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Critical Care
Published in: Critical Care 5/2013

Open Access 01-10-2013 | Research

Critical illness induces nutrient-independent adipogenesis and accumulation of alternatively activated tissue macrophages

Authors: Mirna Bastos Marques, Sarah Vander Perre, Annelies Aertgeerts, Sarah Derde, Fabian Güiza, Michael P Casaer, Greet Hermans, Greet Van den Berghe, Lies Langouche

Published in: Critical Care | Issue 5/2013

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Abstract

Introduction

We previously reported that in artificially-fed critically ill patients, adipose tissue reveals an increase in small adipocytes and accumulation of M2-macrophages. We hypothesized that nutrient-independent factors of critical illness explain these findings, and that the M2-macrophage accumulation may not be limited to adipose tissue.

Methods

In a long-term cecal ligation and puncture (CLP) mouse model of sepsis, we compared the effect of parenteral nutrition (CLP-fed, n = 13) with nutrient restriction (CLP-restricted, n = 11) on body composition, adipocyte size and macrophage accumulation in adipose tissue, liver and lungs. Fed healthy mice (n = 11) were studied as controls. In a human study, in vivo adipose tissue biopsies were studied from ICU patients (n = 40) enrolled in a randomized control trial which compared early initiation of parenteral nutrition (PN) versus tolerating nutrient restriction during the first week of ICU stay. Adipose tissue morphology was compared with healthy human controls (n = 13).

Results

Irrespective of nutritional intake, critically ill mice lost weight, fat and fat-free mass. Adipocyte number, proliferation marker Proliferating Cell Nuclear Antigen (PCNA) and adipogenic markers PPARγ and CCAAT/enhancer binding protein-β (C/EBPβ) increased with illness, irrespective of nutritional intake. M2-macrophage accumulation was observed in adipose tissue, liver and lungs of critically ill mice. Macrophage M2-markers correlated with CCL2 expression. In adipose tissue biopsies of critically ill patients, increased adipogenic markers and M2 macrophage accumulation were present irrespective of nutritional intake.

Conclusions

Adipogenesis and accumulation of tissue M2-macrophages are hallmarks of prolonged critical illness, irrespective of nutritional management. During critical illness, M2-macrophages accumulate not only in adipose tissue, but also in the liver and lungs.
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Metadata
Title
Critical illness induces nutrient-independent adipogenesis and accumulation of alternatively activated tissue macrophages
Authors
Mirna Bastos Marques
Sarah Vander Perre
Annelies Aertgeerts
Sarah Derde
Fabian Güiza
Michael P Casaer
Greet Hermans
Greet Van den Berghe
Lies Langouche
Publication date
01-10-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc12887

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