This work was supported by grants from the National Institutes of Health, National Institute of General Medical Science (R01GM063075) and the National Center of Complementary and Alternative Medicine (R01AT05076).

1. Establishment of Animal Model of Sepsis
<ol>
	<li>Mice are anesthetized with ketamine (75 mg/kg, intramuscular, i.m.) and xylazine (10 mg/kg, i.m.), and placed in supine position.</li>
	<li>Fix the feet of the mouse with tape to ensure a stable position.</li>
	<li>Clean the abdomen with 3 alternating scrubs of betadine or other skin disinfectant and alcohol. Then, make a 15 mm midline incision to expose the cecum.</li>
	<li>Ligate the cecum with a 4-0 silk suture at approximately 5.0 mm from the cecal tip, and then...

<ol>
	<li>Wichterman, K. A., Baue, A. E., Chaudry, I. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sepsis+and+septic+shock--a+review+of+laboratory+models+and+a+proposal.">Sepsis and septic shock--a review of laboratory models and a proposal.</a> J. Surg. Res. 29, 189-201 (1980).</li><li>Baker, C. C., Chaudry, I. H., Gaines, H. O., Baue, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+factors+affecting+mortality+rate+after+sepsis+in+a+murine+cecal+ligation+and+puncture+model.">Evaluation of factors affecting mortality rate after sepsis in a murine cecal ligation and puncture model.</a> Surgery. 94, 331-335 (1983).</li><li>Hubbard, W. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cecal+ligation+and+puncture.">Cecal ligation and puncture.</a> Shock. 24, 52-57 (2005).</li><li>Akira, S., Takeda, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Toll-like+receptor+signalling.">Toll-like receptor signalling.</a> Nat. Rev. Immunol. 4, 499-511 (2004).</li><li>Baggiolini, M., Loetscher, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chemokines+in+inflammation+and+immunity.">Chemokines in inflammation and immunity.</a> Immunol. Today. 21, 418-420 (2000).</li><li>Balkwill, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cytokines--soluble+factors+in+immune+responses.">Cytokines--soluble factors in immune responses.</a> Curr. Opin. Immunol. 1, 241-249 (1988).</li><li>Wang, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HMG-1+as+a+late+mediator+of+endotoxin+lethality+in+mice.">HMG-1 as a late mediator of endotoxin lethality in mice.</a> Science. 285, 248-251 (1999).</li><li>Yang, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reversing+established+sepsis+with+antagonists+of+endogenous+high-mobility+group+box+1.">Reversing established sepsis with antagonists of endogenous high-mobility group box 1.</a> Proc. Natl. Acad. Sci. U.S.A. 101, 296-301 (2004).</li><li>Qin, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+HMGB1+in+apoptosis-mediated+sepsis+lethality.">Role of HMGB1 in apoptosis-mediated sepsis lethality.</a> J. Exp. Med. 203, 1637-1642 (2006).</li><li>Ray, A., Dittel, B. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Isolation+of+Mouse+Peritoneal+Cavity+Cells.">Isolation of Mouse Peritoneal Cavity Cells.</a> J. Vis. Exp. (35), e1488 (2010).</li><li>Rendon-Mitchell, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=IFN-gamma+Induces+High+Mobility+Group+Box+1+Protein+Release+Partly+Through+a+TNF-Dependent+Mechanism.">IFN-gamma Induces High Mobility Group Box 1 Protein Release Partly Through a TNF-Dependent Mechanism.</a> J. Immunol. 170, 3890-3897 (2003).</li><li>Li, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Major+Ingredient+of+Green+Tea+Rescues+Mice+from+Lethal+Sepsis+Partly+by+Inhibiting+HMGB1.">A Major Ingredient of Green Tea Rescues Mice from Lethal Sepsis Partly by Inhibiting HMGB1.</a> PLoS ONE. 2, e1153 (2007).</li><li>Osuchowski, M. F., Welch, K., Siddiqui, J., Remick, D. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Circulating+cytokine/inhibitor+profiles+reshape+the+understanding+of+the+SIRS/CARS+continuum+in+sepsis+and+predict+mortality.">Circulating cytokine/inhibitor profiles reshape the understanding of the SIRS/CARS continuum in sepsis and predict mortality.</a> J. Immunol. 177, 1967-1974 (2006).</li><li>Heuer, J. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+protein+C+and+other+biomarkers+as+predictors+of+mortality+in+a+rat+cecal+ligation+and+puncture+model+of+sepsis.">Evaluation of protein C and other biomarkers as predictors of mortality in a rat cecal ligation and puncture model of sepsis.</a> Crit. Care. Med. 32, 1570-1578 (2004).</li><li>Bozza, F. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cytokine+profiles+as+markers+of+disease+severity+in+sepsis:+a+multiplex+analysis.">Cytokine profiles as markers of disease severity in sepsis: a multiplex analysis.</a> Crit. Care. 11, R49 (2007).</li><li>Li, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=EGCG+stimulates+autophagy+and+reduces+cytoplasmic+HMGB1+levels+in+endotoxin-stimulated+macrophages.">EGCG stimulates autophagy and reduces cytoplasmic HMGB1 levels in endotoxin-stimulated macrophages.</a> Biochem. Pharmacol. 81, 1152-1163 (2011).</li><li>Beutler, B., Milsark, I. W., Cerami, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Passive+immunization+against+cachectin/tumor+necrosis+factor+protects+mice+from+lethal+effect+of+endotoxin.">Passive immunization against cachectin/tumor necrosis factor protects mice from lethal effect of endotoxin.</a> Science. 229, 869-871 (1985).</li><li>Tracey, K. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anti-cachectin/TNF+monoclonal+antibodies+prevent+septic+shock+during+lethal+bacteraemia.">Anti-cachectin/TNF monoclonal antibodies prevent septic shock during lethal bacteraemia.</a> Nature. 330, 662-664 (1987).</li><li>Eskandari, M. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anti-tumor+necrosis+factor+antibody+therapy+fails+to+prevent+lethality+after+cecal+ligation+and+puncture+or+endotoxemia.">Anti-tumor necrosis factor antibody therapy fails to prevent lethality after cecal ligation and puncture or endotoxemia.</a> J. Immunol. 148, 2724-2730 (1992).</li><li>Ziegler, E. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+gram-negative+bacteremia+and+septic+shock+with+HA-1A+human+monoclonal+antibody+against+endotoxin.+A+randomized,+double-blind,+placebo-controlled+trial.+The+HA-1A+Sepsis+Study+Group.">Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. A randomized, double-blind, placebo-controlled trial. The HA-1A Sepsis Study Group.</a> N. Engl. J. Med. 324, 429-436 (1991).</li><li>Ziegler, E. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+gram-negative+bacteremia+and+shock+with+human+antiserum+to+a+mutant+Escherichia+coli.">Treatment of gram-negative bacteremia and shock with human antiserum to a mutant Escherichia coli.</a> N. Engl. J. Med. 307, 1225-1230 (1982).</li><li>Abraham, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+and+safety+of+monoclonal+antibody+to+human+tumor+necrosis+factor+alpha+in+patients+with+sepsis+syndrome.+A+randomized,+controlled,+double-blind,+multicenter+clinical+trial.+TNF-alpha+MAb+Sepsis+Study+Group.">Efficacy and safety of monoclonal antibody to human tumor necrosis factor alpha in patients with sepsis syndrome. A randomized, controlled, double-blind, multicenter clinical trial. TNF-alpha MAb Sepsis Study Group.</a> JAMA. 273, 934-941 (1995).</li><li>Cohen, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adjunctive+therapy+in+sepsis:+a+critical+analysis+of+the+clinical+trial+programme.">Adjunctive therapy in sepsis: a critical analysis of the clinical trial programme.</a> Br. Med. Bull. 55, 212-225 (1999).</li><li>Dellinger, R. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surviving+Sepsis+Campaign:+international+guidelines+for+management+of+severe+sepsis+and+septic+shock:+2008.">Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.</a> Crit. Care Med. 36, 296-327 (2008).</li><li>Wang, H., Zhu, S., Zhou, R., Li, W., Sama, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Therapeutic+potential+of+HMGB1-targeting+agents+in+sepsis.">Therapeutic potential of HMGB1-targeting agents in sepsis.</a> Expert. Rev. Mol. Med. 10, e32 (2008).</li><li>Wang, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+aqueous+extract+of+a+popular+herbal+nutrient+supplement,+Angelica+sinensis,+protects+mice+against+lethal+endotoxemia+and+sepsis.">The aqueous extract of a popular herbal nutrient supplement, Angelica sinensis, protects mice against lethal endotoxemia and sepsis.</a> J. Nutr. 136, 360-365 (2006).</li><li>Li, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+cardiovascular+drug+rescues+mice+from+lethal+sepsis+by+selectively+attenuating+a+late-acting+proinflammatory+mediator,+high+mobility+group+box+1.">A cardiovascular drug rescues mice from lethal sepsis by selectively attenuating a late-acting proinflammatory mediator, high mobility group box 1.</a> J. Immunol. 178, 3856-3864 (2007).</li><li>Fukuyama, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mixed+bacterial+infection+model+of+sepsis+in+rabbits+and+its+application+to+evaluate+superantigen-adsorbing+device.">Mixed bacterial infection model of sepsis in rabbits and its application to evaluate superantigen-adsorbing device.</a> Blood Purif. 23, 119-127 (2005).</li></ol>

In the laboratory, several animal models of sepsis have been employed to understand the pathogenesis of sepsis in order to develop potential novel therapies. Their clinical relevance remains a subject of debate before the successful translation of animal studies into clinical applications for sepsis. Although neutralizing antibodies against early cytokines (e.g., TNF) were protective in animal models of bacteremia/endotoxemia17,18, they actually worsen survival in animal model of sepsis19. Similarly...

<table border="1">
 <tbody>
 <tr>
 <td>Name of the reagent</td>
 <td>Company</td>
 <td>Catalogue number</td>
 </tr>
 <tr>
 <td>Betadine </td>
 <td>Purdue Products L.P.</td>
 <td>25655-41-8</td>
 </tr>
 <tr>
 <td>imipenem</td>
 <td>Merck &amp; Co., Inc.</td>
 <td>9882821</td>
 </tr>
 <tr>
 <td>Ketamine HCl</td>
 <td>Hospira Inc.</td>
 <td>RL-0065</td>
 </tr>
 <tr>
 <td>Xylazine</td>
 <td>Lloyd Laboratories</td>
 <td>4821</td>
 </tr>
 <tr>
 <td>Autoclip </td>
 <td>Becton Dickinson</td>
 <td>427631</td>
 </tr>
 <tr>
 <td>4-0 silk suture</td>
 <td>Roboz</td>
 <td>SUT-15-2</td>
 </tr>
 <tr>
 <td>Surflo I.V. Catheter</td>
 <td>Terumo</td>
 <td>SR*OX2419CA</td>
 </tr>
 <tr>
 <td>RayBio mouse cytokine antibody array</td>
 <td>RayBiotech, Inc.</td>
 <td>AAM-CYT-3</td>
 </tr>
 <tr>
 <td>Thioglycollate </td>
 <td>Becton Dickinson</td>
 <td>211716</td>
 </tr>
 </tbody>
</table>

use of animal model of sepsis to evaluate novel herbal therapies

Sepsis refers to a systemic inflammatory response syndrome resulting from a microbial infection. It has been routinely simulated in animals by several techniques, including infusion of exogenous bacterial toxin (endotoxemia) or bacteria (bacteremia), as well as surgical perforation of the cecum by cecal ligation and puncture (CLP)1-3. CLP allows bacteria spillage and fecal contamination of the peritoneal cavity, mimicking the human clinical disease of perforated appendicitis or diverticulitis. The severity of sepsis, as reflected by the eventual mortality rates, can be controlled surgically by varying the size of the needle used for cecal puncture2. In animals, CLP induces similar, biphasic hemodynamic cardiovascular, metabolic, and immunological responses as observed during the clinical course of human sepsis3. Thus, the CLP model is considered as one of the most clinically relevant models for experimental sepsis1-3.
Various animal models have been used to elucidate the intricate mechanisms underlying the pathogenesis of experimental sepsis. The lethal consequence of sepsis is attributable partly to an excessive accumulation of early cytokines (such as TNF, IL-1 and IFN-&gamma;)4-6 and late proinflammatory mediators (e.g., HMGB1)7. Compared with early proinflammatory cytokines, late-acting mediators have a wider therapeutic window for clinical applications. For instance, delayed administration of HMGB1-neutralizing antibodies beginning 24 hours after CLP, still rescued mice from lethality8,9, establishing HMGB1 as a late mediator of lethal sepsis. The discovery of HMGB1 as a late-acting mediator has initiated a new field of investigation for the development of sepsis therapies using Traditional Chinese Herbal Medicine. In this paper, we describe a procedure of CLP-induced sepsis, and its usage in screening herbal medicine for HMGB1-targeting therapies.

Watch this Scientific Journal Video about Use of Animal Model of Sepsis to Evaluate Novel Herbal Therapies at JoVE.com

Use of Animal Model of Sepsis to Evaluate Novel Herbal Therapies

Sepsis refers to a systemic inflammatory response syndrome resulting from a microbial infection, and can be simulated by a surgical technique termed cecal ligation and puncture (CLP). Here we describe a method to use CLP-induced animal model to screen medicinal herbs for therapeutic agents.

Sepsis refers to a systemic inflammatory response syndrome resulting from a microbial infection. It has been routinely simulated in animals by several ...

use-of-animal-model-of-sepsis-to-evaluate-novel-herbal-therapies

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JoVE Journal

Medicine

19.3K Görüntüleme.  North Shore – LIJ Health System. Sepsis bir mikrobik enfeksiyon sonucu ortaya çıkan bir sistemik inflamatuvar yanıt sendromu ifade eder ve çekal ligasyon ve delme (CLP) diye adlandırdıkları bir cerrahi teknik ile simüle edilebilir. Burada tedavi ajanları için şifalı otlar taranması amacıyla CLP bağlı hayvan modelinde kullanılacak bir yöntem açıklanmaktadır.