The impact of ulinastatin on lymphocyte apoptosis and autophagy in sepsis patients

• Published in: Scientific reports 2024-11, Vol.14 (1), p.28791-8, Article 28791
• Main Authors: Zhang, Dexin, Song, Juanjuan, Zhan, Jie, Wang, Yi, Deng, Junyi, Deng, Ying
• Format: Article
• Language: English
• Subjects: 692/4017; 692/699/255; Adult; Aged; Apoptosis; Apoptosis - drug effects; Autophagy; Autophagy - drug effects; BAX protein; Bcl-2 protein; C-reactive protein; Cardiac function; Creatinine; Enzymes; Female; Glycoproteins - pharmacology; Heart; Humanities and Social Sciences; Humans; Inflammation; Inflammatory response; Kidneys; Liver; Lymphocyte apoptosis; Lymphocytes; Lymphocytes - drug effects; Lymphocytes - metabolism; Male; Middle Aged; multidisciplinary; Patients; Peripheral blood; Procalcitonin; Science; Science (multidisciplinary); Sepsis; Sepsis - drug therapy; Transmission electron microscopy; Ulinastatin (UTI)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-79878-y

This study aimed to assess the influence of ulinastatin (UTI) on lymphocyte apoptosis and autophagy in sepsis patients, as well as its effect on inflammatory factors and vital organ function, with the goal of providing insights for improved clinical management of sepsis. A total of 40 sepsis patients were randomly assigned to the UTI group or the control group. The UTI group received standard treatment plus intravenous UTI, while the control group received standard treatment alone. Peripheral blood samples were collected at multiple time points for analysis of lymphocyte apoptosis, autophagy, inflammatory markers, and organ function. Various experimental techniques including Hoechst staining, transmission electron microscopy, and Western blot analysis were utilized to assess lymphocyte apoptosis, autophagy, and related protein expression levels. The study revealed that UTI treatment significantly inhibited lymphocyte apoptosis and promoted autophagy in sepsis patients. The levels of autophagy-related proteins LC3-II and Beclin-1 were substantially elevated, while the ratio of anti-apoptotic Bcl-2 to pro-apoptotic Bax was increased following UTI treatment. Furthermore, the levels of inflammatory markers IL-6, procalcitonin, and C-reactive protein were markedly reduced in the UTI group compared to the control group. Additionally, UTI treatment led to improved liver, kidney and cardiac function as evidenced by reduced levels of liver enzymes and creatinine, and cardiac enzymes. The findings of this study demonstrate that UTI exerts a protective effect on septic patients by inhibiting lymphocyte apoptosis, promoting autophagy, and attenuating systemic inflammation. Moreover, UTI treatment was associated with improved liver, kidney, and cardiac function in septic patients. These results contribute to a better understanding of the clinical management of sepsis and underscore the potential of UTI as a therapeutic intervention in septic patients.