Toll-Like Receptors, Associated Biochemical Signaling Networks, and S100 Ligands
Host cells recognize molecules that signal danger using pattern recognition receptors (PRRs). Toll-like receptors (TLRs) are the most studied class of PRRs and detect pathogen-associated molecular patterns and danger-associated molecular patterns. Cellular TLR activation and signal transduction can therefore contain, combat, and clear danger by enabling appropriate gene transcription. Here, we review the expression, regulation, and function of different TLRs, with an emphasis on TLR-4, and how TLR adaptor protein binding directs intracellular signaling resulting in activation or termination of an innate immune response. Fi...
Source: Shock - July 22, 2021 Category: Emergency Medicine Tags: Review Articles Source Type: research
Childhood Mortality After Fluid Bolus With Septic or Severe Infection Shock: A Systematic Review and Meta-Analysis
Background:
A considerable debate on whether fluid bolus could decrease childhood mortality in pediatric patients with septic or severe infection shock is still unresolved. A systematic review and meta-analysis was conducted to investigate the mortality rates after fluid bolus among children with septic or severe infection shock.
Methods:
A systematic electronic search of PubMed, MEDLINE, Cochrane Library, and EMBASE databases was conducted to identify relevant published studies till March 30, 2020.
Results:
A total of 19 studies with 9,321 severe sepsis or septic shock pediatric patients were included an...
Source: Shock - July 22, 2021 Category: Emergency Medicine Tags: Review Articles Source Type: research
What's New in Shock, August 2021?
No abstract available (Source: Shock)
Source: Shock - July 22, 2021 Category: Emergency Medicine Tags: Commentary Source Type: research
Reply to “Do Not Blame the Rodent for the Failure of Developing Sepsis Therapies”
No abstract available (Source: Shock)
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research
Reply to Moldawer, Darden, and Efron's Reply to “Do Not Blame the Rodent for the Failure of Developing Sepsis Therapies”
No abstract available (Source: Shock)
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research
Prognostic Value of the Lactate–Albumin Difference in Predicting 30-Day Mortality in Critically Ill Patients
No abstract available (Source: Shock)
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Letters to the Editors Source Type: research
Pharmacological and Genetic Inhibition of Translocator Protein 18 kDa Ameliorated Neuroinflammation in Murine Endotoxemia Model
Sepsis-associated encephalopathy (SAE) is a diffuse brain dysfunction associated with sepsis. The development of an effective strategy for early diagnosis and therapeutic intervention is essential for the prevention of poor prognosis of SAE. Translocator protein 18 kDa (TSPO) is a mitochondrial protein implicated in steroidogenesis and inflammatory responses. Despite accumulating evidence that implicates TSPO in the neuroinflammatory response of the central nervous system, the possible role of TSPO in SAE remains unclear. The aim of this study is to address a role of TSPO in neuroinflammation using mice 24 h after system...
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Mesenchymal Stem/Stromal Cells Increase Cardiac miR-187-3p Expression in a Polymicrobial Animal Model of Sepsis
Sepsis-induced myocardial dysfunction (MD) is an important pathophysiological feature of multiorgan failure caused by a dysregulated host response to infection. Patients with MD continue to be managed in intensive care units with limited understanding of the molecular mechanisms controlling disease pathogenesis. Emerging evidences support the use of mesenchymal stem/stromal cell (MSC) therapy for treating critically ill septic patients. Combining this with the known role that microRNAs (miRNAs) play in reversing sepsis-induced myocardial-dysfunction, this study sought to investigate how MSC administration alters miRNA expr...
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Burn Injury Impairs Neutrophil Chemotaxis Through Increased Ceramide
Infection is a common and often deadly complication after burn injury. A major underlying factor is burn-induced immune dysfunction, particularly with respect to neutrophils as the primary responders to infection. Temporally after murine scald injury, we demonstrate impaired bone marrow neutrophil chemotaxis toward CXCL1 ex vivo. Additionally, we observed a reduced recruitment of neutrophils to the peritoneal after elicitation 7 days after injury. We demonstrate that neutrophil ceramide levels increase after burn injury, and this is associated with decreased expression of CXCR2 and blunted chemotaxis. A major signaling eve...
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Direct Airway Instillation of Neutrophils Overcomes Chemotactic Deficits Induced by Injury
Conclusion:
Injury-derived mtFPs suppress global PMN localization into complex chemotactic environments like infected alveoli. Transplantation of naive exogenous human neutrophils into the airway circumvents that pathologic process and prevents development of post-traumatic pneumonia without injury noted to the recipients. (Source: Shock)
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Muscle-Derived Mitochondrial Transplantation Reduces Inflammation, Enhances Bacterial Clearance, and Improves Survival in Sepsis
Conclusions:
These data displayed that mitochondrial replenishment reduces systemic inflammation and organ injury, enhances bacterial clearance, and improves the survival rate in sepsis. Thus, extraneous mitochondrial replenishment may be an effective adjunctive treatment to reduce sepsis-related mortality. (Source: Shock)
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Triggering Receptor Expressed on Myeloid Cells-2 Protects Aged Mice Against Sepsis by Mitigating the IL-23/IL-17A Response
Background:
Advancing age is an independent predictor of mortality in septic patients. Recent animal studies were unable to reflect this clinical pathophysiological process, largely hampering the development of new efficacious therapies. Triggering receptor expressed on myeloid cells-2 (TREM-2) is a novel immune regulator with multiple activities. However, very little is known about the regulatory role of TREM-2 in sepsis upon aging.
Methods:
Blood samples were collected from septic patients within 24 h after intensive care unit admission. The patients were preselected into two groups based on the age (age wit...
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Resonance Raman Spectroscopy Derived Tissue Hemoglobin Oxygen Saturation in Critically Ill and Injured Patients
In this study, we examined the ability of resonance Raman spectroscopy to measure tissue hemoglobin oxygenation (R-StO2) noninvasively in critically ill patients and compared its performance with conventional central venous hemoglobin oxygen saturation (ScvO2).
Methods:
Critically ill patients (n = 138) with an indwelling central venous or pulmonary artery catheter in place were consented and recruited. R-StO2 measurements were obtained by placing a sensor inside the mouth on the buccal mucosa. R-StO2 was measured continuously for 5 min. Blood samples were drawn from the distal port of the indwelling central ven...
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research
HIF-1α and Hypoxia Responsive Genes are Differentially Expressed in Leukocytes From Survivors and Non-Survivors Patients During Clinical Sepsis
Hypoxia inducible factor 1 alpha (HIF-1α) is linked to the metabolic and immune alterations in septic patients. Stabilization of HIF-1α by hypoxia or inflammation promotes the expression of several genes related to glycolytic metabolism, angiogenesis, coagulation, cell proliferation, and apoptosis. Here, we analyzed public available blood transcriptome datasets from septic patients and evaluated by PCR array the expression of HIF-1α and other hypoxia responsive genes in peripheral blood mononuclear cells from patients with sepsis secondary to community acquired infections. Samples were collected at intensive care unit a...
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research
Predicting the Need For Vasopressors in the Intensive Care Unit Using an Attention Based Deep Learning Model
Conclusions:
We used Bi-LSTM to develop a model to predict the need for vasopressor for critically ill patients for the first 24 h of ICU admission. With attention mechanism, respiratory rate, mean arterial pressure, and heart rate were identified as key sequential determinants of vasopressor requirements. (Source: Shock)
Source: Shock - July 1, 2021 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research
