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Neuroprotection in Sepsis by Complement Inhibition and Immunoglobulin Therapy

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Annual Update in Intensive Care and Emergency Medicine 2011

Part of the book series: Annual Update in Intensive Care and Emergency Medicine 2011 ((AUICEM,volume 1))

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Abstract

Understanding of the importance of inflammation’s role in many neurologic disease pathogenesis has increased rapidly in recent years. Neuroinflammation has been viewed as the most common phenomenon observed in disorders of the central nervous system (CNS), either in the acute insult, like infection, trauma, and stroke, or in chronic neurodegenerative states like Alzheimer’s disease, Parkinson disease and multiple sclerosis [1]. This ‘neuroinflammation hypothesis’ furth challenged attempts to expand our understanding of neuronal injury and neurodegeneration because of the activation of brain cells to stress and insult, and targeting neuroinflammation and the major elements of the inflammatory response has become the most effective neuroprotective strategy [2].

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References

  1. Griffin WS, Sheng JG, Royston MC, et al (1998) Glial-neuronal interactions in Alzheimer’s disease: the potential role of a “cytokine cycle” in disease progression. Brain Pathol 8: 65–72

    Article  PubMed  CAS  Google Scholar 

  2. Craft JM, Watterson DM, Van Eldik LJ (2005) Neuroinflammation: a potential therapeutic target. Expert Opin Ther Targets 9: 887–900

    Article  PubMed  CAS  Google Scholar 

  3. Gasque P, Pontaine M, Morgan BP (1995) Complement expression in human brain. J Immunol. 154: 4726–4733

    PubMed  CAS  Google Scholar 

  4. Arumugam TV, Shiels IA, Woodruff TM, Granger DN, Taylor SM (2004) The role of the complement system in ischemia-reperfusion injury. Shock 5: 401–409

    Article  Google Scholar 

  5. Bradt BM, Kolb WP, Cooper NR (1998) Complement dependent proinflammatory proteins of Alzheimer’s disease beta-peptide. J Exp Med 188: 431–438

    Article  PubMed  CAS  Google Scholar 

  6. Kulkarni AP, Kellaway LA, Lahiri DK, Kotwal GJ (2004) Neuroprotection from complement-mediated inflammatory damage. Ann NY Acad Sci 1035: 147–164

    Article  PubMed  CAS  Google Scholar 

  7. Jacob A, Hensley LK, Safratowich BD, Quigg RJ, Alexander JJ (2007) The role of complement cascade in endotoxin-induced septic encephalopathy. Lab Invest 87: 1186–1194

    Article  PubMed  CAS  Google Scholar 

  8. Arumugam TV, Tang SC, Lathia JD, et al (2007) Intravenous immunoglobulin (IVIG) protects the brain against experimental stroke by preventing complement-mediated neuronal cell death. Proc Natl Acad Sci USA 104: 14104–14109

    Article  PubMed  CAS  Google Scholar 

  9. Sewell DL, Nacewicz B, Liu F, et al (2004) Complement C3 and C5 play critical roles in traumatic brain cryoinjury: blocking effects on neutrophil extravasation by C5a receptor antagonist. J Neuroimmunol 155: 55–63

    Article  PubMed  CAS  Google Scholar 

  10. Flierl MA, Stahel PF, Rittirsch D, et al (2009) Inhibition of complement C5a prevents breakdown of the blood-brain barrier and pituitary dysfunction in experimental sepsis. Crit Care 13: R12

    Article  PubMed  Google Scholar 

  11. Sapir T, Shoenfeld Y (2005) Facing the enigma of immunomodulatory effects of intravenous immunoglobulin. Clin Rev Allergy Immunol 180: 9–16

    Google Scholar 

  12. Lapointe BM, Herx LM, Gill V, Metz LM, Kubes P (2004) IVIg therapy in brain inflammation: etiology dependent differential effects on leukocyte recruitment. Brain 127: 2649–2656

    Article  PubMed  Google Scholar 

  13. Esen F, Senturk E, Ergin Ozcan P, et al. (2010) Intravenous immunoglobulins prevent breakdown of the blood-brain barrier in experimental sepsis. Crit Care 14(Suppl 1): P24(abst)

    Article  Google Scholar 

  14. Skaper SD (2007) The brain as a target for inflammatory processes and neuroprotective strategies. Ann NY Acad Sci 1122: 23–34

    Article  PubMed  CAS  Google Scholar 

  15. Tracy KJ (2002) The inflammatory reflex. Nature 420: 853–859

    Article  Google Scholar 

  16. Sharshar T, Hopkinson NS, Orlikowski D, Annane D (2005) Science review: The brain in sepsis — culprit and victim. Crit Care 9: 37–44

    Article  PubMed  Google Scholar 

  17. Papadopoulos MC, Davies DC, Moss RF, Tighe D, Bennett ED (2000) Pathophysiology of septic encephalopathy: a review. Crit Care Med 28: 3019–3024

    Article  PubMed  CAS  Google Scholar 

  18. Papadopoulos MC, Lamb FJ, Moss RF, Davies DC, Tighe D, Bennett ED (1999) Faecal peritonitis causes edema and neuronal injury in pig cerebral cortex Clin Sci 96: 461–466

    Article  PubMed  CAS  Google Scholar 

  19. Alexander JJ, Anderson AJ, Barnum SR, Stevens B, Tenner AJ (2008) The complement cascade Yin-Yang in neuroinflammation — neuro-protection and-degeneration. J Neurochem 107: 1169–1187

    Article  PubMed  CAS  Google Scholar 

  20. Lossinsky AS, Shivers RR (2004) Structural pathways for macromolecular and cellular transport across the blood-brain barrier during inflammatory conditions Review Histol Histopathol 19: 535–564

    CAS  Google Scholar 

  21. Gaillard PJ, de Boer AB, Breimer DD (2003) Pharmacological investigations on LPSinduced permeability changes in the blood-brain barrier invitro. Microvasc Res 65: 24–31

    Article  PubMed  CAS  Google Scholar 

  22. Vaszelka S, Urbanyi Z, Pazmany T, et al (2005) Human serum amyloid P component attenuates the bacterial lipopolysaccaride-induced increase in blood brain barrier permeability in mice. Neurosci Lett 352: 57–60

    Article  Google Scholar 

  23. Arumugam TV, Woodruff TM, Lathia JD, Selvaraj PK, Mattson MP, Taylor SM (2009) Neuroprotection in stroke by complement inhibition and immunoglobulin therapy. Neuroscience 158: 1074–1089

    Article  PubMed  CAS  Google Scholar 

  24. Misra N, Bayry J, Ephrem A, et al (2005)Intravenous immunoglobulin in neurological disorders: a mechanistic perspective. J Neurol 252: 11–16

    Article  Google Scholar 

  25. Antel J, Bar-Or A (2006) Roles of immunoglobulins and B cells in multiple sclerosis: from pathogenesis to treatment. J Neuroimmunol 180: 3–8

    Article  PubMed  CAS  Google Scholar 

  26. Hughes RA, Comblath DR (2005) Guillain-Barre syndrome. Lancet 366: 1653–1666

    Article  PubMed  CAS  Google Scholar 

  27. Dodel RC, Du Y, Depboylu C, et al (2004) Intravenous immunoglobulins containing antibodies against beta-amyloid for the treatment of Alzheimer’s disease. J Neurol Neurosurg Psychiatry 75: 1472–1474

    Article  PubMed  CAS  Google Scholar 

  28. Gok B, Sciubba DM, Okutan O, et al (2009) Immunomodulation of acute experimental spinal cord injury with human immunoglobulin. J Clin Neurosci 16: 549–553

    Article  PubMed  CAS  Google Scholar 

  29. Arumugam TV, Selvaraj PK, Woodruff TM, Mattson MP (2008) Targeting ischemic brain injury with intravenous immunoglobulin. Expert Opin Ther Targets 12: 19–29

    Article  PubMed  CAS  Google Scholar 

  30. Negi VS, Elluru S, Sibéril S, et al (2007) Intravenous immunoglobulin: an update on the clinical use and mechanisms of action. J Clin Immunol 27: 233–245

    Article  PubMed  CAS  Google Scholar 

  31. Stangel M, Compston A (2001) Polyclonal immunoglobulins (IVIg) modulate nitric oxide production and microglial functions invitro via Fc receptors. J Neuroimmunol 112: 63–71

    Article  PubMed  CAS  Google Scholar 

  32. Prasad NK, Papoff G, Zeuner A, et al (1998) Therapeutic preparations of normal polyspecific IgG (IVIg) induce apoptosis in human lymphocytesa nd monocytes: a novel mechanism of action od IVIg involving the Fas apoptotic pathway. J Immunol 161: 3781–3790

    PubMed  CAS  Google Scholar 

  33. Basta M, Van Goor F, Luccioli S, et al (2003) F(ab)-mediated neutralization of C3a and C5a anaphylatoxins: a novel effector function of immunoglobulins. Nature Med 4: 431–438

    Google Scholar 

  34. Crow AR, Song S, Semple JW, Freedman J, Lazarus AH (2007) A role for IL-1 Receptor antagonist or other cytokines in the acute therapeutic effects of IVIg? Blood 109: 155–158

    Article  PubMed  CAS  Google Scholar 

  35. Jonas E, Dwenger A, Jonas M. (1995) Chemiluminescence response and adherence of neutrophils to cultured endothelial cells - influence of immunoglobulin G. J Biolumin Chemilumin 10: 169–173

    Article  PubMed  CAS  Google Scholar 

  36. Toungouz M, Denys CH, De Groote D, Dupont E (1995) In vitro inhibition of tumor necrosis factor-alpha and interleukin — 6 production by intravenous immunoglobulins. Br J Haematol 89: 698–703

    Article  PubMed  CAS  Google Scholar 

  37. Basta M (2008) Ambivalent effects of immunoglobulins on the complement system: Activation versus inhibition. Mol Immunol 45: 4073–4079

    Article  PubMed  CAS  Google Scholar 

  38. Ballander BM, Singhrao SK, Ohlsson M, Mattsson P, Svensson M (2001) Complement activation in the human brain after traumatic brain injury. J Neurotrauma 18: 1295–1311

    Article  Google Scholar 

  39. Kaczorowski SL, Schiding JK, Toth CA, Kochanek PM (1995) Effect of soluble complement receptor-1 on neutrophil accumulation after traumatic brain injury in rats. J Cereb Blood Flow Metab 15: 860–864

    PubMed  CAS  Google Scholar 

  40. Arumugam TV, Magnus T, Woodruff TM, Proctor LM, Shiels IA, Taylor SM (2006) Complement mediators in ischemia-reperfusion injury. Clin Chim Acta 374: 33–45

    Article  PubMed  CAS  Google Scholar 

  41. Mocco J, Mack WJ, Ducruet AF, et al (2006) Complement component C3 mediates inflammatory injury following focal cerebral ischemia. Circ Res 99: 209–217

    Article  PubMed  CAS  Google Scholar 

  42. O’Barr SA, Caguioa J, Gruol D, et al (2001) Neuronal expression of a functional receptor for the C5a complement activation fragment. J Immunol 166: 4154–4162

    PubMed  Google Scholar 

  43. Persson M, Pekna M, Hansson E, Ronback L (2009) The complement derived anaphylatoxin C5a increases microglial GLT-1 expession and glutamate uptake in a TNF-a independent manner. Eur J Neurosci 29: 267–274

    Article  PubMed  Google Scholar 

  44. Faustmann PM, Krause D, Dux R, Dermietzel R (1995) Morphological study in the early stages of complement C5a fragment-induced experimental meningitis: activation of macrophages and astrocytes. Acta Neuropathol 89: 239–247

    Article  PubMed  CAS  Google Scholar 

  45. Riedemann NC, Guo RF, Neff TA, et al (2002) Increased C5a receptor expression in sepsis. J Clin Invest 110: 101–108

    PubMed  CAS  Google Scholar 

  46. Annane D (2009) Sepsis associated delirium: the pro and con of C5a blockade. Crit Care 13: 135

    Article  PubMed  Google Scholar 

  47. Rieben R, Roos A, Mulzert Y, Tinguely C, Gerritsen AF, Daha MR (1999) Immunoglobulin M-enriched human intravenous immunoglobulin prevents complement activation in-vitro and in-vivo in a rat model of acute inflammation. Blood 93: 942–951

    PubMed  CAS  Google Scholar 

  48. Laupland KB, Kirkpatrick AW, Delaney A (2007) Polyclonal intravenous immunoglobulin for the treatment of severe sepsis and septic shock in critically ill adults: a systematic review and metaanalysis. Crit Care Med 35: 2689–2692

    Article  Google Scholar 

  49. Mohr M, Englisch L, Roth A, Burchardi H, Zielmann S (1997) Effects of early treatment with immunoglobulin on critical illness polyneuropathy following multiple organ failure and gram-negative sepsis. Intensive Care Med 23: 1144–1149

    Article  PubMed  CAS  Google Scholar 

  50. Werdan K, Pilz G, Bujdoso O, et al (2007) Score-based immunoglobulin G therapy of patients with sepsis: the SBITS study. Crit Care Med 35: 2693–2701

    Article  PubMed  CAS  Google Scholar 

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Esen, F. (2011). Neuroprotection in Sepsis by Complement Inhibition and Immunoglobulin Therapy. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2011. Annual Update in Intensive Care and Emergency Medicine 2011, vol 1. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18081-1_58

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  • DOI: https://doi.org/10.1007/978-3-642-18081-1_58

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-18080-4

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