Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery

Viikinkoski, Emma; Jalkanen, Juho; Gunn, Jarmo; Vasankari, Tuija; Lehto, Joonas; Valtonen, Mika; Biancari, Fausto; Jalkanen, Sirpa; Airaksinen, K. E. Juhani; Hollmén, Maija; Kiviniemi, Tuomas

doi:10.1038/s41598-021-01695-4

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…Moreover, an increased risk of pneumonia of 3.4-fold is reported in postoperative patients receiving blood transfusion [ 35 ]; interestingly, the mechanism through which adverse outcomes, such as pneumonia, occur, in patients undergoing cardiac surgery, concerns the blunting of postoperative factor-1 alpha (HIF-1α) response after blood transfusion [ 36 ].…”

Section: Risk Factorsmentioning

confidence: 99%

Nosocomial Extracardiac Infections After Cardiac Surgery

Zardi

Chello

Zardi³

et al. 2022

Curr Infect Dis Rep

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Purpose of Review Nosocomial extracardiac infections after cardiac surgery are a major public health issue affecting 3–8.2% of patients within 30–60 days following the intervention. Recent Findings Here, we have considered the most important postoperative infective complications that, in order of frequency, are pneumonia, surgical site infection, urinary tract infection, and bloodstream infection. The overall picture that emerges shows that they cause a greater perioperative morbidity and mortality with a longer hospitalization time and excess costs. Preventive interventions and corrective measures, diminishing the burden of nosocomial extracardiac infections, may reduce the global costs. A multidisciplinary team may assure a more appropriate management of nosocomial extracardiac infections leading to a reduction of hospitalization time and mortality rate. Summary The main and most current data on epidemiology, prevention, microbiology, diagnosis, and management for each one of the most important postoperative infective complications are reported. The establishment of an antimicrobial stewardship in each hospital seems to be, at the moment, the more valid strategy to counteract the challenging problems.

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Section: Risk Factorsmentioning

confidence: 99%

Nosocomial Extracardiac Infections After Cardiac Surgery

Zardi

Chello

Zardi³

et al. 2022

Curr Infect Dis Rep

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“…Although the strength of this stimulus must still be measured, this paradox could have several clinical implications, from the treatment of anemia, thus limiting blood transfusions [70], to adjuvant therapy for septic patients [71], to precondition agent for sports training [72,73], to therapy in critical care settings in which a HIF response without an actual hypoxic state could be effective in cardio and neuroprotection [74,75].…”

Section: Future Perspectivesmentioning

confidence: 99%

The Normobaric Oxygen Paradox—Hyperoxic Hypoxic Paradox: A Novel Expedient Strategy in Hematopoiesis Clinical Issues

Salvagno¹,

Coppalini²,

Taccone³

et al. 2022

IJMS

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Hypoxia, even at non-lethal levels, is one of the most stressful events for all aerobic organisms as it significantly affects a wide spectrum of physiological functions and energy production. Aerobic organisms activate countless molecular responses directed to respond at cellular, tissue, organ, and whole-body levels to cope with oxygen shortage allowing survival, including enhanced neo-angiogenesis and systemic oxygen delivery. The benefits of hypoxia may be evoked without its detrimental consequences by exploiting the so-called normobaric oxygen paradox. The intermittent shift between hyperoxic-normoxic exposure, in addition to being safe and feasible, has been shown to enhance erythropoietin production and raise hemoglobin levels with numerous different potential applications in many fields of therapy as a new strategy for surgical preconditioning aimed at frail patients and prevention of postoperative anemia. This narrative review summarizes the physiological processes behind the proposed normobaric oxygen paradox, focusing on the latest scientific evidence and the potential applications for this strategy. Future possibilities for hyperoxic-normoxic exposure therapy include implementation as a synergistic strategy to improve a patient’s pre-surgical condition, a stimulating treatment in critically ill patients, preconditioning of athletes during physical preparation, and, in combination with surgery and conventional chemotherapy, to improve patients’ outcomes and quality of life.

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“…Hypoxia-inducible factor (HIF) is a transcription factor for cellular adaptation to hypoxic conditions, and, in recent years, the determination of serum HIF has been increasingly used in clinical disease prediction and assessment. 1,2 The production of erythropoietin (EPO) and the absorption and utilization of iron can indirectly down-regulate hepcidin. 3 Erythroferrone (ERFE) is a newly discovered erythroid regulator for iron metabolism, and EPO can stimulate the production of ERFE, thereby promoting the production of erythrocytes and inhibiting the synthesis of hepcidin by hepatocytes.…”

Section: Introductionmentioning

confidence: 99%

The effects of hypoxia-inducible factors-1α and -2α and erythroferrone on hepcidin in patients with chronic kidney disease stages 3–5 and renal anemia

et al. 2022

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Objective This study aimed to investigate the effects of hypoxia-inducible factor-1α (HIF-1α), hypoxia-inducible factor-2α (HIF-2α), and erythroferrone (ERFE) on hepcidin in patients with chronic kidney disease (CKD) stages 3–5 and renal anemia. Methods A total of 90 patients with CKD stages 3–5 and renal anemia were selected for the study at the Nephrology Department of Fujian Provincial People’s Hospital and divided into three groups, according to CKD stage, while another 30 healthy subjects who underwent a physical examination at the hospital during the same period were selected as the normal group. The serum levels of hepcidin, HIF-1α, HIF-2α, ERFE, and furin were measured using an avidin biotin peroxidase complex enzyme-linked immunosorbent assay to compare the differences between the groups in the related indicators. Results ① Serum HIF-2α, HIF-1α, ERFE, and furin levels increased gradually in the patients with CKD stages 3–5 ( p < 0.05, p < 0.01). ②Simple correlation analysis:Serum hepcidin was positively correlated with HIF-2α, ERFE, and HIF-1α in the CKD patients ( p < 0.01). ③Serum hepcidin was positively correlated with HIF-2α, HIF-1α, and ERFE in the CKD patients injected with erythropoietin (EPO) ( p < 0.01), while serum hepcidin was positively correlated with HIF-2α and HIF-1α ( p < 0.01) in the patients not injected with EPO. ④ Multivariate linear regression analysis showed that HIF-1α, (β = 4.36, p < 0.01), serum ferritin(SF) (β = 0.13, p < 0.01), and HIF-2α (β = 0.66, p < 0.01) were significantly correlated with hepcidin. Conclusion HIF-1α, HIF-2α, and SF are factors which have an effect on hepcidin in patients with CKD stages 3–5 and renal anemia. The increase of HIF-1α, HIF-2α, and ERFE does not seem to inhibit the increase of hepcidin.

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Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery

Cited by 7 publications

References 27 publications

Nosocomial Extracardiac Infections After Cardiac Surgery

Nosocomial Extracardiac Infections After Cardiac Surgery

The Normobaric Oxygen Paradox—Hyperoxic Hypoxic Paradox: A Novel Expedient Strategy in Hematopoiesis Clinical Issues

The effects of hypoxia-inducible factors-1α and -2α and erythroferrone on hepcidin in patients with chronic kidney disease stages 3–5 and renal anemia

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