title: The effect of plasma from septic ICU patients on healthy rat muscle mitochondria.
abstract: BACKGROUND
  Although sepsis-induced organ failure is a major cause of death in ICU worldwide, the associated mitochondrial dysfunction is not fully characterized and there is presently no evidence of causality. In this study, we examined whether a central factor in septic plasma could directly affect respiratory function of healthy rat muscle mitochondria.
  
  
  METHODS
  ICU patients with severe sepsis or septic shock were recruited within 24 h of admission together with age-matched controls. Blood samples were centrifuged and immediately frozen. Two trials were performed, and mitochondrial respiration was analyzed using an Oxygraph chamber with a Clark-electrode. (1) Isolated mitochondria from the rat skeletal muscle were divided and incubated for 30 min with plasma from patients or postoperative controls (n = 10). Respiration was normalized for citrate synthase activity. (2) Permeabilized muscle fibers from rats were divided and incubated with plasma from patients or healthy controls, for 30 and 120 min, and analyzed for mitochondrial respiration (n = 10). Respiration was normalized for wet weight. Primary outcome was state 3 respiration, corresponding to the maximal respiration initiated by ADP and energy substrates (malate and pyruvate). T test was used for statistical comparison.
  
  
  RESULTS
  No differences in respiratory function of the mitochondria were seen between the groups in either of the experiments. (1) State 3 respiration of isolated mitochondria were 19.9 ± 6.7 vs. 20.2 ± 8.8 nmol O2 × U CS(-1) × min(-1) for sepsis vs. control, respectively. (2) State 3 respiration for fibers incubated with septic and control plasma were after 30 min 2.6 ± 0.3 vs. 2.4 ± 0.7 and after 120 min 2.5 ± 0.4 vs. 2.5 ± 0.6 nmol O2 × mg × w.w(-1) × min(-1). Respiratory control ratios were good in all experiments (8.8-11.2), ensuring functioning mitochondria.
  
  
  CONCLUSIONS
  These findings indicate that muscle mitochondria are not directly influenced by a factor in plasma of septic patients. The effects seen in mitochondrial function in sepsis may rather be a result of intracellular processes and signaling, such as e.g., production of reactive oxygen species.
authors.affiliation: Department of Anesthesiology and Intensive Care, Clintec, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. jonathan.grip@ki.se.
authors.forename: Jonathan
authors.identifier: http://orcid.org/0000-0001-9735-4160
authors.initials: J
authors.lastname: Grip
authors.affiliation: Department of Anesthesiology and Intensive Care, Clintec, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Towe
authors.initials: T
authors.lastname: Jakobsson
authors.affiliation: Department of Anesthesiology and Intensive Care, Clintec, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Tardif
authors.affiliation: Department of Anesthesiology and Intensive Care, Clintec, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Olav
authors.initials: O
authors.lastname: Rooyackers
keywords: Mitochondria; Multiple organ failure; Rat muscle; Respiratory function; Sepsis; Septic plasma