Iodine Redistribution During Trauma, Sepsis, and Hibernation: An Evolutionarily Conserved Response to Severe Stress

• Published in: Critical Care Explorations
• Main Authors: Morrison, Michael L., Iwata, Akiko, Wick, Merry L., VandenEkart, Emily, Insko, Michael A., Henning, Daniel J., Frare, Carla, Rice, Sarah A., Drew, Kelly L., Maier, Ronald V., Roth, Mark B.
• Format: Text
• Language: English
• Published: Lippincott Williams & Wilkins 2020
• Subjects: Original Basic Science Report; Arctic
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531756/; https://doi.org/10.1097/CCE.0000000000000215

OBJECTIVE: We performed these studies to learn how iodine in the form of free iodide behaves during stress. DESIGN: Prospective observational trial using samples obtained from human trauma patients and retrospective observational study using remnant samples from human sepsis patients and arctic ground squirrels. Preclinical interventional study using hind-limb ischemia and reperfusion injury in mice. SETTING: Level I trauma center emergency room and ICU and animal research laboratories. SUBJECTS: Adult human sepsis and trauma patients, wild-caught adult arctic ground squirrels, and sexually mature laboratory mice. INTERVENTIONS: Ischemia and reperfusion injury was induced in mice by temporary application of tourniquet to one hind-limb. Iodide was administered IV just prior to reperfusion. MEASUREMENTS AND MAIN RESULTS: Free iodide was measured using ion chromatography. Relative to iodide in plasma from normal donors, iodide was increased 17-fold in plasma from trauma patients and 26-fold in plasma from sepsis patients. In arctic ground squirrels, iodide increases over three-fold during hibernation. And during ischemia/reperfusion injury in mice, iodide accumulates in ischemic tissue and reduces both local and systemic tissue damage. CONCLUSIONS: Iodide redistributes during stress and improves outcome after injury. Essential functions of iodide may have contributed to its evolutionary selection and be useful as a therapeutic intervention for human patients.