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Section of Neonatology, Department of Pediatrics, Rush Children's Hospital, Rush Presbyterian St. Luke's Medical Center, Chicago, Illinois 60612
Most models of
liver dysfunction in sepsis use endotoxin (lipopolysaccharide; LPS) to
induce a pathophysiological response. In our study published in this
issue (Beno DWA, Uhing MR, Goto M, Chen Y, Jiyamapa-Serna VA, and
Kimura RE. Am J Physiol Gastrointest Liver Physiol 280:
G858-G865, 2001), the adverse effect of LPS on hepatic function in
vivo was only significant at relatively high LPS doses despite high
tumor necrosis factor-
concentrations. However, many
patients with sepsis are exposed to multiple bacterial toxins that may
augment the immune response, resulting in increased hepatic
dysfunction. We have developed a model of polymicrobial sepsis by
parentally administering a combination of staphylococcal enterotoxin B
(SEB) and LPS. Using this model, we demonstrate that SEB (50 µg/kg)
potentiates the effect of LPS-induced hepatic dysfunction as measured
by decreased rates of biliary indocyanine green clearance and bile
flow. These increases were most pronounced with doses of 10 and 100 µg/kg LPS, doses that by themselves do not induce hepatic
dysfunction. This may explain the seemingly increased incidence and
severity of liver dysfunction in sepsis, and it suggests that the
exclusive use of LPS for replicating septic shock may not be relevant
for studies of hepatic dysfunction.
interferon-
; hepatocellular dysfunction; sepsis; cholestasis; in
vivo studies
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