Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, China.
Department of Critical Care Medicine, Chifeng Municipal Hospital, Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, 024000, China.
J Neuroinflammation. 2024 May 27;21(1):138. doi: 10.1186/s12974-024-03135-2.
Sepsis-associated encephalopathy (SAE) is a significant cause of mortality in patients with sepsis. Despite extensive research, its exact cause remains unclear. Our previous research indicated a relationship between non-hepatic hyperammonemia (NHH) and SAE. This study aimed to investigate the relationship between NHH and SAE and the potential mechanisms causing cognitive impairment. In the in vivo experimental results, there were no significant abnormalities in the livers of mice with moderate cecal ligation and perforation (CLP); however, ammonia levels were elevated in the hippocampal tissue and serum. The ELISA study suggest that fecal microbiota transplantation in CLP mice can reduce ammonia levels. Reduction in ammonia levels improved cognitive dysfunction and neurological impairment in CLP mice through behavioral, neuroimaging, and molecular biology studies. Further studies have shown that ammonia enters the brain to regulate the expression of aquaporins-4 (AQP4) in astrocytes, which may be the mechanism underlying brain dysfunction in CLP mice. The results of the in vitro experiments showed that ammonia up-regulated AQP4 expression in astrocytes, resulting in astrocyte damage. The results of this study suggest that ammonia up-regulates astrocyte AQP4 expression through the gut-brain axis, which may be a potential mechanism for the occurrence of SAE.
脓毒症相关性脑病(SAE)是脓毒症患者死亡的重要原因。尽管进行了广泛的研究,但确切的病因仍不清楚。我们之前的研究表明非肝脏性高血氨症(NHH)与 SAE 之间存在关系。本研究旨在探讨 NHH 与 SAE 之间的关系以及导致认知障碍的潜在机制。在体内实验结果中,中度盲肠结扎和穿孔(CLP)小鼠的肝脏没有明显异常;然而,其海马组织和血清中的氨水平升高。ELISA 研究表明,CLP 小鼠的粪便微生物群移植可以降低氨水平。通过行为学、神经影像学和分子生物学研究表明,降低氨水平可以改善 CLP 小鼠的认知功能障碍和神经损伤。进一步的研究表明,氨进入大脑调节星形胶质细胞中水通道蛋白-4(AQP4)的表达,这可能是 CLP 小鼠脑功能障碍的机制。体外实验结果表明,氨上调星形胶质细胞中 AQP4 的表达,导致星形胶质细胞损伤。本研究结果表明,氨通过肠-脑轴上调星形胶质细胞 AQP4 的表达,这可能是 SAE 发生的潜在机制。
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