CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
Multidisciplinary Organ Dysfunction Evaluation Research Network, Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Barranco de la Ballena s/n, 35019 Las Palmas de Gran Canaria, Spain.
Mediators Inflamm. 2020 Oct 15;2020:5101834. doi: 10.1155/2020/5101834. eCollection 2020.
Supplemental oxygen is a supportive treatment in patients with sepsis to balance tissue oxygen delivery and demand in the tissues. However, hyperoxia may induce some pathological effects. We sought to assess organ damage associated with hyperoxia and its correlation with the production of reactive oxygen species (ROS) in a preclinical model of intra-abdominal sepsis. For this purpose, sepsis was induced in male, Sprague-Dawley rats by cecal ligation and puncture (CLP). We randomly assigned experimental animals to three groups: control (healthy animals), septic (CLP), and sham-septic (surgical intervention without CLP). At 18 h after CLP, septic ( = 39), sham-septic ( = 16), and healthy ( = 24) animals were placed within a sealed Plexiglas cage and randomly distributed into four groups for continuous treatment with 21%, 40%, 60%, or 100% oxygen for 24 h. At the end of the experimental period, we evaluated serum levels of cytokines, organ damage biomarkers, histological examination of brain and lung tissue, and ROS production in each surviving animal. We found that high oxygen concentrations increased IL-6 and biomarkers of organ damage levels in septic animals, although no relevant histopathological lung or brain damage was observed. Healthy rats had an increase in IL-6 and aspartate aminotransferase at high oxygen concentration. IL-6 levels, but not ROS levels, are correlated with markers of organ damage. In our study, the use of high oxygen concentrations in a clinically relevant model of intra-abdominal sepsis was associated with enhanced inflammation and organ damage. These findings were unrelated to ROS release into circulation. Hyperoxia could exacerbate sepsis-induced inflammation, and it could be by itself detrimental. Our study highlights the need of developing safer thresholds for oxygen therapy.
补充氧气是治疗脓毒症患者的支持性治疗方法,旨在平衡组织的氧输送和需求。然而,高氧可能会引起一些病理效应。我们旨在评估高氧与活性氧(ROS)产生相关的组织损伤,并在腹腔脓毒症的临床前模型中评估其相关性。为此,我们通过盲肠结扎和穿刺(CLP)诱导雄性 Sprague-Dawley 大鼠发生脓毒症。我们将实验动物随机分为三组:对照组(健康动物)、脓毒症组(CLP)和假脓毒症组(无 CLP 的手术干预)。在 CLP 后 18 小时,脓毒症组(n=39)、假脓毒症组(n=16)和健康组(n=24)动物被放置在密封的有机玻璃笼中,并随机分为四组,分别接受 21%、40%、60%或 100%氧气连续治疗 24 小时。在实验期末,我们评估了每个存活动物的血清细胞因子水平、器官损伤生物标志物、脑和肺组织的组织学检查以及 ROS 产生情况。我们发现,高氧浓度增加了脓毒症动物的 IL-6 和器官损伤标志物水平,尽管没有观察到相关的肺或脑组织病理学损伤。健康大鼠在高氧浓度下 IL-6 和天冬氨酸氨基转移酶水平升高。IL-6 水平,但不是 ROS 水平,与器官损伤标志物相关。在我们的研究中,在临床相关的腹腔脓毒症模型中使用高氧浓度与增强的炎症和器官损伤相关。这些发现与循环中 ROS 的释放无关。高氧可能会加重脓毒症引起的炎症,并且本身可能有害。我们的研究强调需要为氧疗开发更安全的阈值。