Vol. 284, Issue 2, L270-L278, February 2003
Prior burn insult induces lethal acute lung injury in
endotoxemic mice: effects of cytokine inhibition
Junichi
Sasaki1,
Seitaro
Fujishima1,
Hiroyuki
Iwamura2,
Korekiyo
Wakitani2,
Sadakazu
Aiso3, and
Naoki
Aikawa1
Departments of 1 Emergency and Critical Care
Medicine and 3 Anatomy, School of Medicine, Keio
University, Tokyo 1608582; and 2 Central Pharmaceutical
Research Institute, Japan Tobacco Incorporated, Osaka,
Japan 5691125
Many patients who
experience surgical stress, including burn injury, become susceptible
to severe sepsis and septic organ dysfunction, which remains the
primary contributor to morbidity and mortality in burn patients. In the
present study, we developed a murine model of burn-primed sublethal
endotoxemia by producing a 15% BSA full-thickness burn on the dorsum
of BALB/c mice under ether anesthesia and administering 10 mg/kg of LPS
intravenously on day 11 to model endotoxemia. The prior burn
injury in this model induced two-peaked production of cytokines,
TNF-
, and macrophage inflammatory protein-2 at 2 and 12 h after
LPS administration, and it was associated with increased mortality. We
also assessed the effect of pharmacological modulation with cytokine
synthesis inhibitors prednisolone and JTE-607 and found that
pretreatment with them attenuated later cytokine production and
decreased mortality after LPS administration. We speculate that the
prior burn injury primed the mice for the secondary insult via cytokine
production. These results also suggested that an anticytokine strategy
might serve as a novel prophylactic therapy for septic organ
dysfunction in burn-primed patients.
two-hit phenomenon; priming; systemic inflammatory response
syndrome; chemokine; JTE-607