Bosutinib reduces endothelial permeability and organ failure in a rat polytrauma transfusion model. (May 2021)

• Record Type: Journal Article
• Authors: Kleinveld, Derek J.B.; Botros, Liza; Maas, M. Adrie W.; Kers, Jesper; Aman, Jurjan; Hollmann, Markus W.; Juffermans, Nicole P.
• Is Part Of: British journal of anaesthesia. Volume 126:Number 5(2021)
• Page Start: 958
• Page End: 966
• Publication Date: 2021-05
• Subjects: bosutinib -- endothelial dysfunction -- shock -- transfusion -- trauma -- tyrosine kinase inhibitor; Anesthesiology -- Periodicals; Anesthesia -- Periodicals; 617.9605
• DOI: 10.1016/j.bja.2021.01.032
• Languages: English
• ISSNs: 0007-0912

Abstract

Abstract: Background: Trauma-induced shock is associated with endothelial dysfunction. We examined whether the tyrosine kinase inhibitor bosutinib as an adjunct therapy to a balanced blood component resuscitation strategy reduces trauma-induced endothelial permeability, thereby improving shock reversal and limiting transfusion requirements and organ failure in a rat polytrauma transfusion model. Methods: Male Sprague–Dawley rats ( n =13 per group) were traumatised and exsanguinated until a MAP of 40 mm Hg was reached, then randomised to two groups: red blood cells, plasma and platelets in a 1:1:1 ratio with either bosutinib or vehicle. Controls were randomised to sham (median laparotomy, no trauma) with bosutinib or vehicle. Organs were harvested for histology and wet/dry (W/D) weight ratio. Results: Traumatic injury resulted in shock, with higher lactate levels compared with controls. In trauma-induced shock, the resuscitation volume needed to obtain a MAP of 60 mm Hg was lower in bosutinib-treated animals (2.8 [2.7–3.2] ml kg −1 ) compared with vehicle (6.1 [5.1–7.2] ml kg −1, P <0.001). Lactate levels in the bosutinib group were 2.9 [1.7–4.8] mM compared with 6.2 [3.1–14.1] mM in the vehicle group ( P =0.06). Bosutinib compared with vehicle reduced lung vascular leakage (W/D ratio of 5.1 [4.6–5.3] vs 5.7 [5.4–6.0] ( P =0.046) and lung injury scores ( P =0.027). Conclusions: Bosutinib as an adjunct therapy to a balanced transfusion strategy reduced resuscitation volume, improved shock reversal, and reduced vascular leak and organ injury in a rat polytrauma model.