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Raia L, Zafrani L. Endothelial Activation and Microcirculatory Disorders in Sepsis. Front Med (Lausanne) 2022; 9:907992. [PMID: 35721048 PMCID: PMC9204048 DOI: 10.3389/fmed.2022.907992] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/16/2022] [Indexed: 11/19/2022] Open
Abstract
The vascular endothelium is crucial for the maintenance of vascular homeostasis. Moreover, in sepsis, endothelial cells can acquire new properties and actively participate in the host's response. If endothelial activation is mostly necessary and efficient in eliminating a pathogen, an exaggerated and maladaptive reaction leads to severe microcirculatory damage. The microcirculatory disorders in sepsis are well known to be associated with poor outcome. Better recognition of microcirculatory alteration is therefore essential to identify patients with the worse outcomes and to guide therapeutic interventions. In this review, we will discuss the main features of endothelial activation and dysfunction in sepsis, its assessment at the bedside, and the main advances in microcirculatory resuscitation.
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Affiliation(s)
- Lisa Raia
- Medical Intensive Care Unit, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Lara Zafrani
- Medical Intensive Care Unit, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris, Paris, France
- INSERM UMR 976, University of Paris Cité, Paris, France
- *Correspondence: Lara Zafrani
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Kajitani H, Nishiwaki H, Ueno T, Koiwa F, Iwasaki S, Hirade S. Biopsy-proven Streptococcus suis-associated Infectious Glomerulonephritis. Intern Med 2022; 61:1201-1204. [PMID: 34565773 PMCID: PMC9107994 DOI: 10.2169/internalmedicine.7823-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/16/2021] [Indexed: 11/22/2022] Open
Abstract
A 64-year-old Japanese man who worked at a butcher shop was hospitalized for a fever, headache, and deafness. We diagnosed him with sepsis and meningitis caused by Streptococcus suis infection. The patient's renal function declined rapidly, and hemodialysis was performed temporarily. A renal biopsy was performed, and the renal function tended to improve with antimicrobial therapy. This case seemed rather similar to one of staphylococcal-associated nephritis in that it showed mesangial proliferative nephritis with immunoglobulin A deposition, even though the nephritis was caused by streptococci. Similarly, intramembranous electron-dense deposits were characteristic findings. We present new findings of an in vivo renal biopsy in a case of S. suis-associated glomerulonephritis.
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Affiliation(s)
- Hideto Kajitani
- Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Hiroki Nishiwaki
- Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
- Showa University Research Administration Center (SURAC), Showa University, Japan
- Division of Nephrology and Hypertension, Seirei Yokohama Hospital, Japan
| | | | - Fumihiko Koiwa
- Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Shigeki Iwasaki
- Division of Nephrology and Hypertension, Seirei Yokohama Hospital, Japan
- Division of Nephrology, Yokohama Municipal Citizen's Hospital, Japan
| | - Satoshi Hirade
- Division of Nephrology and Hypertension, Seirei Yokohama Hospital, Japan
- Division of Nephrology and Dialysis, Yokohama Chuo Hospital, Japan
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Barichello T, Generoso JS, Dominguini D, Córneo E, Giridharan VV, Sahrapour TA, Simões LR, Rosa MID, Petronilho F, Ritter C, Sharshar T, Dal-Pizzol F. Postmortem Evidence of Brain Inflammatory Markers and Injury in Septic Patients: A Systematic Review. Crit Care Med 2022; 50:e241-e252. [PMID: 34402457 DOI: 10.1097/ccm.0000000000005307] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Sepsis is a life-threatening organ dysfunction caused by a host's unregulated immune response to eliminate the infection. After hospitalization, sepsis survivors often suffer from long-term impairments in memory, attention, verbal fluency, and executive functioning. To understand the effects of sepsis and the exacerbated peripheral inflammatory response in the brain, we asked the question: What are the findings and inflammatory markers in the brains of deceased sepsis patients? To answer this question, we conducted this systematic review by the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. DATA SOURCES Relevant studies were identified by searching the PubMed/National Library of Medicine, PsycINFO, EMBASE, Bibliographical Index in Spanish in Health Sciences, Latin American and Caribbean Health Sciences Literature, and Web of Science databases for peer-reviewed journal articles published on April 05, 2021. STUDY SELECTION A total of 3,745 articles were included in the primary screening; after omitting duplicate articles, animal models, and reviews, 2,896 articles were selected for the study. These studies were selected based on the title and abstract, and 2,772 articles were still omitted based on the exclusion criteria. DATA EXTRACTION The complete texts of the remaining 124 articles were obtained and thoroughly evaluated for the final screening, and 104 articles were included. DATA SYNTHESIS The postmortem brain had edema, abscess, hemorrhagic and ischemic injuries, infarction, hypoxia, atrophy, hypoplasia, neuronal loss, axonal injuries, demyelination, and necrosis. CONCLUSIONS The mechanisms by which sepsis induces brain dysfunction are likely to include vascular and neuronal lesions, followed by the activation of glial cells and the presence of peripheral immune cells in the brain.
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Affiliation(s)
- Tatiana Barichello
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil
| | - Jaqueline S Generoso
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil
| | - Diogo Dominguini
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil
| | - Emily Córneo
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil
| | - Vijayasree V Giridharan
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Taha A Sahrapour
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Lutiana R Simões
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil
| | - Maria Inês da Rosa
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil
| | - Fabricia Petronilho
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Graduate Program in Health Sciences, Health Sciences Unit, University of South Santa Catarina, Santa Catarina, Brazil
| | - Cristiane Ritter
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil
| | - Tarek Sharshar
- Department of Neurointensive Care and Neuroanesthesia, GHU Paris Psychiatrie et Neuroscience, Paris, France
- Université de Paris, Paris, France
| | - Felipe Dal-Pizzol
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil
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Post-Mortem Investigations for the Diagnosis of Sepsis: A Review of Literature. Diagnostics (Basel) 2020; 10:diagnostics10100849. [PMID: 33092081 PMCID: PMC7590167 DOI: 10.3390/diagnostics10100849] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022] Open
Abstract
To date, sepsis is still one of the most important causes of death due to the difficulties concerning the achievement of a correct diagnosis. As well as in a clinical context, also in a medico-legal setting the diagnosis of sepsis can reveal challenging due to the unspecificity of the signs detected during autopsies, especially when no ante-mortem clinical data, laboratory, and cultural results are available. Thus, a systematic review of literature was performed to provide an overview of the main available and updated forensic tools for the post-mortem diagnosis of sepsis. Moreover, the aim of this review was to evaluate whether a marker or a combination of markers exist, specific enough to allow a correct and definite post-mortem diagnosis. The review was conducted searching in PubMed and Scopus databases, and using variable combinations of the keywords "post mortem sepsis diagnosis", "macroscopic signs", "morphology", "histology", "immunohistochemical markers", "biochemical markers", and "forensic microbiology". The article selection was carried out following specific inclusion and exclusion criteria. A total of 44 works was identified, providing data on morphological aspects of the organs examined, histological findings, immunohistochemical and biochemical markers, and cultural assays. The review findings suggested that the post-mortem diagnosis of sepsis can be achieved by a combination of data obtained from macroscopic and microscopic analysis and microbial investigations, associated with the increased levels of at least two of three biochemical and/or immunohistochemical markers evaluated simultaneously on blood samples.
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Katayama M, Mori T, Hasegawa S, Kanakubo Y, Shimizu A, Hayano S, Hosokawa N, Moody S. New technology meets clinical knowledge: Diagnosing Streptococcus suis meningitis in a 67-year-old man. IDCases 2018; 12:119-120. [PMID: 29942766 PMCID: PMC6010972 DOI: 10.1016/j.idcr.2018.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/03/2018] [Accepted: 04/03/2018] [Indexed: 11/29/2022] Open
Abstract
Strepotocuccus suis (S. suis) infection is known to be caused by the exposure to contaminated animals, specifically pigs and wild boars. This pathogen can cause bacterial meningitis, and one report indicated that it is the most common pathogen causing bacterial meningitis in Vietnam (Mai et al., 2008). A 67-year-old man was diagnosed with S. suis bacteremia and meningitis. In general, identification of this pathogen using standard biochemical methods takes time. We successfully diagnosed S. suis bacteremia in this patient, however, using the relatively new technology called Matrix-Assisted Laser Desorption/Ionization Time-of-Flight mass spectrometry (MALDI-TOF MS). Knowledge of the characteristics of S. suis and this newer technology led to the definitive diagnosis and prompt management of this patient. Herein, we highlight the use of a new technology in the context of sound microbiological knowledge in caring for patients.
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Affiliation(s)
- Mitsuya Katayama
- Department of General Internal Medicine, Kameda Medical Center, Japan
| | - Takahiro Mori
- Department of General Internal Medicine, Eastern Chiba Medical Center, Japan.,Research and Development Center for Health Services, Faculty of Medicine, University of Tsukuba, Japan
| | - Shinya Hasegawa
- Department of General Internal Medicine, Kameda Medical Center, Japan
| | - Yusuke Kanakubo
- Department of General Internal Medicine, Kameda Medical Center, Japan
| | - Akihiko Shimizu
- Department of Infectious Disease, Kameda Medical Center, Japan
| | - Satoshi Hayano
- Department of Infectious Disease, Kameda Medical Center, Japan
| | - Naoto Hosokawa
- Department of Infectious Disease, Kameda Medical Center, Japan
| | - Sandra Moody
- Department of General Internal Medicine, Kameda Medical Center, Japan
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Kong D, Chen Z, Wang J, Lv Q, Jiang H, Zheng Y, Xu M, Zhou X, Hao H, Jiang Y. Interaction of factor H-binding protein of Streptococcus suis with globotriaosylceramide promotes the development of meningitis. Virulence 2017; 8:1290-1302. [PMID: 28402705 DOI: 10.1080/21505594.2017.1317426] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Streptococcus suis is an important emerging zoonotic agent that causes acute bacterial meningitis in humans with high mortality and morbidity. Our previous work showed that factor H-binding protein (Fhb) contributed to virulence of S. suis, but the role of Fhb in the development of S. suis meningitis remained unclear. In this study, we demonstrated for the first time that Fhb contributed to the traversal of S. suis across the human blood-brain barrier by allelic-exchange mutagenesis, complementation and specific antibody blocking studies. We also showed that globotriaosylceramide (Gb3), the receptor of Fhb, was involved in this process and affected S. suis infection-induced activation of myosin light chain 2 through Rho/ROCK signaling in hCMEC/D3 cells. Using a murine model of S. suis meningitis, we further demonstrated that Gb3-deficiency prevented the mice from developing severe brain inflammation or injury. Our results demonstrate that the Fhb-Gb3 interaction plays an important role in the development of S. suis meningitis and might be a potential therapeutic target against S. suis infection.
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Affiliation(s)
- Decong Kong
- a State Key Laboratory of Pathogen and Biosecurity , Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences , Beijing , China
| | - Zhe Chen
- a State Key Laboratory of Pathogen and Biosecurity , Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences , Beijing , China.,b College of Biological Science & Technology , Shenyang Agricultural University , Shenyang , China
| | - Junping Wang
- a State Key Laboratory of Pathogen and Biosecurity , Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences , Beijing , China.,d Urumqi Ethnic Cadres' College , Urumqi , China
| | - Qingyu Lv
- a State Key Laboratory of Pathogen and Biosecurity , Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences , Beijing , China
| | - Hua Jiang
- a State Key Laboratory of Pathogen and Biosecurity , Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences , Beijing , China
| | - Yuling Zheng
- a State Key Laboratory of Pathogen and Biosecurity , Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences , Beijing , China
| | - Maokai Xu
- a State Key Laboratory of Pathogen and Biosecurity , Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences , Beijing , China
| | - Xuyu Zhou
- c CAS Key Laboratory of Pathogenic Microbiology and Immunology , Institute of Microbiology, Chinese Academy of Sciences , Beijing , China
| | - Huaijie Hao
- c CAS Key Laboratory of Pathogenic Microbiology and Immunology , Institute of Microbiology, Chinese Academy of Sciences , Beijing , China
| | - Yongqiang Jiang
- a State Key Laboratory of Pathogen and Biosecurity , Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences , Beijing , China
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Hanterdsith B, Tharavichitkul P, Mahanupab P, Raksamat W. Postmortem diagnosis of sudden unexpected death from Streptococcus suis type 2 infection: a case report. J Forensic Leg Med 2012; 20:347-9. [PMID: 23622489 DOI: 10.1016/j.jflm.2012.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 07/12/2012] [Accepted: 09/02/2012] [Indexed: 11/16/2022]
Abstract
Streptococcus suis causes meningitis, septicemia, arthritis, endocarditis and death in both pigs and humans. Sudden death is rarely documented in the forensic field and almost all cases were diagnosed pre-mortem. Here we report a 49-year-old man who died from S. suis type 2 infection. S. suis was identified as the causative pathogen using bacterial culture, standard biochemical and coagglutination tests, specific DNA amplification by polymerase chain reaction, and histopathologic examination. We discuss the postmortem investigation of a suspected S. suis infection.
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Affiliation(s)
- Boonsak Hanterdsith
- Department of Emergency Medicine and Forensic Medicine, Maharaj Nakhonratsima Hospital, Thailand.
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Liu M, Tan C, Fang L, Xiao S, Chen H. Microarray analyses of THP-1 cells infected with Streptococcus suis serotype 2. Vet Microbiol 2010; 150:126-31. [PMID: 21255946 DOI: 10.1016/j.vetmic.2010.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 11/12/2010] [Accepted: 12/07/2010] [Indexed: 01/18/2023]
Abstract
Streptococcus suis serotype 2 (S. suis 2) is a pathogen responsible for several diseases in both pigs and humans. To gain more insight into the pathogenesis of this organism, an oligonucleotide (oligo)-based microarray was used to investigate gene expression changes in human monocytic cells (THP-1) in response to exposure to S. suis 2 strain SC19. A total of 328 differentially expressed genes were identified. These differentially expressed genes belonged to a variety of functional categories, including genes involved in apoptosis, immunity, signal transduction, chemokine production and the ubiquitin-proteasome system. Our findings can be of interest for future research.
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Affiliation(s)
- Manli Liu
- Division of Animal Pathogens, State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan 430070, PR China
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Streptococcus suis Infections in Humans: What is the prognosis for Western countries? (Part I). ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.clinmicnews.2010.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Gottschalk M, Xu J, Calzas C, Segura M. Streptococcus suis: a new emerging or an old neglected zoonotic pathogen? Future Microbiol 2010; 5:371-91. [DOI: 10.2217/fmb.10.2] [Citation(s) in RCA: 318] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Infections caused by Streptococcus suis are considered a global and an economical problem in the swine industry. Moreover, S. suis is an agent of zoonosis that afflicts people in close contact with infected pigs or pork-derived products. Although sporadic cases of S. suis infections in humans (mainly meningitis) have been reported during the last 40 years, a large outbreak due to this pathogen emerged in the summer of 2005 in China. The severity of the infection in humans during the outbreak, such as a shorter incubation time, more rapid disease progression and higher rate of mortality, attracted a lot of attention from the scientific community and the general press. In fact, the number of publications on S. suis (including the number of reported human cases) has significantly increased during recent years. In this article we critically review the present knowledge on S. suis infection in humans, we discuss the hypotheses that may explain the 2005 outbreak and the repercussion of such an episode on the scientific community.
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Affiliation(s)
- Marcelo Gottschalk
- Streptococcus suis Research Laboratory & International Reference Laboratory for S. suis Serotyping, Faculté de Médecine Vétérinaire, Département de Pathologie et Microbiologie, Université de Montréal, CP 5000, St-Hyacinthe, Québec, Canada
| | - Jianguo Xu
- State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Diseases Control and Prevention, 155 Changbai Road, Changping Disrict, Beijing 102206, People’s Republic of China
| | - Cynthia Calzas
- Laboratory of Immunology & Streptococcus suis Research Laboratory, Faculté de Médecine Vétérinaire, Département de Pathologie et Microbiologie, Université de Montréal, CP 5000, St-Hyacinthe, Québec, Canada
| | - Mariela Segura
- Laboratory of Immunology, Faculté de Médecine Vétérinaire, Département de Pathologie et Microbiologie, Université de Montréal, CP 5000, St-Hyacinthe, Québec, Canada
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