• Patricia A Cristofaro, Steven M Opal, John E Palardy, Nicolas A Parejo, Jhung Jhung, James C Keith, and Heather A Harris.
• Infectious Disease Division, Memorial Hospital of Rhode Island, Brown Medical School, Providence, RI, USA.
• Crit. Care Med. 2006 Aug 1; 34 (8): 2188-93.

ObjectiveTo determine the effect of an estrogen receptor-beta selective agent in experimental models of systemic infection and sepsis.DesignWAY-202196, a nonsteroidal selective estrogen receptor-beta agonist, was tested in the murine listeriosis model, the neutropenic rat Pseudomonas aeruginosa infection, and the mouse cecal ligation and puncture sepsis models.SettingUniversity-affiliated biomedical research laboratory.SubjectsBALB/c mice and Sprague-Dawley rats.InterventionsWAY-202196 or control (vehicle) was administered orally in doses ranging from 1.5 to 50 mg/kg at various time points in the three experimental model systems.Measurements And Main ResultsSusceptibility of mice treated with a single oral dose of up to 50 mg/kg WAY-202196 did not differ from those treated with vehicle alone after systemic challenge by Listeria monocytogenes, suggesting a lack of generalized immunosuppression. In the neutropenic rat model, daily administration of WAY-202196 (50 mg/kg) significantly increased survival against an otherwise lethal challenge of P. aeruginosa 12.4.4 compared with the control group (83% vs. 25% survival; p < 0.05). Preservation of intestinal mucosal weight and prevention of histopathologic changes were also observed with the administration of WAY-202196. Similar results were obtained in a cecal ligation and puncture model, in which multiple oral doses of WAY-202196 (50 mg/kg) improved survival (83% vs. 0%; p < 0.05), preserved intestinal epithelial integrity, and significantly reduced systemic bacteremia and peritoneal interleukin-6 and tumor necrosis factor levels. The estrogen receptor-beta agonist provided a comparable level of protection in both male and female animals.ConclusionThese results indicate that oral administration of WAY-202196 preserved gastrointestinal barrier function and improved outcome in experimental models of systemic infection and inflammation. WAY-202196 and similar agents may prove useful clinically as a novel treatment strategy for the treatment or prevention of severe sepsis.

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