Clinical Trials Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2023; 29(35): 5154-5165
Published online Sep 21, 2023. doi: 10.3748/wjg.v29.i35.5154
Heparanase inhibition leads to improvement in patients with acute gastrointestinal injuries induced by sepsis
Ting-Ting Chen, Jia-Jun Lv, Ling Chen, Min Li, Li-Ping Liu
Ting-Ting Chen, Jia-Jun Lv, The First Clinical Medical School of Lanzhou University, Lanzhou University, Lanzhou 730000, Gansu Province, China
Ling Chen, Min Li, Li-Ping Liu, Department of Emergency Critical Care Medicine, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Author contributions: Chen TT collected the clinical data for data analysis and mapping and drafted the manuscript; Lv JJ collected the blood samples from the patients and performed the flow cytometry; Chen L collected blood from the patients and completed the enzyme-linked immunosorbent assays; Li M screened the research subjects and carried out clinical interventions; Liu LP participated in the experimental design, supervised the experimental process and reviewed the experimental results; and all the authors have read and approved the final manuscript.
Supported by the Science and Technology Department of Gansu Province, No. 20JR5RA35; Science and Technology Project of Gansu Province, No. 22JR10KA009; Talent Innovation and Entrepreneurship Project of Science and Technology Bureau of Chengguan District, Lanzhou, No. 2020RCCX0030; and Lanzhou Science and Technology Development Guiding Plan Project, No. 2019-ZD-37.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Clinical Research (drugs, devices) of The First Hospital of Lanzhou University.
Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry (https://www.chictr.org.cn/). The registration identification number is ChiCTR2300072241.
Informed consent statement: All study participants or their legal guardians agreed to be enrolled in the study and provided consent (written or oral).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: This study is registered at Chinese Clinical Trial Registry (https://www.chictr.org.cn/), and the data is shared on this platform.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Ping Liu, MD, PhD, Doctor, Department of Emergency Critical Care Medicine, The First Hospital of Lanzhou University, No. 1 West Road, Donggang, Chengguan District, Lanzhou 730000, Gansu Province, China. liulipingldyy@126.com
Received: July 5, 2023
Peer-review started: July 5, 2023
First decision: August 10, 2023
Revised: August 23, 2023
Accepted: September 5, 2023
Article in press: September 5, 2023
Published online: September 21, 2023
Processing time: 71 Days and 9.3 Hours
ARTICLE HIGHLIGHTS
Research background

Patients with sepsis are at high risk for acute gastrointestinal injury (AGI), heparanase (HPA) plays an important role in septic AGI (S-AGI), but its specific mechanism is not completely understood, and few clinical reports are available.

Research motivation

This study is to explore the effect and mechanism of HPA inhibition in S-AGI patients.

Research objectives

To prove the role of HPA in S-AGI and search for effective biomarkers and therapeutic targets for the diagnosis of S-AGI.

Research methods

The therapeutic effect of S-AGI patients in control group and low molecular weight heparin group was compared by a prospective double-blind randomized controlled trial. To evaluate the feasibility of HPA as a diagnostic biomarker for S-AGI.

Research results

HPA inhibitors can significantly improve AGI score, gastrointestinal function, coagulation function and immune function in S-AGI patients. The inhibitory effect of HPA in gastrointestinal protection may be achieved by enhanced autophagy.

Research conclusions

HPA has great potential as a diagnostic marker for S-AGI. Inhibition of HPA activity reduces syndecan-1 shedding and alleviates S-AGI symptoms. The inhibitory effect of HPA in gastrointestinal protection may be achieved by enhanced autophagy.

Research perspectives

HPA has great potential as a diagnostic biomarker for S-AGI, and its inhibitor is a good therapeutic drug choice in clinical practice.