, DR underwent sham burn (37 °C water, 30% BSA, 12 s). DR plasma (harvested 4 h post-trauma) was transferred to healthy individuals for positive controls. Study rats received burn plasma (BP) and a Bolus injection of Ketanserin (Ket) (1 mg kg(-1) body weight). Negative controls underwent sham burn plasma infusion. Intravital microscopy was performed in mesenteric venules (0/60/120 min). Edema was assessed by FITC-albumin extravasation. Additionally, leukocyte rolling and sticking (cells mm(-2)) as well as microhemodynamic parameters were assessed.

RESULTS

Significant systemic capillary leakage was observed after BP transfer at 120 min and additional administration of Ket attenuated the postburn edema to sham burn levels. Ket also leads to significantly decreased leukocyte-endothelial interactions when compared to positive controls.

CONCLUSION

5-HT2a antagonism reduces plasma extravasation after burn plasma transfer in healthy individuals. The influence of leukocyte-endothelial interactions on postburn edema remains unclear.

Effects of activated protein C on post cardiac arrest microcirculation: an in vivo microscopy study

BACKGROUND

The clinical symptoms and pathophysiologic mechanisms during and after ischaemia-reperfusion following cardiac arrest (CA) and successful cardiopulmonary resuscitation (CPR) closely resemble those observed in patients with severe sepsis. Impairment of microcirculation and endothelial leakage seem to play key roles in the underlying pathophysiology. Recombinant human activated protein C (rhAPC) is the first drug being licensed for the treatment of severe sepsis in patients. Therefore, for the first time, we investigated effects of rhAPC on microhaemodynamic changes and endothelial leakage applying in vivo microscopy of postcapillary mesenteric venules after CA and CPR in rats.

METHODS

After 6 min of CA, male Wistar rats were randomised into two groups (n=10) to receive rhAPC or placebo (0.9% NaCl). Sham-operated animals (n=10) served as non-ischaemic controls. At 360, 420, and 480 min after CA in vivo microscopy was performed to assess wall shear rate (WSR) and plasma extravasation (PE).

RESULTS

Both treatment groups showed typical signs of impaired microcirculation and a severe endothelial leakage after CA at all time points studied when compared to the sham group. However, no significant differences between the treatment groups were observed with regard to WSR and PE.

CONCLUSION

Our results show that CA with consecutive successful CPR leads to a microcirculatory impairment closely resembling experimentally induced sepsis. Intriguingly, despite these similarities, rhAPC had no significant effects on WSR and PE. Our results strongly suggest that further mechanisms such as mast cell activation might play an important role and have therefore to be studied to elucidate the pathophysiology of "postresuscitation disease".

Influence of serotonin-receptor antagonism on mast cell activation during endotoxemia

INTRODUCTION: Mast cells have been implicated in the aetiology of many diseases and are particularly important in evoking leukocyte-endothelial interactions during endotoxemia. Mast cell activity can be modified by histamine. There are only little data available whether serotonin (5-HT), another amine, is involved in alterations of mast cell activity, too. The aim of the study was to investigate the effects of the 5-HT-receptor antagonists methysergide (5-HT(1/2/7)-receptor antagonist), and ketanserin (5-HT(2A)-receptor antagonist) on mesenteric mast cell activation during endotoxemia. MATERIALS AND METHODS: In male Wistar rats, mast cell activity was determined in the mesentery using intravital microscopy. Rats were randomised in four groups of 12 animals each. Animals underwent laparotomy and the mesentery was exposed beneath an in-vivo videomicroscope. After baseline measurment endotoxemia was induced by continuous intravenous infusion of 2 mg/kg/h endotoxin (ETX group). Animals in the ETX/5-HT(1/2)-ANT group received methysergide (1 mg/kg body weight), animals in the ETX/5-HT(2A)-ANT group received ketanserin (1 mg/kg body weight) additionally prior to laparotomy and to the procedure described above. Animals in saline group served as controls and received equivalent volumes of NaCl 0.9%. Activated mast cells were stained by superfusion of the mesentery with ruthenium red. RESULTS: The relative mast cell activity to baseline value increased significantly in all groups. Values of the ETX-group versus the ETX/5-HT(1/2)-ANT group, the ETX/5-HT(2A)-ANT group, and the saline group were significantly higher at 120 min. CONCLUSIONS: Serotonin receptor antagonism using the 5-HT(1/2/7)-receptor antagonist methysergide or the 5-HT(2A)-receptor antagonist ketanserin reduces endotoxin-induced mast cell activation in-vivo, most probably via the 5-HT(2A)-receptor subtype.