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Targeting the gut to prevent sepsis from a cutaneous burn
Fatemeh Adiliaghdam, … , Laurence G. Rahme, Richard A. Hodin
Fatemeh Adiliaghdam, … , Laurence G. Rahme, Richard A. Hodin
Published October 2, 2020
Citation Information: JCI Insight. 2020;5(19):e137128. https://doi.org/10.1172/jci.insight.137128.
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Research Article Gastroenterology Microbiology

Targeting the gut to prevent sepsis from a cutaneous burn

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Abstract

Severe burn injury induces gut barrier dysfunction and subsequently a profound systemic inflammatory response. In the present study, we examined the role of the small intestinal brush border enzyme, intestinal alkaline phosphatase (IAP), in preserving gut barrier function and preventing systemic inflammation after burn wound infection in mice. Mice were subjected to a 30% total body surface area dorsal burn with or without intradermal injection of Pseudomonas aeruginosa. Mice were gavaged with 2000 units of IAP or vehicle at 3 and 12 hours after the insult. We found that both endogenously produced and exogenously supplemented IAP significantly reduced gut barrier damage, decreased bacterial translocation to the systemic organs, attenuated systemic inflammation, and improved survival in this burn wound infection model. IAP attenuated liver inflammation and reduced the proinflammatory characteristics of portal serum. Furthermore, we found that intestinal luminal contents of burn wound–infected mice negatively impacted the intestinal epithelial integrity compared with luminal contents of control mice and that IAP supplementation preserved monolayer integrity. These results indicate that oral IAP therapy may represent an approach to preserving gut barrier function, blocking proinflammatory triggers from entering the portal system, preventing gut-induced systemic inflammation, and improving survival after severe burn injuries.

Authors

Fatemeh Adiliaghdam, Paul Cavallaro, Vidisha Mohad, Marianna Almpani, Florian Kühn, Mohammad Hadi Gharedaghi, Mehran Najibi, Laurence G. Rahme, Richard A. Hodin

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Figure 1

Lack of IAP results in an increased burn site infection–induced gut hyperpermeability, augmented systemic inflammation, and earlier burn site infection–induced death.

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Lack of IAP results in an increased burn site infection–induced gut hype...
(A) FITC-dextran levels at 18 hours after burn wound infection in serum of WT and IAP-KO mice after 4 hours of intragastric FITC administration. (B) Bacterial burden in mesenteric lymph nodes (MLN) of mice expressed as log of colony-forming units (CFU) normalized to tissue weight. (C) Serum endotoxin level measured by Limulus amebocyte lysate assay. (D) Bacterial burden in systemic blood expressed as log of CFU normalized to blood volume. (E) TNF-α levels in serum of WT and IAP-KO mice 18 hours after burn wound infection injury measured by ELISA. (F) Survival of WT and IAP-KO mice after receiving burn wound infection insult. For multiple comparisons, 1-way ANOVA with multiple post hoc comparisons using Tukey’s test was performed. Kaplan-Meier survival curve was used for the survival study, and the groups were compared using the log-rank test. Each group included 5 animals and data are representative of 3 biological replicates. The survival study includes 19 WT and 26 IAP-KO mice. *P < 0.05, ***P < 0.001, ****P < 0.0001. IAP, intestinal alkaline phosphatase.

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