Journal: |
Quality of Life Research
ZU
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Volume: |
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Abstract: |
Background:
Septic shock is a serious clinical
situation characterized by progressive
hypotension with refractoriness to
vasopressor proceeding to severe
hemodynamic disturbances that lead to
multiple system organ failure (MSOF)
resulting in increased mortality.
Objective:
Study the role of nitric oxide (NO)
signaling and K+- channels in the vascular
hyporesponsivness to the vasopressors at
early and late phases of the experimentally
induced septic shock.
Design:
54 Adult male Wistar albino rats were
utilized in the present study.
–In vivo experiment: Consisted of 30
animals which were subdivided equally into
5 groups; 1stgroup (Sham operated): Ceca
were exposed, but without ligation or
puncture. Animals were injected by vehicle
intravenously(I.V); 2nd group (CLP): Rats
were subjected to cecal ligation and
puncture (CLP), and they were injected by
vehicle I.V; 3rd group (L-NAME treated
CLP): CLP rats treated with 100 mg /Kg of
nitric oxide synthase inhibitor; { L- nitro Narginine
methyl ester (L-NAME) }I.V; 4th
group (MB treated CLP):CLP rats treated
with 10 mg/Kg of soluble guanylylcyclase
inhibitor{Methylene blue(MB)} S.C; 5th
group (TEA treated CLP): CLP rats treated
with 8mg/Kg of {Tetraethylammonium
(TEA)}S.C .30 minutes after treatment with
phosphate buffer saline(PBS); L- NAME;
MB; TEA. Mean arterial pressure
measurement, and dose response curves to
PBS, and angiotensin II at 10, 20 & 30
Pmol/kg were obtained at 6 and 30 hrs postoperative.
Blood samples were collected
from sham and CLP operated rats at zero, 6
and/or 30 hrs after surgery to estimate the
serum levels of AST, ALT, Creatinine, and
Lactate as indicators for liver & kidney
functions and acidosis respectively as well
as for assessment of nitrate (NOx) levels.
-In vitro experiment: 24 animals were
prepared for isolation of aortic strips. The
animals were subdivided into 2 main equal
groups; 1stgroup: Sham operated (control):
Animals were further subdivided equally
and, sacrificed at time 6, and 30 hrs after
sham operation; 2nd group (CLP): Animals
were further subdivided equally, and
sacrificed at times 6, and 30 hrs after CLP
surgery. Vascular contractile response to
norepinephrine (NE) was evaluated in both
groups.
Results:
The present study revealed that LNAME,
MB and TEA induced significant
increases in MAP in vivo as well as
increased contraction of isolated aortic
strips in vitro upon exposure to increasing
doses of the vasopressors angiotensin II &
norepinephrine respectively in the late
phase (30 hrs) of septic shock. Also,
2
1Elsayed M. Kamel et al.,
administration of the aforementioned
compounds produced significant
improvement in the biochemical indicators
of liver and kidney impairment as well as
lactate level, which were worsened by
septic shock at the same point of time
(30hrs). While they failed to produce these
effects in the early phase (6 hrs) of septic
shock.
Conclusion:
The nitric oxide signaling and K+-
channels are crucial components implicated
in the vasoplagia and vascular
hyporesponesviness to the vasopressors in
the late hypodynamic phase of septic shock.
Moreover, they are involved in the
consecutive tissue damage induced by long
standing septic shock. So, NO pathway may
constitute an attractive target for treatment
of the late phase of this critical situation.
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