Preoperative glucocorticoid administration attenuates the systemic stress response and hyperglycemia after surgical trauma in the rat

Hager, Peter; Permert, Johan; Wikström, Ann–Charlotte; Herrington, Margery K.; Östenson, Claes‐Göran; Strömmer, Lisa

doi:10.1016/j.metabol.2008.10.021

Cited by 8 publications

(2 citation statements)

References 26 publications

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“…Interleukin-6 (IL-6) has been reported to act synergistically with glucocorticoids in stimulating the production of acute-phase reactants [4]. However, cytokines consist only a part of the deranged metabolism during stress in children.…”

Section: Introductionmentioning

confidence: 99%

Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness

Briassoulis

Venkataraman

Thompson

2010

Journal of Immunology Research

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It is not known if cytokines, which are cell-derived mediators released during the host immune response to stress, affect metabolic response to stress during critical illness. The aim of this prospective study was to determine whether the metabolic response to stress is related to the inflammatory interleukin-6 (IL-6), 10 (IL-10), and other stress mediators' responses and to assess their relationships with different feeding patterns, nutritional markers, the severity of illness as assessed by the Multiple Organ System Failure (MOSF), the Pediatric Risk of Mortality Score (PRISM), systemic inflammatory response syndrome (SIRS), and mortality in critically ill children. Patients were classified as hypermetabolic, normometabolic, and hypometabolic when the measured resting energy expenditures (REE) were >110%, 90–110% and, <90% of the predicted basal metabolic rate, respectively. The initial predominance of the hypometabolic pattern (48.6%) declined within 1 week of acute stress (20%), and the hypermetabolic patterns dominated only after 2 weeks (60%). Only oxygen consumption (VO2) and carbon dioxide production (VCO2) (P < .0001) but none of the cytokines and nutritional markers, were independently associated with a hypometabolic pattern. REE correlated with the IL-10 but not PRISM. In the presence of SIRS or sepsis, CRP, IL-6, IL-10, Prognostic Inflammatory and Nutritional Index (NI), and triglycerides—but not glucose, VO2, or VCO2 increased significantly. High IL-10 levels (P = .0000) and low measured REE (P = .0000) were independently associated with mortality (11.7%), which was higher in the hypometabolic compared to other metabolic patterns (P < .005). Our results showed that only VO2 and VCO2, but not IL-6 or IL-10, were associated with a hypometabolic pattern which predominated the acute phase of stress, and was associated with increased mortality. Although in SIRS or sepsis, the cytokine response was reliably reflected by increases in NI and triglycerides, it was different from the metabolic (VO2, VCO2) or glucose response.

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Section: Introductionmentioning

confidence: 99%

Cytokines and Metabolic Patterns in Pediatric Patients with Critical Illness

Briassoulis

Venkataraman

Thompson

2010

Journal of Immunology Research

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“…This implies that the general stress associated with surgery can affect the neuroendocrine control of the reproductive axis and lead to amenorrhea. In fact, elevated levels of glucocorticoids and hyperglycemia are common consequences of activation of the HPA axis secondary to surgical interventions (Hager et al ., 2004; Hager et al ., 2009). Desborough (Desborough, 2000) suggests that surgery is one of the most potent activators of adrenocorticotrophin and cortisol release.…”

Section: Discussionmentioning

confidence: 99%

Rodent estrous cycle response to incomplete spinal cord injury, surgical interventions, and locomotor training.

Shah¹,

Song²,

Kim³

et al. 2011

Behavioral Neuroscience

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Estrous cycle disruption after spinal cord injury (SCI) in female rats is a common phenomenon. It remains unknown, however, if the aberrant estrous cycle is a result of an injury to the spinal cord itself or due to the general stress associated with surgical interventions. We addressed this issue by determining estrous cyclicality in female rats after a spinal cord hemisection (HX), implantation of EMG wires into selected hindlimb muscles, and/or injections of tracer dyes into the spinal cord. Since it is known that aerobic exercise can enhance the recovery of locomotor function in rodents with an incomplete SCI, we also determined if locomotor training positively impacts the disrupted estrous cycle after a HX. Estrous cycle assessments were made during a 5-8 week period in 27 female rats before and after HX, EMG, and/or dye injection surgeries and in HX rats that recovered spontaneously or underwent locomotor training. Our results show that estrous cyclicality was disrupted (cycle length >5 days) in approximately 76%, 46%, and 50% of the rats after HX, EMG, and dye injection surgeries, respectively. The cyclicality, however, was disrupted for a longer period after HX than after EMG or dye injection surgeries. Furthermore, estrous cycle mean length was shorter in the trained than non-trained HX group. These results suggest that estrous cycle disruption after a major SCI is a consequence of both the direct injury to the spinal cord and to the associated stress. Moreover, moderate aerobic exercise initiated early after a spinal cord HX returns the duration of the estrous cycle towards normal.

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