Early Prediction and Outcome of Septic Encephalopathy in Acute Stroke Patients With Nosocomial Coma

Tong, Daoming; Zhou, Yu; Wang, Guang-Sheng; Chen, Xiao; Yang, Tonghui

doi:10.14740/jocmr2176w

Cited by 5 publications

(5 citation statements)

References 25 publications

(36 reference statements)

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“…One devastating complication of sepsis is septic encephalopathy (SE) [ 28 ]. In this context, aquaporins might play an important role, as SE is associated with vasogenic brain edema [ 29 , 30 ]. The inflammation of the brain occurring in SE is mediated by neutrophil infiltration and causes Aqp4 upregulation which aggravates brain edema [ 31 , 32 ] (Fig.…”

Section: Introductionmentioning

confidence: 99%

Function of aquaporins in sepsis: a systematic review

Rump

Adamzik

2018

Cell Biosci

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BackgroundSepsis is a common cause of death in intensive care units worldwide. Due to the high complexity of this immunological syndrome development of novel therapeutic strategies is urgent. Promising drug targets or biomarkers may depict aquaporins (AQPs) as they regulate crucial key mechanisms of sepsis.Main bodyHere we report on base of the current literature that several AQPs are involved in different physiological processes of sepsis. In immune system mainly AQPs 3, 5 and 9 seem to be important, as they regulate the migration of different immune cells. Several studies showed that AQP3 is essential for T cell function and macrophage migration and that AQP5 and AQP9 regulate neutrophil cell migration and impact sepsis survival. Additionally, to the function in immune system AQPs 1 and 5 play a role in sepsis induced lung injury and their downregulation after inflammatory stimuli impair lung injury. By contrast, AQP4 expression is up-regulated during brain inflammation and aggravates brain edema in sepsis. In kidney AQP2 expression is downregulated during sepsis and can cause renal failure. Some studies also suggest a role of AQP1 in cardiac function.ConclusionIn conclusion, AQPs are involved in many physiological dysfunctions in sepsis and their expressions are differently regulated. Additional research on the regulatory mechanisms of aquaporins may identify potential therapeutic targets.

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Section: Introductionmentioning

confidence: 99%

Function of aquaporins in sepsis: a systematic review

Rump

Adamzik

2018

Cell Biosci

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“…This result suggested involvement of inhibition of MMP-9 expression in the role of QYT in protecting microvascular basement membrane after LPS challenge. Cathepsin B has been known to cleave type IV collagen (Victor et al, 2011; Shoji et al, 2014; Tong et al, 2015) and participate in the regulation of BBB. The present study observed an increase in cathepsin B activation in plasma as well as in brain tissue of mice exposed to LPS, which was significantly repressed by QYT post-treatment (Figures 9F,G).…”

Section: Resultsmentioning

confidence: 99%

“…Lipopolysaccharide (LPS) causes endotoxemia and sepsis, leading to multiple organ failure and infectious shock resulting in a range of disastrous sequels (Berger et al, 2017). Encephalopathy is a common manifestation of endotoxemia (Siami et al, 2008), with a mortality rate of 76.1%, of which the prognosis is mostly neurological dysfunction or persistent vegetative state (Tong et al, 2015). Despite application of fluid resuscitation, vasoactive medicines and glucocorticoid, dealing with endotoxemia remains a challenge for clinician.…”

Section: Introductionmentioning

confidence: 99%

Post-treatment With Qing-Ying-Tang, a Compound Chinese Medicine Relives Lipopolysaccharide-Induced Cerebral Microcirculation Disturbance in Mice

Wang

Huang

et al. 2019

Front. Physiol.

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Objective: Lipopolysaccharide (LPS) causes microvascular dysfunction, which is a key episode in the pathogenesis of endotoxemia. This work aimed to investigate the effect of Qing-Ying-Tang (QYT), a compound Chinese medicine in cerebral microcirculation disturbance and brain damage induced by LPS.Methods: Male C57/BL6 mice were continuously transfused with LPS (7.5 mg/kg/h) through the left femoral vein for 2 h. QYT (14.3 g/kg) was given orally 2 h after LPS administration. The dynamics of cerebral microcirculation were evaluated by intravital microscopy. Brain tissue edema was assessed by brain water content and Evans Blue leakage. Cytokines in plasma and brain were evaluated by flow cytometry. Confocal microscopy and Western blot were applied to detect the expression of junction and adhesion proteins, and signaling proteins concerned in mouse brain tissue.Results: Post-treatment with QYT significantly ameliorated LPS-induced leukocyte adhesion to microvascular wall and albumin leakage from cerebral venules and brain tissue edema, attenuated the increase of MCP-1, MIP-1α, IL-1α, IL-6, and VCAM-1 in brain tissue and the activation of NF-κB and expression of MMP-9 in brain. QYT ameliorated the downregulation of claudin-5, occludin, JAM-1, ZO-1, collagen IV as well as the expression and phosphorylation of VE-cadherin in mouse brain.Conclusions: This study demonstrated that QYT protected cerebral microvascular barrier from disruption after LPS by acting on the transcellular pathway mediated by caveolae and paracellular pathway mediated by junction proteins. This result suggests QYT as a potential strategy to deal with endotoxemia.

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“…At present, EEG is widely used in the diagnosis of patients with sepsis-associated encephalopathy, and the sensitivity is high (17). Although some patients with septic brain disease have no nervous system dysfunction, the mild diffuse abnormal waveform can usually be observed through EEG.…”

Section: Discussionmentioning

confidence: 99%

Changes of rScO2 and ScvO2 in childrenwith sepsis‑related encephalopathywith different prognoses and clinical features

et al. 2019

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Clinical features of sepsis-associated encephalopathy in children with different prognoses were analyzed and the changes of regional cerebral oxygen saturation (rScO 2 ) and central venous oxygen saturation (ScvO 2 ) were measured. Eighty children with sepsis-related encephalopathy, admitted to the Pediatric Intensive Care Unit (PICU) of the Children's Hospital Affiliated to Zhengzhou University, were enrolled in this study and post-intensive care syndrome (PICS) scoring was performed within 24 h after admission. Patients were separated into groups according to the score results and treatment outcomes. Clinical features, functional tests, imaging examinations, PICS scores, and modified Glasgow Coma Scale (GCS) scores were compared among children with varying severities and prognoses. The changes of rScO 2 and ScvO 2 at different time-points among children with different prognoses were measured and compared. According to PICS scores, there were 8 non-critically ill children, 42 critically ill children, and 30 extremely critically ill children. Fifty-two children survived, and the survival rate was 65%. Comparison of the clinical characteristics of children with different conditions showed that deep coma, generalized seizure, severe electroencephalogram (EEG) abnormalities, and the survival of children were significantly associated with the severity of disease (P<0.05). At the same time, compared to the survivors group, the rates of generalized seizures and severe EEG abnormalities were significantly increased in the deceased children group, while the PICS and GCS scores were significantly decreased (P<0.05). rScO 2 values in the deceased group were lower than those in the survival group at different time-points, but the differences were not significant (P>0.05). On the contrary, ScvO 2 values were significantly higher in the deceased group than those in the survivors group (P<0.05). The lower the PICS and GCS scores in children with sepsis-related encephalopathy, the more serious the condition, and the more likely to develop disturbance of consciousness, epileptic seizures, and abnormal EEG changes. Whereas, changes of ScvO 2 are closely related to prognosis.

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Early Prediction and Outcome of Septic Encephalopathy in Acute Stroke Patients With Nosocomial Coma

Cited by 5 publications

References 25 publications

Function of aquaporins in sepsis: a systematic review

Function of aquaporins in sepsis: a systematic review

Post-treatment With Qing-Ying-Tang, a Compound Chinese Medicine Relives Lipopolysaccharide-Induced Cerebral Microcirculation Disturbance in Mice

Changes of rScO2 and ScvO2 in childrenwith sepsis‑related encephalopathywith different prognoses and clinical features

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