Alterations in the Renin-Angiotensin System in Experimental Septic Shock
| Autor: | Bruno Garcia, MD, PhD, Benoit Ter Schiphorst, MD, MSc, Fuhong Su, MD, PhD, Adrien Picod, MD, PhD, Theo Ikenna-Uba, PhD, Raphaël Favory, MD, PhD, Filippo Annoni, MD, Alexandre Mebazaa, MD, PhD, Jean-Louis Vincent, MD, PhD, Jacques Creteur, MD, PhD, Fabio S. Taccone, MD, PhD, Antoine Herpain, MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Critical Care Explorations, Vol 6, Iss 10, p e1163 (2024) |
| Druh dokumentu: | article |
| ISSN: | 2639-8028 00000000 |
| DOI: | 10.1097/CCE.0000000000001163 |
| Popis: | 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. |
| Databáze: | Directory of Open Access Journals |
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