Abstract

We investigated the impact of aerobic exercise (AE) on multiple organ dysfunction syndrome (MODS), aortic injury, pathoglycemia, and death during sepsis. ICR mice were randomized into four groups: Control (Con), Lipopolysaccharide (LPS), Exercise (Ex), and Exercise + LPS (Ex + LPS) groups. Mice were trained with low-intensity for 4 weeks. LPS and Ex + LPS mice received 5 mg/kg LPS intraperitoneally for induction of sepsis. Histopathological micrographs showed the organ morphology and damage. This study examined the effects of AE on LPS-induced changes in systemic inflammation, pulmonary inflammation, lung permeability, and bronchoalveolar lavage fluid (BALF) cell count, oxidative stress-related indicators in the lung, blood glucose levels, plasma lactate levels, serum insulin levels, plasma high-mobility group box 1 (HMGB1) levels, glucose transporter 1 (Glut1) and HMGB1, silent information regulator 1 (Sirt-1), and nuclear factor erythroid 2-related factor 2 (Nrf-2) mRNA expression levels in lung tissue. AE improved sepsis-associated multiple organ dysfunction syndrome (MODS), aortic injury, hypoglycemia, and death. AE prominently decreased pulmonary inflammation, pulmonary edema, and modulated redox balance during sepsis. AE prominently decreased neutrophil content in organ. AE prominently downregulated CXCL-1, CXCL-8, IL-6, TNF-α, Glu1, and HMGB1 mRNA expression but activated IL-1RN, IL-10, Sirt-1, and Nrf-2 mRNA expression in the lung during sepsis. AE decreased the serum levels of lactate and HMGB1 but increased blood glucose levels and serum insulin levels during sepsis. A 4-week AE improves sepsis-associated MODS, aortic injury, pathoglycemia, and death. AE impairs LPS-induced lactate and HMGB1 release partly because AE increases serum insulin levels and decreases the levels of Glut1. AE is a novel therapeutic strategy for sepsis targeting aerobic glycolysis.

Highlights

  • Abbreviations aerobic exercise (AE) Aerobic exercise acute lung injury (ALI) Acute lung injury BG Blood glucose bronchoalveolar lavage fluid (BALF) Bronchoalveolar lavage fluid CXCL C-X-C motif chemokine ligand high-mobility group box 1 (HMGB1) High Mobility Group Box 1 LPS Lipopolysaccharide MDA Malondialdehyde multiple organ dysfunction syndrome (MODS) Multiple organ dysfunction syndromes MPO Myeloperoxidase nuclear factor erythroid 2-related factor 2 (Nrf-2) Nuclear factor erythroid 2-related factor 2 Glu[1] Glucose transporter 1 GSH Glutathione silent information regulator 1 (Sirt-1) Silent information regulator 1 SOD Superoxide dismutase IL Interleukin TNF Tumor necrosis factor

  • A 4-week exercise pretreatment markedly upregulated serum insulin levels (P < 0.01) and blood glucose levels (P < 0.01) but markedly downregulated blood lactate levels (P < 0.05), serum HMGB1 levels (P < 0.05), and Glut (P < 0.001) and HMGB1 (P < 0.001) mRNA expression levels compared to LPS

  • There was convincing evidence that increased serum lactate levels were a biomarker of mortality and MODS during sepsis and lactate clearance was a novel therapeutic strategy for s­ epsis[23,24,25]

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Summary

Introduction

Abbreviations AE Aerobic exercise ALI Acute lung injury BG Blood glucose BALF Bronchoalveolar lavage fluid CXCL C-X-C motif chemokine ligand HMGB1 High Mobility Group Box 1 LPS Lipopolysaccharide MDA Malondialdehyde MODS Multiple organ dysfunction syndromes MPO Myeloperoxidase Nrf-2 Nuclear factor erythroid 2-related factor 2 Glu[1] Glucose transporter 1 GSH Glutathione Sirt-1 Silent information regulator 1 SOD Superoxide dismutase IL Interleukin TNF Tumor necrosis factor. Exercise reduced acute lung injury (ALI) in mice subjected to LPS-induced s­ epsis[17]. Increasing evidence has demonstrated that activated immune cells, including macrophages, neutrophils, and T cells, switched from oxidative phosphorylation to aerobic glycolysis in a manner similar to tumor ­cells[20]. This alteration may contribute to the regulation of innate immune functions and represent a novel target for inflammatory ­diseases[21]. LPS injection induced a switch from oxidative phosphorylation to aerobic glycolysis in the immune cells including dendritic cells and ­macrophages[22]. We attempted to demonstrate whether AE can impair LPS-induced lactate and HMGB1 release during sepsis

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