Astroglia in Sepsis Associated Encephalopathy

Shulyatnikova, T. V.; Verkhratsky, Alexei

doi:10.1007/s11064-019-02743-2

Cited by 81 publications

(98 citation statements)

References 192 publications

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“…Several possible interpretations for the SAE becoming an early with bad survival organ dysfunction are as following. The rst, the brain itself is a leading organ of host response to infection, which is believed to be the blood-brain barrier (BBB) leakage due to an overwhelming in the pro-in ammatory cytokines and anti-in ammation factors released and resulted in severe in ammatory storm [15]. The severe in ammatory storm is further responsible for these in ammation factors/toxins leak into the brain, and leading to the brain edema and cerebral ischemic injure as well as cell death [15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Sepsis-associated Encephalopathy In ICU Admissions: Prevalence, Early Risk of Death, and its Early Prevent and Control

Tong¹,

Wang²,

Wang³

et al. 2020

Preprint

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Background: Sepsis-associated encephalopathy (SAE) is a common encephalopathy in ICU. We are to definite whether SAE present an high prevalence rate and early risk factors for death in ICU 48 hours, while to cognize its important of early prevention/ control.Methods: We retrospectively enrolled patients with acute critically ill from ICU (January, 2015 to January, 2017). All patients were selected from onset to ICU ≤3 hours. The prevalence and some early risk factors of death in SAE was estimated by using a continuous head and thorax /abdominal cavity CT scans. Results: 748 critically ill adults were analyzed. The prevalence of sepsis within initial 48 hours was 40.4% (302/748). The median time from infection to sepsis was 9 hours ( range, 1-48 ). The SAE (93.4%, 282/302) was diagnosed in sepsis patients, and most of them (96.8%) presented multiple organ dysfunction syndromes (MODS). While the fatality of SAE was in 32.0% at initial 48 hours and 69.1% at initial 14 days. Cox regression analysis, unused antibiotic within initial 3 hours (OR, 0.39; 95% CI, 0.22-0.89), severe inflammatory storm (OR, 0.70; 95% CI, 0.58- 0.94), lower GCS (OR, 2.7; 95% CI, 1.5-3.6), and MODS (OR, 0.37; 95% CI, 0.26-0.96) were early risk factors for death in SAE. Early risk factors for predicting SAE were related to severe inflammatory storm (OR, 3.10; 95% CI, 2.28-4.33), MODS (OR, 3.57; 95% CI, 2.73- 4.67), and unused antibiotics within initial 3 hours (OR, 0.25; 95% CI, 0.11-0.56).Conclusions: SAE in ICU is an high prevalent acute brain dysfunction and most with MODS. The early bad prognosis in SAE was related to the failure of early prevention and control.

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Section: Discussionmentioning

confidence: 99%

Sepsis-associated Encephalopathy In ICU Admissions: Prevalence, Early Risk of Death, and its Early Prevent and Control

Tong¹,

Wang²,

Wang³

et al. 2020

Preprint

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“…The novelty of this study is a first to report that 97.2% of sepsis patients had a SABD with bad outcome, and unused a rapid antibiotic treatment within the initial 0.5 to 3.0 hours after an early suspected infection event plays a vital role in advancement of high morbidity and high risk of death in SABD. In addition, this high prevalence of SABD with bad outcome can also be explained by the following several points: (1) the low prevalence of SAE in the ICU was from a population without stroke or traumatic brain injure [11,12], whereas, our current study is included these septic patients from stroke and trauma [2,13,15]; (2) our SABD patients were generally associated with a SIRS ≥2, which involves the pathogenesis of SABD contributed by Bone [27], i.e., the cytokines lead to blood brain barrier leakage and cell death [28]. A mixed SABD can be considered if accompanied by a primary brain injure; (3) most SABD in our series is presented with MODS, and the previous studies also indicated that sepsis patients with MODS were more likely to exhibit a SAE [12,21,29,30].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors for death in sepsis- associated brain dysfunction: a retrospective study from ICU admissions

Tong

Zhou²,

Wang

2020

Preprint

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Background: The prevalence of sepsis-associated brain dysfunction (SABD) in ICU patients with critically ill remains unknown. We are to assess whether the prevalence of sepsis in ICU would present a high prevalent life- threatening SABD. Methods: We enrolled acute critically ill adults patients from ICU (from January 1, 2015, to January 1, 2017). All patients were selected from onset to ICU ≤3 hours and followed up to 30 day for sepsis patients who were treated in initial 48 hours or more in ICU. The predictors and risk of death of SABD was analyzed by multivariate models. Results: Of the 1349 ICU patients with acute critically ill, 748 were enrolled. Among these, the prevalence of sepsis was 48.4% (362/748). The prevalence of SABD accounted for 97.2% of sepsis (352/362), with fatality at initial 30 days was 73.6%. We found that the strong clinical predictors or markers for SABD were a SIRS ≥2 (OR, 3.2; 95% CI, 1.7-6.1), SOFA score ≥6 (OR, 3.0; 95% CI, 2.6-3.5), and qSOFA score ≥2 (OR, 0.34; 95% CI, 0.16-0.58). Cox logistic adjusted analysis revealed that lower mean arterial pressure (MAP) (OR, 1.5; 95% CI, 1.0-1.7)，higher SOFA score (OR, 1.8; 95% CI, 1.1- 1.9), and unused a rapid antibiotics treatment in initial 3 hours (OR, 0.7; 95% CI, 0.5-0.9) were the predictors of the risk of death among ICU patients with SABD. Conclusions: SABD is a leading life-threatening organ dysfunction following critically ill in ICU, with an high fatality. The predictors for worse survival SABD were related to the lower MAP, higher SOFA scores, and unused a rapid antibiotic treatment within initial 3 hours.

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“…Brain injury is one of the most common and early outcomes of multiple organ dysfunction syndromes (MODS) in sepsis (Dal-Pizzol et al, 2014). SAE is generally considered the primary factor determining the clinical evolution and prognosis of sepsis (Shulyatnikova and Verkhratsky, 2019). It is, therefore, of great importance to study the pathogenesis of SAE to identify effective treatments, thereby improving prognosis and reducing the social and economic burden of patients diagnosed with sepsis.…”

Section: Introductionmentioning

confidence: 99%

“…Glial cells, in particular, are responsible for central nervous system homeostasis (Verkhratsky and Butt, 2013). Astrocytes, the most abundant glial cells in the brain, have many functions, including maintenance of ion and fluid balance, neurotransmitter metabolism, neurogenesis, maintenance of synaptic connections, and synaptic plasticity (Shulyatnikova and Verkhratsky, 2019). The defensive function of astrocytes is characterized by astrogliosis, which is a multicomponent and complex remodeling of astrocytes caused by damage to the central nervous system (Brosius Lutz et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Effect of incubation with lipopolysaccharide and interferon-γ on reactive astrogliosis

Hua

Wang

Yang

et al. 2019

Journal of Integrative Neuroscience

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J o u r n a l o f I n t e g r a t i v e N e u r o s c i e n c eThis is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Sepsis associated encephalopathy is a common complication of sepsis, but its pathogenesis of sepsis-associated encephalopathy remains unclear. Astrocytes are the most abundant brain glial cells, and reactive astrogliosis, a pathological response to central nervous system diseases, has a clear disease and disease-stage specificity. Functional changes of astrocytes are of great significance for the detection and prognosis of sepsisassociated encephalopathy. The pathogenesis of sepsisassociated encephalopathy was explored at the cellular level by examining astrogliosis in an in vivo model of sepsis-associated encephalopathy. Astrocytes of Wistar neonatal rats were incubated with different concentrations of lipopolysaccharide combined with interferonγ. Cell viability was assessed by levels of tumor necrosis factor-α, interleukin-6, nitric oxide, reactive oxygen species, glial fibrillary acidic protein, changes of astrocyte morphology, and prevalence of apoptosis and necrosis. Compared with the control group, the cell viability of treated groups was decreased. The levels of tumor necrosis factor-α, interleukin-6, nitric oxide, reactive oxygen species, and glial fibrillary acidic protein were increased, hypertrophy of astrocytes was observed, and apoptosis was increased. The pathogenic outcomes of astrogliosis in sepsis-associated encephalopathy is discussed and a new tool provided to explore the pathogenesis of sepsisassociated encephalopathy at the cellular level.

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Astroglia in Sepsis Associated Encephalopathy

Cited by 81 publications

References 192 publications

Sepsis-associated Encephalopathy In ICU Admissions: Prevalence, Early Risk of Death, and its Early Prevent and Control

Sepsis-associated Encephalopathy In ICU Admissions: Prevalence, Early Risk of Death, and its Early Prevent and Control

Prevalence and risk factors for death in sepsis- associated brain dysfunction: a retrospective study from ICU admissions

Effect of incubation with lipopolysaccharide and interferon-γ on reactive astrogliosis

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