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Open Access 01-06-2010 | Research

Endotoxemia-induced inflammation and the effect on the human brain

Authors: Mark van den Boogaard, Bart P Ramakers, Nens van Alfen, Sieberen P van der Werf, Wilhelmina F Fick, Cornelia W Hoedemaekers, Marcel M Verbeek, Lisette Schoonhoven, Johannes G van der Hoeven, Peter Pickkers

Published in: Critical Care | Issue 3/2010

Abstract

Introduction

Effects of systemic inflammation on cerebral function are not clear, as both inflammation-induced encephalopathy as well as stress-hormone mediated alertness have been described.

Methods

Experimental endotoxemia (2 ng/kg Escherichia coli lipopolysaccharide [LPS]) was induced in 15 subjects, whereas 10 served as controls. Cytokines (TNF-α, IL-6, IL1-RA and IL-10), cortisol, brain specific proteins (BSP), electroencephalography (EEG) and cognitive function tests (CFTs) were determined.

Results

Following LPS infusion, circulating pro- and anti-inflammatory cytokines, and cortisol increased (P < 0.0001). BSP changes stayed within the normal range, in which neuron specific enolase (NSE) and S100-β changed significantly. Except in one subject with a mild encephalopathic episode, without cognitive dysfunction, endotoxemia induced no clinically relevant EEG changes. Quantitative EEG analysis showed a higher state of alertness detected by changes in the central region, and peak frequency in the occipital region. Improved CFTs during endotoxemia was found to be due to a practice effect as CFTs improved to the same extent in the reference group. Cortisol significantly correlated with a higher state of alertness detected on the EEG. Increased IL-10 and the decreased NSE both correlated with improvement of working memory and with psychomotor speed capacity. No other significant correlations between cytokines, cortisol, EEG, CFT and BSP were found.

Conclusions

Short-term systemic inflammation does not provoke or explain the occurrence of septic encephalopathy, but primarily results in an inflammation-mediated increase in cortisol and alertness.

Trial registration

NCT00513110.

Available only for authorised users

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Title: Endotoxemia-induced inflammation and the effect on the human brain
Authors: Mark van den Boogaard
Bart P Ramakers
Nens van Alfen
Sieberen P van der Werf
Wilhelmina F Fick
Cornelia W Hoedemaekers
Marcel M Verbeek
Lisette Schoonhoven
Johannes G van der Hoeven
Peter Pickkers
Publication date: 01-06-2010
Publisher: BioMed Central
Published in: Critical Care / Issue 3/2010
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc9001

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endotoxemia-induced inflammation and the effect on the human brain

Abstract

Introduction

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Trial registration

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