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  1. Article ; Online: Acute and Chronic Kidney Disease Worsen Outcomes in Experimental Sepsis.

    Floyd, Deana F / Colbert, James F / Feng, Frances / Furgeson, Seth B / Montford, John R

    Kidney360

    2024  

    Abstract: Background: Infection is a leading cause of morbidity in individuals with acute and chronic kidney disease (AKD, CKD). However, there is significant difficulty in modeling infection into an animal host with preexisting kidney disease. We report a novel ... ...

    Abstract Background: Infection is a leading cause of morbidity in individuals with acute and chronic kidney disease (AKD, CKD). However, there is significant difficulty in modeling infection into an animal host with preexisting kidney disease. We report a novel method of peritoneal infection induced via cecal slurry inoculation deployed into mice with experimental aristolochic acid-induced AKD and CKD.
    Methods: AKD, CKD, and paired control mice were injected with sham, low, or higher doses of donor-recipient matched cecal slurry solution. Animal survival, sepsis severity, and change in glomerular filtration rate was tracked longitudinally throughout the study. Histology for kidney injury, flow cytometry, plasma cytokines, and evidence of indirect organ injury from sepsis were also assessed.
    Results: Infected AKD mice experienced significantly heightened sepsis severity, with 100% mortality by 24 hours after high cecal slurry doses versus no mortality in control mice. Additionally, AKD mice receiving lower cecal slurry doses developed dramatically increased pro-inflammatory cytokines and persistent cytopenias. Infected CKD mice also had worse outcomes than paired CKD-controls, though less severe than in AKD mice. Interestingly, animals with AKD had worse outcomes than mice with CKD after any cecal slurry dose or time-point after inoculation, despite higher baseline kidney function and less uremic sequela.
    Conclusions: These data confirm that acute bacterial infection can be modeled in animals with established kidney disease; and suggest that the clinical state of kidney disease (AKD versus CKD) may influence host susceptibility to infection more than the degree of kidney failure alone.
    Language English
    Publishing date 2024-02-14
    Publishing country United States
    Document type Journal Article
    ISSN 2641-7650
    ISSN (online) 2641-7650
    DOI 10.34067/KID.0000000000000391
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Endothelial and Microcirculatory Function and Dysfunction in Sepsis.

    Colbert, James F / Schmidt, Eric P

    Clinics in chest medicine

    2016  Volume 37, Issue 2, Page(s) 263–275

    Abstract: The microcirculation is a series of arterioles, capillaries, and venules that performs essential functions of oxygen and nutrient delivery, customized to the unique physiologic needs of the supplied organ. The homeostatic microcirculatory response to ... ...

    Abstract The microcirculation is a series of arterioles, capillaries, and venules that performs essential functions of oxygen and nutrient delivery, customized to the unique physiologic needs of the supplied organ. The homeostatic microcirculatory response to infection can become harmful if overactive and/or dysregulated. Pathologic microcirculatory dysfunction can be directly visualized by intravital microscopy or indirectly measured via detection of circulating biomarkers. Although several treatments have been shown to protect the microcirculation during sepsis, they have not improved patient outcomes when applied indiscriminately. Future outcomes-oriented studies are needed to test sepsis therapeutics when personalized to a patient's microcirculatory dysfunction.
    MeSH term(s) Animals ; Endothelium/physiopathology ; Glycosaminoglycans/therapeutic use ; Humans ; Intravital Microscopy/methods ; Microcirculation ; Sepsis/physiopathology
    Chemical Substances Glycosaminoglycans
    Language English
    Publishing date 2016
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 447455-7
    ISSN 1557-8216 ; 0272-5231
    ISSN (online) 1557-8216
    ISSN 0272-5231
    DOI 10.1016/j.ccm.2016.01.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Hepcidin Removal during Continuous Renal Replacement Therapy.

    Colbert, James F / Griffin, Benjamin R / Rolloff, Kristy / Erzen, Christopher L / Haeger, Sarah M / Altmann, Chris / Okamura, Kayo / Campbell, Ruth / Teitelbaum, Isaac / Faubel, Sarah

    Blood purification

    2023  Volume 53, Issue 1, Page(s) 23–29

    Abstract: Introduction: Patients with acute kidney injury (AKI) or end stage kidney disease (ESKD) may require continuous renal replacement therapy (CRRT) as a supportive intervention. While CRRT is effective at achieving solute control and fluid balance, the ... ...

    Abstract Introduction: Patients with acute kidney injury (AKI) or end stage kidney disease (ESKD) may require continuous renal replacement therapy (CRRT) as a supportive intervention. While CRRT is effective at achieving solute control and fluid balance, the indiscriminate nature of this procedure raises the possibility that beneficial substances may similarly be removed. Hepcidin, an antimicrobial peptide with pivotal roles in iron homeostasis and pathogen clearance, has biochemical properties amenable to direct removal via CRRT. We hypothesized that serum hepcidin levels would significantly decrease after initiation of CRRT.
    Methods: In this prospective, observational trial, we enrolled 13 patients who required CRRT: 11 due to stage 3 AKI, and 2 due to critical illness in the setting of ESKD. Plasma was collected at the time of enrollment, and then plasma and effluent were collected at 10:00 a.m. on the following 3 days. Plasma samples were also collected from healthy controls, and we compared hepcidin concentrations in those with renal disease compared to normal controls, evaluated trends in hepcidin levels over time, and calculated the hepcidin sieving coefficient.
    Results: Plasma hepcidin levels were significantly higher in patients initiating CRRT than in normal controls (158 ± 60 vs. 17 ± 3 ng/mL respectively, p < 0.001). Hepcidin levels were highest prior to CRRT initiation (158 ± 60 ng/mL), and were significantly lower on day 1 (102 ± 24 ng/mL, p < 0.001) and day 2 (56 ± 14 ng/mL, p < 0.001) before leveling out on day 3 (51 ± 11 ng/mL). The median sieving coefficient was consistent at 0.82-0.83 for each of 3 days.
    Conclusions: CRRT initiation is associated with significant decreases in plasma hepcidin levels over the first 2 days of treatment regardless of indication for CRRT, or presence of underlying ESKD. Since reduced hepcidin levels are associated with increased mortality and our data implicate CRRT in hepcidin removal, larger clinical studies evaluating relevant clinical outcomes based on hepcidin trends in this population should be pursued.
    MeSH term(s) Humans ; Continuous Renal Replacement Therapy ; Renal Replacement Therapy/methods ; Prospective Studies ; Hepcidins ; Acute Kidney Injury ; Retrospective Studies ; Critical Illness/therapy
    Chemical Substances Hepcidins
    Language English
    Publishing date 2023-11-03
    Publishing country Switzerland
    Document type Observational Study ; Journal Article
    ZDB-ID 605548-5
    ISSN 1421-9735 ; 0253-5068
    ISSN (online) 1421-9735
    ISSN 0253-5068
    DOI 10.1159/000534297
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Announcing a New JAMA Internal Medicine Website.

    Colbert, James A / Steinbrook, Robert / Redberg, Rita F

    JAMA internal medicine

    2016  Volume 176, Issue 12, Page(s) 1749

    MeSH term(s) Humans ; Internal Medicine ; Internet ; Periodicals as Topic ; Publishing
    Language English
    Publishing date 2016-09-30
    Publishing country United States
    Document type Editorial
    ZDB-ID 2699338-7
    ISSN 2168-6114 ; 2168-6106
    ISSN (online) 2168-6114
    ISSN 2168-6106
    DOI 10.1001/jamainternmed.2016.6676
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Bacterial pneumonia-induced shedding of epithelial heparan sulfate inhibits the bactericidal activity of cathelicidin in a murine model.

    Zehr, Evan P / Erzen, Christopher L / Oshima, Kaori / Langouet-Astrie, Christophe J / LaRiviere, Wells B / Shi, Deling / Zhang, Fuming / McCollister, Bruce D / Windham, Samuel L / Rizzo, Alicia N / Bastarache, Julie A / Horswill, Alexander R / Schmidt, Eric P / Kwiecinski, Jakub M / Colbert, James F

    American journal of physiology. Lung cellular and molecular physiology

    2023  Volume 326, Issue 2, Page(s) L206–L212

    Abstract: Bacterial pneumonia is a common clinical syndrome leading to significant morbidity and mortality worldwide. In the current study, we investigate a novel, multidirectional relationship between the pulmonary epithelial glycocalyx and antimicrobial peptides ...

    Abstract Bacterial pneumonia is a common clinical syndrome leading to significant morbidity and mortality worldwide. In the current study, we investigate a novel, multidirectional relationship between the pulmonary epithelial glycocalyx and antimicrobial peptides in the setting of methicillin-resistant
    MeSH term(s) Mice ; Humans ; Animals ; Cathelicidins/pharmacology ; Cathelicidins/therapeutic use ; Methicillin-Resistant Staphylococcus aureus ; Antimicrobial Cationic Peptides ; Disease Models, Animal ; Pneumonia, Bacterial/drug therapy ; Heparitin Sulfate ; Oligosaccharides/therapeutic use ; Anti-Bacterial Agents
    Chemical Substances Cathelicidins ; Antimicrobial Cationic Peptides ; Heparitin Sulfate (9050-30-0) ; Oligosaccharides ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-12-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1013184-x
    ISSN 1522-1504 ; 1040-0605
    ISSN (online) 1522-1504
    ISSN 1040-0605
    DOI 10.1152/ajplung.00178.2023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Severe Sepsis Outcomes Among Hospitalizations With Inflammatory Bowel Disease.

    Colbert, James F / Schmidt, Eric P / Faubel, Sarah / Ginde, Adit A

    Shock (Augusta, Ga.)

    2017  Volume 47, Issue 2, Page(s) 128–131

    Abstract: Background: Patients with inflammatory bowel disease have a unique inflammatory response to infection given the pathogenesis of these diseases and the common use of immunosuppressive therapy.: Aims: The goal of this study is to determine severe ... ...

    Abstract Background: Patients with inflammatory bowel disease have a unique inflammatory response to infection given the pathogenesis of these diseases and the common use of immunosuppressive therapy.
    Aims: The goal of this study is to determine severe sepsis outcomes in a subgroup of visits with the comorbidities of inflammatory bowel disease.
    Methods: The 2012 National Inpatient Sample database was used to identify patients with explicitly coded diagnoses of severe sepsis or septic shock. Visits with chronic inflammatory bowel disease and other inflammatory diagnoses were identified using ICD-9 codes. Sepsis outcomes of interest were identified using ICD-9 codes.
    Results: There were 92,296 visits for severe sepsis or septic shock in the analysis. In the control group, the in-hospital mortality rate was 26.5%. Ulcerative colitis visits had a higher mortality rate (34.9%) while Crohn disease visits had lower mortality (19.6%). After adjusting for potential confounders, ulcerative colitis was independently associated with higher mortality (odds ratio [OR] 1.61, 95% CI 1.35-1.93). Conversely, Crohn disease was independently associated with lower mortality (OR 0.78, 95% CI 0.63-0.97).
    Conclusions: Sepsis visits with Crohn disease had improved outcomes compared with the control group. Conversely, visits with ulcerative colitis had markedly worsened sepsis-related outcomes. Further investigation is needed to determine the mechanisms underlying these clinical differences.
    Language English
    Publishing date 2017-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1185432-7
    ISSN 1540-0514 ; 1073-2322
    ISSN (online) 1540-0514
    ISSN 1073-2322
    DOI 10.1097/SHK.0000000000000742
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Identification of immunodominant T cell epitopes induced by natural Zika virus infection.

    Eickhoff, Christopher S / Meza, Krystal A / Terry, Frances E / Colbert, Chase G / Blazevic, Azra / Gutiérrez, Andres H / Stone, E Taylor / Brien, James D / Pinto, Amelia K / El Sahly, Hana M / Mulligan, Mark J / Rouphael, Nadine / Alcaide, Maria L / Tomashek, Kay M / Focht, Chris / Martin, William D / Moise, Leonard / De Groot, Anne S / Hoft, Daniel F

    Frontiers in immunology

    2023  Volume 14, Page(s) 1247876

    Abstract: Zika virus (ZIKV) is a flavivirus primarily transmitted ... ...

    Abstract Zika virus (ZIKV) is a flavivirus primarily transmitted by
    MeSH term(s) Adult ; Animals ; Female ; Pregnancy ; Humans ; Zika Virus Infection ; Zika Virus ; Epitopes, T-Lymphocyte ; Genes, MHC Class I ; Aedes
    Chemical Substances Epitopes, T-Lymphocyte
    Language English
    Publishing date 2023-08-29
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2023.1247876
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  8. Article ; Online: Heparin as a therapy for COVID-19: current evidence and future possibilities.

    Hippensteel, Joseph A / LaRiviere, Wells B / Colbert, James F / Langouët-Astrié, Christophe J / Schmidt, Eric P

    American journal of physiology. Lung cellular and molecular physiology

    2020  Volume 319, Issue 2, Page(s) L211–L217

    Abstract: Coronavirus disease 2019 (COVID-19), the clinical syndrome associated with infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has impacted nearly every country in the world. Despite an unprecedented focus of scientific ... ...

    Abstract Coronavirus disease 2019 (COVID-19), the clinical syndrome associated with infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has impacted nearly every country in the world. Despite an unprecedented focus of scientific investigation, there is a paucity of evidence-based pharmacotherapies against this disease. Because of this lack of data-driven treatment strategies, broad variations in practice patterns have emerged. Observed hypercoagulability in patients with COVID-19 has created debate within the critical care community on the therapeutic utility of heparin. We seek to provide an overview of the data supporting the therapeutic use of heparin, both unfractionated and low molecular weight, as an anticoagulant for the treatment of SARS-CoV-2 infection. Additionally, we review preclinical evidence establishing biological plausibility for heparin and synthetic heparin-like drugs as therapies for COVID-19 through antiviral and anti-inflammatory effects. Finally, we discuss known adverse effects and theoretical off-target effects that may temper enthusiasm for the adoption of heparin as a therapy in COVID-19 without confirmatory prospective randomized controlled trials. Despite previous failures of anticoagulants in critical illness, plausibility of heparin for COVID-19 is sufficiently robust to justify urgent randomized controlled trials to determine the safety and effectiveness of this therapy.
    MeSH term(s) Anticoagulants/therapeutic use ; Antiviral Agents/therapeutic use ; Betacoronavirus/drug effects ; Blood Coagulation Disorders/drug therapy ; Blood Coagulation Disorders/epidemiology ; Blood Coagulation Disorders/virology ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/drug therapy ; Coronavirus Infections/transmission ; Coronavirus Infections/virology ; Heparin/therapeutic use ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/transmission ; Pneumonia, Viral/virology ; SARS-CoV-2 ; COVID-19 Drug Treatment
    Chemical Substances Anticoagulants ; Antiviral Agents ; Heparin (9005-49-6)
    Keywords covid19
    Language English
    Publishing date 2020-06-10
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 1013184-x
    ISSN 1522-1504 ; 1040-0605
    ISSN (online) 1522-1504
    ISSN 1040-0605
    DOI 10.1152/ajplung.00199.2020
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  9. Article: Aging-associated augmentation of gut microbiome virulence capability drives sepsis severity.

    Colbert, James F / Kirsch, Joshua M / Erzen, Christopher L / Langouët-Astrié, Christophe J / Thompson, Grace E / McMurtry, Sarah A / Kofonow, Jennifer M / Robertson, Charles E / Kovacs, Elizabeth J / Sullivan, Ryan C / Hippensteel, Joseph A / Sawant, Namrata V / De Nisco, Nicole J / McCollister, Bruce D / Schwartz, Robert S / Horswill, Alexander R / Frank, Daniel N / Duerkop, Breck A / Schmidt, Eric P

    bioRxiv : the preprint server for biology

    2023  

    Abstract: Prior research has focused on host factors as mediators of exaggerated sepsis-associated morbidity and mortality in older adults. This focus on the host, however, has failed to identify therapies that improve sepsis outcomes in the elderly. We ... ...

    Abstract Prior research has focused on host factors as mediators of exaggerated sepsis-associated morbidity and mortality in older adults. This focus on the host, however, has failed to identify therapies that improve sepsis outcomes in the elderly. We hypothesized that the increased susceptibility of the aging population to sepsis is not only a function of the host, but also reflects longevity-associated changes in the virulence of gut pathobionts. We utilized two complementary models of gut microbiota-induced experimental sepsis to establish the aged gut microbiome as a key pathophysiologic driver of heightened disease severity. Further murine and human investigations into these polymicrobial bacterial communities demonstrated that age was associated with only subtle shifts in ecological composition, but an overabundance of genomic virulence factors that have functional consequence on host immune evasion.
    One sentence summary: The severity of sepsis in the aged host is in part mediated by longevity-associated increases in gut microbial virulence.
    Language English
    Publishing date 2023-01-11
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2023.01.10.523523
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Aging-Associated Augmentation of Gut Microbiome Virulence Capability Drives Sepsis Severity.

    Colbert, James F / Kirsch, Joshua M / Erzen, Christopher L / Langouët-Astrié, Christophe J / Thompson, Grace E / McMurtry, Sarah A / Kofonow, Jennifer M / Robertson, Charles E / Kovacs, Elizabeth J / Sullivan, Ryan C / Hippensteel, Joseph A / Sawant, Namrata V / De Nisco, Nicole J / McCollister, Bruce D / Schwartz, Robert S / Horswill, Alexander R / Frank, Daniel N / Duerkop, Breck A / Schmidt, Eric P

    mBio

    2023  Volume 14, Issue 3, Page(s) e0005223

    Abstract: Prior research has focused on host factors as mediators of exaggerated sepsis-associated morbidity and mortality in older adults. This focus on the host, however, has failed to identify therapies that improve sepsis outcomes in the elderly. We ... ...

    Abstract Prior research has focused on host factors as mediators of exaggerated sepsis-associated morbidity and mortality in older adults. This focus on the host, however, has failed to identify therapies that improve sepsis outcomes in the elderly. We hypothesized that the increased susceptibility of the aging population to sepsis is not only a function of the host but also reflects longevity-associated changes in the virulence of gut pathobionts. We utilized two complementary models of gut microbiota-induced experimental sepsis to establish the aged gut microbiome as a key pathophysiologic driver of heightened disease severity. Further murine and human investigations into these polymicrobial bacterial communities demonstrated that age was associated with only subtle shifts in ecological composition but also an overabundance of genomic virulence factors that have functional consequence on host immune evasion.
    MeSH term(s) Humans ; Animals ; Mice ; Aged ; Gastrointestinal Microbiome/physiology ; Virulence ; Bacteria/genetics ; Aging ; Sepsis/microbiology
    Language English
    Publishing date 2023-04-27
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2557172-2
    ISSN 2150-7511 ; 2161-2129
    ISSN (online) 2150-7511
    ISSN 2161-2129
    DOI 10.1128/mbio.00052-23
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