| Tryptophan metabolism to kynurenine is a potential novel contributor to hypotension in human sepsis. | |
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MedLine Citation:
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PMID: 21765346 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES:: To determine whether tryptophan metabolism to kynurenine contributes to the direct regulation of vascular tone in human septic shock. BACKGROUND:: Indoleamine 2,3-dioxygenase 1 is an inducible enzyme that converts tryptophan to kynurenine and shares functional similarities with inducible nitric oxide synthase. Recently, kynurenine has been identified as an endothelium-derived relaxing factor produced during inflammation, raising the possibility that this novel pathway may contribute to hypotension in human sepsis. DESIGN:: Prospective, matched, single-center, cohort study. SETTINGS:: Intensive care unit of a tertiary teaching hospital matched to control subjects from the general medical ward and healthy volunteers. SUBJECTS:: Patients (n = 16) with septic shock had indoleamine 2,3-dioxygenase 1 activity assessed as the kynurenine-to-tryptophan ratio, and the severity of hypotension was determined by their inotrope requirements. Healthy and blood pressure-matched nonseptic control subjects were also studied. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Tissues from septic and control patients were stained for the presence of indoleamine 2,3-dioxygenase 1. Indoleamine 2,3-dioxygenase 1 activity increased up to ninefold in patients with septic shock and was significantly higher than in the two control groups (p < .005). Indoleamine 2,3-dioxygenase 1 activity was strongly correlated with inotrope requirements (p < .001). Indoleamine 2,3-dioxygenase 1 protein was expressed in inflamed cardiac tissue as well as in endothelial cells of resistance vessels in hearts and kidneys from subjects who died from sepsis. CONCLUSIONS:: Indoleamine 2,3-dioxygenase 1 is expressed in resistance vessels in human sepsis and Indoleamine 2,3-dioxygenase 1 activity correlates with hypotension in human septic shock. Indoleamine 2,3-dioxygenase 1 is thus a potential novel contributor to hypotension in sepsis. |
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Authors:
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Dechaboon Changsirivathanathamrong; Yutang Wang; Dorrilyn Rajbhandari; Ghassan J Maghzal; Wendy M Mak; Clive Woolfe; Johan Duflou; Val Gebski; Cris G Dos Remedios; David S Celermajer; Roland Stocker |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-14 |
Journal Detail:
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Title: Critical care medicine Volume: - ISSN: 1530-0293 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Centre for Vascular Research (DC, YW, GJM, WMM, RS), School of Medical Sciences (Pathology) and Bosch Institute, Sydney, Australia; Royal Prince Alfred Hospital (DC, DR, CW, DSC), Sydney, Australia; the Department of Forensic Medicine Sydney (JD), Sydney, Australia; NHMRC Clinical Trials Centre (VG), Sydney, Australia; and the School of Medical Sciences (Anatomy) and Bosch Institute (CGdR), The University of Sydney, Sydney NSW, Australia. |
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