The vasculature in sepsis: delivering poison or remedy to the brain?
Benjamin H. Singer
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Address correspondence to: Benjamin H. Singer, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, 4067 Biomedical Science Research Building, 109 Zina Pitcher Place, Ann Arbor, Michigan 48109, USA. Phone: 734.764.4554; Email: singerb@med.umich.edu.
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First published March 18, 2019 - More info
J Clin Invest. 2019;129(4):1527–1529. https://doi.org/10.1172/JCI127679.
© 2019 American Society for Clinical Investigation
Survivors of sepsis and other forms of critical illness frequently experience significant and disabling cognitive and affective disorders. Inflammation, ischemia, and glial cell dysfunction contribute to this persistent brain injury. In this issue of the JCI, Hippensteel et al. show that endothelial injury in animal models of sepsis or endotoxemia leads to shedding of heparan fragments from the endothelial glycocalyx. These fragments directly sequester brain-derived neurotrophic factor and impair hippocampal long-term potentiation, an electrophysiologic correlate of memory. The authors further explore the specific characteristics of heparan fragments that bind neurotrophins and the presence of these fragments in the circulation of patients who survive sepsis. This study highlights an important mechanism by which vascular injury can impair brain function.
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Copyright © 2019 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)