The role of endotoxin in septic shock.

Endotoxic septic shock Endotoxin Phenotypes Sepsis Septic shock

Journal

Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902

Informations de publication

Date de publication:
19 10 2023
Historique:
received: 17 09 2023
accepted: 16 10 2023
medline: 23 10 2023
pubmed: 20 10 2023
entrez: 20 10 2023
Statut: epublish

Résumé

Septic shock can be caused by a variety of mechanisms including direct effects of bacterial toxins such as endotoxin. Annually, approximately 5-7 million patients worldwide develop sepsis with very high endotoxin activity in the blood and more than half die. The term endotoxic septic shock has been used for these patients but it is important to emphasize that endotoxin may be a factor in all forms of septic shock including non-bacterial etiologies like COVID-19 since translocation of bacterial products is a common feature of septic shock. A pattern of organ failure including hepatic dysfunction, acute kidney injury and various forms of endothelial dysfunction ranging from disseminated intravascular coagulation to thrombotic microangiopathy characterize endotoxic septic shock. However, while characteristic, the clinical phenotype is not unique to patients with high endotoxin, and the diagnosis relies on the measurement of endotoxin activity in addition to clinical assessment. Therapies for endotoxic septic shock are limited with immune modulating therapies under investigation and extracorporeal blood purification still controversial in many parts of the world.

Identifiants

pubmed: 37858258
doi: 10.1186/s13054-023-04690-5
pii: 10.1186/s13054-023-04690-5
pmc: PMC10585761
doi:

Substances chimiques

Endotoxins 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

400

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

Références

Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, Colombara DV, Ikuta KS, Kissoon N, Finfer S, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–11.
doi: 10.1016/S0140-6736(19)32989-7 pubmed: 31954465 pmcid: 6970225
Vincent JL, Jones G, David S, Olariu E, Cadwell KK. Frequency and mortality of septic shock in Europe and North America: a systematic review and meta-analysis. Crit Care. 2019;23(1):196.
doi: 10.1186/s13054-019-2478-6 pubmed: 31151462 pmcid: 6545004
Seymour CW, Kennedy JN, Wang S, Chang CH, Elliott CF, Xu Z, Berry S, Clermont G, Cooper G, Gomez H, et al. Derivation, validation, and potential treatment implications of novel clinical phenotypes for sepsis. JAMA. 2019;321(20):2003–17.
doi: 10.1001/jama.2019.5791 pubmed: 31104070 pmcid: 6537818
Leligdowicz A, Matthay MA. Heterogeneity in sepsis: new biological evidence with clinical applications. Crit Care. 2019;23(1):80.
doi: 10.1186/s13054-019-2372-2 pubmed: 30850013 pmcid: 6408778
Kellum JA, Formeck CL, Kernan KF, Gomez H, Carcillo JA. Subtypes and Mimics of Sepsis. Crit Care Clin. 2022;38(2):195–211.
doi: 10.1016/j.ccc.2021.11.013 pubmed: 35369943
Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013;369(9):840–51.
doi: 10.1056/NEJMra1208623 pubmed: 23984731
Brinkworth JF, Valizadegan N. Sepsis and the evolution of human increased sensitivity to lipopolysaccharide. Evol Anthropol. 2021;30(2):141–57.
doi: 10.1002/evan.21887 pubmed: 33689211
Dellinger RP, Bagshaw SM, Antonelli M, Foster DM, Klein DJ, Marshall JC, Palevsky PM, Weisberg LS, Schorr CA, Trzeciak S, et al. Effect of targeted polymyxin B hemoperfusion on 28-day mortality in patients with septic shock and elevated endotoxin level: the EUPHRATES randomized clinical trial. JAMA. 2018;320(14):1455–63.
doi: 10.1001/jama.2018.14618 pubmed: 30304428 pmcid: 6233793
Sirivongrangson P, Kulvichit W, Payungporn S, Pisitkun T, Chindamporn A, Peerapornratana S, Pisitkun P, Chitcharoen S, Sawaswong V, Worasilchai N, et al. Endotoxemia and circulating bacteriome in severe COVID-19 patients. Intensive Care Med Exp. 2020;8(1):72.
doi: 10.1186/s40635-020-00362-8 pubmed: 33284413 pmcid: 7719737
Adamik B, Smiechowicz J, Jakubczyk D, Kubler A. Elevated serum PCT in septic shock with endotoxemia is associated with a higher mortality rate. Medicine. 2015;94(27): e1085.
doi: 10.1097/MD.0000000000001085 pubmed: 26166090 pmcid: 4504546
van Lier D, Geven C, Leijte GP, Pickkers P. Experimental human endotoxemia as a model of systemic inflammation. Biochimie. 2019;159:99–106.
doi: 10.1016/j.biochi.2018.06.014 pubmed: 29936295
Akitomi SSY, Tanaka Y, Endo S. Whole blood gene expression profiling in response to treatment for septic shock: a case report. Ann Clin Med Case Rep. 2021;6(17):1–5.
Taveira da Silva AM, Kaulbach HC, Chuidian FS, Lambert DR, Suffredini AF, Danner RL. Brief report: shock and multiple-organ dysfunction after self-administration of Salmonella endotoxin. N Engl J Med. 1993;328(20):1457–60.
doi: 10.1056/NEJM199305203282005 pubmed: 8479465
Molteni M, Gemma S, Rossetti C. The role of toll-like receptor 4 in infectious and noninfectious inflammation. Mediators Inflamm. 2016;2016:6978936.
doi: 10.1155/2016/6978936 pubmed: 27293318 pmcid: 4887650
Marshall JC, Foster D, Vincent JL, Cook DJ, Cohen J, Dellinger RP, Opal S, Abraham E, Brett SJ, Smith T, et al. Diagnostic and prognostic implications of endotoxemia in critical illness: results of the MEDIC study. J Infect Dis. 2004;190(3):527–34.
doi: 10.1086/422254 pubmed: 15243928
Ikeda T, Ikeda K, Suda S, Ueno T. Usefulness of the endotoxin activity assay as a biomarker to assess the severity of endotoxemia in critically ill patients. Innate Immun. 2014;20(8):881–7.
doi: 10.1177/1753425913516885 pubmed: 24398861
Fujimori K, Tarasawa K, Fushimi K. Effectiveness of polymyxin B hemoperfusion for sepsis depends on the baseline SOFA score: a nationwide observational study. Ann Intensive Care. 2021;11(1):141.
doi: 10.1186/s13613-021-00928-z pubmed: 34568980 pmcid: 8473472
Klein DJ, Foster D, Walker PM, Bagshaw SM, Mekonnen H, Antonelli M. Polymyxin B hemoperfusion in endotoxemic septic shock patients without extreme endotoxemia: a post hoc analysis of the EUPHRATES trial. Intensive Care Med. 2018;44(12):2205–12.
doi: 10.1007/s00134-018-5463-7 pubmed: 30470853 pmcid: 6280819
Romaschin AD, Obiezu-Forster CV, Shoji H, Klein DJ. Novel insights into the direct removal of endotoxin by polymyxin B hemoperfusion. Blood Purif. 2017;44(3):193–7.
doi: 10.1159/000475982 pubmed: 28601867
Sorensen TI, Nielsen GG, Andersen PK, Teasdale TW. Genetic and environmental influences on premature death in adult adoptees. N Engl J Med. 1988;318(12):727–32.
doi: 10.1056/NEJM198803243181202 pubmed: 3347221
Rautanen A, Mills TC, Gordon AC, Hutton P, Steffens M, Nuamah R, Chiche JD, Parks T, Chapman SJ, Davenport EE, et al. Genome-wide association study of survival from sepsis due to pneumonia: an observational cohort study. Lancet Respir Med. 2015;3(1):53–60.
doi: 10.1016/S2213-2600(14)70290-5 pubmed: 25533491 pmcid: 4314768
Scherag A, Schoneweck F, Kesselmeier M, Taudien S, Platzer M, Felder M, Sponholz C, Rautanen A, Hill AVS, Hinds CJ, et al. Genetic factors of the disease course after sepsis: a genome-wide study for 28 day mortality. EBioMedicine. 2016;12:239–46.
doi: 10.1016/j.ebiom.2016.08.043 pubmed: 27639821 pmcid: 5078589
Kernan KF, Ghaloul-Gonzalez L, Shakoory B, Kellum JA, Angus DC, Carcillo JA. Adults with septic shock and extreme hyperferritinemia exhibit pathogenic immune variation. Genes Immun. 2019;20(6):520–6.
doi: 10.1038/s41435-018-0030-3 pubmed: 29977033
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10.
doi: 10.1001/jama.2016.0287 pubmed: 26903338 pmcid: 4968574
Hurley JC. Towards clinical applications of anti-endotoxin antibodies; a re-appraisal of the disconnect. Toxins (Basel). 2013;5(12):2589–620.
doi: 10.3390/toxins5122589 pubmed: 24351718
Behre G, Schedel I, Nentwig B, Wormann B, Essink M, Hiddemann W. Endotoxin concentration in neutropenic patients with suspected gram-negative sepsis: correlation with clinical outcome and determination of anti-endotoxin core antibodies during therapy with polyclonal immunoglobulin M-enriched immunoglobulins. Antimicrob Agents Chemother. 1992;36(10):2139–46.
doi: 10.1128/AAC.36.10.2139 pubmed: 1444293 pmcid: 245468
Wortel CH, von der Mohlen MA, van Deventer SJ, Sprung CL, Jastremski M, Lubbers MJ, Smith CR, Allen IE, ten Cate JW. Effectiveness of a human monoclonal anti-endotoxin antibody (HA-1A) in gram-negative sepsis: relationship to endotoxin and cytokine levels. J Infect Dis. 1992;166(6):1367–74.
doi: 10.1093/infdis/166.6.1367 pubmed: 1431255
Opal SM, Laterre PF, Francois B, LaRosa SP, Angus DC, Mira JP, Wittebole X, Dugernier T, Perrotin D, Tidswell M, et al. Effect of eritoran, an antagonist of MD2-TLR4, on mortality in patients with severe sepsis: the ACCESS randomized trial. JAMA. 2013;309(11):1154–62.
doi: 10.1001/jama.2013.2194 pubmed: 23512062
Shimizu T, Miyake T, Tani M. History and current status of polymyxin B-immobilized fiber column for treatment of severe sepsis and septic shock. Ann Gastroenterol Surg. 2017;1(2):105–13.
doi: 10.1002/ags3.12015 pubmed: 29863114 pmcid: 5881300
Fujimori K, Tarasawa K, Fushimi K. Effects of polymyxin B hemoperfusion on septic shock patients requiring noradrenaline: analysis of a nationwide administrative database in Japan. Blood Purif. 2021;50(4–5):560–5.
doi: 10.1159/000513213 pubmed: 33582663
Cruz DN, Antonelli M, Fumagalli R, Foltran F, Brienza N, Donati A, Malcangi V, Petrini F, Volta G, Bobbio Pallavicini FM, et al. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial. JAMA. 2009;301(23):2445–52.
doi: 10.1001/jama.2009.856 pubmed: 19531784
Payen DM, Guilhot J, Launey Y, Lukaszewicz AC, Kaaki M, Veber B, Pottecher J, Joannes-Boyau O, Martin-Lefevre L, Jabaudon M, et al. Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial. Intensive Care Med. 2015;41(6):975–84.
doi: 10.1007/s00134-015-3751-z pubmed: 25862039 pmcid: 4477725
Payen D, Dupuis C, Deckert V, Pais de Barros JP, Rerole AL, Lukaszewicz AC, Coudroy R, Robert R, Lagrost L. Endotoxin mass concentration in plasma is associated with mortality in a multicentric cohort of peritonitis-induced shock. Front Med (Lausanne). 2021;8:749405.
doi: 10.3389/fmed.2021.749405 pubmed: 34778311
Dargent A, Pais De Barros JP, Ksiazek E, Fournel I, Dusuel A, Rerole AL, Choubley H, Masson D, Lagrost L, Quenot JP. Improved quantification of plasma lipopolysaccharide (LPS) burden in sepsis using 3-hydroxy myristate (3HM): a cohort study. Intensive Care Med. 2019;45(11):1678–80.
doi: 10.1007/s00134-019-05749-0 pubmed: 31451860
Carcillo JA, Kellum JA. Is there a role for plasmapheresis/plasma exchange therapy in septic shock, MODS, and thrombocytopenia-associated multiple organ failure? We still do not know–but perhaps we are closer. Intensive Care Med. 2002;28(10):1373–5.
doi: 10.1007/s00134-002-1428-x pubmed: 12373459
Klein DJ, Foster D, Schorr CA, Kazempour K, Walker PM, Dellinger RP. The EUPHRATES trial (Evaluating the Use of Polymyxin B Hemoperfusion in a Randomized controlled trial of Adults Treated for Endotoxemia and Septic shock): study protocol for a randomized controlled trial. Trials. 2014;15(1):218.
doi: 10.1186/1745-6215-15-218 pubmed: 24916483 pmcid: 4066268
Zarbock A, Nadim MK, Pickkers P, Gomez H, Bell S, Joannidis M, Kashani K, Koyner JL, Pannu N, Meersch M, et al. Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup. Nat Rev Nephrol. 2023;19(6):401–17.
doi: 10.1038/s41581-023-00683-3 pubmed: 36823168
Ronco C, Chawla L, Husain-Syed F, Kellum JA. Rationale for sequential extracorporeal therapy (SET) in sepsis. Crit Care. 2023;27(1):50.
doi: 10.1186/s13054-023-04310-2 pubmed: 36750878 pmcid: 9904264

Auteurs

John A Kellum (JA)

Department of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, 600 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA. kellum@pitt.edu.
Spectral Medical Inc, Toronto, ON, Canada. kellum@pitt.edu.

Claudio Ronco (C)

International Renal Research Institute of Vicenza, IRRIV Foundation, Department of Nephrology, Dialysis and Transplantation, St. Bortolo Hospital, aULSS8 Berica, Via Rodolfi, 37, 36100, Vicenza, Italy.
Department of Medicine (DIMED), University of Padua, Via Giustiniani, 2, 35128, Padua, Italy.

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