Use of ulinastatin was associated with reduced mortality in critically ill patients with sepsis

Ulinastatin attenuates spinal cord injury by targeting AMPK/NLRP3 signaling pathway

The AMPK and NLRP3 inflammasome signaling pathways are reported to participant in the inflammatory responses following spinal cord injury (SCI). Ulinastatin (ULI) is a urinary trypsin inhibitor with excellent anti-inflammatory effects, but the functions of ULI on SCI are rarely reported. Hence, this study was designed to investigate whether ULI could modulate SCI through regulating the AMPK/NLRP3 signaling pathway. Cell Counting Kit-8 (CCK-8) assays were used to investigate whether ULI had cytotoxic effects on BV-2 cells. Basso-Beattie-Bresnahan (BBB) scale, spinal cord water content detection, hematoxylin-eosin (HE) and Nissl stainings were used to investigate the protective effects of ULI on rat SCI. The expressions of inflammatory cytokines were detected by ELISA and RT-qPCR. The expressions of key proteins of AMPK and NLRP3 inflammasome were analyzed by western blot. The CCK-8 assays indicated that ULI did not significantly influence the viability of BV-2 cells at various concentrations below 10,000 U/ml. It was witnessed that ULI could dramatically inhibit the activation of NLRP3 inflammasome via activating the AMPK signaling pathway, thus relieving inflammatory responses. Besides, the in vivo experiment suggested that treatment with ULI remarkably relieve spinal cord edema, ameliorated spinal cord tissue architecture, and improved neurological function following SCI. The findings indicate that ULI significantly ameliorates neurological function following SCI by regulating the AMPK/NLRP3 inflammasome signaling pathway.

Sigma-1 Receptor and Binding Immunoglobulin Protein Interact with Ulinastatin Contributing to a Protective Effect in Rat Cerebral Ischemia/Reperfusion

OBJECTIVE

To investigate impact of ulinastatin (UTI) on sigma-1 receptor (σ1R) and binding immunoglobulin protein (BiP) after cerebral ischemia/reperfusion injury.

METHODS

The middle cerebral artery occlusion (MCAO) model was used to induce cerebral ischemia/reperfusion injury. Eighty male Sprague Dawley rats were randomly divided into 6 groups: control, MCAO, MCAO+50,000 U/kg UTI, MCAO+100,000 U/kg UTI, MCAO+200,000 U/kg UTI, MCAO+300,000 U/kg UTI. At 24 and 48 hours after MCAO, infarct volume, neurological dysfunction, and grip strength test were measured, and level of σ1R and BiP proteins was further detected using Western blot. Molecular docking assays were carried out to verify interaction between σ1R, BiP, and UTI. The serum concentration of BiP and the binding assay between σ1R, BiP, and UTI were determined using enzyme-linked immunosorbent assay.

RESULTS

UTI increased the modified neurological severity score and upregulated σ1R and BiP expression in the cerebral cortex after MCAO. The grip strength of forelimbs increased significantly in the MCAO+200,000 U/kg UTI and MCAO+300,000 U/kg UTI groups compared with the MCAO group, while BiP serum levels remained unchanged. The molecular docking assay indicated putative binding between σ1R, BiP, and UTI. The binding assay also revealed that both σ1R and BiP could be combined with UTI.

CONCLUSIONS

UTI displays a neuroprotective effect via upregulation of σ1R and BiP during ischemia/reperfusion injury, suggesting that UTI modulates σ1R and BiP and their interaction may provide a novel insight into potential therapeutic mechanisms for stroke.

Ulinastatin protects against sepsis‑induced myocardial injury by inhibiting NLRP3 inflammasome activation

Myocardial injury is the primary manifestation of multiple organ dysfunction during sepsis, however, the mechanisms underlying sepsis-induced myocardial injury remain unclear. Similarly, no effective therapeutics have yet been developed for myocardial injury. In the present study, the role of the NOD-like receptor 3 (NLRP3) inflammasome on cardiac function were characterized and the effects of different ulinastatin (UTI) doses in protecting a septic rat model from myocardial injury were elucidated. To evaluate UTI efficacy on cardiac function, its effects on anti-inflammatory mediators were analyzed and its cardioprotective effects were investigated. It was demonstrated that circulatory levels of tumor necrosis factor-α and interleukin-1β were elevated during sepsis. It was also observed that NLRP3 and caspase-1 expression enhanced post-cecal ligation and puncture (CLP), and that high UTI levels protected against myocardial injury induced by sepsis. To the best of our knowledge, this is the first study to demonstrate that the mechanisms underpinning UTI-mediated myocardial protection were due to the downregulation of the NLRP3/caspase-1/IL-1β signaling pathway. Based on these findings, it is proposed that UTI exerts beneficial effects during sepsis-induced myocardial injury.

[Neonatal capillary leak syndrome]

Neonatal capillary leak syndrome is a clinical syndrome with definite etiology or predisposing factors and has the manifestations of hypotension, hemoconcentration, hypoproteinemia, and systemic edema. This disease often has critical conditions and may lead to multiple organ failure and even death. There are still controversies over the diagnosis and treatment of this disease. This article summarizes the recent advances in the diagnosis and treatment of neonatal capillary leak syndrome, in order to improve the diagnosis and treatment of this disease among clinicians.