Hypertonic saline resuscitation reduces apoptosis of intestinal mucosa in a rat model of hemorrhagic shock

Lu, Yuan-Qiang; Huang, Weidong; Cai, Xiujun; Gu, Linhui; Mou, Haiwei

doi:10.1631/jzus.b0820116

Cited by 15 publications

(18 citation statements)

References 34 publications

(35 reference statements)

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“…However, the results of the present study indicated that resuscitation with all three fluids equally restored MAP levels in the early stage of hemorrhagic shock. Although the MAP in rats receiving HTS was slightly lower than those in the other groups at the end of the fluid resuscitation stage, it was still high enough ((97.50±6.83) mmHg) to maintain blood supply to vital organs, based on previous reports (Lu et al, 2010;Barros et al, 2011;Vallet, 2011;Cui et al, 2014). Fluid resuscitation with NS or HES may result in hypoosmolar dehydration, thus stimulating an immune system response and inflammatory injury, whereas HTS may promote a more beneficial state of immunologic stress.…”

Section: Discussionmentioning

confidence: 75%

“…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%

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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: 75%

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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“…The dosages of HTS and HES were both 1:1 volume to shed blood. The actual dose used in each group was readjusted according to the directions from previous studies (Lu et al, 2008;.…”

Section: Experimental Protocolmentioning

confidence: 99%

“…The crystalloid or colloidal solutions, such as normal saline (NS), hypertonic saline (HTS), and hydroxyethyl starch (HES), are widely used fluids in clinical practice and research. Actually, HTS has been already proven to attenuate the increase of some cytokine production and the activity of immune cells in peripheral circulation (Lu et al, 2008;2010;Chen et al, 2011;Motaharinia et al, 2015). It was also found that HES ameliorated oxidative stress and inflammatory response in the rat model during hemorrhagic shock resuscitation (Watters et al, 2006;Wang et al, 2009;Chen et al, 2013).…”

Section: Introductionmentioning

confidence: 97%

Distribution and differentiation of myeloid-derived suppressor cells after fluid resuscitation in mice with hemorrhagic shock

Jiang

Fang

Ling

et al. 2017

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To investigate the distribution and differentiation of myeloid-derived suppressor cells (MDSCs) in hemorrhagic shock mice, which are resuscitated with normal saline (NS), hypertonic saline (HTS), and hydroxyethyl starch (HES). Methods: BALB/c mice were randomly divided into control, NS, HTS, and HES resuscitation groups. Three subgroups (n=8) in each resuscitation group were marked as 2, 24, and 72 h. Flow cytometry was used to detect the MDSCs, monocytic MDSCs (M-MDSCs), and granulocytic/neutrophilic MDSCs (G-MDSCs) in peripheral blood nucleated cells (PBNCs), spleen single-cell suspension, and bone marrow nucleated cells (BMNCs). Results: The MDSCs in BMNCs among three resuscitation groups were lower 2 h after shock, in PBNCs of the HTS group were higher, and in spleen of the NS group were lower (all P<0.05 vs. control). The M-MDSC/G-MDSC ratios in PBNCs of the HTS and HES groups were lower (both P<0.05 vs. control). At 24 h, the MDSCs in PBNCs of the NS and HTS groups were higher, while the spleen MDSCs in the HTS group were higher (all P<0.05 vs. control). The M-MDSC/ G-MDSC ratios were all less in PBNCs, spleen, and BMNCs of the NS and HTS groups, and were lower in BMNCs of the HES group (all P<0.05 vs. control). At 72 h, the elevated MDSCs in PBNCs were presented in the HTS and HES groups, and in spleen the augment turned up in three resuscitation groups (all P<0.05 vs. control). The inclined ratios to M-MDSC were exhibited in spleen of the NS and HTS groups, and in PBNCs of the NS group; the inclination to G-MDSC in BMNCs was shown in the HES group (all P<0.05 vs. control). Conclusions: HTS induces the earlier elevation of MDSCs in peripheral blood and spleen, and influences its distribution and differentiation, while HES has a less effect on the distribution but a stronger impact on the differentiation of MDSCs, especially in bone marrow.

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“…In a separate report, the same protocol showed that hemorrhage induced intense apoptosis in the intestinal mucosa; and that this is partially reduced by hypertonic saline resuscitation, but not by resuscitation with normal saline. 24 …”

Section: Lymphocyte Functionmentioning

confidence: 99%

Hypertonic saline for treatment of shock: have we looked for everything?

Silva

2014

Medical Express

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This review is dedicated to the memory of Luis Poli de Figueiredo, who is responsible for much of what we know about small volume resuscitation. Small volume hypertonic resuscitation was originally based on the concept that a physiologically significant blood volume expansion follows the administration of a comparatively small volume of hypertonic fluid. Because hypertonicity is a physiological vasodilator, its use after severe blood loss induces reperfusion. Previously reported research disclosed a number of additional properties of hypertonic NaCl, amongst them (i) the correction of endothelial and red cell edema with significant consequences in terms of capillary blood flow; (ii) modulation of the immune system, with applications repercussions in the field of sepsis. This review covers developments in this field that occurred from 2005 through 2013. We discuss the discrepancy between animal experiments and human trials, and argue that the basic objective of most multicenter clinical trials may have been based upon a poor strategy.K EYWORDS: Shock; Hemorrhage; Sepsis Hypertonic saline; Immune circulation.Rocha-e-Silva M. Hypertonic saline for treatment of shock: have we looked for everything? MEDICALEXPRESS. 2014;1(1):14-21.

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Hypertonic saline resuscitation reduces apoptosis of intestinal mucosa in a rat model of hemorrhagic shock

Cited by 15 publications

References 34 publications

Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock

Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock

Distribution and differentiation of myeloid-derived suppressor cells after fluid resuscitation in mice with hemorrhagic shock

Hypertonic saline for treatment of shock: have we looked for everything?

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