Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model
Systemic inflammatory responses in patients undergoing extracorporeal membrane oxygenation (ECMO) contribute significantly to ECMO-associated morbidity and mortality. In recent years, the number of type 2 diabetes mellitus patients has increased, and the number of these patients undergoing ECMO has...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-04-01
|
| Series: | Membranes |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0375/11/4/283 |
| _version_ | 1797538040641486848 |
|---|---|
| author | Yutaka Fujii Takuya Abe Kikuo Ikegami |
| author_facet | Yutaka Fujii Takuya Abe Kikuo Ikegami |
| author_sort | Yutaka Fujii |
| collection | DOAJ |
| description | Systemic inflammatory responses in patients undergoing extracorporeal membrane oxygenation (ECMO) contribute significantly to ECMO-associated morbidity and mortality. In recent years, the number of type 2 diabetes mellitus patients has increased, and the number of these patients undergoing ECMO has also increased. Type 2 diabetes mellitus is a high-risk factor for complications during ECMO. We studied the effects of ECMO on inflammatory response in a diabetic rat ECMO model. Twenty-eight rats were divided into 4 groups: normal SHAM group (normal rats: <i>n</i> = 7), diabetic SHAM group (diabetic rats: <i>n</i> = 7), normal ECMO group (normal rats: <i>n</i> = 7), and diabetic ECMO group (diabetic rats: <i>n</i> = 7). We measured the plasma levels of cytokines, tumor necrosis factor-α, and interleukin-6. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), blood urea nitrogen (BUN), creatinine (Cr), and liver-type fatty acid binding protein (L-FABP) were examined in the rat cardiopulmonary bypass model to ascertain organ damage. In addition, the lung wet-to-dry weight (W/D) ratio was measured as an index of pulmonary tissue edema. A pathologic evaluation of kidneys was conducted by hematoxylin-eosin (HE) and periodic-acid-methenamine-silver (PAM) staining. In the diabetic ECMO group, levels of cytokines, AST, ALT, LDH, and L-FABP increased significantly, reaching a maximum at the end of ECMO in comparison with other groups (<i>p</i> < 0.05). In addition, hematoxylin-eosin and periodic acid-methenamine-silver staining of renal tissues showed marked injury in the ECMO group (normal ECMO and diabetic ECMO groups). Furthermore, when the normal ECMO and diabetic ECMO groups were compared, severe organ injury was seen in the diabetic ECMO group. There was remarkable organ injury in the diabetic ECMO group. These data demonstrate that diabetes enhances proinflammatory cytokine release, renal damage, and pulmonary edema during ECMO in an animal model. |
| first_indexed | 2024-03-10T12:24:49Z |
| format | Article |
| id | doaj.art-1bb6cfdd5cfc49efb54cb63a826205be |
| institution | Directory Open Access Journal |
| issn | 2077-0375 |
| language | English |
| last_indexed | 2024-03-10T12:24:49Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Membranes |
| spelling | doaj.art-1bb6cfdd5cfc49efb54cb63a826205be2023-11-21T15:06:24ZengMDPI AGMembranes2077-03752021-04-0111428310.3390/membranes11040283Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat ModelYutaka Fujii0Takuya Abe1Kikuo Ikegami2Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata 950-3198, JapanDepartment of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata 950-3198, JapanDepartment of Health and Medical Sciences, Chiba Institute of Science, Choshi 288-0025, JapanSystemic inflammatory responses in patients undergoing extracorporeal membrane oxygenation (ECMO) contribute significantly to ECMO-associated morbidity and mortality. In recent years, the number of type 2 diabetes mellitus patients has increased, and the number of these patients undergoing ECMO has also increased. Type 2 diabetes mellitus is a high-risk factor for complications during ECMO. We studied the effects of ECMO on inflammatory response in a diabetic rat ECMO model. Twenty-eight rats were divided into 4 groups: normal SHAM group (normal rats: <i>n</i> = 7), diabetic SHAM group (diabetic rats: <i>n</i> = 7), normal ECMO group (normal rats: <i>n</i> = 7), and diabetic ECMO group (diabetic rats: <i>n</i> = 7). We measured the plasma levels of cytokines, tumor necrosis factor-α, and interleukin-6. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), blood urea nitrogen (BUN), creatinine (Cr), and liver-type fatty acid binding protein (L-FABP) were examined in the rat cardiopulmonary bypass model to ascertain organ damage. In addition, the lung wet-to-dry weight (W/D) ratio was measured as an index of pulmonary tissue edema. A pathologic evaluation of kidneys was conducted by hematoxylin-eosin (HE) and periodic-acid-methenamine-silver (PAM) staining. In the diabetic ECMO group, levels of cytokines, AST, ALT, LDH, and L-FABP increased significantly, reaching a maximum at the end of ECMO in comparison with other groups (<i>p</i> < 0.05). In addition, hematoxylin-eosin and periodic acid-methenamine-silver staining of renal tissues showed marked injury in the ECMO group (normal ECMO and diabetic ECMO groups). Furthermore, when the normal ECMO and diabetic ECMO groups were compared, severe organ injury was seen in the diabetic ECMO group. There was remarkable organ injury in the diabetic ECMO group. These data demonstrate that diabetes enhances proinflammatory cytokine release, renal damage, and pulmonary edema during ECMO in an animal model.https://www.mdpi.com/2077-0375/11/4/283ECMOdiabetesinflammatory responserat ECMO model |
| spellingShingle | Yutaka Fujii Takuya Abe Kikuo Ikegami Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model Membranes ECMO diabetes inflammatory response rat ECMO model |
| title | Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model |
| title_full | Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model |
| title_fullStr | Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model |
| title_full_unstemmed | Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model |
| title_short | Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model |
| title_sort | diabetic pathophysiology enhances inflammation during extracorporeal membrane oxygenation in a rat model |
| topic | ECMO diabetes inflammatory response rat ECMO model |
| url | https://www.mdpi.com/2077-0375/11/4/283 |
| work_keys_str_mv | AT yutakafujii diabeticpathophysiologyenhancesinflammationduringextracorporealmembraneoxygenationinaratmodel AT takuyaabe diabeticpathophysiologyenhancesinflammationduringextracorporealmembraneoxygenationinaratmodel AT kikuoikegami diabeticpathophysiologyenhancesinflammationduringextracorporealmembraneoxygenationinaratmodel |