Department of Pharmaceutical Sciences, Albany College of Pharmacy & Health Sciences, Albany, NY, USA Trauma Research, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil.
J Physiol. 2014 Sep 1;592(17):3901-16. doi: 10.1113/jphysiol.2014.277277. Epub 2014 Jun 20.
We tested the hypothesis that development of hypothermia instead of fever in endotoxic shock is consequential to hypoxia. Endotoxic shock was induced by bacterial lipopolysaccharide (LPS, 500 μg kg(-1) i.v.) in rats at an ambient temperature of 22 °C. A β3-adrenergic agonist known to activate metabolic heat production, CL316,243, was employed to evaluate whether thermogenic capacity could be impaired by the fall in oxygen delivery (ḊO2) during endotoxic shock. This possibility was rejected as CL316,243 (0.15 mg kg(-1) i.v.) evoked similar rises in oxygen consumption (V̇O2) in the presence and absence of endotoxic shock. Next, to investigate whether a less severe form of circulatory hypoxia could be triggering hypothermia, the circulating volume of LPS-injected rats was expanded using 6% hetastarch with the intention of improving tissue perfusion and alleviating hypoxia. This intervention attenuated not only the fall in arterial pressure induced by LPS, but also the associated falls in V̇O2 and body temperature. These effects, however, occurred independently of hypoxia, as they were not accompanied by any detectable changes in NAD(+)/NADH ratios. Further experimentation revealed that even the earliest drops in cardiac output and ḊO2 during endotoxic shock did not precede the reduction in V̇O2 that brings about hypothermia. In fact, ḊO2 and V̇O2 fell in such a synchrony that the ḊO2/V̇O2 ratio remained unaffected. Only when hypothermia was prevented by exposure to a warm environment (30 °C) did an imbalance in the ḊO2/V̇O2 ratio become evident, and such an imbalance was associated with reductions in the renal and hypothalamic NAD(+)/NADH ratios. In conclusion, hypometabolism and hypothermia in endotoxic shock are not consequential to hypoxia but serve as a pre-emptive strategy to avoid hypoxia in this model.
我们检验了这样一个假设,即在内毒素休克中发展为低体温而不是发热是缺氧的结果。在环境温度为 22°C 的情况下,通过静脉内给予细菌脂多糖(LPS,500μgkg(-1))在大鼠中诱导内毒素休克。已知β3-肾上腺素能激动剂 CL316,243 可激活代谢产热,我们用它来评估在内毒素休克期间氧输送(ḊO2)下降是否会损害产热能力。由于 CL316,243(0.15mgkg(-1)静脉内给予)在存在和不存在内毒素休克的情况下均引起相似的氧耗量(V̇O2)升高,因此否定了这种可能性。接下来,为了研究循环性缺氧是否可以引发低体温,使用 6%羟乙基淀粉扩张 LPS 注射大鼠的循环量,旨在改善组织灌注和减轻缺氧。这种干预不仅减轻了 LPS 诱导的动脉血压下降,而且减轻了相关的 V̇O2 和体温下降。然而,这些作用是独立于缺氧发生的,因为它们没有伴随着 NAD(+)/NADH 比值的任何可检测变化。进一步的实验表明,即使在内毒素休克期间,心脏输出和ḊO2 的最早下降也不会先于导致低体温的 V̇O2 下降。实际上,ḊO2 和 V̇O2 的下降如此同步,以至于ḊO2/V̇O2 比值保持不变。只有当通过暴露于温暖环境(30°C)防止低体温时,ḊO2/V̇O2 比值才会出现不平衡,并且这种不平衡与肾脏和下丘脑的 NAD(+)/NADH 比值降低有关。总之,内毒素休克中的低代谢和低体温不是缺氧的结果,而是作为该模型中避免缺氧的一种先发制人的策略。