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Tepes M, Krezic I, Vranes H, Smoday IM, Kalogjera L, Zizek H, Vukovic V, Oroz K, Kovac KK, Madzar Z, Rakic M, Miskic B, Sikiric S, Barisic I, Strbe S, Antunovic M, Novosel L, Kavelj I, Vlainic J, Dobric I, Staresinic M, Skrtic A, Seiwerth S, Blagaic AB, Sikiric P. Stable Gastric Pentadecapeptide BPC 157 Therapy: Effect on Reperfusion Following Maintained Intra-Abdominal Hypertension (Grade III and IV) in Rats. Pharmaceuticals (Basel) 2023; 16:1554. [PMID: 38004420 PMCID: PMC10675657 DOI: 10.3390/ph16111554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
Given in reperfusion, the use of stable gastric pentadecapeptide BPC 157 is an effective therapy in rats. It strongly counteracted, as a whole, decompression/reperfusion-induced occlusion/occlusion-like syndrome following the worst circumstances of acute abdominal compartment and intra-abdominal hypertension, grade III and grade IV, as well as compression/ischemia-occlusion/occlusion-like syndrome. Before decompression (calvariectomy, laparotomy), rats had long-lasting severe intra-abdominal hypertension, grade III (25 mmHg/60 min) (i) and grade IV (30 mmHg/30 min; 40 mmHg/30 min) (ii/iii), and severe occlusion/occlusion-like syndrome. Further worsening was caused by reperfusion for 60 min (i) or 30 min (ii/iii). Severe vascular and multiorgan failure (brain, heart, liver, kidney, and gastrointestinal lesions), widespread thrombosis (peripherally and centrally) severe arrhythmias, intracranial (superior sagittal sinus) hypertension, portal and caval hypertension, and aortal hypotension were aggravated. Contrarily, BPC 157 therapy (10 µg/kg, 10 ng/kg sc) given at 3 min reperfusion times eliminated/attenuated venous hypertension (intracranial (superior sagittal sinus), portal, and caval) and aortal hypotension and counteracted the increases in organ lesions and malondialdehyde values (blood ˃ heart, lungs, liver, kidney ˃ brain, gastrointestinal tract). Vascular recovery promptly occurred (i.e., congested inferior caval and superior mesenteric veins reversed to the normal vessel presentation, the collapsed azygos vein reversed to a fully functioning state, the inferior caval vein-superior caval vein shunt was recovered, and direct blood delivery returned). BPC 157 therapy almost annihilated thrombosis and hemorrhage (i.e., intracerebral hemorrhage) as proof of the counteracted general stasis and Virchow triad circumstances and reorganized blood flow. In conclusion, decompression/reperfusion-induced occlusion/occlusion-like syndrome counteracted by BPC 157 therapy in rats is likely for translation in patients. It is noteworthy that by rapidly counteracting the reperfusion course, it also reverses previous ischemia-course lesions, thus inducing complete recovery.
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Affiliation(s)
- Marijan Tepes
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
- Department of Clinical Medicine, Faculty of Dental Medicine and Health Osijek, 31000 Osijek, Croatia;
- PhD Program Translational Research in Biomedicine-TRIBE, School of Medicine, University of Split, 21000 Split, Croatia
| | - Ivan Krezic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Hrvoje Vranes
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Ivan Maria Smoday
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Luka Kalogjera
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Helena Zizek
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Vlasta Vukovic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Katarina Oroz
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Katarina Kasnik Kovac
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Zrinko Madzar
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Mislav Rakic
- Department of Abdominal Surgery, Clinical Hospital Dubrava, 10040 Zagreb, Croatia;
| | - Blazenka Miskic
- Department of Clinical Medicine, Faculty of Dental Medicine and Health Osijek, 31000 Osijek, Croatia;
| | - Suncana Sikiric
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.S.); (S.S.)
| | - Ivan Barisic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Sanja Strbe
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Marko Antunovic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Luka Novosel
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Ivana Kavelj
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Josipa Vlainic
- Laboratory for Advanced Genomics, Division of Molecular Medicine, Institute Ruder Boskovic, 10000 Zagreb, Croatia;
| | - Ivan Dobric
- Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Mario Staresinic
- Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Anita Skrtic
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.S.); (S.S.)
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.S.); (S.S.)
| | - Alenka Boban Blagaic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
| | - Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
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Pereira R, Buglevski M, Perdigoto R, Marcelino P, Saliba F, Blot S, Starkopf J. Intra-abdominal hypertension and abdominal compartment syndrome in the critically ill liver cirrhotic patient-prevalence and clinical outcomes. A multicentric retrospective cohort study in intensive care. PLoS One 2021; 16:e0251498. [PMID: 33984016 PMCID: PMC8118291 DOI: 10.1371/journal.pone.0251498] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/28/2021] [Indexed: 12/16/2022] Open
Abstract
Background Liver cirrhosis and ascites are risk factors for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS); however, data is scarce. We aimed to determine the prevalence of IAH/ACS in a population of critically ill cirrhotic patients with acute medical illness in intensive care and to assess for risk factors and clinical outcomes. Methods This was a multicentric retrospective cohort study including two general ICUs and pooled data from a multicentric study between January 2009 and October 2019. Results A total of 9,345 patients were screened, and 95 were included in the analysis. Mean age was 56.7±1.3 years, and 79% were male. Liver cirrhosis etiology included alcohol in 45.3% and alcohol plus hepatitis C virus in 9.5%. Precipitating events included infection in 26% and bleeding in 21% of cases. Mean severity score MELD and SAPS II were 26.2±9.9 and 48.5±15.3, respectively, at ICU admission. The prevalence of IAH and ACS was respectively 82.1% and 23.2% with a mean value of maximum IAP of 16.0±5.7 mmHg and IAH grades: absent 17.9%, I 26.3%, II 33.7%, III 17.9%, and IV 4.2%. Independent risk factors for IAH were alcoholic cirrhosis (p = 0.01), West-Haven score (p = 0.01), and PaO2/FiO2 ratio (p = 0.02); as well as infection (p = 0.048) for ACS. Overall, 28-day mortality was 52.6% associated with higher IAP and ACS, and independent risk factors were MELD (p = 0.001), white blood cell count (p = 0.03), PaO2/FiO2 ratio (p = 0.03), and lactate concentration (p = 0.04) at ICU admission. Conclusions This study demonstrates a very high prevalence of IAH/ACS in the critically ill cirrhotic patient in intensive care. Increased IAP and ACS were associated with severity of disease and adverse outcomes and independent risk factors for IAH were alcoholic cirrhosis, hepatic encephalopathy and PO2/FiO2 ratio, as well as infection for ACS. Early diagnosis, prevention, and treatment of IAH/ACS might improve outcome in critically ill cirrhotic patients.
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Affiliation(s)
- Rui Pereira
- Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
- * E-mail:
| | - Maria Buglevski
- University of Tartu, Tartu University Hospital, Tartu, Estonia
| | - Rui Perdigoto
- Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Paulo Marcelino
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Faouzi Saliba
- AP-HP Hôpital Paul Brousse, Université Paris Saclay, Villejuif, France
| | | | - Joel Starkopf
- University of Tartu, Tartu University Hospital, Tartu, Estonia
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Chen P, Tang H, Zhang Q, Xu L, Zhou W, Hu X, Deng Y, Zhang L. Basic Fibroblast Growth Factor (bFGF) Protects the Blood-Brain Barrier by Binding of FGFR1 and Activating the ERK Signaling Pathway After Intra-Abdominal Hypertension and Traumatic Brain Injury. Med Sci Monit 2020; 26:e922009. [PMID: 32036381 PMCID: PMC7029819 DOI: 10.12659/msm.922009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Intra-abdominal hypertension (IAH) is associated with high morbidity and mortality. IAH leads to intra-abdominal tissue damage and causes dysfunction in distal organs such as the brain. The effect of a combined injury due to IAH and traumatic brain injury (TBI) on the integrity of the blood–brain barrier (BBB) has not been investigated. Material/Methods Intracranial pressure (ICP) monitoring, brain water content, EB permeability detection, immunofluorescence staining, real-time PCR, and Western blot analysis were used to examine the effects of IAH and TBI on the BBB in rats, and to characterize the protective effects of basic fibroblast growth factor (bFGF) on combined injury-induced BBB damage. Results Combined injury from IAH and TBI to the BBB resulted in brain edema and increased intracranial pressure. The effects of bFGF on alleviating the rat BBB injuries were determined, indicating that bFGF regulated the expression levels of the tight junction (TJ), adhesion junction (AJ), matrix metalloproteinase (MMP), and IL-1β, as well as reduced BBB permeability, brain edema, and intracranial pressure. Moreover, the FGFR1 antagonist PD 173074 and the ERK antagonist PD 98059 decreased the protective effects of bFGF. Conclusions bFGF effectively protected the BBB from damage caused by combined injury from IAH and TBI, and binding of FGFR1 and activation of the ERK signaling pathway was involved in these effects.
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Affiliation(s)
- Peng Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center of People's Liberation Army (PLA), Daping Hospital, Army Medical University, Chongqing, China (mainland).,Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China (mainland)
| | - Hao Tang
- State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center of People's Liberation Army (PLA), Daping Hospital, Army Medical University, Chongqing, China (mainland)
| | - Qingtao Zhang
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China (mainland)
| | - Lei Xu
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China (mainland)
| | - Wei Zhou
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China (mainland)
| | - Xi Hu
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China (mainland)
| | - Yongbing Deng
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China (mainland)
| | - Lianyang Zhang
- State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center of People's Liberation Army (PLA), Daping Hospital, Army Medical University, Chongqing, China (mainland)
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Crisman C, Ward M, Majmundar N, Damodara N, Hsueh WD, Eloy JA, Liu JK. Pituitary Apoplexy Following Endoscopic Retrograde Cholangiopancreatography. World Neurosurg 2018; 121:201-204. [PMID: 30292038 DOI: 10.1016/j.wneu.2018.09.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Pituitary apoplexy is an uncommon neurosurgical emergency that may be the initial presentation of undiagnosed pituitary adenomas. Though the exact pathogenesis is unclear, there appears to be an association between pituitary apoplexy and medical interventions that disturb the blood supply and venous drainage of the abnormal sellar region. We present the first case of pituitary apoplexy occurring after an endoscopic retrograde cholangiopancreatography (ERCP). CASE DESCRIPTION A 43-year-old male who was several hours status post ERCP presented with a severe headache, bilateral ptosis, and multidirectional ophthalmoplegia. Computed tomography scan and magnetic resonance imaging of the brain revealed a hemorrhagic and necrotic sellar mass with suprasellar extension compressing the optic chiasm and bilateral extension displacing the cavernous carotid arteries laterally. The patient underwent emergent endoscopic endonasal transsphenoidal resection of the underlying pituitary tumor apoplexy with eventual resolution of his cranial nerve palsies. CONCLUSIONS Although pituitary apoplexy has been recognized as a sequela of surgical and laparoscopic procedures, it should also be considered in less invasive gastrointestinal procedures which may alter the intraabdominal pressures, such as ERCP. Early detection of this unusual complication allows for rapid diagnosis and timely surgical intervention in select cases to prevent debilitating cranial nerve palsies, preserve visual function, and retain normal pituitary function.
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Affiliation(s)
- Celina Crisman
- Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Max Ward
- Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Neil Majmundar
- Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Nitesh Damodara
- Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Wayne D Hsueh
- Department of Otolaryngology, Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA; Department of Otolaryngology, Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - James K Liu
- Department of Neurological Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA; Department of Otolaryngology, Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
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Antoniou EA, Kairi E, Margonis GA, Andreatos N, Sasaki K, Damaskos C, Garmpis N, Samaha M, Argyra E, Polymeneas G, Weiss MJ, Pawlik TM, Voros D, Kouraklis G. Effect of Increased Intra-abdominal Pressure on Liver Histology and Hemodynamics: An Experimental Study. ACTA ACUST UNITED AC 2017; 32:85-91. [PMID: 29275303 DOI: 10.21873/invivo.11208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/16/2017] [Accepted: 09/19/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND While reduction of portal venous (PV) blood flow has been described in animal models of intra-abdominal hypertension, reports on compensatory changes in hepatic arterial (HA) flow, known as the hepatic arterial buffer response are controversial. MATERIALS AND METHODS Pneumoperitoneum with helium was induced in 13 piglets. Hemodynamic measurements and pathological assessment were conducted at baseline and during the three subsequent phases: Phase A: 45 minutes with a stable intra-abdominal pressure of 25 mmHg; phase B: 45 minutes with a stable intra-abdominal pressure of 40 mmHg; and phase C during which the abdomen was re-explored and reperfusion of the liver was allowed to take place. RESULTS Phase B pressure was significantly greater than phase A pressure in both the PV and the inferior vena cava, demonstrating a positive association between escalating intra-abdominal hypertension and the pressure in these two vessels (all p<0.001). In contrast, HA pressure was comparable between baseline and phase A, while it tended to decrease in phase B. Regarding histology, the most notable abnormality was the presence of inflammatory infiltrates and hepatocyte necrosis. CONCLUSION Helium-insufflation increased PV pressure with a partial compensatory decrease of HA pressure. Nonetheless, findings consistent with hepatic ischemia were observed on pathology.
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Affiliation(s)
- Efstathios A Antoniou
- Second Department of Propaedeutic Surgery, Laiko Hospital, University of Athens, Athens, Greece
| | - Evi Kairi
- Department of Pathology, Aretaieion Hospital, University of Athens School of Medicine, Athens, Greece
| | - Georgios A Margonis
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Nikolaos Andreatos
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Kazunari Sasaki
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Christos Damaskos
- Second Department of Propaedeutic Surgery, Laiko Hospital, University of Athens, Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propaedeutic Surgery, Laiko Hospital, University of Athens, Athens, Greece
| | - Mario Samaha
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Eriphyli Argyra
- First Department of Anesthesiology, Aretaieion Hospital, University of Athens School of Medicine, Athens, Greece
| | - George Polymeneas
- Second Department of Surgery, Aretaieion Hospital, University of Athens School of Medicine, Athens, Greece
| | - Matthew J Weiss
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Timothy M Pawlik
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Dionysios Voros
- Second Department of Surgery, Aretaieion Hospital, University of Athens School of Medicine, Athens, Greece
| | - Gregory Kouraklis
- Second Department of Propaedeutic Surgery, Laiko Hospital, University of Athens, Athens, Greece
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Guo S, Liu Y, Ma R, Li J, Su B. Neuroprotective effect of endogenous cannabinoids on ischemic brain injury induced by the excess microglia-mediated inflammation. Am J Transl Res 2016; 8:2631-2640. [PMID: 27398146 PMCID: PMC4931157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 02/29/2016] [Indexed: 06/06/2023]
Abstract
Increasing evidence has demonstrated the role of endogenous cannabinoids system (ECS) on protecting brain injury caused by ischemia (IMI). Papers reported that microglia-mediated inflammation has become one of the most pivotal mechanisms for IMI. This study was aimed to investigate the potential roles of ECS on neuron protection under microglia-mediated inflammation. Inflammatory cytokines level both in vitro (BV-2 cells) and in vivo (brain tissue from constructed IMI model and brain-isolated microglia) was detected. ECS levels were detected, and its effects on inflammations was also analyzed. Influence of microglia-mediated inflammation on neuron injury was analyzed. Moreover, the effects of ECS on protecting neuron injury were also analyzed. Our results showed that the levels of inflammatory cytokines including TNFα and IL-1β were higher while IKBα was lower in IMI model brain tissue, brain-isolated microglia and BV-2 cells compared to the control. Inflammation was activated in microglia, as well as the activation of ECS characterized by the increasing level of AEA and 2-AG. Furthermore, the activated microglia-mediated self-inflammation performed harmful influence on neurons via suppressing cell viability and inducing apoptosis. Moreover, ECS functioned as a protector on neuron injury though promoting cell proliferation and suppressing cell apoptosis which were caused by the activated BV-2 cells (LPS induced for 3 h). Our data suggested that ECS may play certain neuroprotective effects on microglia-mediated inflammations-induced IMI through anti-inflammatory function.
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Affiliation(s)
- Shuyun Guo
- Department of Pharmaceutics, Tangdu Hospital, The Fourth Military Medical UniversityXi’an, Shaanxi 710038, China
| | - Yanwu Liu
- Institute of Orthopedics, Xijing Hospital, The Fourth Military Medical UniversityXi’an, Shaanxi 710032, China
| | - Rui Ma
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical UniversityXi’an, Shaanxi 710032, China
| | - Jun Li
- Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical UniversityXi’an, Shaanxi 710032, China
| | - Binxiao Su
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical UniversityXi’an, Shaanxi 710032, China
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Liu D, Zhang HG, Zhao ZA, Chang MT, Li Y, Yu J, Zhang Y, Zhang LY. Melanocortin MC4 receptor agonists alleviate brain damage in abdominal compartment syndrome in the rat. Neuropeptides 2015; 49:55-61. [PMID: 25616531 DOI: 10.1016/j.npep.2014.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 12/17/2014] [Accepted: 12/22/2014] [Indexed: 12/11/2022]
Abstract
Intra-abdominal hypertension (IAH) is accompanied by high morbidity and mortality in surgical departments and ICUs. However, its specific pathophysiology is unclear. IAH not only leads to intra-abdominal tissue damage but also causes dysfunction in distal organs, such as the brain. In this study, we explore the protective effects of melanocortin 4 receptor agonists in IAH-induced brain injury. The IAH rat models were induced by hemorrhagic shock/resuscitation (with the mean arterial pressure (MAP) maintained at 30 mm Hg for 90 min followed by the reinfusion of the withdrawn blood with lactated Ringer's solution). Then, air was injected into the peritoneal cavity of the rats to maintain an intra-abdominal pressure of 20 mm Hg for 4 h. The effects of the melanocortin 4 receptor agonist RO27-3225 in alleviating the rats' IAH brain injuries were observed, which indicated that RO27-3225 could reduce brain edema, the expressions of the IL-1β and TNF-α inflammatory cytokines, the blood-brain barrier's permeability and the aquaporin4 (AQP4) and matrix metalloproteinase 9 (MMP9) levels. Moreover, the nicotinic acetylcholine receptor antagonist chlorisondamine and the selective melanocortin 4 receptor antagonist HS024 can negate the protective effects of the RO27-3225. The MC4R agonist can effectively reduce the intracerebral proinflammatory cytokine gene expression and alleviate the brain injury caused by blood-brain barrier damage following IAH.
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Affiliation(s)
- Dong Liu
- Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Hong-Guang Zhang
- Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Zi-Ai Zhao
- Molecular Biology Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Research Institute of Surgery and Daping Hospital, Third Military Medical University, Chongqing, China
| | - Ming-Tao Chang
- Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Yang Li
- Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Jian Yu
- Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Ye Zhang
- Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Lian-Yang Zhang
- Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
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Pressure, perfusion, and compartments: challenges for the acute care surgeon. J Trauma Acute Care Surg 2014; 76:1341-8. [PMID: 24854298 DOI: 10.1097/ta.0000000000000240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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9
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Elevation of intra-abdominal pressure by pneumoperitoneum decreases pancreatic perfusion in an in vivo porcine model. Surg Laparosc Endosc Percutan Tech 2014; 24:221-5. [PMID: 24710250 DOI: 10.1097/sle.0b013e3182937bd6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The goal of this study is to examine changes in pancreatic perfusion due to pneumoperitoneum using perfusion CT in vivo. METHODS Three pigs were studied. Under general anesthesia, pneumoperitoneum was induced to 16 mm Hg. Perfusion CT scans were acquired at a rate of 1 image per 2 seconds for 60 seconds. Scans were repeated 5 days later without pneumoperitoneum using the same protocol, in the same animals. The time density curve, color map, peak enhancement, time to peak, blood flow, blood volume, and permeability were evaluated. RESULTS In the presence of pneumoperitoneum, peak enhancement in radiodensity was decreased and time to peak was increased, and both blood flow and blood volume decreased. However, there was no consistent change in permeability observed. CONCLUSION This study demonstrates that pneumoperitoneum quantitatively results in decreased blood flow and blood volume to the pancreas in an in vivo animal model.
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10
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Intra-abdominal hypertension causes disruption of the blood-brain barrier in mice, which is increased with added severe head trauma. J Trauma Acute Care Surg 2012; 73:1175-9. [DOI: 10.1097/ta.0b013e31825dec35] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Abdominal compartment syndrome: a decade of progress. J Am Coll Surg 2012; 216:135-46. [PMID: 23062520 DOI: 10.1016/j.jamcollsurg.2012.09.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 08/26/2012] [Accepted: 09/10/2012] [Indexed: 12/22/2022]
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Avraamidou A, Marinis A, Asonitis S, Perrea D, Polymeneas G, Voros D, Argyra E. The impact of ischemic preconditioning on hemodynamic, biochemical and inflammatory alterations induced by intra-abdominal hypertension: an experimental study in a porcine model. Langenbecks Arch Surg 2012; 397:1333-41. [DOI: 10.1007/s00423-012-0977-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 06/22/2012] [Indexed: 11/28/2022]
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Sánchez-Miralles A, Castellanos G, Badenes R, Conejero R. [Abdominal compartment syndrome and acute intestinal distress syndrome]. Med Intensiva 2012; 37:99-109. [PMID: 22244213 DOI: 10.1016/j.medin.2011.11.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 11/18/2011] [Accepted: 11/22/2011] [Indexed: 12/19/2022]
Abstract
Seriously ill patients frequently present intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) as complications, and the associated mortality is very high. This review offers an update on the most controversial aspects of these entities: factors favoring their appearance, the most common causes, prognosis, and methods of measuring intra-abdominal pressure (IAP), physiopathological consequences in relation to the different organs and systems, and the currently accepted treatment measures (medical and/or surgical). Simultaneously to the strictly physical mechanisms of injury, such as direct compression of intra-abdominal organs and vessels, the transmission of IAP to other compartments, and the drop in cardiac output, a series of immune-inflammatory mediators generated in the intestine itself may also intervene. Hypoperfusion, sustained ischemia and the ischemia-reperfusion phenomenon, would act upon the microbiota, intestinal epithelium and intestinal immune system, triggering a systemic inflammatory response and multiorgan dysfunction that appears in the final stages of ACS.
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Affiliation(s)
- A Sánchez-Miralles
- Servicio de Medicina Intensiva, Hospital Universitario San Juan de Alicante, Alicante, España
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