Hypocalcemia in sepsis: analysis of the subcellular distribution of Ca2+ in septic rats and LPS/TNF-α-treated HUVECs

J Infect Dev Ctries. 2020 Aug 31;14(8):908-917. doi: 10.3855/jidc.12341.

Abstract

Introduction: Hypocalcemia has been widely recognized in sepsis patients. However, the cause of hypocalcemia in sepsis is still not clear, and little is known about the subcellular distribution of Ca2+ in tissues during sepsis.

Methodology: We measured the dynamic change in Ca2+ levels in body fluid and subcellular compartments, including the cytosol, endoplasmic reticulum and mitochondria, in major organs of cecal ligation and puncture (CLP)-operated rats, as well as the subcellular Ca2+ flux in HUVECs which treated by endotoxin and cytokines.

Results: In the model of CLP-induced sepsis, the blood and urinary Ca2+ concentrations decreased rapidly, while the Ca2+ concentration in ascites fluid increased. The Ca2+ concentrations in the cytosol, ER, and mitochondria were elevated nearly synchronously in major organs in our sepsis model. Moreover, the calcium overload in CLP-operated rats treated with calcium supplementation was more severe than that in the non-calcium-supplemented rats but was alleviated by treatment with the calcium channel blocker verapamil. Similar subcellular Ca2+ flux was found in vitro in HUVECs and was triggered by lipopolysaccharide (LPS)/TNF-α.

Conclusions: Ca2+ influx from the blood into the intercellular space and Ca2+ release into ascites fluid may cause hypocalcemia in sepsis and that this process may be due to the synergistic effect of endotoxin and cytokines.

Keywords: Calcium overload; Hypocalcemia; Mechanism; Sepsis; Subcellular Redistribution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Calcium / blood*
  • Calcium / urine
  • Disease Models, Animal
  • Humans
  • Hypocalcemia / blood
  • Hypocalcemia / etiology*
  • Hypocalcemia / urine
  • Lipopolysaccharides
  • Rats
  • Rats, Sprague-Dawley
  • Sepsis / blood
  • Sepsis / physiopathology*
  • Sepsis / urine
  • Tumor Necrosis Factor-alpha

Substances

  • Lipopolysaccharides
  • Tumor Necrosis Factor-alpha
  • Calcium