Reduced erythrocyte deformability related to activated lipid peroxidation during the early postburn period

Metabolic Influences Modulating Erythrocyte Deformability and Eryptosis

Many factors in the surrounding environment have been reported to influence erythrocyte deformability. It is likely that some influences represent reversible changes in erythrocyte rigidity that may be involved in physiological regulation, while others represent the early stages of eryptosis, i.e., the red cell self-programmed death. For example, erythrocyte rigidification during exercise is probably a reversible physiological mechanism, while the alterations of red blood cells (RBCs) observed in pathological conditions (inflammation, type 2 diabetes, and sickle-cell disease) are more likely to lead to eryptosis. The splenic clearance of rigid erythrocytes is the major regulator of RBC deformability. The physicochemical characteristics of the surrounding environment (thermal injury, pH, osmolality, oxidative stress, and plasma protein profile) also play a major role. However, there are many other factors that influence RBC deformability and eryptosis. In this comprehensive review, we discuss the various elements and circulating molecules that might influence RBCs and modify their deformability: purinergic signaling, gasotransmitters such as nitric oxide (NO), divalent cations (magnesium, zinc, and Fe2+), lactate, ketone bodies, blood lipids, and several circulating hormones. Meal composition (caloric and carbohydrate intake) also modifies RBC deformability. Therefore, RBC deformability appears to be under the influence of many factors. This suggests that several homeostatic regulatory loops adapt the red cell rigidity to the physiological conditions in order to cope with the need for oxygen or fuel delivery to tissues. Furthermore, many conditions appear to irreversibly damage red cells, resulting in their destruction and removal from the blood. These two categories of modifications to erythrocyte deformability should thus be differentiated.

Blood rheology as a mirror of endocrine and metabolic homeostasis in health and disease1

Rheological properties of plasma and blood cells are markedly influenced by the surrounding milieu: physicochemical factors, metabolism and hormones. Acid/base status, osmolality, lipid status, plasma protein pattern, oxidative stress induced by increased free radicals production, endothelium-derived factors such as nitric oxide (NO), achidonic acid derivatives modulate both red blood cell (RBC) and white cell mechanics. Therefore, regulatory axes involving liver, endothelium, kidney, pancreas, adrenal gland, endocrine heart, adipose tissue, pituitary gland, and surely other tissues play important roles in the regulation of blood fluidity. A comprehensive picture of all this complex network of regulatory loops is still unavailable but current progress of knowledge suggest that some attempts can currently be made.

Hemorheological effects of secoisolariciresinol in ovariectomized rats

BACKGROUND

Postmenopausal women often develop hemorheological disorders which may affect the systemic blood circulation and present a cardiovascular risk factor.

OBJECTIVE

We evaluated effects of secoisolariciresinol (SECO), a phytoestrogen, on hemorheological parameters and lipid peroxidation in a model of the age-related and/or surgical menopause induced by ovariectomy in rats.

METHODS

Arterial blood was sampled from sham-operated female rats, ovariectomized rats (OVX), and OVX treated with SECO (OVXSECO) (20 mg/kg/day intragastrically for two weeks). Plasma estrogen concentration and the following hemorheological parameters were measured: RBC aggregation (half-time of aggregation, T1/2; amplitude of aggregation, AMP; aggregation index, AI), RBC deformability (elongation index, EI), whole blood viscosity at the shear rate of 3-300 s-1, plasma viscosity, hematocrit, plasma fibrinogen. Lipid peroxidation was evaluated by measuring conjugated dienes (CD) and thiobarbituric acid reactive substances (TBARS) in plasma.

RESULTS

Ovariectomy in rats caused a 60% decrease in plasma estrogen level and triggered the development of macro- and microhemorheological abnormalities. Blood viscosity increased by 12-31%, RBC elongation index reduced by 16-28%, and T1/2 and AI increased by 35% and 29% respectively. The increase in blood viscosity correlated predominantly with reduced RBC deformability. Plasma CD and TBARS were elevated by 47% and 104% respectively. SECO therapy for OVX rats reduced blood viscosity by 9-18% and T1/2 by 32%, and increased EI by 4-17%. SECO therapy disrupted the correlation between blood viscosity and RBC deformability. Lipid peroxidation was significantly inhibited, as shown by the reduction in CD and TBARS plasma concentrations by 89% and 70% respectively. SECO did not affect plasma viscosity, estrogen or fibrinogen levels.

CONCLUSIONS

SECO treatment for OVX rats improves blood macro- and microrheological parameters, possibly through antioxidant protection of RBC.

Evaluation of plasma oxidative stress, with or without antioxidant supplementation, in superficial partial thickness burn patients: a pilot study

BACKGROUND

Oxidative stress is one of the main causes of pathophysiological alterations observed during burn injury. The present pilot study aimed to determine whether a specific oral antioxidant supplementation could in any way influence free radical blood values in patients affected by superficial partial thickness burns.

MATERIALS AND METHODS

Plasma oxidants and plasma antioxidant capacity were analysed in 20 superficial partial thickness burn patients for a 2-week period; patients were randomly divided into two groups, one of which was supported with a specifically designed oral antioxidant formula (Squalene 100 mg, Vitamin C 30 mg, Coenzyme Q10 10 mg, Zinc 5 mg, Beta Carotene 3.6 mg, Bioflavonoids 30 mg, Selenium 55 mcg) administered daily, starting from the day of admission, for the whole study period.

RESULTS

No significant differences were found in plasma oxidants and plasma antioxidant capacity between the two groups of patients.

CONCLUSIONS

These results did not reflect any significant benefits of an antioxidant oral supplementation at usual dosages when considering oxidative plasmatic values of superficial partial thickness burn patients.

Micronutrients after burn injury: a review

Supplementation of micronutrients after burn injury is common practice in order to fight oxidative stress, support the immune system, and optimize wound healing. Assessing micronutrient status after burn injury is difficult because of hemodilution in the resuscitation phase, redistribution of nutrients from the serum to other organs, and decreases in carrier proteins such as albumin. Although there are many preclinical data, there are limited studies in burn patients. Promising research is being conducted on combinations of micronutrients, especially via the intravenous route.

Melatonin protection against burn-induced liver injury. A review

Severe thermal injury may be complicated by dysfunction of organs distant from the original burn wound, including the liver, and represents a serious clinical problem. Although pathophysiology of burn-induced liver injury remains unclear, increasing evidence implicate activation of inflammatory response, oxidative stress, endothelial dysfunction and microcirculatory disorders as the main mechanisms of hepatic injury. Several studies suggest melatonin as a multifunctional indolamine that counteracts some of the pathophysiologic steps and displays significant beneficial effects against burn-induced cellular injury. This review summarizes the role of melatonin in restricting the burn-induced hepatic injury and focuses on its effects on oxidative stress, inflammatory response, endothelial dysfunction and microcirculatory disorders as well as on signaling pathways such as regulation of nuclear erythroid 2-related factor 2 (Nrf2) and nuclear factor-kappaB (NF-kB). Further studies are necessary to elucidate the modulating effect of melatonin on the transcription factor responsible for the regulation of the pro-inflammatory and antioxidant genes involved in burn injuries.

Pathophysiology of perioperative anaemia

Perioperative anaemia is a common clinical entity. It is usually due to combination of various mechanisms, including: pre-existing anaemia prior to surgery; anaemia due to impaired erythropoiesis, including alterations of metabolism of iron and erythropoietin (EPO); anaemia due to increased destruction of red blood cells (RBCs); and anaemia due to iatrogenic causes. Postoperatively, anaemia resembles anaemia of chronic disease and is probably related to the effects of inflammatory mediators released during and after surgery on the production and survival of RBCs. Pro-inflammatory cytokines, such as tumour necrosis factor, impair erythropoietin-dependent signalling and iron homeostasis. Iatrogenic causes, notably excessive phlebotomies, remain a major cause of perioperative anaemia. With increasing emphasis on restrictive blood transfusion strategies, understanding these mechanisms is important for the clinician.

Ulinastatin suppresses burn-induced lipid peroxidation and reduces fluid requirements in a Swine model

Objective. Lipid peroxidation plays a critical role in burn-induced plasma leakage, and ulinastatin has been reported to reduce lipid peroxidation in various models. This study aims to examine whether ulinastatin reduces fluid requirements through inhibition of lipid peroxidation in a swine burn model. Methods. Forty miniature swine were subjected to 40% TBSA burns and were randomly allocated to the following four groups: immediate lactated Ringer's resuscitation (ILR), immediate LR containing ulinastatin (ILR/ULI), delayed LR resuscitation (DLR), and delayed LR containing ulinastatin (DLR/ULI). Hemodynamic variables, net fluid accumulation, and plasma thiobarbituric acid reactive substances (TBARS) concentrations were measured. Heart, liver, lung, skeletal muscle, and ileum were harvested at 48 hours after burn for evaluation of TBARS concentrations, activities of antioxidant enzymes, and tissue water content. Results. Ulinastatin significantly reduced pulmonary vascular permeability index (PVPI) and extravascular lung water index (ELWI), net fluid accumulation, and water content of heart, lung, and ileum in both immediate or delayed resuscitation groups. Furthermore, ulinastatin infusion significantly reduced plasma and tissue concentrations of TBARS in both immediate or delayed resuscitation groups. Conclusions. These results indicate that ulinastatin can reduce fluid requirements through inhibition of lipid peroxidation.

Propagation of cutaneous thermal injury: a mathematical model

Cutaneous burn wounds represent a significant public health problem with 500,000 patients per year in the USA seeking medical attention. Immediately after skin burn injury, the volume of the wound burn expands due to a cascade of chemical reactions, including lipid peroxidation chain reactions. Such expansion threatens life and is therefore highly clinically significant. Based on these chemical reactions, the present paper develops for the first time a three-dimensional mathematical model to quantify the propagation of tissue damage within 12 hours post initial burn. We use the model to investigate the effect of supplemental antioxidant vitamin E for intercepting propagation. We show, for example, that if tissue levels of vitamin E tocotrienol are increased, postburn, by five times then this would slow down the lipid peroxide propagation by at least 50%. We chose the alpha-tocotrienol form of vitamin E as it is a potent inhibitor of 12-lipoxygenase, which is known to propagate oxidative lipid damage. Our model is formulated in terms of differential equations, and sensitivity analysis is performed on the parameters to ensure the robustness of the results.

Effect of melatonin on burn-induced gastric mucosal injury in rats

We studied the effect of melatonin treatment on gastric mucosal damage induced by experimental burns and its possible relation to changes in gastric lipid peroxidation status. Melatonin was intraperitoneally applied immediately after third-degree burns over 30% of total body skin surface area of rats. Malondialdehyde (MDA), uric acid (UA) and sulphydril (SH) levels were determined in gastric mucosa and blood plasma and used as biomarkers of the oxidative stress. The results showed that the skin burn caused oxidative stress evidenced by accumulation of MDA and UA as well as the depletion of SHs in gastric mucosa. Plasma MDA concentrations were elevated, while plasma SH concentrations were decreased after burns. Melatonin (10 mg per kg body weight) protected gastric mucosa from oxidative damage by suppressing lipid peroxidation and activating the antioxidant defence. It may be hypothesised that melatonin restores the redox balance in the gastric mucosa and protects it from burn-induced oxidative injury. Melatonin has no significant influence on the concentrations of plasma MDA and antioxidants after burn; therefore, it should largely be considered as a limiting factor for tissue-damage.

Alterations of red blood cell shape in patients with severe trauma

BACKGROUND

Trauma is accompanied by a decrease in red blood cell (RBC) deformability, which may manifest itself earlier than secondary septic complications. The mechanisms of this phenomenon are not clear. The aim of this study is to determine when the alterations of RBC shape appear in trauma patients.

METHODS

RBC shape was examined by scanning electron microscopy in 43 patients with multisystem trauma. Blood samples were taken at admission and every 24 hours afterward for 4 to 10 days. The patients were divided into two groups: the survivors and those who died of septic complications. The control group consisted of 10 healthy volunteers.

RESULTS

A significant decrease in the percentage of discoid erythrocytes, compared with the volunteers, was observed in both groups of patients at admission (77.6 +/- 11.9 and 66.7 +/- 5.8 vs. 96.0 +/- 2.9%, p < 0.01). The percentage of irreversibly changed RBC (spherostomatocytes, spherocytes) was lower in survivors (12.9 +/- 2.0% vs. 20.3 +/- 9.4%, p < 0.01). This phenomenon remained constant until the end of the study. The survivors only showed a tendency toward the improvement of RBC shape.

CONCLUSION

RBC shape alterations appear within the first hours after trauma and persist for at least 7 to 10 days. These changes are more severe in patients with secondary septic complications.

Caffeic Acid Phenethyl Ester Improves Oxidative Erythrocyte Damage in a Rat Model of Thermal Injury

Oxygen-derived free radicals impair cell membrane functions and induce circulatory disturbances, and free radicals, such as superoxide anion, hydrogen peroxide, hydroxyl radicals, and peroxynitrite, have been suggested to play important roles in the pathogenesis of major burn injuries. The present study investigated the effects of thermal injury on erythrocyte lipid peroxidation and antioxidant status and investigated the effects of caffeic acid phenethyl ester (CAPE), a new antioxidant and anti-inflammatory agent, in rats subjected to thermal injury. Burn injury caused a remarkable increase in erythrocyte lipid peroxidation, levels of nitric oxide (NO), and activities of antioxidant enzymes and xanthine oxidase (XO). The treatment with CAPE decreased both activity of burn-induced XO activity and levels of NO in the erythrocytes. In conclusion, CAPE treatment resulted in decreased erythrocyte lipid peroxidation in thermal injury and helped to prevent oxidative damage by decreasing activity of XO and levels of NO.

Red blood cell physiology in critical illness

OBJECTIVE

Reduction in red blood cell mass, as well as structural and functional alterations of erythrocytes, occurs in critical illness. This review discusses these changes in red blood cell physiology, emphasizing the pathogenesis of anemia in intensive care unit patients.

DATA SOURCE

Studies published in biomedical journals.

DATA SYNTHESIS AND CONCLUSION

Anemia in intensive care unit patients resembles the anemia of chronic disease, being characterized by diminished erythropoietin production relative to decreased hematocrit, altered iron metabolism, and impaired proliferation and differentiation of erythroid progenitors in the bone marrow. Inflammatory mediators play a major role in the development of insufficient erythropoiesis and altered iron metabolism. Furthermore, a proinflammatory milieu promotes structural and functional alterations of erythrocytes, impairing their deformability and possibly impairing microvascular perfusion. Collectively, these changes in red blood cell physiology can impair oxygen transport to tissues and, thereby, might contribute to the development of multiple organ failure in critical illness.

Burn-induced red blood cell deformability and shape changes are modulated by sex hormones

BACKGROUND

Burns are known to cause changes in red blood cell (RBC) deformability and resting shape. However, it is unclear whether sex and sex hormones can influence the severity of these alterations.

METHODS

Red blood cell deformability and shape were examined in proestrus and diestrus female rats, ovariectomized female rats, as well as castrated and non-castrated male rats (6 animals per group) subjected to scald burn. Red blood cell deformability was measured by laser ektacytometry and erythrocyte shape was evaluated by scanning electron microscopy.

RESULTS

Burn-induced RBC deformability changes (decrease in elongation index) and shape alterations (increase in the percentage of reversibly and irreversibly changed cells) were less severe in proestrus females than in diestrus females or males. Ovariectomized rats demonstrated more severe RBC changes than non-ovariectomized ones. The degree of RBC damage was the same in castrated and non-castrated males.

CONCLUSIONS

Removal of female sex hormones increases the severity of burn-induced RBC, indicating that female sex hormones protect against burn-induced RBC dysfunction. In contrast, male sex hormones do not appear to modulate burn-induced RBC dysfunction.

Dissociation between gene expression and protein contents of tissue superoxide dismutase in a rat model of lethal burns

The aim of this study was to examine the changes in the tissue Cu/Zn- and the Mn-SOD contents and gene expression following mild and severe burns in a rodent burn model. Thirty-eight male Wistar rats, weighing 208-278g, were divided into a sham burn group and two burn groups, with one receiving burns to 35% of the body surface and the other to 60%. Twenty animals of the burn groups were monitored daily for 7 days after injuries to examine survival. Six animals in the sham, 35 or 60% burn group were sacrificed at 3h postburn, and the blood, lungs and kidneys were collected for a biological analysis. The Cu/Zn- and Mn-SOD contents of the tissue and plasma specimens were measured using ELISA. The mRNA expressions of Cu/Zn- and Mn-SOD were determined by a Northern blot analysis. The survival rate of the 60% burn group for 7 days was 30%, whereas the survival rate of the 35% burn group was 100%. The mRNA expressions of Mn-SODs in the lung and the kidney were significantly higher in the 60% burn group than in 35% burn or sham burn group, as was the mRNA expression of lung Cu/Zn-SOD. Nevertheless, the tissue SOD contents in the 60% burn group (mortality 70%) did not exceed those in the 35% group. Based on these findings, tissue SOD synthesis is thus suggested to be inhibited in lethal burns in spite of a strong mRNA expression of SOD.

Effect of trauma-hemorrhagic shock on red blood cell deformability and shape

Previous work in our laboratory has demonstrated a decrease in red blood cell (RBC) deformability in sepsis. This has not been studied following hemorrhagic shock. We tested the hypotheses that hemorrhagic shock, associated with soft tissue trauma, leads to decreased RBC deformability and that this is related to alterations in the resting shape of the RBC. Elongation index (EI), a measure of RBC deformability, was determined over a range of shear stresses from 0.3 to 30 Pa in 26 male rats before and at various times after 90 min of hemorrhagic shock. RBC resting shape was determined by scanning electron microscopy. The data demonstrate that EI decreased significantly at the end of shock (before resuscitation), and remained below normal throughout the 6-h postshock period. Eight of the 26 animals decompensated during shock, requiring return of a portion of the shed blood to maintain a mean arterial pressure of 30-40 mmHg. Four of eight decompensated animals died before the end of the study period, compared with none of the compensated rats. The decompensated rats had significantly lower EI at 0.3 Pa by the end of the shock period (0.050 +/- 0.009) than the compensated shock group (0.058 +/- 0.006; P < 0.05). RBC shape alterations were first demonstrated at the end of the shock period and persisted throughout the 6-h postshock resuscitation period. These data indicate that trauma and hemorrhagic shock cause RBC shape alterations and a significant decrease in RBC deformability, which becomes manifested during the shock period and persists for at least 6 h postshock. Additionally, a direct relationship appears to exist between the magnitude of the physiologic insult and the degree of RBC damage.

Beneficial effects of intraperitoneally administered alpha-tocopheryl acetate on the levels of lipid peroxide and activity of glutathione peroxidase and superoxide dismutase in skin, blood and liver of thermally injured guinea pigs

The aim of this study was to investigate the effects of intraperitoneal alpha-tocopheryl acetate administration on concentration of lipid peroxide (as malonyldialdehyde, MDA), reduced glutathione (GSH), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in plasma, red blood cells (RBC), skin and liver of thermally injured guinea pigs. MDA levels in the plasma, skin and liver were increased at the 15th min after the thermal injury compared to the control group. However, they were significantly lower in the alpha-tocopheryl-acetate-treated groups than both control and thermally injured groups from the 15th min to the 6th day. SOD activity of the skin and RBC and vitamin E levels in the plasma were significantly decreased between the 15th min and 6th day and then both parameters, i.e. SOD and vitamin E, were significantly increased by alpha-tocopheryl acetate administration. GSH-Px activity in the skin was also significantly decreased in groups from the 15th min to the 6th day, whereas it remained unchanged by the alpha-tocopheryl acetate administration. On the other hand, GSH-Px activity and GSH levels in the RBC remained the same during both thermal injury and alpha-tocopheryl acetate administration. In conclusion, we observed that the intraperitoneal administration of alpha-tocopheryl acetate protects the skin against thermal injury, which suggests that it may be due to the upregulation of enzymatic antioxidants.

Protective effect of quercetin against cigarette tar extract-induced impairment of erythrocyte deformability

Quercetin (3,3',4',5,7-pentahydroxyflavone) is one of the most abundant flavonol-type flavonoids rich in diet and suggested to possess a beneficial role in blood circulation. This study was conducted to know the effect of quercetin aglycone and one of its possible metabolite, quercetin-3-O-beta-D-glucuronide on cigarette tar extract-induced impairment of erythrocyte deformability. Erythrocyte suspension containing quercetin aglycone, quercetin-3-O-beta-D-glucuronide or quercetin-3-O-beta-D-glucoside was forced to flow through microchannels with equivalent diameter of 7 &mgr;m and its transit time was measured as an index of erythrocyte deformability using microchannel array method. Both quercetin aglycone and quercetin-3-O-beta-D-glucuronide, but not quercetin-3-O-beta-D-glucoside, substantially increased erythrocyte deformability indicating that the former two compounds affect the physicochemical state of erythrocyte by interacting with its membranes. Aqueous cigarette tar extract caused marked decrease in erythrocyte deformability with concomitant increase of membranous lipid peroxidation. In that case, quercetin aglycone suppressed the impairment of erythrocyte deformability as well as membranous lipid peroxidation. The same effect was found in quercetin-3-O-beta-D-glucuronide, eventhough its effect was lower than that of quercetin aglycone. Thus, not only quercetin aglycone but also its conjugate metabolite protects erythrocyte membrane from the damage of smoking by scavenging reactive oxygen species generated from cigarette tar. Intake of quercetin-rich food may be helpful to protect membranous damage in erythrocytes from smoking.

Characteristics of plasma extracellular SOD in burned patients

The aim of this study was to examine three types of superoxide dismutase (SOD) in plasma after burns, and especially to clarify the characteristics of plasma extracellular SOD (EC-SOD) in burned patients. A total of 71 blood samples were collected from 18 patients on arrival, day 1, day 3 and day 5 after burns. We measured three types of SOD (Mn, Cu/Zn, EC) in plasma using ELISA, and the relationships among the three types of SOD concentrations were examined. We next analyzed the characteristics of plasma EC-SOD using stepwise multivariate regression analysis. Any plasma SOD isoenzyme concentration measured after burns was beyond the normal range and EC-SOD accounted for the major part of plasma SODs. EC-SOD and Cu/Zn-SOD were positively correlated, whereas Mn-SOD was not related to the other SODs. Also, plasma EC-SOD was significantly related to existence of inhalation injury, %TBSA and age, respectively. The plasma EC-SOD might therefore play some roles in the pathophysiology of burned patients.

Changes in the tissue and plasma superoxide dismutase (SOD) levels in a burned rat model

To examine whether thermal injury alters the superoxide dismutase (SOD) concentrations in various types of tissue or plasma, we studied the plasma and tissue Mn- and Cu/Zn-SOD levels in a rodent burn model. The animals were resuscitated with saline (50 mg/kg, i.p.) immediately following thermal injury and thereafter were sacrificed at either 6 or 24 hours post-burn. The Mn- and Cu/Zn-SOD levels were measured using an enzyme-linked immunosorbent assay (ELISA). The plasma Mn- and Cu/Zn-SOD concentrations significantly increased 6 hours after the injury and positively correlated with the burn size. The kidney Mn-SOD concentrations were significantly higher 24 hours after the injury in the animals with 30% burns than in those with either sham or 50% burn injuries. The lung Cu/Zn-SOD concentrations were also significantly higher 6 hours after the injury in animals with 30% burns than in the other two types above. These findings suggest that the changes in the SOD concentrations after burn injury vary according to the type of SOD and also the type of tissue. As a result, the SOD concentrations may play some role in the early response to thermal trauma.

Generation of peroxynitrite in localised, moderate temperature burns

Simultaneous generation of nitric oxide (NO*) and superoxide (O2-) can lead to the formation of peroxynitrite (ONOO-), a potent oxidant that has been implicated in the pathogenesis of a number of disease states. This study was designed to investigate the possible generation of ONOO- in local cutaneous tissues following thermal injury. Male Wistar rats were anaesthetised in a nonrecovery procedure and subjected to a small (1 cm diameter), abdominal burn of moderate temperature (50 degrees C, 5-15 min). At either the 60 or 180 min time point postburn the animals were killed, and skin sites were removed and homogenised. An ELISA was used to quantify protein bound 3-nitrotyrosine (3NT), a biomarker for ONOO- in the rat skin. In separate experiments the accumulation of [125I]-albumin in thermally injured skin was used to calculate plasma extravasation. Thermal injury (50 degrees C, 10 min) to rat abdominal skin caused a significant increase in both 3NT (p < 0.05) and oedema formation (p < 0.001) when compared to unheated control sites at the 180 min time point postburn. This data is the first to show protein nitration in thermally injured, oedematous skin and strongly suggests that ONOO- is generated in thermally damaged cutaneous tissue.

Subcellular membrane impairment and application of phospholipase A2 inhibitors in endotoxic shock

The study aims at elucidating the mechanism involved in the cell dysfunction or impairment and the protective effects of phospholipase A2 (PLA2) inhibitors in endotoxin shock. Thirty-four rabbits were divided randomly into four groups: (1) normal control group (NC, n = 6), receiving saline intravenously; (2) endotoxin shock group (ES, n = 12), receiving 3 mg/kg of E. coli endotoxin; (3) chloroquine pretreated group (CQ, n = 8), receiving 3 mg/kg of chloroquine 3 min before endotoxin injection and (4) chlorpromazine pretreated group (CPZ, n = 8), receiving 0.3 mg/kg of chlorpromazine 30 min before endotoxin injection. Hepatic mitochondria were extracted either 8 h after commencement of the experiment or when the animals died for detecting PLA2 activity, membrane fluidity, membrane bound succinate dehydrogenate (SDH) and malondialdehyde (MDA). Mitochondria of the lung, heart and kidney were also used for detection of the membrane fluidity. It was revealed that the survival rate of 8 h was 100% (NC), 58% (ES), 87.5% (CQ) and 75% (CPZ), respectively. Mean arterial pressure (MAP) dropped soon after endotoxin injection and descended continuously afterwards in the ES group (P < 0.01). Fluorescence polarization, microviscosity and anisotrophy with a DPH probe were elevated above control levels (P < 0.01). SDH was decreased obviously following endotoxin infusion (P < 0.01). Chloroquine and chlorpromazine, serving as PLA2 inhibitors, could abate cellular dysfunction and increase survival rate. It is proposed that PLA2 plays a pivotal role in cellular injury in endotoxin shock. PLA2 inhibitor might serve as a useful adjunct in combating sepsis and shock.