TY - JOUR
T1 - Bosutinib reduces endothelial permeability and organ failure in a rat polytrauma transfusion model
AU - Kleinveld, Derek J.B.
AU - Botros, Liza
AU - Maas, M. Adrie W.
AU - Kers, Jesper
AU - Aman, Jurjan
AU - Hollmann, Markus W.
AU - Juffermans, Nicole P.
N1 - Publisher Copyright: © 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - Background: Trauma-induced shock is associated with endothelial dysfunction. We examined whether the tyrosine kinase inhibitor bosutinib as an adjunct therapy to a balanced blood component resuscitation strategy reduces trauma-induced endothelial permeability, thereby improving shock reversal and limiting transfusion requirements and organ failure in a rat polytrauma transfusion model. Methods: Male Sprague–Dawley rats (n=13 per group) were traumatised and exsanguinated until a MAP of 40 mm Hg was reached, then randomised to two groups: red blood cells, plasma and platelets in a 1:1:1 ratio with either bosutinib or vehicle. Controls were randomised to sham (median laparotomy, no trauma) with bosutinib or vehicle. Organs were harvested for histology and wet/dry (W/D) weight ratio. Results: Traumatic injury resulted in shock, with higher lactate levels compared with controls. In trauma-induced shock, the resuscitation volume needed to obtain a MAP of 60 mm Hg was lower in bosutinib-treated animals (2.8 [2.7–3.2] ml kg−1) compared with vehicle (6.1 [5.1–7.2] ml kg−1, P<0.001). Lactate levels in the bosutinib group were 2.9 [1.7–4.8] mM compared with 6.2 [3.1–14.1] mM in the vehicle group (P=0.06). Bosutinib compared with vehicle reduced lung vascular leakage (W/D ratio of 5.1 [4.6–5.3] vs 5.7 [5.4–6.0] (P=0.046) and lung injury scores (P=0.027). Conclusions: Bosutinib as an adjunct therapy to a balanced transfusion strategy reduced resuscitation volume, improved shock reversal, and reduced vascular leak and organ injury in a rat polytrauma model.
AB - Background: Trauma-induced shock is associated with endothelial dysfunction. We examined whether the tyrosine kinase inhibitor bosutinib as an adjunct therapy to a balanced blood component resuscitation strategy reduces trauma-induced endothelial permeability, thereby improving shock reversal and limiting transfusion requirements and organ failure in a rat polytrauma transfusion model. Methods: Male Sprague–Dawley rats (n=13 per group) were traumatised and exsanguinated until a MAP of 40 mm Hg was reached, then randomised to two groups: red blood cells, plasma and platelets in a 1:1:1 ratio with either bosutinib or vehicle. Controls were randomised to sham (median laparotomy, no trauma) with bosutinib or vehicle. Organs were harvested for histology and wet/dry (W/D) weight ratio. Results: Traumatic injury resulted in shock, with higher lactate levels compared with controls. In trauma-induced shock, the resuscitation volume needed to obtain a MAP of 60 mm Hg was lower in bosutinib-treated animals (2.8 [2.7–3.2] ml kg−1) compared with vehicle (6.1 [5.1–7.2] ml kg−1, P<0.001). Lactate levels in the bosutinib group were 2.9 [1.7–4.8] mM compared with 6.2 [3.1–14.1] mM in the vehicle group (P=0.06). Bosutinib compared with vehicle reduced lung vascular leakage (W/D ratio of 5.1 [4.6–5.3] vs 5.7 [5.4–6.0] (P=0.046) and lung injury scores (P=0.027). Conclusions: Bosutinib as an adjunct therapy to a balanced transfusion strategy reduced resuscitation volume, improved shock reversal, and reduced vascular leak and organ injury in a rat polytrauma model.
KW - bosutinib
KW - endothelial dysfunction
KW - shock
KW - transfusion
KW - trauma
KW - tyrosine kinase inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85102039794&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.bja.2021.01.032
DO - https://doi.org/10.1016/j.bja.2021.01.032
M3 - Article
C2 - 33685634
SN - 0007-0912
VL - 126
SP - 958
EP - 966
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 5
ER -