Think locally: evaluation of the microcirculation in sepsis

Hollenberg, S. M.

doi:10.1007/s00134-010-1973-7

Cited by 19 publications

(15 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…11–15 Thus, there is a pressing need for the development of novel therapeutic approaches to treat sepsis-induced AKI, which can restore perfusion of the renal microcirculation even when initiated after the onset of sepsis. 6,16,17 …”

mentioning

confidence: 99%

“…Hallmarks of sepsis include excessive generation of nitric oxide (NO), 10 endothelial injury, and a loss of vascular reactivity, 6,18 resulting in areas of local microcirculatory hypoperfusion 6,17 and areas of tissue hypoxia. This leads to a peritubular pro-oxidant microenvironment favoring the generation of reactive oxygen and reactive nitrogen species (RNS).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Resveratrol improves renal microcirculation, protects the tubular epithelium, and prolongs survival in a mouse model of sepsis-induced acute kidney injury

Holthoff

Wang

Seely

et al. 2012

Kidney International

167

151

View full text Add to dashboard Cite

The mortality rate of patients who develop acute kidney injury during sepsis nearly doubles. The effectiveness of therapy is hampered because it is usually initiated only after the onset of symptoms. As renal microvascular failure during sepsis is correlated with the generation of reactive nitrogen species, the therapeutic potential of resveratrol, a polyphenol vasodilator that is also capable of scavenging reactive nitrogen species, was investigated using the cecal ligation and puncture (CLP) murine model of sepsis-induced acute kidney injury. Resveratrol when given at 5.5 h following CLP reversed the decline in cortical capillary perfusion, assessed by intravital microscopy, at 6 h in a dose-dependent manner. Resveratrol produced the greatest improvement in capillary perfusion and increased renal blood flow and the glomerular filtration rate without raising systemic pressure. A single dose at 6 h after CLP was unable to improve renal microcirculation assessed at 18 h; however, a second dose at 12 h significantly improved microcirculation and decreased the levels of reactive nitrogen species in tubules, while improving renal function. Moreover, resveratrol given at 6, 12, and 18 h significantly improved survival. Hence, resveratrol may have a dual mechanism of action to restore the renal microcirculation and scavenge reactive nitrogen species, thus protecting the tubular epithelium even when administered after the onset of sepsis.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Resveratrol improves renal microcirculation, protects the tubular epithelium, and prolongs survival in a mouse model of sepsis-induced acute kidney injury

Holthoff

Wang

Seely

et al. 2012

Kidney International

167

151

View full text Add to dashboard Cite

show abstract

“…Lactate concentrations also appeared to increase after starting angiotensin II in a pilot study of patients with vasodilatory shock . These higher lactate concentrations with angiotensin II could be due to uncoupling of the macro‐ and microcirculation in patients with septic shock . Although not yet studied, one hypothesis is that while angiotensin II may improve systemic blood pressure, it could potentially worsen (or not improve) microcirculatory blood flow leading to impaired tissue oxygen delivery and higher lactate concentrations.…”

Section: Adrs Of Angiotensin II and Risk Mitigationmentioning

confidence: 99%

Safe Use of Vasopressin and Angiotensin II for Patients with Circulatory Shock

2018

View full text Add to dashboard Cite

Circulatory shock is a medical emergency that requires rapid intervention to optimize patient outcomes. Although catecholamine vasopressors are considered life‐sustaining therapy, they are associated with adverse reactions, and vasopressin and angiotensin II may be used to minimize these adverse effects. However, vasopressin and angiotensin II are also associated with adverse reactions that must be known to the clinician to mitigate risk for patients. This review focuses on the known adverse drug effects of vasopressin and angiotensin II while offering potential solutions to minimize harm with these agents. Future directions with vasoactive medication safety including optimization of the electronic medical record, clinical decision support, prediction analytics, and precision medicine for patients with circulatory shock are also discussed.

show abstract

“…Although systemic mechanisms involved in sepsis differ from those in hypertension, both conditions are characterized by areas of local renal microcirculatory hypo-perfusion and areas of tissue hypoxia which lead to a pro-oxidant microenvironment favoring generation of ROS and are viable targets for treatment with resveratrol (Walker et al, 2001; Lundy and Trzeciak, 2009; Hollenberg, 2010; Wang et al, 2011). In vitro , resveratrol is a potent scavenger of peroxynitrite and thus protects tubular epithelial cells from injury (Holthoff et al, 2010).…”

Section: Amelioration Of Oxidative Stress and Hypertension By Resveramentioning

confidence: 99%

Systemic and renal oxidative stress in the pathogenesis of hypertension: modulation of long-term control of arterial blood pressure by resveratrol

Hamza

Dyck

2014

Front. Physiol.

View full text Add to dashboard Cite

Hypertension affects over 25% of the global population and is associated with grave and often fatal complications that affect many organ systems. Although great advancements have been made in the clinical assessment and treatment of hypertension, the cause of hypertension in over 90% of these patients is unknown, which hampers the development of targeted and more effective treatment. The etiology of hypertension involves multiple pathological processes and organ systems, however one unifying feature of all of these contributing factors is oxidative stress. Once the body's natural anti-oxidant defense mechanisms are overwhelmed, reactive oxygen species (ROS) begin to accumulate in the tissues. ROS play important roles in normal regulation of many physiological processes, however in excess they are detrimental and cause widespread cell and tissue damage as well as derangements in many physiological processes. Thus, control of oxidative stress has become an attractive target for pharmacotherapy to prevent and manage hypertension. Resveratrol (trans-3,5,4′-Trihydroxystilbene) is a naturally occurring polyphenol which has anti-oxidant effects in vivo. Many studies have shown anti-hypertensive effects of resveratrol in different pre-clinical models of hypertension, via a multitude of mechanisms that include its function as an anti-oxidant. However, results have been mixed and in some cases resveratrol has no effect on blood pressure. This may be due to the heavy emphasis on peripheral vasodilator effects of resveratrol and virtually no investigation of its potential renal effects. This is particularly troubling in the arena of hypertension, where it is well known and accepted that the kidney plays an essential role in the long term regulation of arterial pressure and a vital role in the initiation, development and maintenance of chronic hypertension. It is thus the focus of this review to discuss the potential of resveratrol as an anti-hypertensive treatment via amelioration of oxidative stress within the framework of the fundamental physiological principles of long term regulation of arterial blood pressure.

show abstract

Think locally: evaluation of the microcirculation in sepsis

Cited by 19 publications

References 16 publications

Resveratrol improves renal microcirculation, protects the tubular epithelium, and prolongs survival in a mouse model of sepsis-induced acute kidney injury

Resveratrol improves renal microcirculation, protects the tubular epithelium, and prolongs survival in a mouse model of sepsis-induced acute kidney injury

Safe Use of Vasopressin and Angiotensin II for Patients with Circulatory Shock

Systemic and renal oxidative stress in the pathogenesis of hypertension: modulation of long-term control of arterial blood pressure by resveratrol

Contact Info

Product

Resources

About