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Multiple Organ Dysfunctions in Perioperative or ICU Critical Illnesses
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Multiple Organ Dysfunctions in Perioperative or ICU Critical Illnesses

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Mechanisms of Diseases".

Deadline for manuscript submissions: closed (20 March 2023) | Viewed by 12555

Special Issue Editor

Prof. Dr. Keliang Xie

E-Mail Website
Guest Editor
1. Department of Critical Care Medicine and Anesthesiology, Tianjin Medical University General Hospital, Tianjin, China
2. Institute of Anesthesiology, Tianjin, China
Interests: sepsis; H2; multiple organ dysfunctions; critical illness

Special Issue Information

Dear Colleagues,

Multiorgan dysfunction has a high incidence in perioperative or ICU critical illnesses, including sepsis-related organ dysfunction (brain, kidney, heart, etc.), sleep disorders, delirium, etc. Perioperative organ dysfunction mostly occurs due to a dysregulated inflammatory response, oxidative stress, or ischemia reperfusion in response to perioperative insults. Critical illness has a significantly worse prognosis after ICU or perioperative multiorgan dysfunction. This is a major challenge for global health care. There are limited effective treatment options for organ dysfunction in perioperative or ICU critical illnesses, mainly owing to its unclear pathogenesis and the lack of early-warning biomarkers and early-monitoring tools and interventions. Therefore, it is of great importance to study the mechanisms and related biomarkers of perioperative or ICU organ dysfunction, as well as early-monitoring tools and interventions for its treatment.

With this Special Issue, we aim to collect data on the mechanisms, early-warning biomarkers, early-monitoring tools and interventions relating to organ dysfunction in perioperative or ICU critical diseases.

Authors are welcome to submit reviews, original research and other article types on the following themes:

  1. The mechanisms of multiorgan dysfunction in critical disease, such as oxidative stress, inflammatory response, etc.;
  2. Early biomarkers for organ dysfunction in critical disease;
  3. Monitoring or evaluation measures for organ dysfunction in perioperative or ICU critical disease;
  4. Precision treatment strategies for organs undergoing critical diseases.

Prof. Dr. Keliang Xie
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • organ dysfunction
  • perioperative
  • critical disease
  • mechanisms
  • biomarkers
  • monitoring

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Published Papers (6 papers)

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Research

11 pages, 4257 KiB  
Article
Effect of Hydrogen on AM Pyroptosis Induced by Severe Burns in Rats
by Ning Luo, Hua Lin, Linlin Zhang, Yi Jiang, Yue Zhao, Qingqing Han, Xin Wang, Yonghao Yu and Chao Qin
J. Pers. Med. 2023, 13(3), 377; https://doi.org/10.3390/jpm13030377 - 21 Feb 2023
Cited by 2 | Viewed by 1494
Abstract
Background: Hydrogen has anti-inflammatory and antioxidant effects and is beneficial to multiple organs. However, its effect on alveolar macrophage (AM) pyroptosis induced by burns is still unclear. The purpose of this research was to study the possible positive effects of hydrogen on burn-induced [...] Read more.
Background: Hydrogen has anti-inflammatory and antioxidant effects and is beneficial to multiple organs. However, its effect on alveolar macrophage (AM) pyroptosis induced by burns is still unclear. The purpose of this research was to study the possible positive effects of hydrogen on burn-induced lung injury and the effects of hydrogen on AM pyroptosis during acute lung injury (ALI) induced by burns. Methods: In this study, histological changes in rat lungs in vivo were evaluated by micro-CT, and histological changes in isolated lungs were evaluated by hematoxylin and eosin (HE) staining. The expressions of leucine rich repeat (LRR) and pyrin domain (PYD) containing protein 3 (NLRP3), caspase-1 and Gasdermin-D (GSDMD) were analyzed by Western blotting. The expression of GSDMD was measured by immunofluorescence to evaluate the levels of lung inflammation and pyroptosis. The level of inflammation was assessed by enzyme-linked immunosorbent assay (ELISA). Pyroptosis was observed by transmission electron microscopy. Results: We observed that severe burn resulted in increased IL-1β and IL-18, overexpression of NLRP3 and caspase-1 proteins, and pyroptosis in rat lung tissues, as demonstrated by GSDMD overexpression and electron microscopy of AMs. We also observed that hydrogen treatment partially reversed the increase in lung tissue density and reduced pulmonary inflammation. Moreover, hydrogen reduced the HE pathological injury score in the lung tissues of severely burned rats. Hydrogen treatment significantly reduced the contents of IL-1β and IL-18 in the lung tissues and decreased the expression of NLRP3, caspase-1 and GSDMD proteins compared with the burn group. Transmission electron microscopy results also showed that the number of AM membrane pores was significantly reduced in the hydrogen treatment group. Conclusions: The results of this study suggest that hydrogen may protect against ALI induced by burn injury by inhibiting pyroptosis of macrophages via NLRP3. Full article
(This article belongs to the Special Issue Multiple Organ Dysfunctions in Perioperative or ICU Critical Illnesses)
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15 pages, 2684 KiB  
Article
High Concentration Hydrogen Mitigates Sepsis-Induced Acute Lung Injury in Mice by Alleviating Mitochondrial Fission and Dysfunction
by Nan Zhao, Ruiqiang Sun, Yan Cui, Yu Song, Wanjie Ma, Yingning Li, Jing Liang, Guolin Wang, Yonghao Yu, Jiange Han and Keliang Xie
J. Pers. Med. 2023, 13(2), 244; https://doi.org/10.3390/jpm13020244 - 29 Jan 2023
Cited by 7 | Viewed by 1993
Abstract
Background: Multiple organ failure (MOF) is the main cause of early death in septic shock. Lungs are among the organs that are affected in MOF, resulting in acute lung injury. A large number of inflammatory factors and stress injury in sepsis can [...] Read more.
Background: Multiple organ failure (MOF) is the main cause of early death in septic shock. Lungs are among the organs that are affected in MOF, resulting in acute lung injury. A large number of inflammatory factors and stress injury in sepsis can lead to alterations in mitochondrial dynamics. Numerous studies have confirmed that hydrogen can alleviate sepsis in the animal model. The purpose of this experiment was to explore the therapeutic effect of high concentration (67%) hydrogen on acute lung injury in septic mice and its mechanism. Methods: The moderate and severe septic models were prepared by cecal ligation and puncture. Hydrogen with different concentrations was inhaled for one hour at 1 h and 6 h after the corresponding surgery. The arterial blood gas of mice during hydrogen inhalation was monitored in real time, and the 7-day survival rate of mice with sepsis was recorded. The pathological changes of lung tissues and functions of livers and kidneys were measured. The changes of oxidation products, antioxidant enzymes and pro-inflammatory cytokines in lungs and serums were detected. Mitochondrial function was measured. Results: The inhalation of 2% or 67% hydrogen improves the 7-day survival rate and reduces acute lung injury as well as liver and kidney injury in sepsis. The therapeutic effect of 67% hydrogen inhalation on sepsis was related to increasing antioxidant enzyme activity, reducing oxidation products and pro-inflammatory cytokines in lungs and serums. Compared with the Sham group, mitochondrial dysfunction was alleviated in hydrogen groups. Conclusions: Hydrogen inhalation by high or low concentration can both significantly improve sepsis; however, a high concentration demonstrates a better protective effect. High concentration hydrogen inhalation can significantly improve the mitochondrial dynamic balance and reduce the lung injury in septic mice. Full article
(This article belongs to the Special Issue Multiple Organ Dysfunctions in Perioperative or ICU Critical Illnesses)
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11 pages, 1087 KiB  
Article
Hydrogen Gas Treatment Improves Postoperative Delirium and Cognitive Dysfunction in Elderly Noncardiac Patients
by Hua Lin, Jian Du, Zhigang Tian, Yonghao Yu, Yan Cui and Keliang Xie
J. Pers. Med. 2023, 13(1), 67; https://doi.org/10.3390/jpm13010067 - 28 Dec 2022
Cited by 3 | Viewed by 2548
Abstract
Purpose: Postoperative delirium is a state of acute brain dysfunction characterized by fluctuating mental status that affects millions of patients each year. We used prophylactic inhalation of hydrogen gas in elderly patients undergoing elective surgery to compare their occurrence of postoperative delirium [...] Read more.
Purpose: Postoperative delirium is a state of acute brain dysfunction characterized by fluctuating mental status that affects millions of patients each year. We used prophylactic inhalation of hydrogen gas in elderly patients undergoing elective surgery to compare their occurrence of postoperative delirium with that of controls. Methods: A total of 184 patients aged ≥ 65 years were enrolled and randomized into either a control group or a hydrogen inhalation group. The quality of sleep was assessed 1 day before and 1, 3, and 7 days after surgery at 8 A.M. The Confusion Assessment Method (CAM) was used as a screening tool for delirium and assessed the patients’ state of consciousness 1–7 days after surgery. Results: Postoperative delirium occurred in 17 (24%) of 70 patients without hydrogen inhalation and in 10 (12%) of 83 patients after hydrogen inhalation. The incidence of delirium was decreased in the hydrogen group. No significant differences were found between length of stay in hospital after surgery and sleep quality at 1, 3, and 7 days postoperatively between the two groups. The numerical rating scale (NRS) pain scores were higher in the hydrogen group (4.08 ± 1.77) than the control group (3.54 ± 1.77) on day 1 (p < 0.05); however, the mean difference between the two groups was small (1 to 1.6). There were no significant differences on day 3 and 7. The postoperative C-reactive protein level was significantly lower in the hydrogen group than the control group. Conclusions: This study suggests that hydrogen inhalation can prevent postoperative delirium in elderly noncardiac patients by reducing the inflammatory response. Full article
(This article belongs to the Special Issue Multiple Organ Dysfunctions in Perioperative or ICU Critical Illnesses)
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15 pages, 2491 KiB  
Article
IGFBP2 Drives Regulatory T Cell Differentiation through STAT3/IDO Signaling Pathway in Pancreatic Cancer
by Longhao Sun, Yang Zhang, Tiantian Yang, Junhang Chen, Xuebin Zhang and Xiaoyu Liang
J. Pers. Med. 2022, 12(12), 2005; https://doi.org/10.3390/jpm12122005 - 3 Dec 2022
Cited by 5 | Viewed by 2112
Abstract
Pancreatic ductal adenocarcinoma (PDAC) represents one of the deadliest malignancies. Elevated regulatory T cell (Treg) infiltration has a potent immunosuppressive function in tumor biology, which contributes to low survival in PDAC. Nonetheless, the crosstalk between malignant cells and tumor-infiltrating Tregs in PDAC is [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) represents one of the deadliest malignancies. Elevated regulatory T cell (Treg) infiltration has a potent immunosuppressive function in tumor biology, which contributes to low survival in PDAC. Nonetheless, the crosstalk between malignant cells and tumor-infiltrating Tregs in PDAC is not well understood. Here, clinical data demonstrates that the insulin-like growth factor binding protein 2 (IGFBP2) is associated with Treg accumulation in the microenvironment of PDAC in humans. Additionally, IGFBP2 increases Treg infiltration in the tumor microenvironment and promotes disease progression in mouse PDAC. Bioinformatic analysis and mechanistic assessment reveals IGFBP2 upregulated indoleamine 2, 3-dioxygenase (IDO) by activating signal transducer and activator of transcription 3 (STAT3) signaling in PDAC cells, thus inducing Treg differentiation and an immunosuppressive tumor microenvironment. These findings provide mechanistic insights into an important molecular pathway that promotes an immunosuppressive microenvironment, which suggests the IGFBP2 axis as a potential target for improved immune response in PDAC. Full article
(This article belongs to the Special Issue Multiple Organ Dysfunctions in Perioperative or ICU Critical Illnesses)
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12 pages, 2373 KiB  
Article
New Strategies to Optimize Hemodynamics for Sepsis-Associated Encephalopathy
by Lina Zhao, Bin Liu, Yunying Wang, Zhiwei Wang, Keliang Xie and Yun Li
J. Pers. Med. 2022, 12(12), 1967; https://doi.org/10.3390/jpm12121967 - 28 Nov 2022
Cited by 1 | Viewed by 1406
Abstract
Background: Sepsis-associated encephalopathy (SAE) is associated with high morbidity and mortality. Hemodynamic dysfunction plays a significant role in the incidence and mortality of SAE. Therefore, this study aimed to explore the relationship between hemodynamic indicators and SAE. Methods: 9033 patients with [...] Read more.
Background: Sepsis-associated encephalopathy (SAE) is associated with high morbidity and mortality. Hemodynamic dysfunction plays a significant role in the incidence and mortality of SAE. Therefore, this study aimed to explore the relationship between hemodynamic indicators and SAE. Methods: 9033 patients with sepsis 3.0 were selected in a prospective study cohort. The LASSO regression model was used to select characteristic variables and remove the collinearity between them. In addition, a generalized additive model was used to find the optimal hemodynamic index value for patients with SAE. Multivariate logistic regression models, propensity matching scores, inverse probability weighting, and doubly robust estimation confirmed the reliability of the study results (i.e., the optimal hemodynamic indicators targeting patients with SAE). Results: A mean arterial pressure ≥ 65 mmHg, systolic blood pressure ≥ 90 mmHg, and lactate levels ≤ 3.5 mmol/L decrease the incidence of SAE, whereas a mean arterial pressure ≥ 59 mmHg and lactate levels ≤ 4.5 mmol/L decrease the 28-day mortality in patients with SAE. Conclusions: The hemodynamic indices of patients with SAE should be maintained at certain levels to reduce the incidence and mortality in patients with SAE, such that the mean arterial pressure is ≥65 mmHg, lactate levels are ≤3.5 mmol/L, and systolic blood pressure is ≥90 mmHg. These hemodynamic indicators should be targeted in patients with SAE. Full article
(This article belongs to the Special Issue Multiple Organ Dysfunctions in Perioperative or ICU Critical Illnesses)
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14 pages, 2802 KiB  
Article
Dynamic Plasma Lipidomic Analysis Revealed Cholesterol Ester and Amides Associated with Sepsis Development in Critically Ill Patients after Cardiovascular Surgery with Cardiopulmonary Bypass
by Wenyan Ding, Shaohang Xu, Baojin Zhou, Ruo Zhou, Peng Liu, Xiangyi Hui, Yun Long and Longxiang Su
J. Pers. Med. 2022, 12(11), 1838; https://doi.org/10.3390/jpm12111838 - 3 Nov 2022
Cited by 6 | Viewed by 1844
Abstract
Background: Sepsis in patients after cardiovascular surgery with cardiopulmonary bypass (CPB) has a high rate of mortality. We sought to determine whether changes in lipidomics can predict sepsis after cardiac surgery. Methods: We used high-performance liquid chromatography coupled to tandem mass spectrometry to [...] Read more.
Background: Sepsis in patients after cardiovascular surgery with cardiopulmonary bypass (CPB) has a high rate of mortality. We sought to determine whether changes in lipidomics can predict sepsis after cardiac surgery. Methods: We used high-performance liquid chromatography coupled to tandem mass spectrometry to explore global lipidome changes in samples from a prospective case-control cohort (30 sepsis vs. 30 nonsepsis) hospitalized with cardiovascular surgery. All patients were sampled before and within 48–72 h after surgery. A bioinformatic pipeline was applied to acquire reliable features and MS/MS-driven identifications. Furthermore, a multiple-step machine learning framework was performed for signature discovery and performance evaluation. Results: Compared with preoperative samples, 94 features were upregulated and 282 features were downregulated in the postoperative samples of the sepsis group, and 73 features were upregulated and 265 features were downregulated in the postoperative samples of the nonsepsis group. “Autophagy”, “pathogenic Escherichia coli infection” and “glycosylphosphatidylinositol-anchor biosynthesis” pathways were significantly enriched in the pathway enrichment analysis. A multistep machine learning framework further confirmed that two cholesterol esters, CE (18:0) and CE (16:0), were significantly decreased in the sepsis group (p < 0.05). In addition, oleamide and stearamide were increased significantly in the postoperative sepsis group (p < 0.001). Conclusions: This study revealed characteristic lipidomic changes in the plasma of septic patients before and after cardiac surgery with CPB. We discovered two cholesterol esters and two amides from peripheral blood that could be promising signatures for sepsis within a dynamic detection between the preoperative and postoperative groups. Full article
(This article belongs to the Special Issue Multiple Organ Dysfunctions in Perioperative or ICU Critical Illnesses)
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