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      Critical role of endogenous histamine in promoting end-organ tissue injury in sepsis

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          Abstract

          Background

          Histamine assumes an important role as a major mediator in various pathologic disorders associated with inflammation and immune reactions. However, the involvement of histamine in the pathological conditions and symptoms of sepsis remains entirely unknown. In this study, we establish that histamine is identified as a contributory mediator to promoting the development of organ injury in sepsis.

          Methods

          Histidine decarboxylase (HDC) gene knockout (HDC −/−) mice, histamine H 1-/H 2-receptor gene-double knockout (H 1R −/−/H 2R −/−) mice, and their littermate wild-type (WT) C57BL/6J mice underwent cecal ligation and puncture (CLP) or sham operation. Some WT mice were injected intraperitoneally with d-chlorpheniramine and famotidine 60 min before CLP to block H 1- and H 2-receptors, respectively.

          Results

          In mice rendered septic by CLP, tissue histamine levels were elevated in association with increased HDC expression. Sepsis-induced abnormal cytokine production and multiple organ injury (lung, liver, and kidney) were significantly less pronounced in HDC −/− mice as compared with WT controls, and HDC deficiency had improved survival in sepsis. This benefit corresponded with a significant reduction in activation levels of the nuclear factor (NF)-κB signaling pathway. H 1R −/−/H 2R −/− mice apparently behaved similar to HDC knockout mice in reducing sepsis-related pathological changes. Pharmacological interventions with H 1- and H 2-receptor antagonists indicated that both H 1- and H 2-receptors were involved in septic lung and liver injury, whereas only H 2-receptors contributed to septic kidney injury.

          Conclusions

          In the setting of sepsis, histamine, through activation of H 1- and H 2-receptors, serves as an aggravating mediator to contribute to the development of sepsis-driven major end-organ failure.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s40635-016-0109-y) contains supplementary material, which is available to authorized users.

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          Most cited references33

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          Sepsis: current dogma and new perspectives.

          Sepsis, a clinical syndrome occurring in patients following infection or injury, is a leading cause of morbidity and mortality worldwide. Current immunological mechanisms do not explain the basis of cellular dysfunction and organ failure, the ultimate cause of death. Here we review current dogma and argue that it is time to delineate novel immunometabolic and neurophysiological mechanisms underlying the altered cellular bioenergetics and failure of epithelial and endothelial barriers that produce organ dysfunction and death. These mechanisms might hold the key to future therapeutic strategies. Copyright © 2014 Elsevier Inc. All rights reserved.
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            NF-kappa B activation as a pathological mechanism of septic shock and inflammation.

            The pathophysiology of sepsis and septic shock involves complex cytokine and inflammatory mediator networks. NF-kappaB activation is a central event leading to the activation of these networks. The role of NF-kappaB in septic pathophysiology and the signal transduction pathways leading to NF-kappaB activation during sepsis have been an area of intensive investigation. NF-kappaB is activated by a variety of pathogens known to cause septic shock syndrome. NF-kappaB activity is markedly increased in every organ studied, both in animal models of septic shock and in human subjects with sepsis. Greater levels of NF-kappaB activity are associated with a higher rate of mortality and worse clinical outcome. NF-kappaB mediates the transcription of exceptional large number of genes, the products of which are known to play important roles in septic pathophysiology. Mice deficient in those NF-kappaB-dependent genes are resistant to the development of septic shock and to septic lethality. More importantly, blockade of NF-kappaB pathway corrects septic abnormalities. Inhibition of NF-kappaB activation restores systemic hypotension, ameliorates septic myocardial dysfunction and vascular derangement, inhibits multiple proinflammatory gene expression, diminishes intravascular coagulation, reduces tissue neutrophil influx, and prevents microvascular endothelial leakage. Inhibition of NF-kappaB activation prevents multiple organ injury and improves survival in rodent models of septic shock. Thus NF-kappaB activation plays a central role in the pathophysiology of septic shock.
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              National estimates of severe sepsis in United States emergency departments.

              The emergency department (ED) often serves as the first site for the recognition and treatment of patients with suspected severe sepsis. However, few evaluations of the national epidemiology and distribution of severe sepsis in the ED exist. We sought to determine national estimates of the number, timing, ED length of stay, and case distribution of patients presenting to the ED with suspected severe sepsis. Analysis of 2001-2004 ED data from the National Hospital Ambulatory Medical Care Survey. National multistage probability sample of United States ED data. Adult (age, >or=18 yrs) patients with suspected severe sepsis, defined as the concurrent presence of an infec-tion (ED International Classification of Diseases, 9th Revision; ICD-9) diagnosis of infection, or a triage temperature or=100.4 degrees F) and organ dysfunction (ED ICD-9) diagnosis of organ dysfunction, intubation, or a triage systolic blood pressure 6 hrs in the ED. Of suspected severe sepsis patients, 20.6% presented to a low-volume ED (
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                Author and article information

                Contributors
                +81-76-4347262 , yhattori@med.u-toyama.ac.jp
                Journal
                Intensive Care Med Exp
                Intensive Care Med Exp
                Intensive Care Medicine Experimental
                Springer International Publishing (Cham )
                2197-425X
                8 November 2016
                8 November 2016
                December 2016
                : 4
                : 36
                Affiliations
                [1 ]Department of Molecular and Medical Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
                [2 ]Department of Anesthesiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
                [3 ]Department of Immunobiology, Division of Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
                [4 ]Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan
                [5 ]Department of Analytical and Bio-Analytical Chemistry, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
                [6 ]Department of Applied Quantum Medical Engineering, School of Engineering, Tohoku University, Sendai, Japan
                [7 ]Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
                Article
                109
                10.1186/s40635-016-0109-y
                5099302
                27822777
                b4747ee5-2a32-4d57-bd17-3dfd158bdb56
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 28 July 2016
                : 29 October 2016
                Funding
                Funded by: The Ministry of Education, Culture, Sports, Science, and Technology of Japan
                Award ID: 26460336
                Award ID: 15K15661
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                sepsis,histamine,histidine decarboxylase,organ injury
                sepsis, histamine, histidine decarboxylase, organ injury

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