Chronic Alcohol Ingestion Increases Mortality and Organ Injury in a Murine Model of Septic Peritonitis

• Type of Material: Article
• Authors: Benyam P. Yoseph, Emory University; Elise Breed, Emory University; Christian E. Overgaard, Emory University; Christina J. Ward, Emory University; Zhe Liang, Emory University; Maylene E. Wagener, Emory University; Daniel R. Lexcen, University of Minnesota; Elizabeth R. Lusczek, University of Minnesota; Greg J. Beilman, University of Minnesota; Eileen Burd, Emory University; Alton B Farris III, Emory University; David M Guidot, Emory University; Michael H Koval, Emory University; Mandy L Ford, Emory University; Craig Coopersmith, Emory University
• Language: English
• Date: 2013-05-22
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2013 Yoseph et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
• License: Creative Commons Attribution 2.5 Generic
• Final Published Version (URL): http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0062792
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 8
• Issue: 5
• Start Page: 1
• End Page: 14
• Grant/Funding Information: This research was supported by the United States National Institutes of Health: T32GM095442, R01GM072808, P50AA013757, R01AI073707, R01AA017627, R01HL083120, T32AA013528.
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Background Patients admitted to the intensive care unit with alcohol use disorders have increased morbidity and mortality. The purpose of this study was to determine how chronic alcohol ingestion alters the host response to sepsis in mice. Methods Mice were randomized to receive either alcohol or water for 12 weeks and then subjected to cecal ligation and puncture. Mice were sacrificed 24 hours post-operatively or followed seven days for survival. Results Septic alcohol-fed mice had a significantly higher mortality than septic water-fed mice (74% vs. 41%, p = 0.01). This was associated with worsened gut integrity in alcohol-fed mice with elevated intestinal epithelial apoptosis, decreased crypt proliferation and shortened villus length. Further, alcohol-fed mice had higher intestinal permeability with decreased ZO-1 and occludin protein expression in the intestinal tight junction. The frequency of splenic and bone marrow CD4+ T cells was similar between groups; however, splenic CD4+ T cells in septic alcohol-fed mice had a marked increase in both TNF and IFN-γ production following ex vivo stimulation. Neither the frequency nor function of CD8+ T cells differed between alcohol-fed and water-fed septic mice. NK cells were decreased in both the spleen and bone marrow of alcohol-fed septic mice. Pulmonary myeloperoxidase levels and BAL levels of G-CSF and TFG-β were higher in alcohol-fed mice. Pancreatic metabolomics demonstrated increased acetate, adenosine, xanthine, acetoacetate, 3-hydroxybutyrate and betaine in alcohol-fed mice and decreased cytidine, uracil, fumarate, creatine phosphate, creatine, and choline. Serum and peritoneal cytokines were generally similar between alcohol-fed and water-fed mice, and there were no differences in bacteremia, lung wet to dry weight, or pulmonary, liver or splenic histology. Conclusions When subjected to the same septic insult, mice with chronic alcohol ingestion have increased mortality. Alterations in intestinal integrity, the host immune response, and pancreatic metabolomics may help explain this differential response.