Physical interaction of hydroxyethyl starch solution on endothelial glycocalyx structure under inflammation

• Project/Area Number: 15K10549
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Hyogo Medical University
• Principal Investigator: Tatara Tsuneo 兵庫医科大学, 医学部, 教授 (30207039)
• Research Collaborator: NAKAMOTO shiroh
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2017: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000); Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2015: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
• Keywords: グリコカリックス / 炎症 / 血管収縮薬 / 輸液 / 1回拍出量変化量 / glycocalyx / ヒドロキシエチルデンプン / Glycocalyx

Outline of Final Research Achievements

(1) We compared the effects of albumin and hydroxyethyl starch (HES) solutions on the physical properties of sodium hyaluronate solution, a constituent of the ESL. A 3% albumin solution decreased partial specific volumes of hyaluronate by 3% compared to HES. A 3% HES solution, but not albumin, decreased intrinsic viscosities hyaluronate by 34%. These findings suggest that HES locally restricts hyaluronate dispersion, whereas albumin contracts hyaluronate structure.
(2) We compared total fluid infusion volume in patients receiving stroke volume variation (SVV)-guided fluid therapy with or without vasopressors during hepatectomy. Fluid infusion volume during surgery did not differ significantly among the three groups. This was attributed to modest decrease of SVV following fluid boluses for vasopressor groups compared to the control group.

Academic Significance and Societal Importance of the Research Achievements

大手術や敗血症などの重症患者では、輸液は微小循環を改善させる有力な手段である。今回、アルブミンがグリコカリックスの構成成分であるヒアルロン酸の部分モル体積を減少させる一方、人工膠質液であるHES製剤はヒアルロン酸の固有粘度を減少させることが明らかとなった。つまり、アルブミンがヒアルロン酸構造を安定化させるのに対し、HESはヒアルロン酸を“硬く”する。この作用が生体内でも発揮されれば、HESが炎症によるグリコカリックスの崩壊を軽減する可能性がある。この結果は、HES製剤の臨床使用に新たな活路を見出すものであり、重症患者の予後を改善する一助となるため社会に大きく貢献すると期待される。

Research Products

• [Journal Article] Contrasting effects of albumin and hydroxyethyl starch solutions on physical properties of sodium hyaluronate solution. (2018)
  • Author(s): Tatara T
  • Journal Title: Carbohydrate Polymers Volume: 201 Pages: 60-64
  • DOI: 10.1016/j.carbpol.2018.08.046
  • Peer Reviewed
• [Journal Article] Relationship between stroke volume variation and stroke volume during major abdominal surgery using arterial pulse contour analysis (2016)
  • Author(s): Sugi T, Tatara T, Kaneko T, Kaneko H, Hirose M
  • Journal Title: Journal of Anesthesia and Clinical Research Volume: 7 Issue: 03 Pages: 3-9
  • DOI: 10.4172/2155-6148.1000609
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Context-sensitive fluid therapy in critical illness (2016)
  • Author(s): Tatara T
  • Journal Title: Journal of Intensive Care Volume: 4 Issue: 1 Pages: 20-31
  • DOI: 10.1186/s40560-016-0150-7
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Presentation] 輸液管理 (2016)
  • Author(s): 多田羅 恒雄
  • Organizer: 日本麻酔科学会第63回大会
  • Place of Presentation: 福岡県福岡市 ホテル日航福岡
  • Invited