Malate Protects the Kidneys From Hemorrhagic Shock-Induced Injury in an Experimental Rat Model

Mueller, Friederike; Teloh-Benger, Johanna Katharina; Hussmann, Bjoern; Lendemans, Sven; Waack, Indra Naemi

doi:10.1016/j.jss.2019.07.018

Cited by 4 publications

(2 citation statements)

References 35 publications

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“…In addition, blood glucose was measured as a general indicator of trauma and blood loss, 27,28 which has proven useful in shock research in rats 29,30 . A blood glucose meter (Contour 7151H; Bayer HealthCare, Berlin, Germany) was used for measurements using the standard human Contour test strips with a drop of blood.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Hemorrhagic Shock on Lung Ultrasound–Induced Pulmonary Capillary Hemorrhage

Miller

Dou

Raghavendran

et al. 2020

J of Ultrasound Medicine

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Objectives Lung ultrasound (LUS) exposure can induce pulmonary capillary hemorrhage (PCH), depending on biological and physical exposure parameters. This study was designed to investigate the variation in the LUS induction of PCH due to hemorrhagic shock, which itself can engender pulmonary injury. Methods Male rats were anesthetized with isoflurane in air. Shock was induced by withdrawal of 40% of the blood volume and assessed by the blood pressure detected by a femoral artery catheter and by blood glucose tests. B‐mode ultrasound was delivered at 7.3 MHz with a low output (−20 dB) for aiming and with the maximal output (0 dB) for exposure. Pulmonary capillary hemorrhage was quantified by an assessment of comet tail artifacts in the LUS images and by measurement of PCH areas on the surface of fresh lung samples. Results Tests without shock or catheterization surgery gave results for PCH similar to those of previous studies using different methods. Exposure before hemorrhagic shock gave a mean PCH area ± SE of 24.8 ± 9.2 mm2 on the ultrasound scan plane, whereas exposure after shock gave 0 PCH (P < .001; n = 7). Conclusions The presence of hemorrhagic shock significantly reduces the occurrence of LUS‐induced PCH.

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Section: Methodsmentioning

confidence: 99%

The Impact of Hemorrhagic Shock on Lung Ultrasound–Induced Pulmonary Capillary Hemorrhage

Miller

Dou

Raghavendran

et al. 2020

J of Ultrasound Medicine

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“…A study found that MR infusion could maintain stable circulation and pronounced therapeutic effect in patients with acute Ebola virus infection [16]. The other studies also showed that the effect of MR in the resuscitation for hemorrhagic shock was better than LR, and MR resuscitation was beneficial to organ function protection [17][18][19]. As a major component of MR, malic acid is an essential intermediate metabolite of the tricarboxylic acid cycle and the primary source of ATP in mitochondria.…”

Section: Introductionmentioning

confidence: 99%

Effects of Malate Ringer's solution on myocardial injury in sepsis and enforcement effects of TPP@PAMAM-MR

et al. 2022

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Background Myocardial dysfunction played a vital role in organ damage after sepsis. Fluid resuscitation was the essential treatment in which Lactate Ringer's solution (LR) was commonly used. Since LR easily led to hyperlactatemia, its resuscitation effect was limited. Malate Ringer's solution (MR) was a new resuscitation crystal liquid. Whether MR had a protective effect on myocardial injury in sepsis and the relevant mechanism need to be studied. Methods The cecal ligation and puncture (CLP) inducing septic model and lipopolysaccharide (LPS) stimulating cardiomyocytes were used, and the cardiac function, the morphology and function of mitochondria were observed. The protective mechanism of MR on myocardial injury was explored by proteomics. Then the effects of TPP@PAMAM-MR, which consisted of the mitochondria- targeting polymer embodied malic acid, was further observed. Results Compared with LR, MR resuscitation significantly prolonged survival time, improved the cardiac function, alleviated the damages of liver, kidney and lung following sepsis in rats. The proteomics of myocardial tissue showed that differently expressed proteins between MR and LR infusion involved oxidative phosphorylation, apoptosis. Further study found that MR decreased ROS, improved the mitochondrial morphology and function, and ultimately enhanced mitochondrial respiration and promoted ATP production. Moreover, MR infusion decreased the expression of apoptosis-related proteins and increased the expression of anti-apoptotic proteins. TPP@PAMAM@MA was a polymer formed by wrapping l-malic acid with poly amido amine (PAMAM) modified triphenylphosphine material. TPP@PAMAM-MR (TPP-MR), which was synthesized by replacing the l-malic acid of MR with TPP@PAMAM@MA, was more efficient in targeting myocardial mitochondria and was superior to MR in protecting the sepsis-inducing myocardial injury. Conclusion MR was suitable for protecting myocardial injury after sepsis. The mechanism was related to MR improving the function and morphology of cardiomyocyte mitochondria and inhibiting cardiomyocyte apoptosis. The protective effect of TPP-MR was superior to MR.

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Resuscitating the Endothelial Glycocalyx in Trauma and Hemorrhagic Shock

Anand

Reyes

Sjöquist

et al. 2023

Annals of Surgery Open

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The endothelium is lined by a protective mesh of proteins and carbohydrates called the endothelial glycocalyx (EG). This layer creates a negatively charged gel-like barrier between the vascular environment and the surface of the endothelial cell. When intact the EG serves multiple functions, including mechanotransduction, cell signaling, regulation of permeability and fluid exchange across the microvasculature, and management of cell-cell interactions. In trauma and/or hemorrhagic shock, the glycocalyx is broken down, resulting in the shedding of its individual components. The shedding of the EG is associated with increased systemic inflammation, microvascular permeability, and flow-induced vasodilation, leading to further physiologic derangements. Animal and human studies have shown that the greater the severity of the injury, the greater the degree of shedding, which is associated with poor patient outcomes. Additional studies have shown that prioritizing certain resuscitation fluids, such as plasma, cryoprecipitate, and whole blood over crystalloid shows improved outcomes in hemorrhaging patients, potentially through a decrease in EG shedding impacting downstream signaling. The purpose of the following paragraphs is to briefly describe the EG, review the impact of EG shedding and hemorrhagic shock, and begin entertaining the notion of directed resuscitation. Directed resuscitation emphasizes transitioning from macroscopic 1:1 resuscitation to efforts that focus on minimizing EG shedding and maximizing its reconstitution.

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Malate Protects the Kidneys From Hemorrhagic Shock-Induced Injury in an Experimental Rat Model

Cited by 4 publications

References 35 publications

The Impact of Hemorrhagic Shock on Lung Ultrasound–Induced Pulmonary Capillary Hemorrhage

The Impact of Hemorrhagic Shock on Lung Ultrasound–Induced Pulmonary Capillary Hemorrhage

Effects of Malate Ringer's solution on myocardial injury in sepsis and enforcement effects of TPP@PAMAM-MR

Resuscitating the Endothelial Glycocalyx in Trauma and Hemorrhagic Shock

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