[New aspects of perioperative organ protection].
Neue Aspekte der perioperativen Organprotektion.
Dexmedetomidine
HMGB1 protein
Inflammation
Ischemic preconditioning
Reperfusion injury
Journal
Die Anaesthesiologie
ISSN: 2731-6866
Titre abrégé: Anaesthesiologie
Pays: Germany
ID NLM: 9918384886806676
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
accepted:
25
08
2022
pubmed:
7
9
2022
medline:
5
10
2022
entrez:
6
9
2022
Statut:
ppublish
Résumé
Acutely occurring organ damage significantly contributes to morbidity and mortality in the perioperative context. This article highlights new clinical perspectives on how perioperative organ damage can be prevented and ameliorated by influencing the high mobility group box 1 protein (HMGB1) signaling. A MEDLINE search was performed in the fields of clinical and basic research. The presentation of basic mechanisms of perioperative organ damage and the discussion of the importance of HMGB1 in prevention and treatment by pharmaceutical and nonpharmaceutical interventions are the focus of the review. The HMGB1 is a central element in the pathogenesis of septic and aseptic inflammation-induced organ damage. Remote ischemic preconditioning (RIPC) and dexmedetomidine are highly effective approaches to mitigate or prevent organ damage. The RIPC and dexmedetomidine offer protective properties in ischemia-reperfusion injury as well as in inflammation-related organ damage, which are mediated by HMGB1, among others. This effectively protects the kidneys, heart, lungs, liver and brain. The application of these concepts should be considered in routine clinical practice. HINTERGRUND: Akut auftretende Organschädigungen tragen im perioperativen Kontext signifikant zu Morbidität und Mortalität bei. Es sollen Möglichkeiten skizziert werden, wie perioperative Organschäden präventiv und proaktiv durch die Beeinflussung des „high mobility group box 1 protein (HMGB1) signaling“ vermieden und verringert werden können. Es wurde eine MEDLINE-Suche im Bereich der klinischen und der Grundlagenforschung durchgeführt. Die Darstellung grundlegender Mechanismen perioperativer Organschäden und die Diskussion der Bedeutung von HMGB1 in der Prävention und Therapie mithilfe medikamentöser und nichtmedikamentöser Intervention stehen im Mittelpunkt der Betrachtung. In der Pathogenese von septisch und aseptisch bedingten Organschäden ist HMGB1 ein zentrales Element. „Remote ischemic preconditioning“ (RIPC) und Dexmedetomidin sind hocheffektive Möglichkeiten, um Organschäden abzumildern resp. zu vermeiden. Sowohl bei Ischämie-Reperfusionsschäden als auch bei inflammationsbedingten Organschäden bieten RIPC und Dexmedetomidin protektive Eigenschaften, die u. a. HMGB1-vermittelt sind. Hierdurch lassen sich Nieren, Herz, Lungen, Leber und Gehirn wirkungsvoll schützen. Die Anwendung dieser Konzepte sollte im klinischen Alltag Beachtung finden.
Sections du résumé
BACKGROUND
Acutely occurring organ damage significantly contributes to morbidity and mortality in the perioperative context.
OBJECTIVE
This article highlights new clinical perspectives on how perioperative organ damage can be prevented and ameliorated by influencing the high mobility group box 1 protein (HMGB1) signaling.
MATERIAL AND METHODS
A MEDLINE search was performed in the fields of clinical and basic research. The presentation of basic mechanisms of perioperative organ damage and the discussion of the importance of HMGB1 in prevention and treatment by pharmaceutical and nonpharmaceutical interventions are the focus of the review.
RESULTS
The HMGB1 is a central element in the pathogenesis of septic and aseptic inflammation-induced organ damage. Remote ischemic preconditioning (RIPC) and dexmedetomidine are highly effective approaches to mitigate or prevent organ damage.
CONCLUSION
The RIPC and dexmedetomidine offer protective properties in ischemia-reperfusion injury as well as in inflammation-related organ damage, which are mediated by HMGB1, among others. This effectively protects the kidneys, heart, lungs, liver and brain. The application of these concepts should be considered in routine clinical practice.
ZUSAMMENFASSUNG
HINTERGRUND: Akut auftretende Organschädigungen tragen im perioperativen Kontext signifikant zu Morbidität und Mortalität bei.
ZIEL DER ARBEIT
Es sollen Möglichkeiten skizziert werden, wie perioperative Organschäden präventiv und proaktiv durch die Beeinflussung des „high mobility group box 1 protein (HMGB1) signaling“ vermieden und verringert werden können.
MATERIAL UND METHODEN
Es wurde eine MEDLINE-Suche im Bereich der klinischen und der Grundlagenforschung durchgeführt. Die Darstellung grundlegender Mechanismen perioperativer Organschäden und die Diskussion der Bedeutung von HMGB1 in der Prävention und Therapie mithilfe medikamentöser und nichtmedikamentöser Intervention stehen im Mittelpunkt der Betrachtung.
ERGEBNISSE
In der Pathogenese von septisch und aseptisch bedingten Organschäden ist HMGB1 ein zentrales Element. „Remote ischemic preconditioning“ (RIPC) und Dexmedetomidin sind hocheffektive Möglichkeiten, um Organschäden abzumildern resp. zu vermeiden.
SCHLUSSFOLGERUNG
Sowohl bei Ischämie-Reperfusionsschäden als auch bei inflammationsbedingten Organschäden bieten RIPC und Dexmedetomidin protektive Eigenschaften, die u. a. HMGB1-vermittelt sind. Hierdurch lassen sich Nieren, Herz, Lungen, Leber und Gehirn wirkungsvoll schützen. Die Anwendung dieser Konzepte sollte im klinischen Alltag Beachtung finden.
Autres résumés
Type: Publisher
(ger)
HINTERGRUND: Akut auftretende Organschädigungen tragen im perioperativen Kontext signifikant zu Morbidität und Mortalität bei.
Identifiants
pubmed: 36064976
doi: 10.1007/s00101-022-01197-6
pii: 10.1007/s00101-022-01197-6
doi:
Substances chimiques
HMGB1 Protein
0
Pharmaceutical Preparations
0
Dexmedetomidine
67VB76HONO
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
741-749Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
Références
Nepogodiev D, Martin J, Biccard B, Makupe A, Bhangu A, National Institute for Health Research Global Health Research Unit on Global Surgery (2019) Global burden of postoperative death. Lancet 393:401. https://doi.org/10.1016/S0140-6736(18)33139-8
doi: 10.1016/S0140-6736(18)33139-8
pubmed: 30722955
Lobo SM, Rezende E, Knibel MF, Silva NB, Paramo JA, Nacul FE, Mendes CL, Assuncao M, Costa RC, Grion CC et al (2011) Early determinants of death due to multiple organ failure after noncardiac surgery in high-risk patients. Anesth Analg 112:877–883. https://doi.org/10.1213/ANE.0b013e3181e2bf8e
doi: 10.1213/ANE.0b013e3181e2bf8e
pubmed: 20530615
Sauaia A, Moore EE, Johnson JL, Chin TL, Banerjee A, Sperry JL, Maier RV, Burlew CC (2014) Temporal trends of postinjury multiple-organ failure: still resource intensive, morbid, and lethal. J Trauma Acute Care Surg 76:582–592. https://doi.org/10.1097/TA.0000000000000147 (discussion 592–583)
doi: 10.1097/TA.0000000000000147
pubmed: 24553523
pmcid: 4116088
Bainbridge D, Martin J, Arango M, Cheng D, Evidence-based Peri-operative Clinical Outcomes Research (2012) Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet 380:1075–1081. https://doi.org/10.1016/S0140-6736(12)60990-8
doi: 10.1016/S0140-6736(12)60990-8
pubmed: 22998717
Ferdinandy P, Schulz R, Baxter GF (2007) Interaction of cardiovascular risk factors with myocardial ischemia/reperfusion injury, preconditioning, and postconditioning. Pharmacol Rev 59:418–458. https://doi.org/10.1124/pr.107.06002
doi: 10.1124/pr.107.06002
pubmed: 18048761
Conrad C, Eltzschig HK (2020) Disease mechanisms of Perioperative organ injury. Anesth Analg 131:1730–1750. https://doi.org/10.1213/ANE.0000000000005191
doi: 10.1213/ANE.0000000000005191
pubmed: 33186161
pmcid: 7673233
Vachharajani V, McCall CE (2019) Epigenetic and metabolic programming of innate immunity in sepsis. Innate Immun 25:267–279. https://doi.org/10.1177/1753425919842320
doi: 10.1177/1753425919842320
pubmed: 30997862
pmcid: 6830903
Xue J, Suarez JS, Minaai M, Li S, Gaudino G, Pass HI, Carbone M, Yang H (2021) HMGB1 as a therapeutic target in disease. J Cell Physiol 236:3406–3419. https://doi.org/10.1002/jcp.30125
doi: 10.1002/jcp.30125
pubmed: 33107103
Torregroza C, Gnaegy L, Raupach A, Stroethoff M, Feige K, Heinen A, Hollmann MW, Huhn R (2021) Influence of hyperglycemia and diabetes on Cardioprotection by humoral factors released after remote Ischemic preconditioning (RIPC). Int J Mol Sci. https://doi.org/10.3390/ijms22168880
doi: 10.3390/ijms22168880
pubmed: 34830353
pmcid: 8625521
Zarbock A, Schmidt C, Van Aken H, Wempe C, Martens S, Zahn PK, Wolf B, Goebel U, Schwer CI, Rosenberger P et al (2015) Effect of remote ischemic preconditioning on kidney injury among high-risk patients undergoing cardiac surgery: a randomized clinical trial. JAMA 313:2133–2141. https://doi.org/10.1001/jama.2015.4189
doi: 10.1001/jama.2015.4189
pubmed: 26024502
Meersch M, Kullmar M, Pavenstadt H, Rossaint J, Kellum JA, Martens S, Klausmeyer P, Schmidt EA, Kerschke L, Zarbock A (2020) Effects of Different Doses of Remote Ischemic Preconditioning on Kidney Damage Among Patients Undergoing Cardiac Surgery: A Single-Center Mechanistic Randomized Controlled Trial. Crit Care Med 48:e690–e697. https://doi.org/10.1097/CCM.0000000000004415
doi: 10.1097/CCM.0000000000004415
pubmed: 32697510
Moretti C, Cerrato E, Cavallero E, Lin S, Rossi ML, Picchi A, Sanguineti F, Ugo F, Palazzuoli A, Bertaina M et al (2018) The EUROpean and Chinese cardiac and renal remote Ischemic preconditioning study (EURO-CRIPS Cardiogroup I): a randomized controlled trial. Int J Cardiol 257:1–6. https://doi.org/10.1016/j.ijcard.2017.12.033
doi: 10.1016/j.ijcard.2017.12.033
pubmed: 29506674
Otsuka H, Miyoshi T, Ejiri K, Kohno K, Nakahama M, Doi M, Munemasa M, Murakami M, Nakamura K, Ito H (2021) Possible protective effect of remote Ischemic preconditioning on acute kidney injury following elective Percutaneous coronary intervention: secondary analysis of a multicenter, randomized study. Acta Med Okayama 75:45–53. https://doi.org/10.18926/AMO/61433
doi: 10.18926/AMO/61433
pubmed: 33649613
Pierce B, Bole I, Patel V, Brown DL (2017) Clinical outcomes of remote Ischemic preconditioning prior to cardiac surgery: a meta-analysis of randomized controlled trials. J Am Heart Assoc. https://doi.org/10.1161/JAHA.116.004666
doi: 10.1161/JAHA.116.004666
pubmed: 28219918
pmcid: 5523764
Deferrari G, Bonanni A, Bruschi M, Alicino C, Signori A (2018) Remote ischaemic preconditioning for renal and cardiac protection in adult patients undergoing cardiac surgery with cardiopulmonary bypass: systematic review and meta-analysis of randomized controlled trials. Nephrol Dial Transplant 33:813–824. https://doi.org/10.1093/ndt/gfx210
doi: 10.1093/ndt/gfx210
pubmed: 28992285
Wu J, Yu C, Zeng X, Sun C (2021) The hepatoprotective effect from ischemia-reperfusion injury of remote ischemic preconditioning in the liver related surgery: a meta-analysis. ANZ J Surg. https://doi.org/10.1111/ans.17236
doi: 10.1111/ans.17236
pubmed: 34913563
Zheng L, Han R, Tao L, Yu Q, Li J, Gao C, Sun X (2020) Effects of remote ischemic preconditioning on prognosis in patients with lung injury: a meta-analysis. J Clin Anesth 63:109795. https://doi.org/10.1016/j.jclinane.2020.109795
doi: 10.1016/j.jclinane.2020.109795
pubmed: 32203872
Sales AHA, Barz M, Bette S, Wiestler B, Ryang YM, Meyer B, Bretschneider M, Ringel F, Gempt J (2017) Impact of ischemic preconditioning on surgical treatment of brain tumors: a single-center, randomized, double-blind, controlled trial. BMC Med 15:137. https://doi.org/10.1186/s12916-017-0898-1
doi: 10.1186/s12916-017-0898-1
pubmed: 28738862
pmcid: 5525340
Hausenloy DJ, Candilio L, Evans R, Ariti C, Jenkins DP, Kolvekar S, Knight R, Kunst G, Laing C, Nicholas JM et al (2016) Effect of Remote Ischaemic preconditioning on Clinical outcomes in patients undergoing Coronary Artery bypass graft surgery (ERICCA study): a multicentre double-blind randomised controlled clinical trial; Efficacy and Mechanism Evaluation Southampton (UK) (In)
Meybohm P, Kohlhaas M, Stoppe C, Gruenewald M, Renner J, Bein B, Albrecht M, Cremer J, Coburn M, Schaelte G et al (2018) RIPheart (remote Ischemic preconditioning for heart surgery) study: myocardial dysfunction, postoperative Neurocognitive dysfunction, and 1 year follow-up. J Am Heart Assoc. https://doi.org/10.1161/JAHA.117.008077
doi: 10.1161/JAHA.117.008077
pubmed: 29581218
pmcid: 5907591
Kottenberg E, Thielmann M, Bergmann L, Heine T, Jakob H, Heusch G, Peters J (2012) Protection by remote ischemic preconditioning during coronary artery bypass graft surgery with isoflurane but not propofol—a clinical trial. Acta Anaesthesiol Scand 56:30–38. https://doi.org/10.1111/j.1399-6576.2011.02585.x
doi: 10.1111/j.1399-6576.2011.02585.x
pubmed: 22103808
MacAllister R, Clayton T, Knight R, Robertson S, Nicholas J, Motwani M, Veighey K (2015) REmote preconditioning for Protection Against Ischaemia-Reperfusion in renal transplantation (REPAIR): a multicentre, multinational, double-blind, factorial designed randomised controlled trial</i>; Efficacy and Mechanism Evaluation Southampton (UK) (In)
Veighey KV, Nicholas JM, Clayton T, Knight R, Robertson S, Dalton N, Harber M, Watson CJE, De Fijter JW, Loukogeorgakis S et al (2019) Early remote ischaemic preconditioning leads to sustained improvement in allograft function after live donor kidney transplantation: long-term outcomes in the REnal Protection Against Ischaemia-Reperfusion in transplantation (REPAIR) randomised trial. Br J Anaesth 123:584–591. https://doi.org/10.1016/j.bja.2019.07.019
doi: 10.1016/j.bja.2019.07.019
pubmed: 31521337
Chen J, Jiang Z, Zhou X, Sun X, Cao J, Liu Y, Wang X (2019) Dexmedetomidine preconditioning protects Cardiomyocytes against hypoxia/Reoxygenation-induced Necroptosis by inhibiting HMGB1-mediated inflammation. Cardiovasc Drugs Ther 33:45–54. https://doi.org/10.1007/s10557-019-06857-1
doi: 10.1007/s10557-019-06857-1
pubmed: 30675709
Liu J, Shi K, Hong J, Gong F, Mo S, Chen M, Zheng Y, Jiang L, Xu L, Tu Y et al (2020) Dexmedetomidine protects against acute kidney injury in patients with septic shock. Ann Palliat Med 9:224–230. https://doi.org/10.21037/apm.2020.02.08
doi: 10.21037/apm.2020.02.08
pubmed: 32156136
Bao N, Tang B (2020) Organ-protective effects and the underlying mechanism of Dexmedetomidine. Mediators Inflamm 2020:6136105. https://doi.org/10.1155/2020/6136105
doi: 10.1155/2020/6136105
pubmed: 32454792
pmcid: 7232715
Huang YQ, Wen RT, Li XT, Zhang J, Yu ZY, Feng YF (2021) The protective effect of Dexmedetomidine against Ischemia-Reperfusion injury after Hepatectomy: a meta-analysis of randomized controlled trials. Front Pharmacol 12:747911. https://doi.org/10.3389/fphar.2021.747911
doi: 10.3389/fphar.2021.747911
pubmed: 34712138
pmcid: 8546301
Wang C, Yuan W, Hu A, Lin J, Xia Z, Yang CF, Li Y, Zhang Z (2020) Dexmedetomidine alleviated sepsisinduced myocardial ferroptosis and septic heart injury. Mol Med Rep 22:175–184. https://doi.org/10.3892/mmr.2020.11114
doi: 10.3892/mmr.2020.11114
pubmed: 32377745
pmcid: 7248514
Mei B, Li J, Zuo Z (2021) Dexmedetomidine attenuates sepsis-associated inflammation and encephalopathy via central alpha2A adrenoceptor. Brain Behav Immun 91:296–314. https://doi.org/10.1016/j.bbi.2020.10.008
doi: 10.1016/j.bbi.2020.10.008
pubmed: 33039659
Cioccari L, Luethi N, Bailey M, Shehabi Y, Howe B, Messmer AS, Proimos HK, Peck L, Young H, Eastwood GM et al (2020) The effect of dexmedetomidine on vasopressor requirements in patients with septic shock: a subgroup analysis of the sedation practice in intensive care evaluation [SPICE III] trial. Crit Care 24:441. https://doi.org/10.1186/s13054-020-03115-x
doi: 10.1186/s13054-020-03115-x
pubmed: 32678054
pmcid: 7367420
Hegazy MA, Hegazi RA, Hendawy SR, Hussein MS, Abdellateef A, Awad G, Abdeldayem OT (2020) Cardiac preconditioning effect of Ketamine-Dexmedetomidine versus Fentanyl-Propofol during arrested heart Revascularization. Anesth Essays Res 14:312–320. https://doi.org/10.4103/aer.AER_55_20
doi: 10.4103/aer.AER_55_20
pubmed: 33487835
pmcid: 7819405
Cho JS, Shim JK, Soh S, Kim MK, Kwak YL (2016) Perioperative dexmedetomidine reduces the incidence and severity of acute kidney injury following valvular heart surgery. Kidney Int 89:693–700. https://doi.org/10.1038/ki.2015.306
doi: 10.1038/ki.2015.306
pubmed: 26444030
Biccard BM, Goga S, de Beurs J (2008) Dexmedetomidine and cardiac protection for non-cardiac surgery: a meta-analysis of randomised controlled trials. Anaesthesia 63:4–14. https://doi.org/10.1111/j.1365-2044.2007.05306.x
doi: 10.1111/j.1365-2044.2007.05306.x
pubmed: 18086064