Title |
Combined inhibition of complement and CD14 improved outcome in porcine polymicrobial sepsis
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Published in |
Critical Care, December 2015
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DOI | 10.1186/s13054-015-1129-9 |
Pubmed ID | |
Authors |
Espen W. Skjeflo, Caroline Sagatun, Knut Dybwik, Sturla Aam, Sven H. Urving, Miles A. Nunn, Hilde Fure, Corinna Lau, Ole-Lars Brekke, Markus Huber-Lang, Terje Espevik, Andreas Barratt-Due, Erik W. Nielsen, Tom E. Mollnes |
Abstract |
Sepsis is an exaggerated and dysfunctional immune response to infection. Activation of innate immunity recognition systems including complement and the Toll-like receptor family initiate this disproportionate inflammatory response. The aim of this study was to explore the effect of combined inhibition of the complement component C5 and the Toll-like receptor co-factor CD14 on survival, hemodynamic parameters and systemic inflammation including complement activation in a clinically relevant porcine model of polymicrobial sepsis. Norwegian landrace piglets (4 ± 0.5 kg) were blindly randomized to a treatment group (n = 12) receiving the C5 inhibitor coversin (OmCI) and anti-CD14 or to a positive control group (n = 12) receiving saline. Under anesthesia, sepsis was induced by a 2 cm cecal incision and the piglets were monitored in standard intensive care for 8 hours. Three sham piglets had a laparotomy without cecal incision or treatment. Complement activation was measured as sC5b-9 using enzyme immunoassay. Cytokines were measured with multiplex technology. Combined C5 and CD14 inhibition significantly improved survival (p = 0.03). Nine piglets survived in the treatment group and four in the control group. The treatment group had significantly lower pulmonary artery pressure (p = 0.04) and ratio of pulmonary artery pressure to systemic artery pressure (p < 0.001). Plasma sC5b-9 levels were significantly lower in the treatment group (p < 0.001) and correlated significantly with mortality (p = 0.006). IL-8 and IL-10 were significantly (p < 0.05) lower in the treatment group. Combined inhibition of C5 and CD14 significantly improved survival, hemodynamic parameters and inflammation in a blinded, randomized trial of porcine polymicrobial sepsis. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United Kingdom | 1 | 20% |
Unknown | 4 | 80% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 40% |
Practitioners (doctors, other healthcare professionals) | 2 | 40% |
Science communicators (journalists, bloggers, editors) | 1 | 20% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Norway | 1 | 3% |
Unknown | 36 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 6 | 16% |
Student > Ph. D. Student | 5 | 14% |
Other | 2 | 5% |
Professor | 2 | 5% |
Student > Bachelor | 2 | 5% |
Other | 7 | 19% |
Unknown | 13 | 35% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 12 | 32% |
Agricultural and Biological Sciences | 5 | 14% |
Immunology and Microbiology | 4 | 11% |
Computer Science | 2 | 5% |
Veterinary Science and Veterinary Medicine | 1 | 3% |
Other | 2 | 5% |
Unknown | 11 | 30% |