Oxidative stress in severe pulmonary trauma in critical ill patients. Antioxidant therapy in patients with multiple trauma — a review

Bedreag, Ovidiu Horea; Rogobete, Alexandru Florin; Sărăndan, Mirela; Cradigati, Alina Carmen; Păpurică, Marius; Dumbuleu, Maria Corina; Chira, Alexandru Mihai; Roşu, Oana Maria; Săndesc, Dorel

doi:10.5603/ait.a2015.0030

Cited by 26 publications

(33 citation statements)

References 119 publications

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“…We observed no significant differences in the number of patients requiring mechanical ventilation for more than 96 hours between the two groups. One explanation for this could be the high number of patients with severe thoracic trauma, as well as an increased percentage of pulmonary infections [21][22][23][24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Analysis of oxidative stress-related markers in critically ill polytrauma patients: An observational prospective single-center study

Sandesc

Rogobete

Bedreag

et al. 2018

Bosn J of Basic Med Sci

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Critically ill polytrauma patients have increased production of free radicals (FRs) and consequent alterations in biochemical pathways, as well as disruption of cellular integrity, due to increased lipid peroxidation. The aim of this study was to investigate several biomarkers associated with increased oxidative stress in critically ill polytrauma patients, and to evaluate the effect of antioxidant treatment on the clinical outcome in these patients. A total of 67 polytrauma patients from an intensive care unit met the selection criteria. Antiox group included 35/67 patients who received antioxidant therapy, while 32/67 patients without antioxidant treatment were considered as control group. Antioxidant therapy consisted of simultaneous administration of Vitamin C (sodium ascorbate) and N-acetylcysteine, through continuous intravenous infusion. Clinical and paraclinical evaluation of the patients was performed daily until discharge or death. At admission, laboratory parameters did not differ significantly between two groups. At discharge/upon death, statistically significant differences in favor of Antiox group were observed in the following parameters: thrombocytes, activated partial thromboplastin time, prothrombin time, total bilirubin, total cholesterol, high-density lipoproteins, low-density lipoproteins, erythrocyte sedimentation rate, interleukin 6 (all p = 0.0001), total protein (p = 0.0005), serum albumin (p = 0.0004), lactate dehydrogenase (p = 0.0006), and C-reactive protein (p = 0.0014). Starting from day 5, the APACHE II score was significantly decreased in Antiox versus control group (p < 0.05). Finally, the sepsis incidence and mortality rate were significantly lower in Antiox group (p < 0.05). Decreasing the level of oxidative stress by antioxidant substances significantly correlated with a better prognosis and outcome in our patients. Further studies should elucidate more clearly the mechanism of action of antioxidants in critically ill polytrauma patients.

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Section: Discussionmentioning

confidence: 99%

Analysis of oxidative stress-related markers in critically ill polytrauma patients: An observational prospective single-center study

Sandesc

Rogobete

Bedreag

et al. 2018

Bosn J of Basic Med Sci

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“…In this issue, implications of oxidative stress in the critically ill patient with severe head injury are presented in an article by Luca and its research group [14], following numerous publications on the subject [15,16].…”

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confidence: 99%

Oxidative Stress in the Critically Ill Polytrauma Patient

Săndesc

2015

The Journal of Critical Care Medicine

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“…In addition, oxidative stress also participated in the pathogenesis of endotoxemia and contribute to multiple organ failure in septic patients [48,49]. Circulating monocyte and macrophage play an important role in eliminating bacteria [51].…”

Section: Gal-9 Is Highly Expressed In Liver Lung and Kidney After Gamentioning

confidence: 99%

Gelactin-9 Mediates the Therapeutic Effect of Mesenchymal Stem Cells on Experimental Endotoxemia

Zhao

Wang

et al. 2020

Preprint

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Background: Endotoxemia, mediated by uncontrolled immunocytes activation toward Lipopolysaccharide, could deteriorate into severe septic shock, but with limited treatment effect. Mesenchymal stem cells (MSCs), with excellent immune regulatory capacities, have displayed potential in multiple inflammatory disease treatment. Gelactin-9 (Gal-9), a newly discovered immune checkpoint, has been demonstrated to mediate immunomodulatory effect of MSCs in vitro. However, its in vivo role in alleviating endotoxemia remains to be elucidated.Methods: MSCs (2.5×10⁵/ml) were obtained and stimulated with IFN-γ (20ng/ml) for 72 hours. Gal-9 expression on MSCs were measured by ELISA, RT-PCR, flow cytometry and immunofluorescence respectively. Then, experimental endotoxemia was induced by LPS injection (10mg/kg, i.p.), followed by the treatment with Gal-9-MSC (20ng/ml, 72 hours), MSCs and MSC+α-lactose (10.8mg/mL, 500ul, i.v.). Therapeutic effects of MSC-based treatments were assessed by monitoring murine sepsis score, survival rate, splenocyte proportion, phenotype polarization, inflammatory mediator levels and pathological manifestations. Furthermore, Gal-9 expression in multiple organs was also detected after administering the treatments.Results: It has been found that MSCs expressed Gal-9 and its level was increased in a dose-dependent manner after being stimulated by IFN-γ. Moreover, adoptive transferred of IFN-γ pre-stimulated MSCs into endotoxemia mice was found with relieved symptoms and increased survival rate. Flow cytometry analysis indicated that Gal-9-MSC could promote macrophage polarization to M2-subtype and increase Treg ratios in spleen. Further results also demonstrated that, Gal-9-mediated MSC therapy could assist in attenuating local and circulating pro-inflammatory mediators expression (TNF-α, IL-1β, IFN-γ and iNOS), but increasing anti-inflammatory mediators expression (T-SOD and IL-35). Additionally, after administrating Gal-9-MSC, it was also found there was a significant relief in pathological manifestations, and with a higher expression of Gal-9 in liver, kidney and lung homogenate.Conclusions: This study revealed that Gal-9 mediated therapeutic effects of MSCs in alleviating endotoxemia injury, which provides a novel idea for supplementing the research of MSC immunoregulatory mechanism, and offers an excellent candidate to be used in treatment of endotoxemia in the clinical settings.

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Oxidative stress in severe pulmonary trauma in critical ill patients. Antioxidant therapy in patients with multiple trauma — a review

Cited by 26 publications

References 119 publications

Analysis of oxidative stress-related markers in critically ill polytrauma patients: An observational prospective single-center study

Analysis of oxidative stress-related markers in critically ill polytrauma patients: An observational prospective single-center study

Oxidative Stress in the Critically Ill Polytrauma Patient

Gelactin-9 Mediates the Therapeutic Effect of Mesenchymal Stem Cells on Experimental Endotoxemia

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