Thermoregulation and survival during sepsis: insights from the cecal ligation and puncture experimental model

Abstract

Abstract Background Sepsis remains a major global health concern due to its high prevalence and mortality. Changes in body temperature (Tb), such as hypothermia or fever, are diagnostic indicators and play a crucial role in the pathophysiology of sepsis. This study aims to characterize the thermoregulatory mechanisms during sepsis using the cecal ligation and puncture (CLP) model and explore how sepsis severity and ambient temperature (Ta) influence Tb regulation and mortality. Rats were subjected to mild or severe sepsis by CLP while housed at thermoneutral (28 °C) or subthermoneutral (22 °C) Ta, and their Tb was monitored for 12 h. Blood and hypothalamus were collected for cytokines and prostaglandin E2 (PGE2) analysis. Results At 28 °C, febrile response magnitude correlated with sepsis severity and inflammatory response, with tail vasoconstriction as the primary heat retention mechanism. At 22 °C, Tb was maintained during mild sepsis but dropped during severe sepsis, linked to reduced UCP1 expression in brown adipose tissue and less effective vasoconstriction. Despite differences in thermoregulatory responses, both Ta conditions induced a persistent inflammatory response and increased hypothalamic PGE2 production. Notably, mortality in severe sepsis was significantly higher at 28 °C (80%) compared to 22 °C (0%). Conclusions Our findings reveal that ambient temperature and the inflammatory burden critically influence thermoregulation and survival during early sepsis. These results emphasize the importance of considering environmental factors in preclinical sepsis studies. Although rodents in experimental settings are often adapted to cold environments, these conditions may not fully translate to human sepsis, where cold adaptation is rare. Thus, researchers should carefully consider these variables when designing experiments and interpreting translational implications. Graphical Abstract Graphical representation of the thermoregulatory and inflammatory responses to mild and severe sepsis in rats housed at thermoneutral (28 °C) and subthermoneutral (22 °C) ambient temperatures (Ta). The model highlights distinct body temperature outcomes: fever and hypothermia. At thermoneutral Ta, severe sepsis induces a high fever, associated with increased hypothalamic PGE2, cytokine levels, and mortality, while mild sepsis leads to a moderate fever. In contrast, at subthermoneutral Ta, severe sepsis results in hypothermia with decreased UCP1 expression and lower mortality, whereas mild sepsis maintains normal body temperature. The impact of Ta on sepsis severity, thermoregulatory mechanisms, and survival is emphasized.

Keywords

• Fever
• Hypothermia
• PGE2
• Cytokines
• Mortality
• Hypothalamus