Engel J M, Mühling J, Weiss S, Kärcher B, Löhr T, Menges T, Little S, Hempelmann G
Department of Anaesthesiology, Intensive Care Medicine, Pain Management University Hospital, Giessen, Germany.
Amino Acids. 2006 Feb;30(1):87-94. doi: 10.1007/s00726-005-0238-1. Epub 2005 Aug 17.
Recently, an interdependency of plasma taurine and other amino acids as well as metabolic and clinical variables implicating therapeutic options was reported. This result may be an indication that plasma taurine levels are directly related to intracellular levels. Therefore, the aim of this study was to analyse the possible relationship between taurine levels in plasma and in neutrophils, the relationship to other amino acids, and variables quantifying metabolic impairment and severity of sepsis in multiple trauma patients developing sepsis. After multiple trauma taurine decreased significantly in plasma in thirty-two patients as well as within the neutrophil and does not recover in sepsis. Lower individual levels in the neutrophil did not follow lower individual levels in plasma and no correlation of taurine in plasma and in the neutrophils could be observed. In sepsis, only plasma showed an interdependency of taurine, aspartate, and glutamate. No association between taurine plasma or intracellular levels and SOFA score as indicator for severity of sepsis or metabolic variables was observed. After multiple trauma and in sepsis, taurine uptake in cells (which is regulated in different ways), and intracellular taurine (which serves e.g. as an osmolyte) can be influenced. Therefore a prediction of the neutrophil taurine pool seems not fully possible from taurine plasma levels. Intracellular taurine has some unique properties explaining the missing interdependency despite some similarities in osmoregulation and metabolic interactions to other amino acids. The association of taurine, aspartate, and glutamate in plasma cannot be simply transferred to the neutrophils intracellular level. The clinical meaning of the plasma correlation remains unclear. A dependency of plasma and neutrophil taurine to severity of sepsis and to metabolic variables seems not possible because of the multifactorial pathophysiology of sepsis.
最近,有报道称血浆牛磺酸与其他氨基酸以及涉及治疗选择的代谢和临床变量之间存在相互依存关系。这一结果可能表明血浆牛磺酸水平与细胞内水平直接相关。因此,本研究的目的是分析多发伤患者发生脓毒症时血浆和中性粒细胞中牛磺酸水平之间的可能关系、与其他氨基酸的关系以及量化代谢损害和脓毒症严重程度的变量。多发伤后,32例患者的血浆、中性粒细胞内牛磺酸水平均显著下降,且在脓毒症时未恢复。中性粒细胞内较低的个体水平并不随血浆中较低的个体水平而变化,血浆和中性粒细胞中的牛磺酸之间未观察到相关性。在脓毒症中,只有血浆显示出牛磺酸、天冬氨酸和谷氨酸之间的相互依存关系。未观察到血浆或细胞内牛磺酸水平与作为脓毒症严重程度指标的序贯器官衰竭评估(SOFA)评分或代谢变量之间存在关联。多发伤后及脓毒症时,细胞对牛磺酸的摄取(以不同方式调节)和细胞内牛磺酸(例如作为渗透溶质)会受到影响。因此,似乎无法根据血浆牛磺酸水平完全预测中性粒细胞牛磺酸池。尽管细胞内牛磺酸在渗透调节和与其他氨基酸的代谢相互作用方面有一些相似之处,但它具有一些独特的特性,这解释了其缺乏相互依存关系的原因。血浆中牛磺酸、天冬氨酸和谷氨酸之间的关联不能简单地转移到中性粒细胞的细胞内水平。血浆相关性的临床意义仍不清楚。由于脓毒症的多因素病理生理学,血浆和中性粒细胞牛磺酸与脓毒症严重程度和代谢变量之间似乎不存在依赖关系。