N,N'-diacetylchitobiose, an inhibitor of lysozyme, reverses myocardial depression and lessens norepinephrine requirements in Escherichia coli sepsis in dogs.
Cardiovascular dysfunction in septic shock (SS) is ascribed to the release of inflammatory mediators. Norepinephrine (NE) is often administered to treat low MAP in SS. We recently found that lysozyme c (Lzm-S) released from leukocytes was a mediator of myocardial depression in an Escherichia coil model of SS in dogs. This effect can be blocked in an in vitro preparation by chitobiose, a competitive inhibitor of Lzm-S. In the present study, we examined whether chitobiose treatment can reverse myocardial depression and obviate NE requirements in two respective canine E. coli preparations. In a 6-h study, we administered chitobiose after 3.5 h of E. coli bacteremia and compared stroke work (SW) and MAP at 6 h with a sepsis control group. In a 12-h study, we determined whether chitobiose treatment can reduce the need for NE requirements during 12 h of bacteremia. In the latter study, either chitobiose or NE was given when MAP decreased approximately 20% from the presepsis value in respective groups. In anesthetized, mechanically ventilated dogs, we monitored hemodynamic parameters during continuous E. coli infusion. In the 6-h study, chitobiose improved SW and MAP at the 6-h period as compared with the nontreated sepsis group. In the 12-h study, SW and MAP increased after chitobiose without the necessity of NE administration. These results suggest that inhibitors of Lzm-S such as chitobiose may improve myocardial depression and reduce the need for NE requirements in SS.
Mink
Steven N
SN
Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. minksn@cc.umanitoba.ca
Kasian
Krika
K
Jacobs
Hans
H
Cheng
Zhao-Qin
ZQ
Light
R Bruce
RB
D000818:Animals; D016470:Bacteremia / Q000188:drug therapy / Q000201:enzymology / Q000503:physiopathology; D009202:Cardiomyopathies / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D004187:Disaccharides / Q000494:pharmacology*; D004285:Dogs; D004791:Enzyme Inhibitors / Q000494:pharmacology*; D004926:Escherichia coli; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D008297:Male; D009113:Muramidase / Q000037:antagonists & inhibitors*; D009638:Norepinephrine / Q000494:pharmacology*; D012772:Shock, Septic / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
D004187:Disaccharides; D004791:Enzyme Inhibitors; D018836:Inflammation Mediators; D014662:Vasoconstrictor Agents; C010913:N,N-diacetylchitobiose; D009113:Muramidase; D009638:Norepinephrine