Application of alpha1-antitrypsin in a rat model of veno-arterial extracorporeal membrane oxygenation.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
04 08 2021
Historique:
received: 20 11 2020
accepted: 19 07 2021
entrez: 5 8 2021
pubmed: 6 8 2021
medline: 9 11 2021
Statut: epublish

Résumé

Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for patients suffering from respiratory or cardiac failure. The ECMO-associated morbidity and mortality depends to a large extent on the underlying disease and is often related to systemic inflammation, consecutive immune paralysis and sepsis. Here we tested the hypothesis that human α1-antitrypsin (SERPINA1) due to its anti-protease and anti-inflammatory functions may attenuate ECMO-induced inflammation. We specifically aimed to test whether intravenous treatment with α1-antitrypsin reduces the release of cytokines in response to 2 h of experimental ECMO. Adult rats were intravenously infused with α1-antitrypsin immediately before starting veno-arterial ECMO. We measured selected pro- and anti-inflammatory cytokines and found, that systemic levels of tumor necrosis factor-α, interleukin-6 and interleukin-10 increase during experimental ECMO. As tachycardia and hypertension developed in response to α1-antitrypsin, a single additional bolus of fentanyl and midazolam was given. Treatment with α1-antitrypsin and higher sedative doses reduced all cytokine levels investigated. We suggest that α1-antitrypsin might have the potential to protect against both ECMO-induced systemic inflammation and immune paralysis. More studies are needed to corroborate our findings, to clarify the mechanisms by which α1-antitrypsin inhibits cytokine release in vivo and to explore the potential application of α1-antitrypsin in clinical ECMO.

Identifiants

pubmed: 34349162
doi: 10.1038/s41598-021-95119-y
pii: 10.1038/s41598-021-95119-y
pmc: PMC8339069
doi:

Substances chimiques

Cytokines 0
Trypsin Inhibitors 0
alpha 1-Antitrypsin 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

15849

Informations de copyright

© 2021. The Author(s).

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Auteurs

Fabian Edinger (F)

Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus-Liebig University of Giessen, Giessen, Germany. Fabian.Edinger@chiru.med.uni-giessen.de.

Christoph Schmitt (C)

Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus-Liebig University of Giessen, Giessen, Germany.

Christian Koch (C)

Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus-Liebig University of Giessen, Giessen, Germany.

J Michael McIntosh (JM)

George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
Department of Biology, University of Utah, Salt Lake City, UT, USA.
Department of Psychiatry, University of Utah, Salt Lake City, UT, USA.

Sabina Janciauskiene (S)

Department of Respiratory Medicine, Hannover Medical School, German Centre for Lung Research (DZL), Hannover, Germany.

Melanie Markmann (M)

Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus-Liebig University of Giessen, Giessen, Germany.

Michael Sander (M)

Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus-Liebig University of Giessen, Giessen, Germany.

Winfried Padberg (W)

Laboratory of Experimental Surgery, Department of General and Thoracic Surgery, German Centre for Lung Research (DZL), Justus-Liebig-University of Giessen, Giessen, Germany.

Veronika Grau (V)

Laboratory of Experimental Surgery, Department of General and Thoracic Surgery, German Centre for Lung Research (DZL), Justus-Liebig-University of Giessen, Giessen, Germany.

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Classifications MeSH