Bruno Garcia, Benoit Ter Schiphorst, Fuhong Su, Adrien Picod, Theo Ikenna-Uba, Raphaël Favory, Filippo Annoni, Alexandre Mebazaa, Jean-Louis Vincent, Jacques Creteur, Fabio S Taccone, Antoine Herpain
{"title":"实验性脓毒性休克中肾素-血管紧张素系统的变化","authors":"Bruno Garcia, Benoit Ter Schiphorst, Fuhong Su, Adrien Picod, Theo Ikenna-Uba, Raphaël Favory, Filippo Annoni, Alexandre Mebazaa, Jean-Louis Vincent, Jacques Creteur, Fabio S Taccone, Antoine Herpain","doi":"10.1097/CCE.0000000000001163","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To analyze dynamic changes in the renin-angiotensin system (RAS) during septic shock, focusing on angiotensin-converting enzyme (ACE) activity and the balance between angiotensin peptides, using a mass spectrometry method.</p><p><strong>Design: </strong>Experimental septic shock model induced by peritonitis in swine.</p><p><strong>Setting: </strong>Experimental Laboratory, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles.</p><p><strong>Subjects: </strong>Forty time points from eight mechanically ventilated pigs.</p><p><strong>Interventions: </strong>Septic shock was induced using intraperitoneal instillation of autologous feces, followed by standardized fluid resuscitation, norepinephrine infusion, antibiotic administration, and peritoneal lavage.</p><p><strong>Measurements and main results: </strong>The induction of sepsis resulted in a significant increase in plasma renin activity and levels of angiotensin I and II, with a significant decrease in ACE activity observed from 4 hours post-resuscitation and a notable rise in the angiotensin I/angiotensin II ratio at 12 hours. Additionally, a shift toward the angiotensin-(1-7) axis was observed, evidenced by an increased angiotensin-(1-7)/angiotensin II ratio.</p><p><strong>Conclusions: </strong>The study highlighted dynamic shifts in the RAS during septic shock, characterized by reduced circulating ACE activity, elevated angiotensin I/II ratio, and a shift toward the angiotensin-(1-7) axis. These findings suggest an adaptive response within the RAS, potentially offering new insights into sepsis management and therapeutic targets.</p>","PeriodicalId":93957,"journal":{"name":"Critical care explorations","volume":"6 10","pages":"e1163"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473057/pdf/","citationCount":"0","resultStr":"{\"title\":\"Alterations in the Renin-Angiotensin System in Experimental Septic Shock.\",\"authors\":\"Bruno Garcia, Benoit Ter Schiphorst, Fuhong Su, Adrien Picod, Theo Ikenna-Uba, Raphaël Favory, Filippo Annoni, Alexandre Mebazaa, Jean-Louis Vincent, Jacques Creteur, Fabio S Taccone, Antoine Herpain\",\"doi\":\"10.1097/CCE.0000000000001163\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To analyze dynamic changes in the renin-angiotensin system (RAS) during septic shock, focusing on angiotensin-converting enzyme (ACE) activity and the balance between angiotensin peptides, using a mass spectrometry method.</p><p><strong>Design: </strong>Experimental septic shock model induced by peritonitis in swine.</p><p><strong>Setting: </strong>Experimental Laboratory, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles.</p><p><strong>Subjects: </strong>Forty time points from eight mechanically ventilated pigs.</p><p><strong>Interventions: </strong>Septic shock was induced using intraperitoneal instillation of autologous feces, followed by standardized fluid resuscitation, norepinephrine infusion, antibiotic administration, and peritoneal lavage.</p><p><strong>Measurements and main results: </strong>The induction of sepsis resulted in a significant increase in plasma renin activity and levels of angiotensin I and II, with a significant decrease in ACE activity observed from 4 hours post-resuscitation and a notable rise in the angiotensin I/angiotensin II ratio at 12 hours. Additionally, a shift toward the angiotensin-(1-7) axis was observed, evidenced by an increased angiotensin-(1-7)/angiotensin II ratio.</p><p><strong>Conclusions: </strong>The study highlighted dynamic shifts in the RAS during septic shock, characterized by reduced circulating ACE activity, elevated angiotensin I/II ratio, and a shift toward the angiotensin-(1-7) axis. These findings suggest an adaptive response within the RAS, potentially offering new insights into sepsis management and therapeutic targets.</p>\",\"PeriodicalId\":93957,\"journal\":{\"name\":\"Critical care explorations\",\"volume\":\"6 10\",\"pages\":\"e1163\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473057/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical care explorations\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/CCE.0000000000001163\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical care explorations","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/CCE.0000000000001163","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的:分析脓毒性休克期间肾素-血管紧张素系统(RAS)的动态变化:利用质谱法分析脓毒性休克期间肾素-血管紧张素系统(RAS)的动态变化,重点是血管紧张素转换酶(ACE)活性和血管紧张素肽之间的平衡:设计:猪腹膜炎诱发的实验性脓毒性休克模型:地点:布鲁塞尔自由大学 Erasme 医院重症监护部实验实验室:40 个时间点,来自 8 头机械通气的猪:干预措施:通过腹腔灌注自体粪便诱发败血症休克,然后进行标准化液体复苏、去甲肾上腺素输注、抗生素给药和腹腔灌洗:脓毒症诱导导致血浆肾素活性及血管紧张素 I 和 II 水平显著升高,复苏后 4 小时起观察到 ACE 活性显著下降,12 小时时血管紧张素 I/ 血管紧张素 II 比值明显升高。此外,还观察到向血管紧张素-(1-7)轴的转移,表现为血管紧张素-(1-7)/血管紧张素 II 比率的增加:该研究强调了脓毒性休克期间 RAS 的动态变化,其特点是循环 ACE 活性降低、血管紧张素 I/II 比值升高以及向血管紧张素-(1-7)轴转移。这些研究结果表明了 RAS 内的适应性反应,有可能为脓毒症管理和治疗目标提供新的见解。
Alterations in the Renin-Angiotensin System in Experimental Septic Shock.
Objectives: To analyze dynamic changes in the renin-angiotensin system (RAS) during septic shock, focusing on angiotensin-converting enzyme (ACE) activity and the balance between angiotensin peptides, using a mass spectrometry method.
Design: Experimental septic shock model induced by peritonitis in swine.
Setting: Experimental Laboratory, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles.
Subjects: Forty time points from eight mechanically ventilated pigs.
Interventions: Septic shock was induced using intraperitoneal instillation of autologous feces, followed by standardized fluid resuscitation, norepinephrine infusion, antibiotic administration, and peritoneal lavage.
Measurements and main results: The induction of sepsis resulted in a significant increase in plasma renin activity and levels of angiotensin I and II, with a significant decrease in ACE activity observed from 4 hours post-resuscitation and a notable rise in the angiotensin I/angiotensin II ratio at 12 hours. Additionally, a shift toward the angiotensin-(1-7) axis was observed, evidenced by an increased angiotensin-(1-7)/angiotensin II ratio.
Conclusions: The study highlighted dynamic shifts in the RAS during septic shock, characterized by reduced circulating ACE activity, elevated angiotensin I/II ratio, and a shift toward the angiotensin-(1-7) axis. These findings suggest an adaptive response within the RAS, potentially offering new insights into sepsis management and therapeutic targets.