Inhibition of circulating dipeptidyl-peptidase 3 by procizumab in experimental septic shock reduces catecholamine exposure and myocardial injury

Data de publicação:

Autores da FMUP

  • Francisco Aguiar Vasques Novoa Faria

    Autor

Participantes de fora da FMUP

  • Garcia, Bruno
  • ter Schiphorst, Benoit
  • Santos, Karine
  • Su, Fuhong
  • Dewachter, Laurence
  • Rocha-Oliveira, Estela
  • Roncon-Albuquerque Jr, Roberto
  • Uba, Theo
  • Hartmann, Oliver
  • Picod, Adrien
  • Azibani, Feriel
  • Callebert, Jacques
  • Goldman, Serge
  • Annoni, Filippo
  • Favory, Raphael
  • Vincent, Jean-Louis
  • Creteur, Jacques
  • Taccone, Fabio Silvio
  • Mebazaa, Alexandre
  • Herpain, Antoine

Unidades de investigação

Abstract

Background Dipeptidyl peptidase 3 (DPP3) is a ubiquitous cytosolic enzyme released into the bloodstream after tissue injury, that can degrade angiotensin II. High concentrations of circulating DPP3 (cDPP3) have been associated with worse outcomes during sepsis. The aim of this study was to assess the effect of Procizumab (PCZ), a monoclonal antibody that neutralizes cDPP3, in an experimental model of septic shock.Methods In this randomized, open-label, controlled study, 16 anesthetized and mechanically ventilated pigs with peritonitis were randomized to receive PCZ or standard treatment when the mean arterial pressure (MAP) dropped below 50 mmHg. Resuscitation with fluids, antimicrobial therapy, peritoneal lavage, and norepinephrine was initiated one hour later to maintain MAP between 65-75 mmHg for 12 h. Hemodynamic variables, tissue oxygenation indices, and measures of organ failure and myocardial injury were collected. Organ blood flow was assessed using isotopic assessment (99mtechnetium albumin). cDPP3 activity, equilibrium analysis of the renin-angiotensin system and circulating catecholamines were measured. Tissue mRNA expression of interleukin-6 and downregulation of adrenergic and angiotensin receptors were assessed on vascular and myocardial samples.Results PCZ-treated animals had reduced cDPP3 levels and required less norepinephrine and fluid than septic control animals for similar organ perfusion and regional blood flow. PCZ-treated animals had less myocardial injury, and higher PaO2/FiO2 ratios. PCZ was associated with lower circulating catecholamine levels; higher circulating angiotensin II and higher angiotensin II receptor type 1 myocardial protein expression, and with lower myocardial and radial artery mRNA interleukin-6 expression.Conclusions In an experimental model of septic shock, PCZ administration was associated with reduced fluid and catecholamine requirements, less myocardial injury and cardiovascular inflammation, along with preserved angiotensin II signaling.

Dados da publicação

ISSN/ISSNe:
2197-425X,

Intensive Care Medicine Experimental  Springer Science and Business Media Deutschland GmbH

Tipo:
Article
Páginas:
-
PubMed:
38849640

Citações Recebidas na Web of Science: 7

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Keywords

  • Sepsis; Angiotensin II; Dipeptidyl peptidase 3; Vasopressors; Renin-angiotensin system; Shock

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