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Payne GA, Sharma NS, Lal CV, Song C, Guo L, Margaroli C, Viera L, Kumar S, Li J, Xing D, Bosley M, Xu X, Wells JM, George JF, Tallaj J, Leesar M, Blalock JE, Gaggar A. Prolyl endopeptidase contributes to early neutrophilic inflammation in acute myocardial transplant rejection. JCI Insight 2021; 6:139687. [PMID: 33571164 PMCID: PMC8026194 DOI: 10.1172/jci.insight.139687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 02/04/2021] [Indexed: 11/21/2022] Open
Abstract
Altered inflammation and tissue remodeling are cardinal features of cardiovascular disease and cardiac transplant rejection. Neutrophils have increasingly been understood to play a critical role in acute rejection and early allograft failure; however, discrete mechanisms that drive this damage remain poorly understood. Herein, we demonstrate that early acute cardiac rejection increases allograft prolyl endopeptidase (PE) in association with de novo production of the neutrophil proinflammatory matrikine proline-glycine-proline (PGP). In a heterotopic murine heart transplant model, PGP production and PE activity were associated with early neutrophil allograft invasion and allograft failure. Pharmacologic inhibition of PE with Z-Pro-prolinal reduced PGP, attenuated early neutrophil graft invasion, and reduced proinflammatory cytokine expression. Importantly, these changes helped preserve allograft rejection-free survival and function. Notably, within 2 independent patient cohorts, both PGP and PE activity were increased among patients with biopsy-proven rejection. The observed induction of PE and matrikine generation provide a link between neutrophilic inflammation and cardiovascular injury, represent a potential target to reduce allogenic immune responses, and uncover a mechanism of cardiovascular disease that has been previously unrecognized to our knowledge.
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Affiliation(s)
- Gregory A Payne
- Division of Cardiovascular Disease, Department of Medicine.,Vascular Biology and Hypertension Program.,Comprehensive Cardiovascular Center, and.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, Alabama, USA
| | - Nirmal S Sharma
- Department of Internal Medicine, University of South Florida, Tampa, Florida, USA.,Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Charitharth V Lal
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Neonatology, Department of Pediatrics
| | - Chunyan Song
- Division of Cardiovascular Disease, Department of Medicine
| | - Lingling Guo
- Department of Surgery.,Nephrology Research & Training Center, Division of Nephrology, Department of Medicine
| | - Camilla Margaroli
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | - Liliana Viera
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and.,Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Siva Kumar
- Department of Internal Medicine, University of South Florida, Tampa, Florida, USA.,Tampa General Hospital, Tampa, Florida, USA
| | - Jindong Li
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | - Dongqi Xing
- Vascular Biology and Hypertension Program.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | | | - Xin Xu
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and
| | - J Michael Wells
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and.,Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James F George
- Department of Surgery.,Nephrology Research & Training Center, Division of Nephrology, Department of Medicine
| | - Jose Tallaj
- Division of Cardiovascular Disease, Department of Medicine.,Comprehensive Cardiovascular Center, and
| | - Massoud Leesar
- Division of Cardiovascular Disease, Department of Medicine.,Comprehensive Cardiovascular Center, and
| | - J Edwin Blalock
- Vascular Biology and Hypertension Program.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and.,Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amit Gaggar
- Vascular Biology and Hypertension Program.,Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, Alabama, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, and.,Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Fine N, Tasevski N, McCulloch CA, Tenenbaum HC, Glogauer M. The Neutrophil: Constant Defender and First Responder. Front Immunol 2020; 11:571085. [PMID: 33072112 PMCID: PMC7541934 DOI: 10.3389/fimmu.2020.571085] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/24/2020] [Indexed: 12/21/2022] Open
Abstract
The role of polymorphonuclear neutrophils (PMNs) in biology is often recognized during pathogenesis associated with PMN hyper- or hypo-functionality in various disease states. However, in the vast majority of cases, PMNs contribute to resilience and tissue homeostasis, with continuous PMN-mediated actions required for the maintenance of health, particularly in mucosal tissues. PMNs are extraordinarily well-adapted to respond to and diminish the damaging effects of a vast repertoire of infectious agents and injurious processes that are encountered throughout life. The commensal biofilm, a symbiotic polymicrobial ecosystem that lines the mucosal surfaces, is the first line of defense against pathogenic strains that might otherwise dominate, and is therefore of critical importance for health. PMNs regularly interact with the commensal flora at the mucosal tissues in health and limit their growth without developing an overt inflammatory reaction to them. These PMNs exhibit what is called a para-inflammatory phenotype, and have reduced inflammatory output. When biofilm growth and makeup are disrupted (i.e., dysbiosis), clinical symptoms associated with acute and chronic inflammatory responses to these changes may include pain, erythema and swelling. However, in most cases, these responses indicate that the immune system is functioning properly to re-establish homeostasis and protect the status quo. Defects in this healthy everyday function occur as a result of PMN subversion by pathological microbial strains, genetic defects or crosstalk with other chronic inflammatory conditions, including cancer and rheumatic disease, and this can provide some avenues for therapeutic targeting of PMN function. In other cases, targeting PMN functions could worsen the disease state. Certain PMN-mediated responses to pathogens, for example Neutrophil Extracellular Traps (NETs), might lead to undesirable symptoms such as pain or swelling and tissue damage/fibrosis. Despite collateral damage, these PMN responses limit pathogen dissemination and more severe damage that would otherwise occur. New data suggests the existence of unique PMN subsets, commonly associated with functional diversification in response to particular inflammatory challenges. PMN-directed therapeutic approaches depend on a greater understanding of this diversity. Here we outline the current understanding of PMNs in health and disease, with an emphasis on the positive manifestations of tissue and organ-protective PMN-mediated inflammation.
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Affiliation(s)
- Noah Fine
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Nikola Tasevski
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | | | - Howard C Tenenbaum
- Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Dental Oncology, Maxillofacial and Ocular Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada
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