1. Atrial Natriuretic Peptide: A Potential Early Therapy for the Prevention of Multiple Organ Dysfunction Syndrome Following Severe Trauma
- Author
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Zi-Zhuo Liu, Li-Li Liu, Bin Zhang, Meng-Fei Chen, Lan-Lan Zeng, Sheng-Mao Jiang, Rui-Jie Li, Rong-Wei Zhang, Shouyin Jiang, Ye-Hua Shen, Libing Jiang, and Xiao-Gang Zhao
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Multiple Organ Failure ,Endogeny ,Disease ,Early Therapy ,Shock, Hemorrhagic ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,Atrial natriuretic peptide ,Internal medicine ,medicine ,Humans ,business.industry ,medicine.disease ,Intestinal epithelium ,030104 developmental biology ,Severe trauma ,Cardiovascular Diseases ,Emergency Medicine ,Cardiology ,Wounds and Injuries ,Signal transduction ,business ,Multiple organ dysfunction syndrome ,Atrial Natriuretic Factor ,Biomarkers - Abstract
Trauma remains a tremendous medical burden partly because of increased expenditure for the management of multiple organ dysfunction syndrome (MODS) developed during hospital stay. The intestinal barrier injury continues to be a second insult resulting in MODS which currently lacks efficient strategies for prevention. Recent studies have uncovered multi-organ protective benefits of atrial natriuretic peptide (ANP) in cardiovascular disease. However, the role of ANP in the prevention of MODS following severe trauma has not been understood. In our laboratory study, 1-h infusion of exogenous ANP during hemorrhagic shock following severe trauma induced high-level expression of endogenous serum ANP after 24 h, this effect was related to the improved level of functional biomarkers in multiple organs. Such phenomenon has not been found in other laboratories. A thorough literature review consequently was performed to uncover the potential mechanisms, to appraise therapy safety, and to propose uncertainties. In severe trauma, short-term exogenous ANP therapy during hemorrhagic shock may promote sustained endogenous expression of ANP from intestinal epithelium through activating a positive feedback loop mechanism involving phospholipase C-γ1 and reactive oxygen species crosstalk. This feedback loop may prevent MODS through multiple signaling pathways. Administration of ANP during hemorrhagic shock is thought to be safe. Further studies are required to confirm our proposed mechanisms and to investigate the dose, duration, and timing of ANP therapy in severe trauma.
- Published
- 2017