ABSTRACT
Sepsis induces hepatic injury but whether alpha-2 adrenoceptor (α2-AR) modulates the severity of sepsis-induced liver damage remains unclear. The present study used lipopolysaccharide (LPS) to induce hepatic injury and applied α2-AR agonist dexmedetomidine (DEX) and/or antagonist yohimbine to investigate the contribution of α2-AR in LPS-induced liver injury. Our results showed that LPS resulted in histological and functional abnormality of liver tissue (ALT and AST transaminases, lactate), higher mortality, an increase in proinflammatory cytokines (IL-1ß, IL-6 & TNF-α), as well as a change in oxidative stress (MDA, SOD). Activation of α2-AR by dexmedetomidine (DEX) attenuated LPS-induced deleterious effects on the liver and block of α2-AR by yohimbine aggravated LPS-induced liver damage. Our data suggest that α2-AR plays an important role in sepsis-induced liver damage and activation of α2-AR with DEX could be a novel therapeutic avenue to protect the liver against sepsis-induced injury.
Subject(s)
Adrenergic alpha-2 Receptor Agonists/pharmacology , Chemical and Drug Induced Liver Injury/prevention & control , Dexmedetomidine/pharmacology , Lipopolysaccharides , Liver/drug effects , Receptors, Adrenergic, beta-2/drug effects , Adrenergic alpha-2 Receptor Antagonists/pharmacology , Alanine Transaminase/blood , Animals , Aspartate Aminotransferases/blood , Biomarkers/blood , Chemical and Drug Induced Liver Injury/blood , Chemical and Drug Induced Liver Injury/etiology , Chemical and Drug Induced Liver Injury/pathology , Cytoprotection , Disease Models, Animal , Interleukin-1beta/metabolism , Interleukin-6/metabolism , Lactic Acid/blood , Liver/metabolism , Liver/pathology , Male , Malondialdehyde/metabolism , Oxidative Stress/drug effects , Rats, Sprague-Dawley , Receptors, Adrenergic, beta-2/metabolism , Sepsis/chemically induced , Superoxide Dismutase/metabolism , Time Factors , Tumor Necrosis Factor-alpha/metabolism , Yohimbine/pharmacologyABSTRACT
BACKGROUND: Lifestyle modification is an integral component of cardiac secondary prevention, while it has been confirmed that myocardial infarction (MI) patients' health-related behaviors are heavily influenced by their illness perception. OBJECTIVES: To evaluate the effect of a telephone follow-up intervention for improving MI patients' illness perception and lifestyle. DESIGN: A randomized controlled trial, longitudinal research design was employed. SETTINGS: Cardiac care units in four major general hospitals in Guangzhou, China. PARTICIPANTS: Inclusion criteria were being diagnosed with an initial acute MI, being able to communicate orally in Mandarin or Cantonese and read in Chinese, and living in Guangzhou. Exclusion criteria were with continuing uncontrolled arrhythmias or heart failure, being illiteracy, or with a history of major psychiatric illness, exercise-induced asthma, uncontrolled diabetes, or evidence of dementia. METHOD: 124 patients admitted with the first acute MI were randomized to receive either routine care or routine care plus a telephone follow-up intervention, which consist of a pre-discharge education and three telephone follow-up instructions. Data were collected before discharge, at the 6th and the 12th week after discharge from hospital, respectively. RESULTS: At the 6th and the 12th week after discharge, patients in the intervention group had significantly positive perceptions about symptoms of MI (mean difference 3.27, 95% confidence interval 2.48-4.07, p<.001; mean difference 2.12, 95% confidence interval 1.34-2.89, p<.001 respectively) and how long their illness would last (mean difference -0.69, 95% confidence interval -0.91 to -0.47, p<.001; mean difference -0.74, 95% confidence interval -0.96 to -0.51, p<.001 respectively) compared with the control group. The intervention group also had more positive beliefs about the controllability (F=4.23, p=.04) and more improved beliefs about the causes of MI than the control group. Moreover, the intervention improved the patients' nutrition (F=5.16, p=.03) and physical activity at the 12-week follow-up (mean difference 0.37, 95% confidence interval 0.17-0.58, p<.001). CONCLUSION: This telephone follow-up intervention can result in improved illness perception and lifestyle after MI. It could be incorporated into current hospital treatment regimens for MI to improve patients' quality of life.
Subject(s)
Illness Behavior , Life Style , Myocardial Infarction/physiopathology , Telephone , Aged , China , Female , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: To explore illness perception (IP) and its predictors among Chinese patients with myocardial infarction (MI). METHODS: The revised Illness Perception Questionnaire (IPQ-R) was used in the present study. A cross-sectional, descriptive design was employed. The study was conducted in four major hospitals in Guangzhou (China) with a sample of 193 MI patients. Pearson's and Spearman's correlation, t test, one-way ANOVA, factor analysis and multiple linear regression were used. RESULTS: Among the 12 common symptoms of MI, on average only 3.37 were recognized by the subjects. Among the six factors of the cause dimension, "immune factors" received the highest score, followed by "gene and chance", "behavioral factors", "psychological factors", "environmental factors", and "physical factors". Subjects perceived MI as a chronic, cyclic illness with serious consequences that could be controlled through treatment, and believed that they had a negative affective response to MI. Furthermore, the dimensions of patients' IP were correlated, and illness-related factors and socio-demographic factors acted as predictors of IP. CONCLUSION: The IP of Chinese patients with MI needs to be improved. PRACTICE IMPLICATIONS: Based on our findings, effective interventions can be designed to promote MI patients' IP to facilitate their coping strategies after an episode of MI.
