Moore Christopher C, Martin Edward N, Lee Grace H, Obrig Tom, Linden Joel, Scheld W Michael
Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Box 801342, Charlottesville, VA 22908, USA.
BMC Infect Dis. 2008 Oct 20;8:141. doi: 10.1186/1471-2334-8-141.
The pathophysiology of sepsis is due in part to early systemic inflammation. Here we describe molecular and cellular responses, as well as survival, in A 2A adenosine receptor (AR) agonist treated and untreated animals during experimental sepsis.
Sepsis was induced in mice by intraperitoneal inoculation of live bacteria (Escherichia coli or Staphylococcus aureus) or lipopolysaccharide (LPS). Mice inoculated with live bacteria were treated with an A 2A AR agonist (ATL313) or phosphate buffered saline (PBS), with or without the addition of a dose of ceftriaxone. LPS inoculated mice were treated with ATL313 or PBS. Serum cytokines and chemokines were measured sequentially at 1, 2, 4, 8, and 24 hours after LPS was administered. In survival studies, mice were followed until death or for 7 days.
There was a significant survival benefit in mice infected with live E. coli (100% vs. 20%, p = 0.013) or S. aureus (60% vs. 20%, p = 0.02) when treated with ATL313 in conjunction with an antibiotic versus antibiotic alone. ATL313 also improved survival from endotoxic shock when compared to PBS treatment (90% vs. 40%, p = 0.005). The serum concentrations of TNF-alpha, MIP-1 alpha, MCP-1, IFN-gamma, and IL-17 were decreased by ATL313 after LPS injection (p < 0.05). Additionally, ATL313 increased the concentration of IL-10 under the same conditions (p < 0.05). Circulating white blood cell concentrations were higher in ATL313 treated animals (p < 0.01).
Further studies are warranted to determine the clinical utility of ATL313 as a novel treatment for sepsis.
脓毒症的病理生理学部分归因于早期全身炎症反应。在此,我们描述了在实验性脓毒症期间,A2A腺苷受体(AR)激动剂处理和未处理的动物的分子和细胞反应以及生存率。
通过腹腔注射活细菌(大肠杆菌或金黄色葡萄球菌)或脂多糖(LPS)诱导小鼠发生脓毒症。接种活细菌的小鼠用A2A AR激动剂(ATL313)或磷酸盐缓冲盐水(PBS)处理,添加或不添加一剂头孢曲松。接种LPS的小鼠用ATL313或PBS处理。在给予LPS后的1、2、4、8和24小时依次测量血清细胞因子和趋化因子。在生存研究中,对小鼠进行跟踪直至死亡或观察7天。
与单独使用抗生素相比,联合使用ATL313和抗生素治疗的感染活大肠杆菌(100%对20%,p = 0.013)或金黄色葡萄球菌(60%对20%,p = 0.02)的小鼠有显著的生存获益。与PBS治疗相比,ATL313也提高了内毒素休克的生存率(90%对40%,p = 0.005)。LPS注射后,ATL313降低了TNF-α、MIP-1α、MCP-1、IFN-γ和IL-17的血清浓度(p < 0.05)。此外,在相同条件下,ATL313增加了IL-10的浓度(p < 0.05)。ATL313处理的动物循环白细胞浓度更高(p < 0.01)。
有必要进一步研究以确定ATL313作为脓毒症新治疗方法的临床效用。