The ultrastructural changes in the glomeruli and juxtaglomerular apparatus at different periods of endotoxic shock]

It is shown that after endotoxin injection the ultrastructural changes in the glomeruli can favour development of the acute renal insufficiency. In the initial and intermediate periods of the endotoxin shock the granular and agranular forms of juxtaglomerular cells hyperfunction, respectively, are revealed as well as an increase of renin activity in plasma. At the stage of the late endotoxemia ultrastructural alterations are stabilized. The juxtaglomerular cells synthesize and accumulate secretory granules, but renin activity in plasma decreases almost to the initial level.     

Ultrastructural characteristics of the biological action of an endotoxin on sensorimotor cortical neurons

The work is devoted to the ultrastructural investigation of the state of the sensomotor cortex neurons after intravenous and intracisternal administration of endotoxin. The evidences are presented concerning ultrastructural alterations in mitochondria and the presence of compensatory reaction in them after intravenous injection of endotoxin. Besides, coated vesicles and subsurface cisternae whose formation is induced by the endotoxin action have been studied.     

Ultrastructural manifestations of pulmonary thrombohemorrhagic syndrome in endotoxic shock

In electron microscopic investigation in the initial period of endotoxin shock in rats, rabbits and dogs there are haemorrhages and microthrombi with precipitation of fibrin. In intermediate period of shock signs of intravascular coagulation predominate and on the stage of late endotoxemia qualitatively new sign of destruction is interstitial fibrosis. Involving of coagulative link completes and enhances microcirculatory changes in the lungs and promotes formation of acute lung insufficiency.     

Ultrastructural changes in alveolar macrophages in rats under the effect of Escherichia coli endotoxin

Electron-microscopic investigation has shown that alveolar macrophages phagocyte surfactant in the initial period of the endotoxin shock, necrotized cells--in the intermediate period, fibrin--at the stage of late endotoxemia.     

High serum IL-6 level reflects susceptible status of the host to endotoxin and IL-1/tumor necrosis factor.

Patients with high level of serum endotoxin did not necessarily develop into lethal shock, whereas some patients died of septic shock even when their serum endotoxin levels were low. These results indicate that limiting factor which determines the host to be endotoxin shock principally depends on the host susceptibility to endotoxin instead of serum endotoxin level. To understand this susceptible status of the host to endotoxin, we used Propionibacterium acnes primed mouse endotoxin shock model. We found that P. acnes-primed mice responded to low dose of LPS by enhanced production of IL-1 and TNF. And such mice were highly susceptible to the lethal shock inducing effect of IL-1 and/or TNF, which also induced high level of serum IL-6 in these mice. Therefore, measurement of serum IL-6 level provides us with the information of the preceding exposure of the host to either LPS or IL-1 and/or TNF and the highly susceptible status of the host to these stimuli. Based on these results obtained from animal model, we investigated the relationship between serum IL-6 levels and serum endotoxin levels in the patients with malignant hematologic disorders. We found that these patients fell into two groups; an endotoxin susceptible group, equivalent to P. acnes-primed mice, showing high level of serum IL-6 with low level of serum endotoxin, and a nonendotoxin susceptible group, equivalent to P. acnes-nonprimed mice, showing low or undetectable level of serum IL-6 with high level of serum endotoxin. We propose that the measurement of serum IL-6 level in the patients positive for endotoxin is a useful tool in evaluating diagnosis and prognosis of endotoxin shock.     

Potentiation of lethal endotoxin shock by streptococcal pyrogenic exotoxin in rabbits: Possible relevance of hyperreactivity of macrophages to endotoxin

Abstract Streptococcal pyrogenic exotoxin (SPE) potentiates lethal shock induced by endotoxin. We have previously reported that macrophages derived from SPE-treated rabbits showed hyperreactivity to endotoxin, and that the effect of SPE on macrophages was mediated by a lymphokine(s). Here we show that culture supernatants of SPE-stimulated lymphocytes, when administered into rabbits three hours before or together with endotoxin, potentiate a variety of endotoxin-induced pathophysiological changes and even lethal shock. These results suggest that SPE-induced lymphokine(s) mediates the potentiating effect of SPE on the lethal endotoxin shock through enhancing endotoxin reactivity of macrophages which play the central role in mediating endotoxin toxicity.     

Morphologic changes of the pancreas in hemorrhagic shock and the postresuscitation period

The canine pancreas (20) in the terminal period of hemorrhagic shock and postresuscitation period was studied histologically and electronmicroscopically. There were detected ultrastructural signs of the plasmatic membranes of pancreatocytes and membranes of secretory granules with "leakage" of pancreatic ferments in the interstitial tissue. The incretion of pancreatic ferments in the vascular bed is conditioned by the elevation of proteolytic activity of blood serum in hemorrhagic shock and postresuscitation period.     

Features of the morphofunctional response of Peyer's patches in rats during the course of traumatic shock and the early post-shock period

The reaction of Peyer's patches to trauma manifests in: 1) vascular changes; 2) primary or stressor cells shifts recordable in traumatic shock, characterized by depletion of patch follicles by minor lymphocytes; 3) secondary changes associated with the onset of reparative processes; 4) the increased macrophagal activity detectable during the entire period of the traumatic shock and in the early post-shock period. It is suggested that changes seen may be due to endotoxin that penetrates from the intestine.     

Nonenzymatic fibrinolytic reaction to the intravenous administration of small doses of Salmonella endotoxin to rabbits

Intravenous injection of a low dose of Salmonella endotoxin (10 micrograms/kg bw) into rabbits results in an increase in the non-enzymatic fibrinolytic activity of blood at early stages of a pathological process followed by depression of this response at later stages of the pathology. At higher degrees of non-enzymatic fibrinolysis activation the morphological and ultrastructural changes in renal tissues caused by endotoxin injection are the least pronounced. Intravenous injection of heparin after injection of a lethal dose of Salmonella endotoxin (100-200 micrograms/kg) enhances non-enzymatic fibrinolysis activation and decreases the morphological and ultrastructural lesions in renal tissues.     

Effect of Endotoxin on the Serum Ribonuclease Activity in Rats

The effects of endotoxin shock, endotoxin tolerance, and lead acetate plus a minute amount of endotoxin on the serum ribonuclease activity of rats was measured. Changes in serum ribonuclease activity after various entoxin treatments could be a primary effect or a secondary effect of the damaging effect of endotoxin.     

Insoluble glycogen, a metabolizable internal adsorbent, decreases the lethality of endotoxin shock in rats

Insoluble glycogen is an enzymatically modified form of naturally occurring soluble glycogen with a great adsorbing capacity. It can be metabolized by phagocytes to glucose. In this study we used insoluble glycogen intravenously in the experimental endotoxin shock of rats. Wistar male rats were sensitized to endotoxin by Pb acetate. The survival of rats were compared in groups of animals endotoxin shock treated and non-treated with insoluble glycogen. Furthermore, we have determined in vitro the binding capacity of insoluble glycogen for endotoxin, tumour necrosis factor alpha, interleukin-1 and secretable phospholipase A2. Use of 10 mg/kg dose of insoluble glycogen could completely prevent the lethality of shock induced by LD50 quantity of endotoxin in rats. All animals treated survived. Insoluble glycogen is a form of 'metabolizable internal adsorbents'. It can potentially be used for treatment of septic shock.     

Effects of ONO-6240, a platelet-activating factor antagonist, on endotoxin shock in unanesthetized sheep

To determine the role of platelet-activating factor (PAF) in endotoxin shock, we studied the effects of ONO-6240, a PAF antagonist, on endotoxin shock in unanesthetized sheep. Changes in hemodynamics, lung lymph balance, leukocyte and platelet counts, and arterial blood gas tensions were measured in four groups; endotoxin alone; endotoxin plus ONO-6240; ONO-6240 alone; vehicle control. Pretreatment with ONO-6240 in sheep given endotoxin significantly prevented the decreases in systemic arterial pressure, left atrial pressure and cardiac output observed in sheep given endotoxin alone. A partial effect on diminishing the magnitude of peripheral leukopenia was also noted. However, pretreatment with ONO-6240 had little effect on pulmonary hypertension and lung lymph balance. We conclude that endotoxin causes two different effects: vascular collapse and direct lung injury; and that PAF is involved only in the circulatory manifestations.     

Comparative Analysis of Hepatic CD14 Expression between Two Different Endotoxin Shock Model Mice: Relation between Hepatic Injury and CD14 Expression

CD14 is a glycoprotein that recognizes gram-negative bacterial lipopolysaccharide (LPS) and exists in both membrane-bound and soluble forms. Infectious and/or inflammatory diseases induce CD14 expression, which may be involved in the pathology of endotoxin shock. We previously found that the expression of CD14 protein differs among the endotoxin shock models used, although the reasons for these differences are unclear. We hypothesized that the differences in CD14 expression might be due to liver injury, because the hepatic tissue produces CD14 protein. We investigated CD14 expression in the plasma and liver in the carrageenan (CAR)-primed and D-galN-primed mouse models of endotoxin shock. Our results showed that severe liver injury was not induced in CAR-primed endotoxin shock model mice. In this CAR-primed model, the higher mRNA and protein expression of CD14 was observed in the liver, especially in the interlobular bile duct in contrast to D-galN-primed-endotoxin shock model mice. Our findings indicated that the molecular mechanism(s) underlying septic shock in CAR-primed and D-galN-primed endotoxin shock models are quite different. Because CD14 expression is correlated with clinical observations, the CAR-primed endotoxin shock model might be useful for studying the functions of CD14 during septic shock in vivo.     

低血容量休克复合内毒素血症时血和组织髓过氧化物酶的变化

研究观察失血性休克复合内毒素血症时血和组织髓过氧化物酶的变化规律。将雄性wistar大白鼠随机分为对照组、缺血组、缺血再灌流组和缺血再灌流复合内毒素组。用改良的髓过氧化物酶 (MPO)测定方法 ,测定血、肺和小肠组织MPO及相关指标的变化。结果显示肺组织MPO活性从失血性休克末开始升高 ,致内毒素血症时出现峰值 ;小肠组织MPO的活性在失血再灌流后显著升高 ,但在失血性休克复合内毒素血症后显著降低 ;血MPO活性于失血性休克和失血再灌流后均无显著性变化 ,复合内毒素后显著降低。结果表明失血再灌流后肺组织PMN扣留、聚集显著增加 ,内毒素血症促进PMN在肺中的扣留 ,这些变化与PMN上CD11b和CD18表达上调有关 ,提示失血再灌注复合内毒素时组织细胞损伤与PMN的粘附、扣留、激活有关。     

Effects of BM-573, a novel thromboxane A2 inhibitor, on pulmonary hemodynamics in endotoxic shock

Thromboxane A2 is considered to be partially responsible for the increase in pulmonary vascular resistance observed after endotoxin administration and to participate in proinflammatory reactions. The effects of a novel dual TXA2 synthase inhibitor and TXA2 receptor antagonist (BM-573) on pulmonary hemodynamics were investigated in endotoxic shock. 30 mins before the start of a 0.5 mg/kg endotoxin infusion, 6 pigs (Endo group) received a placebo infusion and 6 other pigs (Anta group) received a BM-573 infusion. In Endo group, pulmonary artery pressure increased from 25 +/- 1.8 (T0) to 42 +/- 2.3 mmHg (T60) (p < 0.05) after endotoxin infusion while, in Anta group, it increased from 23 +/- 1.6 (T0) to 25 +/- 1.5 mmHg (T60). This difference is due to a reduction in pulmonary vascular resistance in Anta group while pulmonary arterial compliance changes in Endo group remained comparable with the evolution in Anta group. In Endo group, PaO2 decreased from 131 +/- 21 (T0) to 74 +/- 12 mmHg (T300) (p < 0.05), while in Anta group, PaO2 was 241 +/- 31 mmHg at the end of the experimental period (T300). These results demonstrate that TXA2 plays a major role in pulmonary vascular changes during endotoxin insult. Concomitant inhibition of TXA2 synthesis and of TXA2 receptors by BM-573 inhibited the pulmonary vasopressive response during the early phase of endotoxin shock as well as the deterioration in arterial oxygenation.     

Effects of ONO-6240, a platelet-activating factor antagonist, on endotoxin shock in unanesthetized sheep

To determine the role of platelet-activating factor (PAF) in endotoxin shock, we studied the effects of ONO-6240, a PAF antogonist, on endotoxin shock in unanesthetized sheep. Changes in hemodynamics, lung lymph balance, leukocyte and platelet counts, and arterial blood gas tensions were measured in four groups; (1) endotoxin alone; (2) endotoxin plus ONO-6240; (3) ONO-6240 alone; (4) vehicle control. Pretreatment with ONO-6240 in sheep given endotoxin significantly prevented the decreases in systemic arterial pressure, left atrial pressure and cardiac output observed in sheep given endotoxin alone. A partial effect on diminishing the magnitude of peripheral leukopenia was also noted. However, pretreatment with ONO-6240 had little effect on pulmonary hypertension and lung lymph balance. We conclude that endotoxin causes two different effects: vascular collapse and direct lung injury; and that PAF is involved only in the circulatory manifestations.     

Platelet-activating factor: an endogenous mediator for bowel necrosis in endotoxemia

We have developed a model of isochemic bowel necrosis in the rat by injecting platelet-activating factor (PAF) or PAF in combination with bacterial endotoxin. PAF causes profound hypotension, and it has been suggested that it is released during endotoxin shock. Because ischemic bowel necrosis is often associated with shock or infection, it is possible that PAF is the endogenous mediator that causes shock and bowel necrosis during sepsis. In this study, we have demonstrated that: 1) normal intestine contained a small amount of PAF; 2) necrotic lesions of the intestine could be induced by endotoxin injection; 3) PAF production in the bowel is markedly increased in animals treated with endotoxin; 4) pretreatment of the animal with PAF antagonists prevent endotoxin-induced necrosis; 5) isolated, buffer-perfused small intestine produced a small quantity of PAF in response to endotoxin injection. Therefore, we conclude that PAF is a likely endogenous mediator in endotoxemia, which causes bowel necrosis and shock.     

Experimental studies on the bacterial product CANTASTIM derived from Pseudomonas aeruginosa. V. Protective effect in endotoxin shock

In this paper, we investigated the effect of the treatment with the bacterial immunomodulator CANTASTIM in a model of endotoxin shock in mice. Among the different mouse models described for septic shock, we have chosen the low-dose endotoxin model using D-galactosamine sensitized mice. We noticed a significant increase in the survival rate of the mice treated with CANTASTIM before the endotoxin challenge. This protective effect was correlated with a strong reduction in the level of TNF alpha in the sera of treated mice. Prior exposure to CANTASTIM also attenuated subsequent ex vivo nitric oxide production by peritoneal macrophages of the mice. In this model of endotoxin shock, the major role has been attributed to TNF alpha acting through its receptor TNFRI (p55). A downregulation of this receptor as a consequence of the treatment with CANTASTIM may be hypothesized. However, the intervention of CANTASTIM in other points in the cytokine network involved in endotoxin shock cannot be excluded.     

Effect of endotoxin on protein degradation and lipid peroxidation of erythrocytes.

Sepsis has often been associated with infection due to endotoxin (LPS) produced from gram-negative bacteria. Microcirculatory failure is one of the ultimate causes of septic shock. We studied the effect of endotoxin on the protein breakdown and lipid peroxidation of erythrocyte. In vivo (20 ug LPS/100 g) studies in rats showed increased tyrosine production from erythrocyte, as an index of protein degradation in erythrocyte. In vitro studies using 25 microg to 250 microg LPS per ml also showed similar type of increased effect of endotoxin in protein degradation. Washed erythrocyte devoid of plasma and leucocytes did not show any increased effect after endotoxin treatment. Lipid peroxidation was also increased after endotoxin treatment. However, protein degradation was more prominent than lipid peroxidation. We concluded therefore that the protein degradation and lipid peroxidation of erythrocytes caused by endotoxin are probably related to the production of septic shock.     

Physiological and chemical indicators for early and late stages of sepsis in conscious rats

Endotoxin shock is a major cause of death in patients with septicemia. Endotoxin induces nitric oxide (NO) production and causes tissue damage. In addition, the release of oxygen free radicals has also been observed in endotoxin shock and was found to be responsible for the occurrence of multiple organ failure. The purpose of the present study was to evaluate suitable indicators for early and late stages of endotoxin shock. The experiments were designed to induce endotoxin shock in conscious rats by means of anEscherichia coli lipopolysaccharide (LPS) injection. Arterial pressure (AP) and heart rate (HR) were continuously monitored for 72 h after LPS administration. The maximal decrease in AP and increase in HR and nitrate/nitrite level occurred at 9–12 h following LPS administration. The white blood cell (WBC) count had decreased at 3 h. Hydroxyl radical (methyl guanidine, MG) decreased rapidly after LPS administration. Plasma levels of blood urea nitrogen (BUN), creatinine (Cr), lactic dehydrogenase (LDH), creatine phosphokinase (CPK), and glutamic oxaloacetic transaminase increased before the rise of amylase. Our results suggest that changes in AP, HR, WBC, free radicals, and chemical substances (BUN, Cr) can possibly serve as approximate indicators for the early stage of endotoxin shock. Severe multiple organ damage may be caused by amylase release in the late stage of endotoxin shock.