TY - JOUR
T1 - Endotoxemia-induced inflammation and the effect on the human brain
AU - Van den Boogaard, Mark
AU - Ramakers, Bart P.
AU - van Alfen, Nens
AU - van der Werf, Sieberen P.
AU - Fick, Wilhelmina F.
AU - Hoedemaekers, Cornelia W.
AU - Verbeek, Marcel M.
AU - Schoonhoven, Lisette
AU - van der Hoeven, Johannes G.
AU - Pickkers, Peter
PY - 2010/5
Y1 - 2010/5
N2 - Introduction: Effects of systemic inflammation on cerebral function are not clear, as both inflammation-induced encephalopathy as well as stress-hormone mediated alertness have been described.Methods: Experimental endotoxemia (2 ng/kg Escherichia coli lipopolysaccharide [LPS]) was induced in 15 subjects, whereas 10 served as controls. Cytokines (TNF-?, IL-6, IL1-RA and IL-10), cortisol, brain specific proteins (BSP), electroencephalography (EEG) and cognitive function tests (CFTs) were determined.Results: Following LPS infusion, circulating pro- and anti inflammatory cytokines, and cortisol increased (P <0.0001). BSP changes stayed within the normal range, in which neuron specific enolase (NSE) and S100-? changed significantly. Except in one subject with a mild encephalopathic episode, without cognitive dysfunction, endotoxemia induced no clinically relevant EEG changes. Quantitative EEG analysis showed a higher state of alertness detected by changes in the central region, and peak frequency in the occipital region. Improved CFTs during endotoxemia was found to be due to a practice effect as CFTs improved to the same extent in the reference group. Cortisol significantly correlated with a higher state of alertness detected on the EEG. Increased IL-10 and the decreased NSE both correlated with improvement of working memory and with psychomotor speed capacity. No other significant correlations between cytokines, cortisol, EEG, CFT and BSP were found.Conclusions: Short-term systemic inflammation does not provoke or explain the occurrence of septic encephalopathy, but primarily results in an inflammation-mediated increase in cortisol and alertness.
AB - Introduction: Effects of systemic inflammation on cerebral function are not clear, as both inflammation-induced encephalopathy as well as stress-hormone mediated alertness have been described.Methods: Experimental endotoxemia (2 ng/kg Escherichia coli lipopolysaccharide [LPS]) was induced in 15 subjects, whereas 10 served as controls. Cytokines (TNF-?, IL-6, IL1-RA and IL-10), cortisol, brain specific proteins (BSP), electroencephalography (EEG) and cognitive function tests (CFTs) were determined.Results: Following LPS infusion, circulating pro- and anti inflammatory cytokines, and cortisol increased (P <0.0001). BSP changes stayed within the normal range, in which neuron specific enolase (NSE) and S100-? changed significantly. Except in one subject with a mild encephalopathic episode, without cognitive dysfunction, endotoxemia induced no clinically relevant EEG changes. Quantitative EEG analysis showed a higher state of alertness detected by changes in the central region, and peak frequency in the occipital region. Improved CFTs during endotoxemia was found to be due to a practice effect as CFTs improved to the same extent in the reference group. Cortisol significantly correlated with a higher state of alertness detected on the EEG. Increased IL-10 and the decreased NSE both correlated with improvement of working memory and with psychomotor speed capacity. No other significant correlations between cytokines, cortisol, EEG, CFT and BSP were found.Conclusions: Short-term systemic inflammation does not provoke or explain the occurrence of septic encephalopathy, but primarily results in an inflammation-mediated increase in cortisol and alertness.
U2 - 10.1186/cc9001
DO - 10.1186/cc9001
M3 - Article
SN - 1364-8535
VL - 14
SP - R81-[9pp]
JO - Critical Care
JF - Critical Care
IS - 3
ER -