Sevoflurane Preconditioning Prevents Septic Myocardial Dysfunction in Lipopolysaccharide-Challenged Mice

J Cardiovasc Pharmacol. 2019 Nov;74(5):462-473. doi: 10.1097/FJC.0000000000000734.

Abstract

Myocardial dysfunction accompanied by severe sepsis could significantly increase the mortality rate of septic patients. This study investigated the effects and the potential mechanisms of sevoflurane preconditioning on septic myocardial dysfunction, which was induced by lipopolysaccharide (LPS; from Escherichia coli O55:B5; 18 mg/kg) in mice. Results indicated that 1 hour after the administration, LPS induced a significant increase in cell-surface Toll-like receptor 4 (TLR4), cytoplasmic IKKα protein expression, and nuclear translocation of nuclear factor kappa-B (NF-κB) protein (P < 0.05), which was attenuated by preconditioning with sevoflurane. Two hours after the administration, inhalation of sevoflurane significantly reduced the serum levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-10 (P < 0.05). Twelve hours after administration, LPS caused pathological damage to the heart and elevated the serum levels of lactate dehydrogenase (LDH) and creatine kinase-MB (P < 0.05). Echocardiography indicated that sevoflurane preconditioning significantly improved systolic and diastolic function. The inhalation of sevoflurane inhibited increases in myeloperoxidase (MPO), macrophage inflammatory protein-2 (MIP-2), TNF-α, and IL-1β levels (P < 0.05) induced by endotoxemia, whereas IL-6 release was facilitated. Sevoflurane attenuated the myocardial levels of nitric oxide (P < 0.05) without an apparent influence on malondialdehyde (MDA) or superoxide dismutase (P > 0.05). In conclusion, our study indicates that exposure to 2% sevoflurane before LPS challenge is protective against myocardial dysfunction. Sevoflurane preconditioning may attenuate neutrophil infiltration and the release of inflammatory mediators during endotoxemia.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / administration & dosage*
  • Antioxidants / administration & dosage*
  • Cytokines / blood
  • Disease Models, Animal
  • Drug Administration Schedule
  • Inflammation Mediators / blood
  • Lipopolysaccharides*
  • Male
  • Mice, Inbred BALB C
  • Myocytes, Cardiac / drug effects*
  • Myocytes, Cardiac / metabolism
  • Myocytes, Cardiac / pathology
  • NF-kappa B / metabolism
  • Neutrophil Infiltration / drug effects
  • Neutrophils / drug effects
  • Neutrophils / metabolism
  • Oxidative Stress / drug effects
  • Sepsis / chemically induced
  • Sepsis / drug therapy*
  • Sepsis / metabolism
  • Sepsis / physiopathology
  • Sevoflurane / administration & dosage*
  • Signal Transduction
  • Time Factors
  • Toll-Like Receptor 4 / metabolism
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / metabolism
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / prevention & control*
  • Ventricular Function, Left / drug effects*

Substances

  • Anti-Inflammatory Agents
  • Antioxidants
  • Cytokines
  • Inflammation Mediators
  • Lipopolysaccharides
  • NF-kappa B
  • Tlr4 protein, mouse
  • Toll-Like Receptor 4
  • lipopolysaccharide, E coli O55-B5
  • Sevoflurane