title: Xuebijing injection reduces organ injuries and improves survival by attenuating inflammatory responses and endothelial injury in heatstroke mice.
abstract: BACKGROUND
  The pathogenesis of heatstroke is a multi-factorial process involved with an interplay among subsequent inflammation, endothelial injury and coagulation disturbances, which makes pharmacological therapy of heatstroke a challenging problem. Xuebijing injection (XBJ), a traditional Chinese medicine used to sepsis, has been reported to suppress inflammatory responses and restore coagulation disturbances. However, little is known about the role of XBJ in heatstroke.
  
  
  METHODS
  Mice were treated with indicated dose of XBJ before and/or after the induction of heatstroke. Serum inflammatory cytokines, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and endothelial markers, von Willebrand Factor (vWF) and E-selectin, were measured by ELISA. Liver, kidney and heart profiles including alanine aminotransferase, aspartic aminotransferase, creatinine, blood urea nitrogen, and lactate dehydrogenase, were evaluated by UniCel DxC 800 Synchron Clinical Systems, and troponin was measured by ELISA. Coagulation profiles, including thrombin time, prothrombin time, activated partial thromboplastin time, international normalized ratio, and fibrinogen were examined by STA Compact® Hemostasis System. Jejunum injury was evaluated with H&E staining. Changes in mitochondrial structure in cardiac tissue were assesed by electron microscopy.
  
  
  RESULTS
  Pretreatment with XBJ decreased serum pro-inflammatory cytokines including TNF-α and IL-6, as well as endothelial injury markers, vWF and E-selectin, in a dose-dependent manner in heatstroke mice. Similar protective effects were observed when XBJ was administered after, or both before and after heat insult. These protective effects lasted for over 12 h in mice receiving XBJ before and after heat insult. XBJ also improved survival rates in heatstroke mice, ameliorated liver, heart, and kidney injuries, including mitochondrial damage to the heart, and reduced coagulation disturbances.
  
  
  CONCLUSIONS
  XBJ prevents organ injuries and improves survival in heatstroke mice by attenuating inflammatory responses and endothelial injury. XBJ may be a potentially useful in the prevention and treatment of heatstroke.
authors: Department of ICU, General Hospital of Guangzhou Military Command, Key Laboratory of Tropical Zone Trauma Care and Tissue Repair of PLA, Guangzhou, 510010, China. qiul1978@gmail.com.|Postdoctoral Workstation, Huabo Bio-pharmaceutical Research Institute, Guangzhou, 510515, China. qiul1978@gmail.com.
authors: Qiulin
authors: Q
authors: Xu
authors: Department of ICU, General Hospital of Guangzhou Military Command, Key Laboratory of Tropical Zone Trauma Care and Tissue Repair of PLA, Guangzhou, 510010, China. ljx558@sohu.com.
authors: Jingxian
authors: J
authors: Liu
authors: Department of Pathophysiology, Southern Medical University, Key lab of Shock and Microcirculation Research of Guangdong Province, Guangzhou, 510515, China. lanblue97@gmail.com.
authors: Xiaohua
authors: X
authors: Guo
authors: Department of ICU, General Hospital of Guangzhou Military Command, Key Laboratory of Tropical Zone Trauma Care and Tissue Repair of PLA, Guangzhou, 510010, China. 52923756@qq.com.
authors: Youqing
authors: Y
authors: Tang
authors: Guangzhou University of Chinese Medicine, Guangzhou, 510405, China. zhou13014@sohu.com.
authors: Gengbiao
authors: G
authors: Zhou
authors: Southern Medical University, Guangzhou, 510515, China. yanan8712@sohu.com.
authors: Yanan
authors: Y
authors: Liu
authors: Department of Pathophysiology, Southern Medical University, Key lab of Shock and Microcirculation Research of Guangdong Province, Guangzhou, 510515, China. qbing01@126.com.
authors: Qiaobing
authors: Q
authors: Huang
authors: Department of ICU, General Hospital of Guangzhou Military Command, Key Laboratory of Tropical Zone Trauma Care and Tissue Repair of PLA, Guangzhou, 510010, China. 994606548@qq.com.
authors: Yan
authors: Y
authors: Geng
authors: Department of ICU, General Hospital of Guangzhou Military Command, Key Laboratory of Tropical Zone Trauma Care and Tissue Repair of PLA, Guangzhou, 510010, China. alian0802@126.com.
authors: Zhifeng
authors: Z
authors: Liu
authors: Department of ICU, General Hospital of Guangzhou Military Command, Key Laboratory of Tropical Zone Trauma Care and Tissue Repair of PLA, Guangzhou, 510010, China. slei_icu@126.com.
authors: Lei
authors: L
authors: Su
mesh_terms: D000818:Animals; D001777:Blood Coagulation; D016207:Cytokines / Q000097:blood; D004365:Drugs, Chinese Herbal / Q000494:pharmacology / Q000627:therapeutic use*; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D006321:Heart / Q000187:drug effects*; D018883:Heat Stroke / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D015850:Interleukin-6 / Q000097:blood; D007668:Kidney / Q000187:drug effects*; D008099:Liver / Q000187:drug effects*; D008297:Male; D008516:Medicine, Chinese Traditional; D051379:Mice; D008810:Mice, Inbred C57BL; D008928:Mitochondria / Q000473:pathology; D008517:Phytotherapy; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D016207:Cytokines; D004365:Drugs, Chinese Herbal; D019040:E-Selectin; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; C549376:Xuebijing; D014841:von Willebrand Factor
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