Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, F-44000 Nantes, France.
InFlectis BioScience, 44200 Nantes, France.
Int J Mol Sci. 2023 Apr 16;24(8):7338. doi: 10.3390/ijms24087338.
In clinical practice, extracorporeal circulation (ECC) is associated with coagulopathy and inflammation, eventually leading to organ injuries without preventive systemic pharmacological treatment. Relevant models are needed to reproduce the pathophysiology observed in humans and preclinical tests. Rodent models are less expensive than large models but require adaptations and validated comparisons to clinics. This study aimed to develop a rat ECC model and to establish its clinical relevance. One hour of veno-arterial ECC or a sham procedure were achieved on mechanically ventilated rats after cannulations with a mean arterial pressure objective > 60 mmHg. Five hours post-surgery, the rats' behavior, plasmatic/blood biomarkers, and hemodynamics were measured. Blood biomarkers and transcriptomic changes were compared in 41 patients undergoing on-pump cardiac surgery. Five hours post-ECC, the rats presented hypotension, hyperlactatemia, and behavioral alterations. The same patterns of marker measurements (Lactate dehydrogenase, Creatinine kinase, ASAT, ALAT, and Troponin T) were observed in both rats and human patients. Transcriptome analyses showed similarity in both humans and rats in the biological processes involved in the ECC response. This new ECC rat model seems to resemble both ECC clinical procedures and the associated pathophysiology, but with early organ injury corresponding to a severe phenotype. Although the mechanisms at stake in the post-ECC pathophysiology of rats or humans need to be described, this new rat model appears to be a relevant and costless preclinical model of human ECC.
在临床实践中,体外循环 (ECC) 与凝血异常和炎症有关,最终导致器官损伤,而没有预防性的全身药物治疗。需要相关模型来复制在人类和临床前试验中观察到的病理生理学。啮齿动物模型比大型模型便宜,但需要适应和验证与临床的比较。本研究旨在开发一种大鼠 ECC 模型并确定其临床相关性。在机械通气的大鼠中进行静脉-动脉 ECC 或假手术,通过目标平均动脉压 > 60 mmHg 进行套管插入,持续 1 小时。手术后 5 小时,测量大鼠的行为、血浆/血液生物标志物和血液动力学。在接受体外循环心脏手术的 41 名患者中比较血液生物标志物和转录组变化。在 ECC 后 5 小时,大鼠出现低血压、高乳酸血症和行为改变。在大鼠和人类患者中都观察到相同的标志物测量模式(乳酸脱氢酶、肌酸激酶、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶和肌钙蛋白 T)。转录组分析显示,人类和大鼠在 ECC 反应中涉及的生物学过程中具有相似性。这种新的 ECC 大鼠模型似乎既类似于 ECC 临床程序,也类似于相关的病理生理学,但早期器官损伤对应于严重表型。尽管需要描述大鼠或人类 ECC 后病理生理学中涉及的机制,但这种新的大鼠模型似乎是一种相关且无成本的人类 ECC 临床前模型。