Protti Alessandro, Carré Jane, Frost Matthew T, Taylor Valerie, Stidwill Raymond, Rudiger Alain, Singer Mervyn
Bloomsbury Institute of Intensive Care Medicine, Wolfson Institute for Biomedical Research, and Department of Medicine, University College London, London, UK.
Crit Care Med. 2007 Sep;35(9):2150-5. doi: 10.1097/01.ccm.0000281448.00095.4d.
Mitochondrial dysfunction, particularly affecting complex I of the respiratory chain, could play a fundamental role in the development of multiple organ failure during sepsis. Increasing electron flow through complex II by addition of succinate may improve mitochondrial oxygen utilization and thus adenosine triphosphate production.
Ex vivo animal study.
University research laboratory.
Male adult Wistar rats.
Fecal peritonitis was induced in conscious, fluid-resuscitated, hemodynamically-monitored rats. Sham-operation and naïve animals acted as controls. At 48 hrs, clinical severity was graded. Soleus muscle was taken for measurement of mitochondrial complex activities and oxygen consumption. The effect of glutamate plus malate (complex I substrates) and succinate (complex II substrate) on mitochondrial respiration was assessed.
In the presence of glutamate plus malate, mitochondrial oxygen consumption was abnormally low in skeletal muscle tissue from moderately-to-severely septic animals as compared with naïve and sham-operation controls (both p < .01). On addition of succinate, mitochondrial respiration was augmented in all groups, particularly in moderately-to-severely septic animals (39% +/- 6% increase) as compared with naïve (11% +/- 5%; p < .01) and sham-operation controls (10% +/- 5%; p < .01). In the presence of succinate, mitochondrial oxygen consumption was similar between the groups.
Succinate increases mitochondrial oxygen consumption in ex vivo skeletal muscle taken from septic animals, bypassing the predominant inhibition occurring at complex I. This warrants further exploration in vivo as a putative therapeutic modality.
线粒体功能障碍,尤其是影响呼吸链复合体I,可能在脓毒症期间多器官功能衰竭的发展中起重要作用。通过添加琥珀酸增加通过复合体II的电子流可能改善线粒体氧利用,从而增加三磷酸腺苷的产生。
离体动物研究。
大学研究实验室。
雄性成年Wistar大鼠。
在清醒、液体复苏、血流动力学监测的大鼠中诱导粪性腹膜炎。假手术和未处理动物作为对照。48小时时,对临床严重程度进行分级。取比目鱼肌测量线粒体复合体活性和氧消耗。评估谷氨酸加苹果酸(复合体I底物)和琥珀酸(复合体II底物)对线粒体呼吸的影响。
在存在谷氨酸加苹果酸的情况下,与未处理和假手术对照组相比,中度至重度脓毒症动物骨骼肌组织中的线粒体氧消耗异常低(均p < 0.01)。添加琥珀酸后,所有组的线粒体呼吸均增强,尤其是中度至重度脓毒症动物(增加39% ± 6%),与未处理组(11% ± 5%;p < 0.01)和假手术对照组(10% ± 5%;p < 0.01)相比。在存在琥珀酸的情况下,各组之间的线粒体氧消耗相似。
琥珀酸可增加脓毒症动物离体骨骼肌中的线粒体氧消耗,绕过复合体I处的主要抑制作用。这值得作为一种潜在的治疗方式在体内进行进一步探索。