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Samuelsson, Kersti; Steinvall, Ingrid; Sjöberg, Folke

doi:10.1186/cc5124

Cited by 31 publications

(6 citation statements)

References 44 publications

(57 reference statements)

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“…Despite the fact that insulin levels are lower in peripheral tissues, such as the skin, our results indicate that it has an active local role in maintaining local metabolic homeostasis as well as having an effect on the local microcirculation. Previous studies using microdialysis in the skin, for example in burn patients 27 and in reconstructive surgery 28 , show local effects in the skin that may not be seen in the central circulation, suggesting an un-coupling effect between local tissue homeostasis and central vital functions. Therefore, a better understanding of the connection between local impaired glucose metabolism and ischemia is essential to finding ways to prevent morbidity, and the need for further surgery when the skin homeostasis is challenged.…”

Section: Discussionmentioning

confidence: 97%

Sampling insulin in different tissue compartments using microdialysis: methodological aspects

Högstedt

Ghafouri

Tesselaar

et al. 2020

Sci Rep

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Sampling the concentration of insulin in human skin using microdialysis is challenging because of low intracutaneous concentrations and low recovery, presumably due to adsorption of insulin to the microdialysis system. In this study, we aimed to (1) measure how the concentration of insulin varies in three different tissue compartments (intracutaneous, subcutaneous and intravenous) and (2) to study how much insulin is adsorbed to the microdialysis catheter membranes and tubing during a typical microdialysis experiment, both in vivo and in vitro. We hypothesized that (1) the concentration of insulin decreases from the intravenous compartment to the intracutaneous and subcutaneous tissue, and that (2) adsorption of insulin to the microdialysis membrane and tubing impairs the recovery of insulin from the tissue. In this experimental study, microdialysis catheters were inserted intracutaneously, subcutaneously and intravenously in 11 healthy subjects. Systemic endogenous hyperinsulinemia was induced by intake of an oral glucose load. Insulin concentration was measured in the dialysate and in the extracted samples from the catheter membrane and tubings. In vitro microdialysis was performed to investigate the temporal resolution of the adsorption. After an oral glucose load insulin concentration increased intravenously, but not in the intracutaneous or subcutaneous compartments, while glucose, lactate and pyruvate concentrations increased in all compartments. The adsorption of insulin to the microdialysis membrane in vivo was highest in the intravenous compartment (p = 0.01), compared to the intracutaneous and subcutaneous compartments. In vitro, the adsorption to the microdialysis membrane was highest one hour after sampling, then the concentration gradually decreased after three and five hours of sampling. The concentration of insulin in peripheral tissues is low, probably due to decreasing tissue vascularity. Adsorption of insulin to the microdialysis membrane is modest but time-dependent. This finding highlights the importance of a stabilization time for the microdialysis system before sampling tissue analytes.

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Section: Discussionmentioning

confidence: 97%

Sampling insulin in different tissue compartments using microdialysis: methodological aspects

Högstedt

Ghafouri

Tesselaar

et al. 2020

Sci Rep

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“…Previous research on how the expression of these proteins is affected by a glucose provocation is limited, although the connection between especially angiotensinogen and kininogen-1 is well known in relation to microcirculatory processes and effects on blood flow related to activation of the nitric oxide pathway. An improved understanding of what biological processes occur in skin and subcutaneous tissue, secondary to increased systemic insulin levels, is likely to be of importance for targeted treatments where glucose delivery to the target tissue is hampered as a result of serious illness and deranged glucose-insulin functions 23 .…”

Section: Discussionmentioning

confidence: 99%

Investigation of proteins important for microcirculation using in vivo microdialysis after glucose provocation: a proteomic study

Högstedt

Farnebo

Tesselaar

et al. 2021

Sci Rep

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Insulin has metabolic and vascular effects in the human body. What mechanisms that orchestrate the effects in the microcirculation, and how the responds differ in different tissues, is however not fully understood. It is therefore of interest to search for markers in microdialysate that may be related to the microcirculation. This study aims to identify proteins related to microvascular changes in different tissue compartments after glucose provocation using in vivo microdialysis. Microdialysis was conducted in three different tissue compartments (intracutaneous, subcutaneous and intravenous) from healthy subjects. Microdialysate was collected during three time periods; recovery after catheter insertion, baseline and glucose provocation, and analyzed using proteomics. Altogether, 126 proteins were detected. Multivariate data analysis showed that the differences in protein expression levels during the three time periods, including comparison before and after glucose provocation, were most pronounced in the intracutaneous and subcutaneous compartments. Four proteins with vascular effects were identified (angiotensinogen, kininogen-1, alpha-2-HS-glycoprotein and hemoglobin subunit beta), all upregulated after glucose provocation compared to baseline in all three compartments. Glucose provocation is known to cause insulin-induced vasodilation through the nitric oxide pathway, and this study indicates that this is facilitated through the interactions of the RAS (angiotensinogen) and kallikrein-kinin (kininogen-1) systems.

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“…Only the unbound concentration in the interstitium, however, is considered to contribute to the efficacy of anti-infectives. Similarly, a moderate correlation or a lack or correlation has been observed between serum and tissue cortisol levels in sepsis or burn injury [ 23 , 30 ]. From a pathophysiological point of view the equilibrium between plasma and tissue interstitial space in the setting of sepsis may be incomplete due to interstitial edema, impairment of the microcirculation or administration of vasopressor agents [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, monitoring of the interstitium is feasible with the implementation of minimally invasive techniques, including microdialysis (MD) [ 15 , 16 , 17 , 18 ]. MD is now increasingly used in critically ill septic patients as a research tool and the measurement of metabolites, such as lactate, pyruvate and glycerol together with the calculation of the lactate/pyruvate (L/P) ratio, directly assess energy metabolic disorders at the tissue level [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. In this regard, a recent study by our group examined the interplay between adipose tissue and blood lactate and found that in ICU patients with septic or cardiogenic shock the rise in tissue lactate preceded the increase in blood lactate [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period

et al. 2018

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No study has directly measured tissue lactate clearance in patients with sepsis during the post-resuscitation period. In this study we aimed to assess in ICU patients with sepsis (n = 32) or septic shock (n = 79)—during the post-resuscitation phase—the relative kinetics of blood/tissue lactate clearances and to examine whether these are associated with outcome. We measured serially—over a 48-h period—blood and adipose tissue interstitial fluid lactate levels (with microdialysis) and we calculated lactate clearance. Statistics included mixed model analysis, Friedman’s analysis of variance, Wilcoxon’s test, Mann-Whitney’s test, receiver operating characteristics curves and logistic regression. Forty patients died (28-day mortality rate = 28%). Tissue lactate clearance was higher compared to blood lactate clearance at 0–8, 0–12, 0–16, 0–20 and 0–24 h (all p < 0.05). Tissue lactate clearance was higher in survivors compared to non-survivors at 0–12, 0–20 and 0–24 h (all p = 0.02). APACHE II along with tissue lactate clearance <30% at 0–12, 0–20 and 0–24 h were independent outcome predictors. We did not find blood lactate clearance to be related to survival. Thus, in critically ill septic patients, elevated tissue (but not blood) lactate clearance, was associated with a favorable clinical outcome.

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Untitled

Cited by 31 publications

References 44 publications

Sampling insulin in different tissue compartments using microdialysis: methodological aspects

Sampling insulin in different tissue compartments using microdialysis: methodological aspects

Investigation of proteins important for microcirculation using in vivo microdialysis after glucose provocation: a proteomic study

Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period

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