Moderate glucose supply reduces hemolysis during systemic inflammation

Johannes Jägers,1 Stephan Brauckmann,2 Michael Kirsch,1 Katharina Effenberger-Neidnicht1,3 1Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany; 2Clinic for Anesthesiology and Intensive Care, University Hospital Essen, Essen, Germany; 3Institute of Physiological...

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Autores principales:	Jägers J, Brauckmann S, Kirsch M, Effenberger-Neidnicht K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	lipopolysaccharide sepsis erythrocytes red blood cells cell-free hemoglobin glucose metabolism Pathology RB1-214 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/2ddc60af35a14cb283f757f0ce7e7891
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spelling	oai:doaj.org-article:2ddc60af35a14cb283f757f0ce7e78912021-12-02T05:12:16ZModerate glucose supply reduces hemolysis during systemic inflammation1178-7031https://doaj.org/article/2ddc60af35a14cb283f757f0ce7e78912018-03-01T00:00:00Zhttps://www.dovepress.com/moderate-glucose-supply-reduces-hemolysis-during-systemic-inflammation-peer-reviewed-article-JIRhttps://doaj.org/toc/1178-7031Johannes Jägers,1 Stephan Brauckmann,2 Michael Kirsch,1 Katharina Effenberger-Neidnicht1,3 1Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany; 2Clinic for Anesthesiology and Intensive Care, University Hospital Essen, Essen, Germany; 3Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany Background: Systemic inflammation alters energy metabolism. A sufficient glucose level, however, is most important for erythrocytes, since erythrocytes rely on glucose as sole source of energy. Damage to erythrocytes leads to hemolysis. Both disorders of glucose metabolism and hemolysis are associated with an increased risk of death. The objective of the study was to investigate the impact of intravenous glucose on hemolysis during systemic inflammation.Materials and methods: Systemic inflammation was accomplished in male Wistar rats by continuous lipopolysaccharide (LPS) infusion (1 mg LPS/kg and h, 300 min). Sham control group rats received Ringer’s solution. Glucose was supplied moderately (70 mg glucose/kg and h) or excessively (210 mg glucose/kg and h) during systemic inflammation. Vital parameters (eg, systemic blood pressure) as well as blood and plasma parameters (eg, concentrations of glucose, lactate and cell-free hemoglobin, and activity of lactate dehydrogenase) were measured hourly. Clot formation was analyzed by thromboelastometry.Results: Continuous infusion of LPS led to a so-called post-aggression syndrome with disturbed electrolyte homeostasis (hypocalcemia, hyperkalemia, and hypernatremia), changes in hemodynamics (tachycardia and hypertension), and a catabolic metabolism (early hyperglycemia, late hypoglycemia, and lactate formation). It induced severe tissue injury (significant increases in plasma concentrations of transaminases and lactate dehydrogenase), alterations in blood coagulation (disturbed clot formation), and massive hemolysis. Both moderate and excessive glucose supply reduced LPS-induced increase in systemic blood pressure. Excessive but not moderate glucose supply increased blood glucose level and enhanced tissue injury. Glucose supply did not reduce LPS-induced alterations in coagulation, but significantly reduced hemolysis induced by LPS.Conclusion: Intravenous glucose infusion can diminish LPS-related changes in hemodynamics, glucose metabolism, and, more interestingly, LPS-induced hemolysis. Since cell-free hemoglobin is known to be a predictor for patient’s survival, a reduction of hemolysis by 35% only by the addition of a small amount of glucose is another step to minimize mortality during systemic inflammation. Keywords: lipopolysaccharide, sepsis, erythrocytes, red blood cells, cell-free hemoglobin, glucose metabolismJägers JBrauckmann SKirsch MEffenberger-Neidnicht KDove Medical Pressarticlelipopolysaccharidesepsiserythrocytesred blood cellscell-free hemoglobinglucose metabolismPathologyRB1-214Therapeutics. PharmacologyRM1-950ENJournal of Inflammation Research, Vol Volume 11, Pp 87-94 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	lipopolysaccharide sepsis erythrocytes red blood cells cell-free hemoglobin glucose metabolism Pathology RB1-214 Therapeutics. Pharmacology RM1-950
spellingShingle	lipopolysaccharide sepsis erythrocytes red blood cells cell-free hemoglobin glucose metabolism Pathology RB1-214 Therapeutics. Pharmacology RM1-950 Jägers J Brauckmann S Kirsch M Effenberger-Neidnicht K Moderate glucose supply reduces hemolysis during systemic inflammation
description	Johannes Jägers,1 Stephan Brauckmann,2 Michael Kirsch,1 Katharina Effenberger-Neidnicht1,3 1Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany; 2Clinic for Anesthesiology and Intensive Care, University Hospital Essen, Essen, Germany; 3Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany Background: Systemic inflammation alters energy metabolism. A sufficient glucose level, however, is most important for erythrocytes, since erythrocytes rely on glucose as sole source of energy. Damage to erythrocytes leads to hemolysis. Both disorders of glucose metabolism and hemolysis are associated with an increased risk of death. The objective of the study was to investigate the impact of intravenous glucose on hemolysis during systemic inflammation.Materials and methods: Systemic inflammation was accomplished in male Wistar rats by continuous lipopolysaccharide (LPS) infusion (1 mg LPS/kg and h, 300 min). Sham control group rats received Ringer’s solution. Glucose was supplied moderately (70 mg glucose/kg and h) or excessively (210 mg glucose/kg and h) during systemic inflammation. Vital parameters (eg, systemic blood pressure) as well as blood and plasma parameters (eg, concentrations of glucose, lactate and cell-free hemoglobin, and activity of lactate dehydrogenase) were measured hourly. Clot formation was analyzed by thromboelastometry.Results: Continuous infusion of LPS led to a so-called post-aggression syndrome with disturbed electrolyte homeostasis (hypocalcemia, hyperkalemia, and hypernatremia), changes in hemodynamics (tachycardia and hypertension), and a catabolic metabolism (early hyperglycemia, late hypoglycemia, and lactate formation). It induced severe tissue injury (significant increases in plasma concentrations of transaminases and lactate dehydrogenase), alterations in blood coagulation (disturbed clot formation), and massive hemolysis. Both moderate and excessive glucose supply reduced LPS-induced increase in systemic blood pressure. Excessive but not moderate glucose supply increased blood glucose level and enhanced tissue injury. Glucose supply did not reduce LPS-induced alterations in coagulation, but significantly reduced hemolysis induced by LPS.Conclusion: Intravenous glucose infusion can diminish LPS-related changes in hemodynamics, glucose metabolism, and, more interestingly, LPS-induced hemolysis. Since cell-free hemoglobin is known to be a predictor for patient’s survival, a reduction of hemolysis by 35% only by the addition of a small amount of glucose is another step to minimize mortality during systemic inflammation. Keywords: lipopolysaccharide, sepsis, erythrocytes, red blood cells, cell-free hemoglobin, glucose metabolism
format	article
author	Jägers J Brauckmann S Kirsch M Effenberger-Neidnicht K
author_facet	Jägers J Brauckmann S Kirsch M Effenberger-Neidnicht K
author_sort	Jägers J
title	Moderate glucose supply reduces hemolysis during systemic inflammation
title_short	Moderate glucose supply reduces hemolysis during systemic inflammation
title_full	Moderate glucose supply reduces hemolysis during systemic inflammation
title_fullStr	Moderate glucose supply reduces hemolysis during systemic inflammation
title_full_unstemmed	Moderate glucose supply reduces hemolysis during systemic inflammation
title_sort	moderate glucose supply reduces hemolysis during systemic inflammation
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/2ddc60af35a14cb283f757f0ce7e7891
work_keys_str_mv	AT jagersj moderateglucosesupplyreduceshemolysisduringsystemicinflammation AT brauckmanns moderateglucosesupplyreduceshemolysisduringsystemicinflammation AT kirschm moderateglucosesupplyreduceshemolysisduringsystemicinflammation AT effenbergerneidnichtk moderateglucosesupplyreduceshemolysisduringsystemicinflammation
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Moderate glucose supply reduces hemolysis during systemic inflammation

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