Análise de elementos da sinalização purinérgica em pacientes sépticos

Abstract

Purpose: Purinergic signaling interplays with sepsis pathophysiology is widely documented in pre-clinical research. We speculated that alterations in purinergic signaling are also present in human sepsis. Methods: Purinergic receptor mRNA expression in circulating neutrophils, serum ATP and serum nucleotidase activity was measured in a group of septic ICU patients, non-septic ward patients and healthy volunteers. Results: Septic ICU patients (n=10) had mean age of 59,9 (23 - 80) years, SOFA score of 7,6 (4 - 11) points. Ward non-septic patients (n=10) had mean age of 70,5 (60 - 91) years Both groups had comorbidities like hypertension, diabetes or cancer. Neutrophils from septic patients neutrophils expressed 6 to 7 times more P2Y2 and A2a receptors mRNA level when compared to healthy volunteers (n=10) and non-septic ward patients. Serum ATP levels and nucleotidase activity was significantly elevated in septic patients when compared to controls. Conclusion: We demonstrated purinergic signaling elements to be active in septic ICU patients. Adding to previous evidences, our findings suggest ATP, its receptors and nucleotidases are major players in sepsis development. Purinergic signaling, specially ATPergic signaling, provides a framework to develop diagnosis and therapeutic strategies in sepsis.