Objective Murine models of critical illness are commonly used to test new therapeutic interventions. However, these interventions are often administered at fixed time intervals after the insult, perhaps ignoring the inherent variability in magnitude and temporality of the host response. We propose to use wireless biotelemetry monitoring to define and validate criteria for acute deterioration and generate a physiology-based murine cecal ligation and puncture (CLP) model that is more similar to the conduct of human trials of sepsis. Design Laboratory and animal research Setting University basic science laboratory Subjects Male C57BL/6 mice Interventions Mice underwent CLP, and an HD-X11 wireless telemetry monitor (DSI) was implanted that enabled continuous, real-time measurement of heart rate, core temperature, and mobility. We performed a population-based analysis to determine threshold criteria that met face validity for acute physiologic deterioration. We assessed construct validity by temporally matching mice that met these acute physiologic deterioration thresholds with mice that had not yet met deterioration threshold. We analyzed matched blood samples for blood gas, inflammatory cytokine concentration, Cystatin C, and alanine aminotransferase. Measurements and Main Results We observed that a 10% reduction in both heart rate and temperature sustained for >=10 minutes defined acute physiologic deterioration. There was significant variability in the time to reach acute deterioration threshold across mice, ranging from 339 to 529 minutes after CLP. We found adequate construct validity, as mice, which met criteria for acute deterioration had significantly worse shock, systemic inflammation (elevated TNFα, p=0.003; IL-6, p=0.01; IL-10, p=0.005), and acute kidney injury when compared to mice that had not yet met acute deterioration criteria. Conclusion We defined a murine threshold for acute physiologic deterioration after CLP that has adequate face and construct validity. This model may enable a more physiology-based model for evaluation of novel therapeutics in critical illness.
Evidence suggests that light and circadian rhythms profoundly influence the physiologic capacity with which an organism responds to stress. However, the ramifications of light spectrum on the course of critical illness remain to be determined. Here, we show that acute exposure to bright blue spectrum light reduces organ injury by comparison with bright red spectrum or ambient white fluorescent light in two murine models of sterile insult: warm liver ischemia/reperfusion (I/R) and unilateral renal I/R. Exposure to bright blue light before I/R reduced hepatocellular injury and necrosis and reduced acute kidney injury and necrosis. In both models, blue light reduced neutrophil influx, as evidenced by reduced myeloperoxidase (MPO) within each organ, and reduced the release of high-mobility group box 1 (HMGB1), a neutrophil chemotactant and key mediator in the pathogenesis of I/R injury. The protective mechanism appeared to involve an optic pathway and was mediated, in part, by a sympathetic (β3 adrenergic) pathway that functioned independent of significant alterations in melatonin or corticosterone concentrations to regulate neutrophil recruitment. These data suggest that modifying the spectrum of light may offer therapeutic utility in sterile forms of cellular injury.
Modifying the spectrum of light may offer therapeutic utility in sepsis.
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