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Moderate Peep After Tracheal Lipopolysaccharide Instillation Prevents Inflammation and Modifies the Pattern of Brain Neuronal Activation

BACKGROUND: Ventilatory strategy and specifically positive end-expiratory pressure (PEEP) can modulate the inflammatory response and pulmonary-to-systemic translocation of lipopolysaccharide (LPS). Both inflammation and ventilatory pattern may modify brain activation, possibly worsening the patient&...

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Autores principales: Quilez, María Elisa, Rodríguez-González, Raquel, Turon, Marc, Fernandez-Gonzalo, Sol, Villar, Jesús, Kacmarek, Robert M., Gómez, Ma Nieves, Oliva, Joan Carles, Blanch, Lluís, López-Aguilar, Josefina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851224/
https://www.ncbi.nlm.nih.gov/pubmed/26398809
http://dx.doi.org/10.1097/SHK.0000000000000469
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author Quilez, María Elisa
Rodríguez-González, Raquel
Turon, Marc
Fernandez-Gonzalo, Sol
Villar, Jesús
Kacmarek, Robert M.
Gómez, Ma Nieves
Oliva, Joan Carles
Blanch, Lluís
López-Aguilar, Josefina
author_facet Quilez, María Elisa
Rodríguez-González, Raquel
Turon, Marc
Fernandez-Gonzalo, Sol
Villar, Jesús
Kacmarek, Robert M.
Gómez, Ma Nieves
Oliva, Joan Carles
Blanch, Lluís
López-Aguilar, Josefina
author_sort Quilez, María Elisa
collection PubMed
description BACKGROUND: Ventilatory strategy and specifically positive end-expiratory pressure (PEEP) can modulate the inflammatory response and pulmonary-to-systemic translocation of lipopolysaccharide (LPS). Both inflammation and ventilatory pattern may modify brain activation, possibly worsening the patient's outcome and resulting in cognitive sequelae. METHODS: We prospectively studied Sprague–Dawley rats randomly assigned to undergo 3 h mechanical ventilation with 7 mL/kg tidal ventilation and either 2 cmH(2)O or 7 cmH(2)O PEEP after intratracheal instillation of LPS or saline. Healthy nonventilated rats served as baseline. We analyzed lung mechanics, gas exchange, lung and plasma cytokine levels, lung apoptotic cells, and lung neutrophil infiltration. To evaluate brain neuronal activation, we counted c-Fos immunopositive cells in the retrosplenial cortex (RS), thalamus, supraoptic nucleus (SON), nucleus of the solitary tract (NTS), paraventricular nucleus (PVN), and central amygdala (CeA). RESULTS: LPS increased lung neutrophilic infiltration, lung and systemic MCP-1 levels, and neuronal activation in the CeA and NTS. LPS-instilled rats receiving 7 cmH(2)O PEEP had less lung and systemic inflammation and more c-Fos-immunopositive cells in the RS, SON, and thalamus than those receiving 2 cmH(2)O PEEP. Applying 7 cmH(2)O PEEP increased neuronal activation in the CeA and NTS in saline-instilled rats, but not in LPS-instilled rats. CONCLUSIONS: Moderate PEEP prevented lung and systemic inflammation secondary to intratracheal LPS instillation. PEEP also modified the neuronal activation pattern in the RS, SON, and thalamus. The relevance of these differential brain c-Fos expression patterns in neurocognitive outcomes should be explored.
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spelling pubmed-48512242016-05-23 Moderate Peep After Tracheal Lipopolysaccharide Instillation Prevents Inflammation and Modifies the Pattern of Brain Neuronal Activation Quilez, María Elisa Rodríguez-González, Raquel Turon, Marc Fernandez-Gonzalo, Sol Villar, Jesús Kacmarek, Robert M. Gómez, Ma Nieves Oliva, Joan Carles Blanch, Lluís López-Aguilar, Josefina Shock Basic Science Aspects BACKGROUND: Ventilatory strategy and specifically positive end-expiratory pressure (PEEP) can modulate the inflammatory response and pulmonary-to-systemic translocation of lipopolysaccharide (LPS). Both inflammation and ventilatory pattern may modify brain activation, possibly worsening the patient's outcome and resulting in cognitive sequelae. METHODS: We prospectively studied Sprague–Dawley rats randomly assigned to undergo 3 h mechanical ventilation with 7 mL/kg tidal ventilation and either 2 cmH(2)O or 7 cmH(2)O PEEP after intratracheal instillation of LPS or saline. Healthy nonventilated rats served as baseline. We analyzed lung mechanics, gas exchange, lung and plasma cytokine levels, lung apoptotic cells, and lung neutrophil infiltration. To evaluate brain neuronal activation, we counted c-Fos immunopositive cells in the retrosplenial cortex (RS), thalamus, supraoptic nucleus (SON), nucleus of the solitary tract (NTS), paraventricular nucleus (PVN), and central amygdala (CeA). RESULTS: LPS increased lung neutrophilic infiltration, lung and systemic MCP-1 levels, and neuronal activation in the CeA and NTS. LPS-instilled rats receiving 7 cmH(2)O PEEP had less lung and systemic inflammation and more c-Fos-immunopositive cells in the RS, SON, and thalamus than those receiving 2 cmH(2)O PEEP. Applying 7 cmH(2)O PEEP increased neuronal activation in the CeA and NTS in saline-instilled rats, but not in LPS-instilled rats. CONCLUSIONS: Moderate PEEP prevented lung and systemic inflammation secondary to intratracheal LPS instillation. PEEP also modified the neuronal activation pattern in the RS, SON, and thalamus. The relevance of these differential brain c-Fos expression patterns in neurocognitive outcomes should be explored. Lippincott Williams & Wilkins 2015-12 2015-11-15 /pmc/articles/PMC4851224/ /pubmed/26398809 http://dx.doi.org/10.1097/SHK.0000000000000469 Text en Copyright © 2015 by the Shock Society http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Basic Science Aspects
Quilez, María Elisa
Rodríguez-González, Raquel
Turon, Marc
Fernandez-Gonzalo, Sol
Villar, Jesús
Kacmarek, Robert M.
Gómez, Ma Nieves
Oliva, Joan Carles
Blanch, Lluís
López-Aguilar, Josefina
Moderate Peep After Tracheal Lipopolysaccharide Instillation Prevents Inflammation and Modifies the Pattern of Brain Neuronal Activation
title Moderate Peep After Tracheal Lipopolysaccharide Instillation Prevents Inflammation and Modifies the Pattern of Brain Neuronal Activation
title_full Moderate Peep After Tracheal Lipopolysaccharide Instillation Prevents Inflammation and Modifies the Pattern of Brain Neuronal Activation
title_fullStr Moderate Peep After Tracheal Lipopolysaccharide Instillation Prevents Inflammation and Modifies the Pattern of Brain Neuronal Activation
title_full_unstemmed Moderate Peep After Tracheal Lipopolysaccharide Instillation Prevents Inflammation and Modifies the Pattern of Brain Neuronal Activation
title_short Moderate Peep After Tracheal Lipopolysaccharide Instillation Prevents Inflammation and Modifies the Pattern of Brain Neuronal Activation
title_sort moderate peep after tracheal lipopolysaccharide instillation prevents inflammation and modifies the pattern of brain neuronal activation
topic Basic Science Aspects
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851224/
https://www.ncbi.nlm.nih.gov/pubmed/26398809
http://dx.doi.org/10.1097/SHK.0000000000000469
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