A New Integrated Technique for the Supportive Treatment of Sepsis

Hartmann, Jens; Harm, Stephan

doi:10.5301/ijao.5000550

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…Sepsis is a systemic inflammatory response caused by infection and is one of the most problematic critical illnesses in critical care medicine [25, 26]. When sepsis occurs, the gastrointestinal tract is first involved, the internal environment is imbalanced, inflammatory factor products increase, apoptosis increases, and the intestinal mucosa and epithelium become necrotic, resulting in the destruction of the intestinal mucosal barrier, changes in mucosal permeability, dysbiosis of the intestinal flora and the occurrence of flora translocation, which eventually lead to the occurrence of bacteraemia and multiple organ dysfunction syndrome, causing irreversible and serious damage to the patient [27, 28].…”

Section: Discussionmentioning

confidence: 99%

Cx43-Delivered miR-181b Negatively Regulates Sirt1/FOXO3a Signalling Pathway-Mediated Apoptosis on Intestinal Injury in Sepsis

Zou

Huang

et al. 2023

Digestion

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Introduction: Gap junctions can transmit signals between cells, including miRNAs, leading to the amplification of adjacent cell damage. No previous study has addressed gap junctions and miRNAs in sepsis because the internal mechanism of sepsis-induced intestinal injury is complex. Therefore, we studied the relationship between connexin43 (Cx43) and miR-181b and provided a research direction for further study of sepsis. Methods: A mouse caecal ligation and puncture method was used to construct a mouse sepsis model. Firstly, damage to intestinal tissues at different time points was analysed. The levels of Cx43, miR-181b, Sirt1, and FOXO3a in intestinal tissues and the transcription and translation of the apoptosis-related genes Bim and puma, which are downstream of FOXO3a were analysed. Secondly, the effect of Cx43 levels on miR-181b and Sirt1/FOXO3a signalling pathway activity was explored by using the Cx43 inhibitor heptanol. Finally, luciferase assays were used to determine miR-181b binding to the predicted target sequence. Results: The results show that during sepsis, intestinal injury becomes increasingly worse with time, and the expression of Cx43 and miR-181b increase. In addition, we found that heptanol could significantly reduce intestinal injury. This finding indicates that inhibiting Cx43 regulates the transfer of miR-181b between adjacent cells, thereby reducing the activity of the Sirt1/FOXO3a signalling pathway and reducing the degree of intestinal injury during sepsis. Conclusions: In sepsis, the enhancement of Cx43 gap junctions leads to an increase in miR-181b intercellular transfer, affects the downstream SIRT1/FOXO3a signalling pathway and causes cell and tissue damage.

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Section: Discussionmentioning

confidence: 99%

Cx43-Delivered miR-181b Negatively Regulates Sirt1/FOXO3a Signalling Pathway-Mediated Apoptosis on Intestinal Injury in Sepsis

Zou

Huang

et al. 2023

Digestion

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“…In the meantime, research that aims to explain the immunomodulatory pathogenesis of several critical illnesses will be helpful in order to better understand the role, the indications and the timing of HCO therapy. Future developments may include a sequential approach in which different therapeutic modalities, biomaterials and devices (45–52) can be used in sequence or in parallel with HCO membranes.…”

Section: Discussionmentioning

confidence: 99%

High Cut-off Membranes in Acute Kidney Injury and Continuous Renal Replacement Therapy

2017

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Innovation in continuous renal replacement therapies (CRRT) utilized to treat acute kidney injury (AKI) and sepsis, has brought new machines and techniques. Part of these new advances are due to the availability of innovative biomaterials and the construction of membranes with larger pores and wide distribution of pore sizes. This includes the creation of a new generation of high cut-off membranes whose utilization in clinical practice is promising for the wide spectrum of solutes that are removed during extracorporeal therapies.However, the enlargement of pore diameters brings some loss of albumin during treatment and this effect is still under evaluation, since there is a possibility that this is detrimental for the patient. A thorough review of the available clinical literature is reported in this paper with a reappraisal of the potential application of these new technologies.

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“…It is based on cartridges containing polystyrene fibers functionalized with polymyxin B (PMX-DHP, Toraymyxin), a cationic antibiotic with high affinity for endotoxin. Its primary mechanism of action is through neutralization of circulating endotoxin, while secondary effects may include the entrapment of inflammatory cells in the fiber cartridge (10), the binding of circulating apoptotic fragments (11), as well as the release of low doses of polymyxin B from the polystyrene carrier (12), as discussed in the contribution by Hartmann et al in this issue (13).…”

Section: Summary Of Contentsmentioning

confidence: 99%