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Human and experimental septic shock are characterized by depletion of lipid droplets in the adrenals

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Abstract

Rationale

Cholesteryl ester deficiency which results in adrenal lipid store depletion has been proposed as a potential mechanism of sepsis associated adrenal insufficiency.

Objective

We investigated histological abnormalities associated with sepsis in human and mice adrenals.

Methods

From January 2006 to 2008, seven patients who died of septic shock and seven patients with rapidly fatal nonseptic illness were included. Adrenals were sampled within 12 h from death. Adrenals were also taken from 13 lipopolysaccharide (LPS)-challenged mice, 5 cecal ligation and puncture (CLP) mice and 5 controls. We semi-quantitatively analysed intensity of inflammation, necrosis, haemorrhage and lipid depletion.

Measurements and main results

In patients, lipid depletion scores were significantly higher in septic shock than in controls (p = 0.011). In animals, lipid depletion was higher following LPS or CLP than in controls (p = 0.003). In adrenal cortex, in patients and not in animals, global scores for inflammation (p = 0.002), necrosis (p = 0.009) and haemorrhage (p = 0.009) were significantly higher in septic shock than in controls. Similarly, in zona fasciculata, in patients and not in animals, scores for inflammation (p = 0.007), necrosis (p = 0.023) and haemorrhage (p = 0.023) were significantly higher in septic shock than in controls.

Conclusions

This study shows that diffuse lipid depletion in zona fasciculata is a hallmark of human septic shock, experimental endotoxaemia and sepsis. In patients, sepsis was associated with inflammation, necrosis and haemorrhage predominantly in zona fasciculata.

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Authors and Affiliations

  1. General Intensive Care Unit and Laboratoire d’étude de la réponse neuroendocrine au sepsis EA4342, Service de Réanimation, Raymond Poincaré Hospital (AP-HP), University Versailles Saint-Quentin en Yvelines, 92380, Garches, France

    Andrea Polito, Geoffroy Lorin de la Grandmaison, Arnaud Mansart, Tarek Sharshar & Djillali Annane

  2. Department of Forensic Medicine and Pathology, Raymond Poincaré Hospital (AP-HP), University Versailles Saint-Quentin en Yvelines, Garches, France

    Geoffroy Lorin de la Grandmaison

  3. Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 413, EA4310, Laboratory of Differentiation and Neuronal and Neuroendocrine Communication, University of Rouen, 76821, Mont Saint Aignan, France

    Andrea Polito, Estelle Louiset & Hervé Lefebvre

Authors
  1. Andrea Polito
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  2. Geoffroy Lorin de la Grandmaison
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  3. Arnaud Mansart
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  4. Estelle Louiset
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  5. Hervé Lefebvre
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  6. Tarek Sharshar
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  7. Djillali Annane
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Corresponding author

Correspondence to Djillali Annane.

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Polito, A., Lorin de la Grandmaison, G., Mansart, A. et al. Human and experimental septic shock are characterized by depletion of lipid droplets in the adrenals. Intensive Care Med 36, 1852–1858 (2010). https://doi.org/10.1007/s00134-010-1987-1

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  • DOI: https://doi.org/10.1007/s00134-010-1987-1

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