Freund H R, Muggia-Sullam M, Peiser J, Melamed E
J Surg Res. 1985 Mar;38(3):267-71. doi: 10.1016/0022-4804(85)90037-x.
Patients with sepsis often manifest symptoms of encephalopathy similar to those observed in portasystemic encephalopathy. As a causal relationship has been demonstrated between hepatic encephalopathy and a deranged brain neurotransmitter profile, the catecholaminergic and serotoninergic brain neurotransmitter profile in a septic rat model was investigated. Septic animals exhibited lower levels of norepinephrine (NE), 3,4-dihydroxyphenylacetic acid, and homovanillic acid compared to normal controls. Severely septic animals with encephalopathy exhibited significantly lower levels of NE, dopamine, 5-hydroxytryptamine, and 5-hydroxyindoleacetic acid compared to rats only mildly septic with no encephalopathy. The infusion of branched chain amino acids during sepsis had no effect on this deranged brain neurotransmitter profile. Previous results of derangements in the blood-brain barrier transport mechanism combined with the present findings of a deranged brain amino acid and neurotransmitter profile during sepsis may be responsible, at least in part, for the metabolic encephalopathy observed during sepsis and might suggest a common etiology for septic, hepatic, and other metabolic encephalopathies.
脓毒症患者常表现出与门体分流性脑病相似的脑病症状。由于肝性脑病与大脑神经递质谱紊乱之间已证实存在因果关系，因此对脓毒症大鼠模型中的儿茶酚胺能和5-羟色胺能大脑神经递质谱进行了研究。与正常对照组相比，脓毒症动物的去甲肾上腺素（NE）、3,4-二羟基苯乙酸和高香草酸水平较低。与仅患有轻度脓毒症且无脑病的大鼠相比，患有严重脓毒症且伴有脑病的动物的NE、多巴胺、5-羟色胺和5-羟吲哚乙酸水平显著降低。脓毒症期间输注支链氨基酸对这种紊乱的大脑神经递质谱没有影响。先前血脑屏障转运机制紊乱的结果，结合目前脓毒症期间大脑氨基酸和神经递质谱紊乱的发现，可能至少部分导致了脓毒症期间观察到的代谢性脑病，并可能提示脓毒症性、肝性和其他代谢性脑病存在共同的病因。
