Treatment of hemorrhagic shock with hypertonic saline solution modulates the inflammatory response to live bacteria in lungs

Fernandes, Celia Ivete; Llimona, Flávia; Godoy, Luiz C.; Negri, Elnara M.; Pontieri, Vera; Moretti, Ana Iochabel Soares; Fernandes, Thadeu Rangel; Soriano, Francisco Garcia; Velasco, Irineu Tadeu; Souza, Heraldo Possolo de

doi:10.1590/s0100-879x2009005000024

Cited by 8 publications

(6 citation statements)

References 39 publications

(41 reference statements)

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“…Thus, resuscitation with a small volume (1:5 ratio against blood loss volume) of HTS can stabilize spleen Tregs in the early phase, and may play a beneficial role in reducing immunologic stress after hemorrhagic shock. Indeed previous studies have shown that HTS resuscitation can reduce the injury to lungs and intestinal mucosa after hemorrhagic shock (Fernandes et al, 2009;Gao et al, 2009;Lu et al, 2010). The proposed mechanism by which HTS can mediate these effects is by shrinking cells and mechanically altering membranes, resulting in the release of ATP and promotion of T-cell function (Loomis et al, 2003;Woehrle et al, 2010;Ledderose et al, 2016).…”

Section: Discussionmentioning

confidence: 98%

Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock

Feng

Jiang

et al. 2017

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To investigate the effects of resuscitation with normal saline (NS), hypertonic saline (HTS), and hydroxyethyl starch (HES) on regulatory T cells (Tregs), helper T 1 (Th1)/Th2 and cytotoxic T 1 (Tc1)/Tc2 profiles in the treatment of hemorrhagic shock. Methods: Rats subjected to severe hemorrhagic shock were resuscitated for 30 min with NS (n=8), HTS (n=8), or HES (n=8); sham (n=8) and naive control (n=8) groups were used for comparison. Following fluid resuscitation, the whole shed blood was reinfused for 30 min, and the rats were observed with continuous hemodynamic monitoring for 120 min. CD4 + CD25 + Foxp3 + Treg proportions, Th1/Th2 and Tc1/Tc2 profiles in spleen were analyzed by three-color flow cytometry. Results: The proportion of CD4 + CD25 + Foxp3 + Tregs and ratios of Th1/Th2 and Tc1/Tc2 did not differ among control, sham, and HTS groups, but were significantly lower in NS and HES groups (both P<0.05 vs. sham); NS and HES levels were similar. The level of Tc1 was significantly increased in HTS (P<0.05 vs. sham), and levels of Tc2 were increased in NS, HES, and HTS groups compared to sham (all P<0.05), but did not differ from each other. Conclusions: HTS resuscitation has a greater impact on immune system recovery than NS or HES by preserving the proportion of Tregs and maintaining the balance between Th1/Th2 and Tc1/Tc2 cells in the spleen. Thus, HTS resuscitation provides potential immunomodulatory activity in the early stage after hemorrhagic shock.

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Section: Discussionmentioning

confidence: 98%

Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock

Feng

Jiang

et al. 2017

J. Zhejiang Univ. Sci. B

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“…In our laboratory we demonstrated that inoculation of gram-negative bacteria (E. coli) in trachea or peritoneal cavity of rats induced an expressive increase in TLR2 mRNA transcription in lung tissues (Fig. This phenomenon was not affected neither by previous ischemia-reperfusion injury nor by the site of bacterial inoculation [25]. Interestingly, expression of TLR4, that is the natural ligand for this class of bacteria, remained unchanged after the procedure (Fig.…”

Section: Tlrs In Sepsis: Experimental Modelsmentioning

confidence: 88%

Toll-Like Receptors in Sepsis: A Tale Still Being Told

Souza

Lima-Salgado²,

Neto³

2010

EMIDDT

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Sepsis is a complex clinical situation responsible for thousands of deaths annually in intensive care units around the globe. Despite all our progress in providing medical care to critically ill patients, mortality of severe forms of sepsis did not decrease as expected. Part of this phenomenon is due to our defective understanding about the host immune response to aggression by a microorganism, including the part played by the pattern-recognition receptors (PRRs) in this process. PRRs are part of the innate immunity responsible for detecting non-self antigens and trigger the initial inflammatory response. The best known PRRs are the tol-like receptors (TLRs). In this article, we review some of our knowledge regarding the role of TLRs in sepsis, both in experimental models and in human patients. The improvement in our knowledge about the mediators and signaling pathways that control this immune response is crucial for the development of better markers of disease and new therapeutic targets, leading us to improve the way we treat septic patients.

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“…Hypertonic saline solutions (HTS) have also made a re‐emergence into the trauma resuscitation world . Unlike isotonic crystalloids, experimental animal models have shown HTS may exert positive immunomodulatory effects primarily attributable to alterations of neutrophil‐endothelial interactions . Other reported benefits of HTS include reduced endothelial cell swelling, improved regional blood flow and microcirculation, improved cardiovascular function, and reduced edema formation due to less overall fluid requirements.…”

Section: Nonsanguineous Fluid Resuscitationmentioning

confidence: 99%

Traumatic coagulopathy‐Part 2: Resuscitative strategies

Palmer

Martin

2014

J Vet Emergen Crit Care

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Hemorrhage accounts for up to 40% of human trauma-related deaths and remains the leading cause of preventable death in human trauma. The exact proportion of trauma-related deaths due to exsanguinations in veterinary patients remains uncertain. Survivability depends upon achieving rapid definitive hemostasis, early attenuation of posttraumatic coagulopathy, and timely restoration of effective circulating volume. Early institution of damage control resuscitation in severely injured patients with uncontrolled hemorrhage has the ability to curtail posttraumatic coagulopathy and the exacerbation of metabolic acidosis and hypothermia and improve survival until definitive hemostasis is achieved.

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Treatment of hemorrhagic shock with hypertonic saline solution modulates the inflammatory response to live bacteria in lungs

Cited by 8 publications

References 39 publications

Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock

Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock

Toll-Like Receptors in Sepsis: A Tale Still Being Told

Traumatic coagulopathy‐Part 2: Resuscitative strategies

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