Neutrophil elastase in dexmedetomidine alleviating sepsis-related renal injury in rats

Chen, Lu; Li, Min; Lin, Yi-Cheng; Li, Yanzhen; Liang, Min; Zeng, Kai

doi:10.1016/j.intimp.2023.110441

Cited by 2 publications

(5 citation statements)

References 29 publications

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“…According to present studies, sivelestat sodium has been increasingly reported to alleviate the progression of chronic diseases such as renal failure. [32,33]. The vital data and safety monitoring board found no substantial differences in the incidence of adverse reactions between the two groups.…”

Section: Discussionmentioning

confidence: 90%

Efficacy of Sivelestat Sodium in the Therapy of Critically ill Patients at high risk of developing ARDS due to SIRS: A Multicenter Prospective Study

Jing,

Xu,

Dai

et al. 2024

Preprint

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Background Sivelestat sodium has been proposed as a therapeutic strategy to mitigate respiratory dysfunction and reduce the need for mechanical ventilation in critically ill patients. Its clinical usage remains controversial. This multicenter prospective study aimed to evaluate the efficacy of sivelestat sodium in patients presenting high-risk of developing acute respiratory distress syndrome (ARDS) due to systemic inflammatory response syndrome with an oxygenation index (PaO2/FIO2 ratio; P/F ratio) between 100–400 mmHg upon ICU administration. Methods Eighty-two patients were divided into two groups: sivelestat group and conventional group. Clinical information, including vital sign, etiology, scoring systems for illness severity, laboratory test data, P/F ratio and chronic comorbidities were collected at the time of administration. The primary end points were invasive mechanical ventilation ratio and ventilator-free days (VFDs). Besides, the severe ARDS ratio, changes of P/F ratio (∆P/F ratio), levels of inflammatory factors (procalcitonin (PCT), C-reactive protein (CRP) and Interleukin-6 (IL-6)) before and after 7 days therapy were also collected. Results Prescribe sivelestat sodium, as compared with conventional therapy, did not have a significant effect on mechanical ventilation ratio or severe ARDS ratio. Notably, sivelestat group exhibited significantly higher VFDs and an improved ∆P/F ratio in mild and moderate ARDS subgroup. Additionally, the ∆P/F ratio was significantly elevated on the fifth day following therapy initiation. Furthermore, there was a reduction in the levels of CRP and PCT, indicating a potential anti-inflammatory effect. Conclusion The results facilitate a randomized controlled trial to determine sivelestat sodium may be considered to alleviate inflammation response and protect patients with mild or moderate ARDS.

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Section: Discussionmentioning

confidence: 90%

Efficacy of Sivelestat Sodium in the Therapy of Critically ill Patients at high risk of developing ARDS due to SIRS: A Multicenter Prospective Study

Jing,

Xu,

Dai

et al. 2024

Preprint

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“…Recent reports described that NE played a crucial role in the development of organ injury (such as ARDS, AKI, myocarditis, etc) in sepsis 6–9,32 . NE is a serine protease secreted by primary neutrophils.…”

Section: Discussionmentioning

confidence: 99%

“…Recent reports described that NE played a crucial role in the development of organ injury (such as ARDS, AKI, myocarditis, etc) in sepsis. 6 , 7 , 8 , 9 , 32 NE is a serine protease secreted by primary neutrophils. As a granule protein, NE's vital physiological function is to degrade the phagocytosed molecules within the cells.…”

Section: Discussionmentioning

confidence: 99%

“…One possible mechanism underlying organ damage in sepsis is related to neutrophil elastase (NE). NE was proven to be an important pathogenic factor in sepsis combined with acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), or myocardial injury 6–8 . Accordingly, inhibition of NE was tried to attenuate the sepsis‐related organ injury in animal experiments 7,9,10 .…”

Section: Introductionmentioning

confidence: 99%

“…NE was proven to be an important pathogenic factor in sepsis combined with acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), or myocardial injury. 6 , 7 , 8 Accordingly, inhibition of NE was tried to attenuate the sepsis‐related organ injury in animal experiments. 7 , 9 , 10 In addition, sivelestat sodium, a NE inhibitor, was reported to be potentially efficacious and safe in treating acute lung injury, ARDS, and abdominal infection in clinical retrospective studies.…”

Section: Introductionmentioning

confidence: 99%

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The beneficial effects of neutrophil elastase inhibitor on gastrointestinal dysfunction in sepsis

Sun,

Li,

Deng

et al. 2024

Clinical Translational Sci

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To investigate the effects of neutrophil elastase inhibitor (sivelestat sodium) on gastrointestinal function in sepsis. A reanalysis of the data from previous clinical trials conducted at our center was performed. Septic patients were divided into either the sivelestat group or the non‐sivelestat group. The gastrointestinal dysfunction score (GIDS), feeding intolerance (FI) incidence, serum levels of intestinal barrier function and inflammatory biomarkers were recorded. The clinical severity and outcome variables were also documented. A total of 163 septic patients were included. The proportion of patients with GIDS ≥2 in the sivelestat group was reduced relative to that in the non‐sivelestat group (9.6% vs. 22.5%, p = 0.047) on the 7th day of intensive care unit (ICU) admission. The FI incidence was also remarkably reduced in the sivelestat group in contrast to that in the non‐sivelestat group (21.2% vs. 37.8%, p = 0.034). Furthermore, the sivelestat group had fewer days of FI [4 (3, 4) vs. 5 (4–6), p = 0.008]. The serum levels of d‐lactate (p = 0.033), intestinal fatty acid‐binding protein (p = 0.005), interleukin‐6 (p = 0.001), white blood cells (p = 0.007), C‐reactive protein (p = 0.001), and procalcitonin (p < 0.001) of the sivelestat group were lower than those of the non‐sivelestat group. The sivelestat group also demonstrated longer ICU‐free days [18 (0–22) vs. 13 (0–17), p = 0.004] and ventilator‐free days [22 (1–24) vs. 16 (1–19), p = 0.002] compared with the non‐sivelestat group. In conclusion, sivelestat sodium administration appears to improve gastrointestinal dysfunction, mitigate dysregulated inflammation, and reduce disease severity in septic patients.

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Neutrophil elastase in dexmedetomidine alleviating sepsis-related renal injury in rats

Cited by 2 publications

References 29 publications

Efficacy of Sivelestat Sodium in the Therapy of Critically ill Patients at high risk of developing ARDS due to SIRS: A Multicenter Prospective Study

Efficacy of Sivelestat Sodium in the Therapy of Critically ill Patients at high risk of developing ARDS due to SIRS: A Multicenter Prospective Study

The beneficial effects of neutrophil elastase inhibitor on gastrointestinal dysfunction in sepsis

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