2022 Fiscal Year Final Research Report
Is lactate production in sepsis induced by adrenaline?
Project/Area Number |
17K17058
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Research Category |
Grant-in-Aid for Young Scientists (B)
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Allocation Type | Multi-year Fund |
Research Field |
Emergency medicine
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Research Institution | Sapporo Medical University |
Principal Investigator |
Bunya Naofumi 札幌医科大学, 医学部, 助教 (50721586)
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Project Period (FY) |
2017-04-01 – 2023-03-31
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Keywords | 乳酸 / 敗血症 / 嫌気性代謝 / ストレス反応 |
Outline of Final Research Achievements |
The purpose of this study was to show that lactate elevation in sepsis is not only due to oxygen delivery, called anaerobic metabolism, but also that lactate production by adrenergic secretion due to stress associated by infection plays a major role in the elevation of lactate in sepsis. Multiple pathways are believed to be involved in lactate elevation in sepsis. Among these pathways, lactate elevation due to decreased oxygen delivery is considered to play a major role. First, hypoxic stress loading was applied, and the subject group was compared to adrenalectomized rats without adrenaline secretion. The results showed an association between adrenaline and lactate levels among rats that did not differ in oxygenation, blood pressure, heart rate, and hemoglobin levels. The results suggest that one of the mechanisms of lactate elevation is an adrenergic stress response.
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Free Research Field |
救急医学、集中治療医学
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Academic Significance and Societal Importance of the Research Achievements |
敗血症における乳酸上昇が死亡率上昇と有意に相関する独立した予後予測因子である。この乳酸上昇が従来言われていたような、酸素運搬主体の考え方である嫌気性代謝ではなく、アドレナリンの関与するストレス反応であることを示すことで、酸素運搬を改善させる治療以外の、侵襲を軽減する治療に注目させるメッセージになる可能性がある。 今回の研究の結果は、酸素運搬にほぼ差がないラット間でアドレナリン-乳酸の間に関連性を示すことができたことから、乳酸が上昇するような死亡率の高い病態の治療の際は、酸素運搬に関わる要因以外の他の要因にも治療介入を検討する必要があることに着目するという教訓を伝えられたのではないだろうか。
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