Clinical significance of sirtuin 1 level in sepsis: correlation with disease risk, severity, and mortality risk

Inflammatory liver diseases and susceptibility to sepsis

Patients with inflammatory liver diseases, particularly alcohol-associated liver disease and metabolic dysfunction-associated fatty liver disease (MAFLD), have higher incidence of infections and mortality rate due to sepsis. The current focus in the development of drugs for MAFLD is the resolution of non-alcoholic steatohepatitis and prevention of progression to cirrhosis. In patients with cirrhosis or alcoholic hepatitis, sepsis is a major cause of death. As the metabolic center and a key immune tissue, liver is the guardian, modifier, and target of sepsis. Septic patients with liver dysfunction have the highest mortality rate compared with other organ dysfunctions. In addition to maintaining metabolic homeostasis, the liver produces and secretes hepatokines and acute phase proteins (APPs) essential in tissue protection, immunomodulation, and coagulation. Inflammatory liver diseases cause profound metabolic disorder and impairment of energy metabolism, liver regeneration, and production/secretion of APPs and hepatokines. Herein, the author reviews the roles of (1) disorders in the metabolism of glucose, fatty acids, ketone bodies, and amino acids as well as the clearance of ammonia and lactate in the pathogenesis of inflammatory liver diseases and sepsis; (2) cytokines/chemokines in inflammatory liver diseases and sepsis; (3) APPs and hepatokines in the protection against tissue injury and infections; and (4) major nuclear receptors/signaling pathways underlying the metabolic disorders and tissue injuries as well as the major drug targets for inflammatory liver diseases and sepsis. Approaches that focus on the liver dysfunction and regeneration will not only treat inflammatory liver diseases but also prevent the development of severe infections and sepsis.

Puerarin inhibits NHE1 activity by interfering with the p38 pathway and attenuates mitochondrial damage induced by myocardial calcium overload in heart failure rats

Previous studies have shown that puerarin plays a key role in protecting humans and animals from cardiovascular diseases. The exact mechanism of the therapeutic effect of puerarin on various cardiovascular diseases (protective effect on cardiomyocytes) is still unclear. In the present study, we identify the role of puerarin in an animal model of experimental heart failure (HF) and explore its underlying mechanisms. The HF rat model is induced by intraperitoneal injection of adriamycin (ADR), and puerarin is administered intragastrically at low, medium, and high concentrations. We demonstrate that puerarin significantly improves myocardial fibrosis and inflammatory infiltration and, as a result, improves cardiac function in ADR-induced HF rats. Mechanistically, we find for the first time that puerarin inhibits overactivated Na +/H + exchange isoform 1 (NHE1) in HF, which may improve HF by decreasing Na + and Ca 2+ ion concentrations and attenuating mitochondrial damage caused by calcium overload; on the other hand, puerarin inhibits the activation of the p38 pathway in HF, reduces the expressions of TGF-β and proinflammatory cytokines, and suppresses myocardial fibrosis. In conclusion, our results suggest that Puerarin is an effective drug against HF and may play a protective role in the myocardium by inhibiting the activation of p38 and its downstream NHE1.

An ultra-sensitive electrochemical biosensor for the detection of procalcitonin in sepsis patients' serum, using a Cu-BHT-based thin film

Procalcitonin (PCT) is a polypeptide produced by the parafollicular cells of the thyroid gland and serves as a vital marker for the diagnosis and treatment of sepsis and other infectious diseases, as well as multiple organ failure, due to its high expression levels in affected patients. This article reports on a highly sensitive electrochemical biosensor based on MOF composite materials, based on Cu-BHT, for detecting PCT levels. The surface of the glassy carbon electrode may have better charge transfer resistance owing to the nano-composite material made of Cu-BHT, chitosan, and AuNPs. At the same time, the anti-PCT antibody may also be covalently bonded to the composite material and measure PCT concentration using electrochemical impedance spectroscopy (EIS). The results of the investigation demonstrate that the sensor's response has excellent linear conjunction with the logarithm of PCT concentration under optimum circumstances. The detection limit (LOD) is 14.579 × 10-9 μg/mL, and the linear range of detection is 10-7 μg/mL to 10-1 μg/mL. Simultaneously, we successfully applied this method to detect serum PCT before and after treatment in different sepsis patients and compared it with chemiluminescence immunoassay. The findings indicate that the proposed method holds promising potential for timely diagnosis and treatment of sepsis patients.