Toufekoula Chryssoula, Papadakis Vassileios, Tsaganos Thomas, Routsi Christina, Orfanos Stylianos E, Kotanidou Anastasia, Carrer Dionyssia-Pinelopi, Raftogiannis Maria, Baziaka Fotini, Giamarellos-Bourboulis Evangelos J
Crit Care. 2013 Jan 16;17(1):R6. doi: 10.1186/cc11930.
Recent evidence suggests a link between excess lipid peroxidation and specific organ failures in sepsis. No study has been performed in sepsis by multidrug-resistant (MDR) Gram-negative bacteria.
Lethal sepsis was induced in rats by the intraperitoneal injection of one MDR isolate of Pseudomonas aeruginosa. Produced malondialdehyde (MDA) was measured in tissues 5 hours after bacterial challenge with the thiobarbiturate assay followed by high-performance liquid chromatography (HPLC) analysis. Results were compared with those from a cohort of patients with ventilator-associated pneumonia (VAP) and sepsis by MDR Gram-negative bacteria. More precisely, serum MDA was measured on 7 consecutive days, and it was correlated with clinical characteristics.
MDA of septic rats was greater in the liver, spleen, and aortic wall, and it was lower in the right kidney compared with sham operated-on animals. Findings were confirmed by the studied cohort. Circulating MDA was greater in patients with hepatic dysfunction and acute respiratory distress syndrome (ARDS) compared with patients without any organ failures. The opposite was found for patients with acute renal dysfunction. No differences were found between patients with ARDS without or with cardiovascular (CV) failure and patients without any organ failure. Serial measurements of MDA in serum of patients indicated that levels of MDA were greater in survivors of hepatic dysfunction and ARDS and lower in survivors of acute renal dysfunction.
Animal findings and results of human sepsis are complementary, and they suggest a compartmentalization of lipid peroxidation in systemic infections by MDR gram-negative bacteria.
最近的证据表明，脓毒症中脂质过氧化过量与特定器官功能衰竭之间存在联系。尚未有关于多重耐药（MDR）革兰氏阴性菌所致脓毒症的研究。
通过腹腔注射一株铜绿假单胞菌的MDR分离株诱导大鼠发生致死性脓毒症。在用硫代巴比妥酸测定法检测细菌攻击5小时后，通过高效液相色谱（HPLC）分析测量组织中产生的丙二醛（MDA）。将结果与一组由MDR革兰氏阴性菌引起的呼吸机相关性肺炎（VAP）和脓毒症患者的结果进行比较。更确切地说，连续7天测量血清MDA，并将其与临床特征相关联。
与假手术动物相比，脓毒症大鼠肝脏、脾脏和主动脉壁中的MDA含量更高，而右肾中的MDA含量更低。研究队列证实了这些发现。与没有任何器官功能衰竭的患者相比，肝功能障碍和急性呼吸窘迫综合征（ARDS）患者的循环MDA含量更高。急性肾功能障碍患者的情况则相反。在没有或伴有心血管（CV）衰竭的ARDS患者与没有任何器官功能衰竭的患者之间未发现差异。对患者血清中MDA的系列测量表明，肝功能障碍和ARDS幸存者的MDA水平更高，而急性肾功能障碍幸存者的MDA水平更低。
动物研究结果和人类脓毒症的结果相互补充，它们表明MDR革兰氏阴性菌引起的全身感染中脂质过氧化存在分区现象。
