Hemorrhagic shock induces renal complement activation.

Acute kidney failure Complement Hemorrhagic shock Tight junction Zonulin

Journal

European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 13 04 2019
accepted: 08 07 2019
pubmed: 17 7 2019
medline: 16 10 2021
entrez: 17 7 2019
Statut: ppublish

Résumé

Complement is activated in hemorrhagic shock and protective effects by specific complement inhibition were shown. However, it remains unclear if complement activation contributes to the local tissue damage and organ failure. Zonulin is known to activate complement and affect organ failure. Therefore, local and systemic complement activation during hemorrhagic shock and its consequences on zonulin were examined. Porcine hemorrhagic shock (n = 9) was initiated with mean arterial blood pressure maintained constant for 4 h before retransfusion. Before, 4 h after hemorrhage and 12 and 22 h after resuscitation, central and renal blood samples were drawn. Analysis included HMGB-1, C3a, and zonulin (blood and kidney homogenisates) as well as terminal complement complex (TCC) and CH50 (blood). Organ samples were taken for histological and immunohistochemical analyses (C3c). HMGB-1 was significantly elevated in plasma 4 h after hemorrhagic shock and in homogenized kidneys. TCC after 12 h was significantly elevated centrally, while renal levels were not altered. In contrast, CH50 showed diminished renal values, while normal central levels were observed. Local complement activation was observed with enhanced C3c deposition in kidneys. Zonulin showed significantly diminished levels at 12 and 22 h after hemorrhagic shock (central and renal) and significantly correlated with levels of CH50 and neutrophil gelatinase-associated lipocalin (NGAL). The more pronounced complement activation centrally might indicate consumption of complement products in kidney tissue, which is underlined by C3c staining. Together with diminished levels of zonulin in both systemic and local samples, results could indicate the involvement of complement as well as zonulin in acute kidney failure.

Identifiants

pubmed: 31309238
doi: 10.1007/s00068-019-01187-1
pii: 10.1007/s00068-019-01187-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

373-380

Subventions

Organisme : DFG
ID : SFB1149 A01
Organisme : DFG
ID : B03
Organisme : DFG
ID : Z02

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pubmed: 28164545

Auteurs

Christian Ehrnthaller (C)

Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, Center of Surgery, University of Ulm, Ulm, Germany. christian.ehrnthaller@med.uni-muenchen.de.
Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany. christian.ehrnthaller@med.uni-muenchen.de.
Institute of Clinical and Experimental Traumaimmunology, University of Ulm, Ulm, Germany. christian.ehrnthaller@med.uni-muenchen.de.

Anke Schultze (A)

Institute of Clinical and Experimental Traumaimmunology, University of Ulm, Ulm, Germany.

Gamal Wakileh (G)

Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, Center of Surgery, University of Ulm, Ulm, Germany.
Institute of Clinical and Experimental Traumaimmunology, University of Ulm, Ulm, Germany.

Thomas Neff (T)

Department of Anesthesiology and Intensive Care Medicine, Cantonal Hospital of Muensterlingen, Muensterlingen, Switzerland.

Sebastian Hafner (S)

Anesthesiological Pathophysiology and Process Development, University of Ulm, Ulm, Germany.

Peter Radermacher (P)

Anesthesiological Pathophysiology and Process Development, University of Ulm, Ulm, Germany.

Markus Huber-Lang (M)

Institute of Clinical and Experimental Traumaimmunology, University of Ulm, Ulm, Germany.

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