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The nonessential amino acid L-glutamine (Gln) is the most abundant amino acid in plasma. Clinical trials have demonstrated that Gln therapy is safe and improves clinical outcomes in critically ill patients. We have previously shown that Gln protect animals from endotoxic shock through the inhibition of cytosolic phospholipase A(2) activity. In this study, we investigated how Gln regulates MAPK activation, as the molecular mechanism underlying Gln-induced cytosolic phospholipase A(2) inactivation. Gln rapidly (within 10 min) inactivated p38 and JNK, but not ERK, by dephosphorylating them only when these MAPKs were phosphorylated in response to LPS in vivo as well as in vitro. Western blot analysis revealed that Gln administration resulted in rapid ( approximately 5 min) phosphorylation and protein induction of MAP kinase phosphatase-1 (MKP-1). MKP-1 siRNA abrogated the Gln-mediated 1) inactivation of p38 and JNK, 2) induction of MKP-1, and 3) protection against endotoxic shock. The ERK inhibitor U0126 blocked Gln-induced MKP-1 phosphorylation and protein induction, as well as Gln's protective activity against endotoxic shock. These data suggest that Gln exerts a beneficial effect on endotoxic shock by inactivating p38 and JNK via a rapid induction of MKP-1 protein in an ERK-dependent way.
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http://dx.doi.org/10.4049/jimmunol.0900043 | DOI Listing |
Pediatr Crit Care Med
September 2025
Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR Biomedical Research Centre, London, United Kingdom.
Objective: To review the timing of death in children with sepsis referred for intensive care, 2018-2023, and compare with our previous 2005-2011 practice. We hypothesized that most deaths occur within 24 hours of referral to the PICU, with many before PICU admission.
Design, Setting, And Patients: We reviewed referrals to the Children's Acute Transport Service (CATS), North Thames regional pediatric intensive care transport service in the United Kingdom, between January 2018 and March 2023.
Cardiol Rev
September 2025
Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Sepsis remains a leading cause of critical illness and mortality worldwide, driven by a dysregulated host response to infection and often complicated by persistent tachycardia and cardiovascular dysfunction. Increasing evidence implicates excessive sympathetic activation as a contributor to sepsis-related hemodynamic instability and myocardial injury, prompting growing interest in the use of β-adrenergic blockade as a therapeutic adjunct. This review synthesizes current data on the safety and efficacy of short-acting, cardioselective β-blockers (BBs), particularly esmolol and landiolol, in septic shock.
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September 2025
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Objective: Vitamin C has been linked to alterations in platelet count and aggregation behavior. Given recent findings suggesting an association between vitamin C and adverse outcomes in patients with septic shock, we aimed to investigate whether vitamin C influences mortality in septic patients through its impact on platelets.
Design: Post hoc analysis of the Lessening Organ Dysfunction With Vitamin C (LOVIT) randomized trial (clinicaltrials.
South Afr J Crit Care
May 2025
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Shock, characterised by circulatory hypoperfusion and cellular hypoxia, represents a critical medical condition requiring immediate attention. Despite its significance, there are limited data on shock incidence and outcomes, particularly within the context of Thailand.
Objectives: This retrospective observational study aimed to investigate the incidence, management and outcomes of shock patients admitted to the internal medicine department of Siriraj Hospital, a referral university hospital in Bangkok, Thailand.
Front Med (Lausanne)
August 2025
Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Background: In critically ill patients with septic shock, adequate oxygenation is crucial and hypoxia should be avoided. However, hyperoxia has been linked to the formation of reactive oxygen species, inflammation, and vasoconstriction, which could potentially harm critically ill intensive care patients. Therefore, this study aimed to examine the association between oxygen exposure and mortality and to define optimal oxygen target ranges for this specific group of patients.
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