Caffeic acid phenethyl ester reduces mortality and sepsis-induced lung injury in rats

Objective: Sepsis and ensuing multiorgan failure continue to be the major causes of mortality in intensive care units. Nuclear factor (NF)-kappa B activation is supposed to be one of the targets in the treatment of sepsis. We studied the effectiveness of caffeic phenethyl ester (CAPE), a known NF-kappa B inhibitor, in cecal ligation and puncture (CLP)-induced sepsis and lung injury. Design: Randomized, controlled animal study. Setting: Research laboratory of an academic institution. Subjects: Female Sprague-Dawley rats. Interventions: CLP was performed in all rats except the rats in control and sham+CAPE groups. CAPE was administered to rats at the time of operation in sham+CAPE and CAPE+sepsis(0) groups. CAPE was administered to rats in the CAPE+sepsis(12) group 12 hrs after CLP. Eight rats from each group were killed 24 hrs after CLP. Blood was taken for assessment of interleukin-1, interleukin-6, interieukin-10, and tumor necrosis factor-alpha; the right lung was removed for histopathologic examination and the left lung for biochemical examination. Apoptosis, inducible nitric oxide synthase, heat shock protein 70, malondialdehyde, catalase, superoxide dismutase, and glutarthione peroxidase were studied. The rest of the rats were observed for mortality. Measurements and Main Results: Mortality was significantly decreased in groups that received CAPE compared with the sepsis group. All cytokine levels were similar to control levels only in the CAPE+sepsis(12), group. Apoptosis, inducible nitric oxide synthase, and heat shock protein 70 evaluation were significantly changed between all groups in the following order: control < sham+CAPE < CAPE+sepsis(12)< CAPE+sepsis(0) < sepsis. Malondialdehyde and catalase were increased in the sepsis group. Conclusions: CAPE reduced mortality in sepsis and improved histopathologic variables best when it was administered after the onset of sepsis.