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Z F Ba

Publications and source records attributed to Z F Ba.

At least 19 recordsLinked to original sources

Upregulation of Kupffer cell beta-adrenoceptors and cAMP levels during the late stage of sepsis.

Although a burst of immunoresponsiveness may occur during the early stage of sepsis, late sepsis is characterized by severe immunodepression. In addition, although studies have shown that stimulation of macrophage beta-adrenoceptors results in an increase in cAMP and an associated reduction in macrophage phagocytic activity, it remains unknown whether Kupffer cell beta-adrenoceptor characteristics and cAMP levels are altered during polymicrobial sepsis. To study this, Sprague-Dawley rats were subjected to sepsis by cecal ligation and puncture (CLP). At 5 h (i.e., the early stage of sepsis) or 20 h (late sepsis) after CLP or sham operation, the liver was perfused with collagenase solution and Kupffer cells were isolated. beta-Adrenoceptor characteristics of the isolated Kupffer cells were determined using [125I]iodopindolol, and basal levels of cAMP were measured by radioimmunoassay. The results indicate that while maximum binding capacity (Bmax) of Kupffer cell beta-adrenoceptors was not altered at 5 h, it increased significantly at 20 h after CLP. Similarly, basal levels of cAMP in Kupffer cells did not change at 5 h but increased markedly at 20 h after the onset of sepsis. In contrast, the dissociation constant (Kd, 1/affinity) of Kupffer cell beta-adrenoceptors was not significantly affected by sepsis at both 5 h and 20 h after CLP. Thus, upregulation of beta-adrenoceptors and increase in cAMP levels in Kupffer cells occur during the late stage of polymicrobial sepsis, and this may contribute to the depression of macrophage phagocytic function under such conditions.

Adrenergic beta-Antagonists

Is gut the "motor" for producing hepatocellular dysfunction after trauma and hemorrhagic shock?

BACKGROUND: Although studies suggest that the gut may be the "motor" responsible for producing sepsis and multiple organ failure after injury, it is not known whether enterectomy prior to the onset of hemorrhage alters proinflammatory cytokines TNF and IL-6 and, if so, whether hepatocellular dysfunction and damage are prevented or attenuated under such conditions. MATERIALS AND METHODS: Under methoxyflurane anesthesia, an enterectomy in the rat was performed by excision of the duodenum, jejunum, and ileum. The rats were then bled to and maintained at a mean arterial pressure of 40 mm Hg until 40% of the maximal shed volume was returned in the form of Ringer's lactate. The animals were then resuscitated with four times the volume of shed blood with Ringer's lactate over 1 h. At 1.5 h after the completion of resuscitation, hepatocellular function [i.e., the maximal velocity (Vmax) and transport efficiency (Km) of indocyanine green (ICG) clearance] was assessed by an in vivo ICG clearance technique. Blood samples were taken for the measurement of TNF, IL-6, and liver enzymes (i.e., SGPT and SGOT). Cardiac output and microvascular blood flow were determined by ICG dilution and laser Doppler flowmetry, respectively. RESULTS: The increase in circulating levels of TNF but not IL-6 was prevented by enterectomy prior to hemorrhage. The reduced Vmax and K(m) and elevated SGPT and SGOT following hemorrhage and resuscitation, however, were not significantly affected by prior enterectomy. Moreover, enterectomy before hemorrhage further reduced hepatic perfusion. CONCLUSION: Since enterectomy prior to the onset of hemorrhage does not prevent or attenuate the reduced ICG clearance and elevated liver enzymes despite downregulation of TNF production, it appears that the small intestine does not play a significant role in producing hepatocellular dysfunction and injury following trauma and hemorrhagic shock.

Alanine Transaminase

The pivotal role of adrenomedullin in producing hyperdynamic circulation during the early stage of sepsis.

BACKGROUND: Initial cardiovascular responses during sepsis are characterized by hyperdynamic circulation. Although studies have shown that a novel potent vasodilatory peptide, adrenomedullin (ADM), is up-regulated under such conditions, it remains unknown whether ADM is responsible for initiating the hyperdynamic response. OBJECTIVE: To determine whether increased ADM release during early sepsis plays any major role in producing hyperdynamic circulation. DESIGN, INTERVENTION, AND MAIN OUTCOME MEASURE: Synthetic rat ADM (8.5 microg/kg of body weight) was infused intravenously in normal rats for 15 minutes at a constant rate. Cardiac output, stroke volume, and microvascular blood flow in various organs were determined immediately as well as 30 minutes after ADM infusion. At 30 minutes after infusion, plasma ADM level was also measured. In additional groups, rats were subjected to sepsis by cecal ligation and puncture. At 1.5 hours after cecal ligation and puncture, specific anti-rat ADM antibodies were infused, which completely neutralized the circulating ADM. Various hemodynamic variables were measured 5 hours after cecal ligation and puncture (ie, the early stage of sepsis). RESULTS: Cardiac output, stroke volume, and microvascular blood flow in the liver, small intestine, kidney, and spleen increased, and total peripheral resistance decreased 0 and 30 minutes after ADM infusion. In addition, plasma levels of ADM increased from the preinfusion level of 92.7+/-5.3 to 691.1+/-28.2 pg/mL 30 minutes after ADM infusion, which was similar to ADM levels observed during early sepsis. Moreover, 5 hours after the onset of sepsis, cardiac output, stroke volume, and microvascular blood flow in various organs increased and total peripheral resistance decreased. Administration of anti-ADM antibodies, however, prevented the occurrence of the hyperdynamic response. CONCLUSIONS: The results suggest that increased ADM production and/or release plays a major role in producing hyperdynamic responses during early sepsis. Since our previous studies have shown that vascular responsiveness to ADM decreases in late sepsis, maintenance of ADM vascular responsiveness by pharmacological agents during the course of sepsis may prevent transition from the hyperdynamic to the hypodynamic state.

Adrenomedullin

Up-regulation of a novel potent vasodilatory peptide adrenomedullin during polymicrobial sepsis.

A large number of studies have been and are being carried out to examine the role of nitric oxide in the hyperdynamic and hypodynamic stages of sepsis. It remains unknown, however, whether adrenomedullin (ADM), a novel potent vasodilatory peptide, is up-regulated during hyperdynamic sepsis and, if so, whether its production is sustained during hypodynamic sepsis. To determine this, rats were subjected to sepsis by cecal ligation and puncture (CLP), followed by administration of 3 mL/100 g body weight normal saline to these and sham-operated animals. Blood samples were taken at 1, 1.5, 2, 5, and 10 h (2-10 h post-CLP represents the hyperdynamic stage of sepsis) or at 20 and 30 h after CLP (i.e., the hypodynamic stage). Plasma levels of ADM were measured by radioimmunoassay. Adrenomedullin gene expression in various tissues was examined at 2, 10, or 20 h after CLP by reverse transcription-polymerase chain reaction (RT-PCR). The results indicated that plasma levels of ADM did not increase at 1 and 1.5 h after CLP but increased significantly at 2 h after the onset of sepsis. Moreover, circulating ADM increased progressively at 5-20 h and remained elevated at 30 h after CLP. The increased levels of plasma ADM during sepsis were correlated with up-regulation of ADM mRNA in the small intestine, left ventricle, and thoracic aorta. In contrast, ADM gene expression in renal and hepatic tissues was not significantly altered following the onset of sepsis. The association between the up-regulated ADM and the occurrence of hyperdynamic circulation during the early stage of sepsis (both occur at 2 h after CLP) may indicate a possible cause and effect relationship between the two events. Since we have previously shown that ADM-induced vascular relaxation decreased at 20 h after CLP, it appears that the down-regulation of ADM receptors may be responsible for the transition from the hyperdynamic stage to the hypodynamic stage of sepsis.

Adrenomedullin

Severe hypoxemia in the absence of blood loss depresses hepatocellular function and up-regulates IL-6 and PGE2.

Although hepatocellular function is depressed early after trauma and hemorrhage (which are associated with low flow conditions and tissue hypoxemia), it remains unknown whether hypoxemia without blood loss, produces hepatocellular dysfunction and, if so, whether IL-6 and PGE2 are associated with this dysfunction. To study this, rats were placed in a plastic box which was flushed with a gas mixture containing 6.3% O2:93.7% N2 or room air for 60 min, followed by their return to room air. At 0 and 4 h after hypoxemia, hepatocellular function (i.e., maximum velocity of indocyanine green clearance (Vmax) and the efficiency of the transport (Km)) was measured using an in vivo hemoreflectometer. Cardiac output was assessed by dye dilution technique. Tissue microvascular blood flow was determined by laser Doppler flowmetry. Plasma IL-6 and PGE2 were measured by bioassay and radioimmunoassay, respectively. The results indicate that hypoxemia produced a depression in hepatocellular function (i.e., decreased Vmax by 44-50% and Km by 55-68%) despite stable cardiac output and hepatic microcirculation at 0 and 4 h after hypoxemia. Moreover, hypoxemia resulted in a significant increase in plasma IL-6 (by 372%-389%) as well as PGE2 (by 38% at 0 h post-hypoxemia). Thus, hypoxemia observed after trauma and hemorrhagic shock appears to be responsible for producing hepatocellular dysfunction possibly through the up-regulation of IL-6 and PGE2. In view of this, long-lasting hypoxemia in trauma victims should be avoided, perhaps by early intubation and ventilation so that the potential additional proinflammatory cytokine and PGE2 release can be prevented.

Animals

Liver endothelial cell function is depressed only during hypodynamic sepsis.

Although studies have indicated that hepatocellular function is depressed early after the onset of sepsis, it remains unknown whether liver endothelial cell function is also compromised under such conditions. To study this, male rats were subjected to polymicrobial sepsis by cecal ligation and puncture (CLP), followed by administration of 3 ml/100 g body wt normal saline subcutaneously to these and to sham-operated animals. Blood samples (0.2-ml aliquots) were taken from the carotid artery, portal vein, and hepatic vein at 2, 5, 10 (i.e., hyperdynamic sepsis), or 20 hr (hypodynamic sepsis) after CLP, and plasma hyaluronic acid (HA) was determined using a Pharmacia assay kit. In addition, HA clearance was assessed at 5, 10, or 20 hr after CLP by injecting 30 micrograms/100 g body wt HA intravenously. Plasma HA was determined at 2-40 min after the administration of HA. The results indicate that plasma levels of HA in blood from three different sites did not increase significantly until 10 hr after CLP. Clearance of HA decreased only at 20 hr after CLP, compared to sham-operated animals. These results suggest that the increased plasma levels of HA at 10 hr after the onset of sepsis are solely due to the increased release/production of the polysaccharide. Since circulating HA is cleared exclusively by the liver endothelial cell, the results demonstrate that liver endothelial cell dysfunction (i.e., the increased circulating HA levels and decreased HA clearance) occurs only during the late, hypodynamic stage of polymicrobial sepsis.

Animals

Mechanism of hepatocellular dysfunction during early sepsis. Key role of increased gene expression and release of proinflammatory cytokines tumor necrosis factor and interleukin-6.

BACKGROUND: Hepatocellular dysfunction occurs at 1.5 hours after cecal ligation and puncture (CLP [ie, sepsis model]), despite normal cardiac output and hepatic perfusion. OBJECTIVE: To determine whether proinflammatory cytokines such as tumor necrosis factor (TNF) and interleukin-6 (IL-6) are up-regulated before the occurrence of hepatocellular dysfunction during sepsis. DESIGN, INTERVENTION, AND MAIN OUTCOME MEASURE: Rats were subjected to sepsis by CLP, followed by administration of normal saline solution, 3 mL/100 g of body weight, to these and animals undergoing sham operation. At 0.5, 1, 1.5, or 2 hours after CLP, circulating levels of TNF and IL-6 were measured by enzyme-linked immunosorbent assay and bioassay, respectively. In additional animals, Kupffer cells were isolated at 1, 2, or 5 hours after CLP or sham operation. Kupffer cell TNF and IL-6 messenger RNA levels were determined by reverse-transcription polymerase chain reaction technique. RESULTS: Plasma levels of TNF and IL-6 increased significantly at 1.5 hours and persisted at 2 hours after CLP. Levels of TNF and IL-6 messenger RNA in Kupffer cells increased as early as 1 hour after CLP. The up-regulated gene expression also persisted at 2 and 5 hours after the onset of sepsis. CONCLUSIONS: We have previously shown that TNF-alpha infusion produces hepatocellular dysfunction and that pharmacological inhibition of TNF production prevents it. Since the present study demonstrated that upregulation of proinflammatory cytokine gene expression occurs before hepatocellular dysfunction during sepsis, TNF and/or IL-6 may be responsible for producing hepatocellular dysfunction. Thus, administration of pharmacologic agents that selectively block or inhibit proinflammatory cytokine release may be useful in preventing cellular dysfunction during early sepsis.

Animals

Pentoxifylline maintains hepatocellular function and improves cardiac performance during early sepsis.

BACKGROUND AND OBJECTIVE: Although pentoxifylline (PTX) produces various beneficial effects after endotoxemia, it remains unknown whether this agent attenuates the depressed hepatocellular function and improves heart performance during early sepsis. The aim of this study, therefore, was to determine whether PTX maintains hepatocellular function and improves cardiac function during the early hyperdynamic stages of polymicrobial sepsis. DESIGN, MATERIALS, AND METHODS: Rats were subjected to sepsis by cecal ligation and puncture (CLP). At 1 hour after CLP, PTX (50 mg/kg body weight), or an equal volume of saline, was infused intravenously over 30 minutes. At 2 or 5 hours after CLP (i.e., early hyperdynamic stages of sepsis), hepatocellular function was assessed by in vivo indocyanine green clearance. Cardiac output was determined by dye dilution. Left ventricular performance parameters such as maximal rates of left ventricular pressure rise and fall (+/-dP/dtmax), ventricular peak systemic pressure, etc., were determined using a heart performance analyzer. RESULTS: The results indicate that hepatocellular function was significantly depressed at 2 and 5 hours after CLP. Administration of PTX, however, maintained hepatocellular function to sham levels. Although cardiac output increased after CLP with or without PTX treatment, this agent markedly improved cardiac performance as evidenced by significantly higher + dP/dtmax and ventricular peak systemic pressure as well as other heart performance parameters. CONCLUSIONS: Pentoxifylline appears to be a useful adjunct for maintaining hepatocellular function and improving cardiac performance during the early hyperdynamic stages of polymicrobial sepsis.

Animals

Liver endothelial cell dysfunction occurs early following hemorrhagic shock and persists despite crystalloid resuscitation.

Although hepatocellular function is depressed early following hemorrhage, it remains unknown whether liver endothelial cell function is also compromised under such conditions. The aim of this study, however, was to determine if liver endothelial cell function is depressed during hemorrhage and persists following crystalloid resuscitation. To study this, rats underwent a 5-cm laparotomy (i.e., trauma induced) and were bled to and maintained at a mean arterial pressure of 40 mm Hg until 40% of maximal bleedout volume was returned in the form of Ringer's lactate. The animals were then resuscitated with 4 times the volume of maximal bleedout volume with Ringer's lactate. Arterial blood was taken before and during hemorrhage and after resuscitation. Plasma hyaluronic acid (HA) levels were determined using a Pharmacia assay kit. To determine whether the elevated HA is due to a decrease in its removal, HA clearance was assessed at 0 and 24 hr after resuscitation by injecting 30 microgram/100 g body wt HA intravenously. The results indicate that plasma HA levels increased significantly at the time of maximal bleedout, which persisted even 24 hr after the completion of resuscitation. Hyaluronic acid clearance decreased significantly at 0 and 24 hr after resuscitation, suggesting that the decreased HA clearance plays a major role in producing the elevated plasma HA levels. Since circulating HA is cleared exclusively by liver endothelial cells, these results, taken together, indicate that liver endothelial cell dysfunction (i.e., the increased plasma HA levels and decreased HA clearance) occurs early during hemorrhage (i.e., approximately 44 min after the onset of the insult) and persists despite resuscitation. Thus, the depressed liver endothelial cell function may directly or indirectly contribute to hepatocellular dysfunction observed under such conditions.

Animals

Pentoxifylline maintains vascular endothelial cell function during hyperdynamic and hypodynamic sepsis.

BACKGROUND: Although pentoxifylline produces various beneficial effects after endotoxemia or sepsis occurs, it is not known whether this agent attenuates the depressed endothelial cell function during sepsis. Therefore the aim of this study was to determine whether pentoxifylline maintains vascular endothelial cell function (i.e., improves the release of endothelium-derived nitric oxide) during hyperdynamic and hypodynamic stages of polymicrobial sepsis. METHODS: Rats were subjected to sepsis by cecal ligation and puncture (CLP), after which 3 ml/100 gm body wt normal saline solution was injected subcutaneously in these and rats in a sham-operated group. At 1 hour after the onset of sepsis, pentoxifylline (50 mg/kg body wt) or an equal volume of normal saline solution was infused intravenously during a 30 minute period. At 10 and 20 hours after CLP was performed (10-hour CLP, hyperdynamic sepsis; 20-hour CLP, hypodynamic sepsis), the thoracic aorta was isolated, cut into rings, and placed in organ chambers. Norepinephrine (2 x 10(-7) mol/L) was used to achieve near maximal tension. Dose responses for an endothelium-dependent vasodilator, acetylcholine, and an endothelium-independent vasodilator, nitroglycerine, were carried out. The changes in percentage relaxation in the aortic rings by these agonists were then determined. RESULTS: Endothelium-dependent (acetylcholine-induced) vascular relaxation decreased significantly at 10 and 20 hours after CLP. Administration of pentoxifylline, however, maintained acetylcholine-induced vascular relaxation at both time points. In contrast, no significant reduction in nitroglycerine-induced vascular relaxation was seen in rats with sepsis irrespective of pentoxifylline treatment. CONCLUSIONS: Because pentoxifylline prevented endothelial cell dysfunction at 10 and 20 hours after CLP occurred, this agent appears to be a useful agent for maintaining vascular endothelial function during the hyperdynamic and hypodynamic stages of polymicrobial sepsis.

Acetylcholine

Inhibition of the biologic activity of tumor necrosis factor maintains vascular endothelial cell function during hyperdynamic sepsis.

BACKGROUND AND OBJECTIVE: Although vascular endothelial cell function (i.e., the release of endothelium-derived nitric oxide) decreases and plasma tumor necrosis factor (TNF) increases during sepsis, it is not known whether the elevated TNF is responsible for the depression of endothelial cell function under such conditions. The aim of this study, therefore, was to determine if inhibition of TNF biologic activity by polyethylene glycol dimerized conjugate of the recombinant human form of the p55 soluble TNF receptor (PEG-(rsTNF-R1)2) maintains endothelial function during sepsis. DESIGN, MATERIALS AND METHODS: Rats were subjected to sepsis by cecal ligation and puncture (CLP). Immediately before the onset of sepsis, 600 microgram/rat PEG-(rsTNF-R1)2 or an equal volume of saline was infused intravenously. At 10 hours after CLP (i.e., hyperdynamic sepsis), the thoracic aorta was isolated, cut into rings, and placed in organ chambers. Dose responses for an endothelium-dependent vasodilator, acetylcholine (ACh), and an endothelium-independent vasodilator, nitroglycerine (NTG), were determined. Endothelial cell structure was examined by transmission electron microscopy. RESULTS: Endothelium-dependent vascular relaxation was depressed at 10 hours after the onset of sepsis. Administration of PEG-(rsTNF-R1)2 before CLP, however, maintained ACh-induced relaxation. In contrast, no significant difference in NTG-induced relaxation was seen, irrespective of administration of PEG-(rsTNF-R1)2 Furthermore, the deterioration in endothelial structure during sepsis was prevented by PEG-(rsTNF-R1)2 pretreatment. CONCLUSION: Since administration of PEG-(rsTNF-R1)2 maintains vascular endothelial cell structure and function, it can be concluded that TNF plays a pivotal role in producing endothelial dysfunction during sepsis. Thus, pharmacologic agents that inhibit TNF biologic activity and/or its production may be useful for protecting endothelial cells during sepsis.

Acetylcholine

Administration of a matrix metalloproteinase inhibitor after hemorrhage improves cardiovascular and hepatocellular function.

Although matrix metalloproteinase inhibitors prevent the increase in soluble tumor necrosis factor-alpha during endotoxemia, it remains unknown whether a novel matrix metalloproteinase inhibitor, GM6001, improves cardiovascular and hepatocellular function after trauma and hemorrhage. To determine this, rats underwent laparotomy (i.e., trauma-induced), and were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of maximal shed volume was returned in the form of Ringer's lactate. The animals were then resuscitated with 3 times the volume of maximal bleedout with Ringer's lactate over 45 min, followed by 2 times Ringer's lactate over 60 min. GM6001, at a dose of 100 mg/kg or an equal volume of normal saline, was administered subcutaneously 15 min before the completion of resuscitation. At 2 and 4 h after resuscitation, cardiac output was measured by indocyanine green (ICG) dilution. Hepatocellular function (i.e., maximum velocity and the efficiency of ICG clearance) was determined by in vivo ICG clearance. Microvascular blood flow in various organs was assessed by laser Doppler flowmetry. The results indicate that cardiac output, hepatocellular function, and tissue microvascular blood flow decreased significantly at 2 and 4 h after resuscitation. GM6001 treatment, however, significantly improved the depressed cardiovascular and hepatocellular function. Since GM6001 improves cardiovascular and hepatocellular function, this agent may be a useful adjunct to fluid resuscitation after trauma and hemorrhagic shock.

Animals

Effects of nonanticoagulant heparin on cardiovascular and hepatocellular function after hemorrhagic shock.

Although heparinization of animals before hemorrhage improves cell and organ function, the potent anticoagulant activity of conventional heparin sodium precludes its potential clinical use. To determine whether a novel nonanticoagulant heparin, GM1892, would have any beneficial effects on cardiovascular and hapatocellular functions and would decrease susceptibility to sepsis after hemorrhage, laparotomy was performed on rats (i.e., trauma induced), after which they were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of maximal bleedout volume was returned in the form of Ringer lactate solution (RL). The rats were then resuscitated with three times the volume of shed blood with RL over 45 min, followed by infusion of two times RL plus GM1892 (7 mg/kg body wt; approximately 2% the anticoagulant activity of regular heparin) of saline over 60 min. At 2 and 4 h after the completion of resuscitation, cardiac output, hepatocellular function, and microvascular blood flow were determined. The results indicated that cardiac output, hepatocellular function, and microvascular blood flow in the liver, spleen, and small intestine decreased significantly after hemorrhage and resuscitation. Administration of GM1892, however, restored these parameters. The morphological abnormality observed after hemorrhage in the liver, kidney, and small gut was also attenuated with GM1892 treatment. Moreover, GM1892 normalized the elevated plasma prostaglandin E2 levels. Sepsis was induced in additional rats by cecal ligation and puncture (CLP) 20 h after hemorrhage, and the necrotic cecum was excised 10 h thereafter. GM1892 treatment significantly decreased mortality after CLP and cecal excision. Thus GM1892 appears to be a useful adjunct to fluid resuscitation, since it restores the depressed cardiovascular responses and decreases susceptibility to sepsis after trauma and hemorrhage.

Animals

Pentoxifylline attenuates the depressed endothelial cell function and vascular muscle contractility following trauma and hemorrhagic shock.

Although pentoxifylline (PTX) produces various beneficial effects following adverse circulatory conditions, it is not known whether this agent attenuates the depressed vascular endothelial cell function [i.e., the reduced release of endothelium-derived nitric oxide (EDNO)] and smooth muscle contractility after trauma and hemorrhage. To study this, rats underwent a midline laparotomy (i.e., trauma induced) and were bled to and maintained at a mean arterial pressure of 40 mm Hg until 40% of maximal shed volume was returned in the form of lactated Ringer's solution. The animals were then resuscitated with 4 times the volume of maximal bleedout with lactated Ringer's solution, following which PTX (50 mg/kg body weight), or an equivalent volume of normal saline, was infused intravenously over 95 minutes. At 1.5 hours after resuscitation, the aorta was isolated and studied in vitro. Norepinephrine-induced vascular contraction and dose responses for acetylcholine (ACh), an endothelium-dependent vasodilator, were then determined. The results indicate that the decreased ACh-induced relaxation in hemorrhaged animals was restored with PTX treatment. Moreover, the increased ACh IC50 values (ACh concentration that causes half-maximum relaxation) after hemorrhage were reduced by PTX. In contrast, there was no significant difference in the relaxation induced by an endothelium-independent vasodilator, nitroglycerine, in the tested groups. Thus, PTX restores a hemorrhage-induced decrease in endothelium-derived nitricoxide production. In addition, the depressed smooth muscle contractile function was also attenuated by PTX treatment. Because PTX restored the depressed endothelial cell function and smooth muscle contractility, this agent appears to be a useful adjunct to fluid resuscitation for the management of trauma and hemorrhage.

Animals

Sustained elevation in circulating catecholamine levels during polymicrobial sepsis.

Although studies have indicated that the levels of catecholamines increase during sepsis, it remains unknown whether the elevated levels of epinephrine, norepinephrine, and dopamine observed in early sepsis are sustained during late, hypodynamic stages of sepsis. In this study, rats were subjected to sepsis by cecal ligation and puncture (CLP, i.e., polymicrobial sepsis). Immediately after CLP or sham operation, animals received 3 mL/100 g body weight normal saline subcutaneously. At .5, 2, 10 (i.e., early sepsis), or 20 h (late sepsis) after CLP, blood samples were drawn and the plasma was separated. Plasma levels of epinephrine, norepinephrine, and dopamine were determined using a [3H]-radioenzymatic assay. The results indicate that plasma levels of epinephrine, norepinephrine, and dopamine increased significantly as early as .5 h after CLP. The increase in catecholamine levels persisted throughout the study periods. Thus, circulating levels of catecholamines were elevated in both early and late stages of polymicrobial sepsis. These results suggest that the increased catecholamine levels at .5-10 h after CLP may contribute to the hypermetabolic conditions that occur during early, hyperdynamic sepsis. However, there is a lack of an association between the elevated plasma catecholamine levels and hypometabolic/hypodynamic state in late sepsis.

Animals

Tumor necrosis factor-alpha administration increases Kupffer cell cyclic adenosine monophosphate levels.

Although studies have indicated that both Kupffer cell cyclic adenosine monophosphate (cAMP) and circulating TNF levels increase following trauma-hemorrhage and resuscitation, it remains unknown whether the elevated TNF levels are responsible for the increased Kupffer cell cAMP levels. To determine this, recombinant murine TNF-alpha (1.2 x 10(7) U/mg) was infused intravenously (.25 mg/kg body wt) over 30 min in normal rats. At 1 h after TNF-alpha or vehicle infusion, Kupffer cells and hepatocytes were isolated and cAMP levels were determined by radioimmunoassay. The levels of cAMP in the spleen and kidney were also measured. In addition, the maximal binding capacity and affinity of beta-adrenergic receptors were determined in Kupffer cells and hepatocytes by using [125I]iodopindolol. To determine whether there is any correlation between Kupffer cell cAMP and prostaglandin E2 (PGE2) or epinephrine, plasma levels of catecholamines and PGE2 were measured. The results indicated that TNF-alpha infusion significantly increased Kupffer cell cAMP levels while hepatocyte cAMP levels were not altered. Moreover, cAMP levels also increased in the macrophage/lymphocyte-rich spleen but were not altered in the kidney. Kupffer cell beta-receptor binding characteristics were not significantly affected by TNF-alpha infusion. In contrast, TNF-alpha administration markedly increased plasma levels of PGE2 and epinephrine. Thus, the elevated Kupffer cell cAMP levels induced by TNF-alpha are not due to upregulation of beta-adrenergic receptors, but may be associated with the elevated levels of circulating PGE2 and/or epinephrine.

Animals

Downregulation of hepatic beta-adrenergic receptors after trauma and hemorrhagic shock.

Although it is well known that sympathoadrenal activity increases under various adverse circulatory conditions, it is not known whether there are any alterations in hepatic plasma membrane beta-adrenergic receptors after trauma-hemorrhage and crystalloid resuscitation. To study this, rats underwent a 5-cm midline laparotomy (i.e., trauma induced) and were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of the maximal bleedout (MB) volume was returned in the form of Ringer lactate. The animals were then resuscitated with four times the volume of MB in the form of Ringer lactate over 60 min. Hepatic plasma membranes were isolated using discontinuous Percoll gradient centrifugation. The maximal binding capacity and dissociation constant (i.e., 1/affinity) of [125I]iodopindolol binding to beta-adrenergic receptors were determined using a membrane filtration assay and Scatchard analysis. The results indicate that there was a significant decrease in the maximal binding capacity at the time of MB, which persisted despite crystalloid resuscitation after hemorrhage. However, there were no significant changes in the dissociation constant at any time point during this study. The downregulation of beta-adrenergic receptor binding capacity may be responsible for metabolic abnormalities observed after hemorrhagic shock.

5'-Nucleotidase

ATP-MgCl2 restores depressed endothelial cell function after hemorrhagic shock and resuscitation.

Although ATP-MgCl2 produces beneficial effects following various adverse circulatory conditions, it remains unknown whether this agent restores the depressed endothelial cell function [i.e., the reduced release of endothelium-derived nitric oxide (EDNO) and endothelium-derived contracting factors (EDCF)] in a model of trauma-hemorrhage and resuscitation. To determine this, rats underwent laparotomy (i.e., trauma induced), were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of shed blood volume was returned in the form of Ringer lactate (RL). The animals were then resuscitated with four times the volume of maximal bleedout with RL, following which ATP-MgCl2 (50 mumol/kg body wt) or saline was administered. At 1.5 h postresuscitation, the aorta and superior mesenteric artery (SMA) were isolated, and dose-responses for acetylcholine (ACh, an endothelium-dependent vasodilator, via EDNO) and nitroglycerin (an endothelium-independent vasodilator) were determined. In addition, hypoxia-induced contraction, a process mediated by EDCF, was assessed. The results indicate that the decreased endothelium-dependent relaxation after hemorrhage (sham 94 +/- 3 and 97 +/- 3% vs. hemorrhage 64 +/- 5 and 57 +/- 11% at 10-5 M ACh in aorta and SMA, respectively, P < 0.05) was restored with ATP-MgCl2 treatment. In contrast, there was no significant difference in nitroglycerin-induced relaxation. Moreover, the decreased hypoxia-induced aortic contraction after hemorrhage (sham 221 +/- 26 mg/ring vs. hemorrhage 124 +/- 22 mg/ring, P < 0.05) was attenuated by administration of ATP-MgCl2.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine