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Kim J, Kim JH, Kim Y, Lee J, Lee HJ, Koh SJ, Im JP, Kim JS. iRhom2 deficiency reduces sepsis-induced mortality associated with the attenuation of lung macrophages in mice. Histochem Cell Biol 2024; 162:415-428. [PMID: 39134731 PMCID: PMC11393161 DOI: 10.1007/s00418-024-02318-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2024] [Indexed: 09/13/2024]
Abstract
Sepsis has a high mortality rate and leads to multi-organ failure, including lung injury. Inactive rhomboid protease family protein (iRhom2) has been identified as accountable for the release of TNF-α, a crucial mediator in the development of sepsis. This study aimed to evaluate the role of iRhom2 in sepsis and sepsis-induced acute lung injury (ALI). TNF-α and IL-6 secretion in vitro by peritoneal macrophages from wild-type (WT) and iRhom2 knoukout (KO) mice was assessed by enzyme-linked immunosorbent assay. Cecal ligation and puncture (CLP)-induced murine sepsis model was used for in vivo experiments. To evaluate the role of iRhom2 deficiency on survival during sepsis, both WT and iRhom2 KO mice were monitored for 8 consecutive days following the CLP. For histologic and biochemical examination, the mice were killed 18 h after CLP. iRhom2 deficiency improved the survival of mice after CLP. iRhom2 deficiency decreased CD68+ macrophage infiltration in lung tissues. Multiplex immunohistochemistry revealed that the proportion of Ki-67+ CD68+ macrophages was significantly lower in iRhom2 KO mice than that in WT mice after CLP. Moreover, CLP-induced release of TNF-α and IL-6 in the serum were significantly inhibited by iRhom2 deficiency. iRhom2 deficiency reduced NF-kB p65 and IκBα phosphorylation after CLP. iRhom2 deficiency reduces sepsis-related mortality associated with attenuated macrophage infiltration and proliferation in early lung injury. iRhom2 may play a pivotal role in the pathogenesis of sepsis and early stage of sepsis-induced ALI. Thus, iRhom2 may be a potential therapeutic target for the management of sepsis and sepsis-induced ALI.
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Affiliation(s)
- Jihye Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 03080, South Korea
- Center for Health Promotion and Optimal Aging, Seoul National University Hospital, Seoul, South Korea
| | - Jee Hyun Kim
- Department of Gastroenterology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Younghoon Kim
- Department of Pathology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jooyoung Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 03080, South Korea
| | - Hyun Jung Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 03080, South Korea
| | - Seong-Joon Koh
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 03080, South Korea
| | - Jong Pil Im
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 03080, South Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 03080, South Korea.
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Stoiber A, Hermann A, Wanka ST, Heinz G, Speidl WS, Hengstenberg C, Schellongowski P, Staudinger T, Zilberszac R. Enhancing SAPS-3 Predictive Accuracy with Initial, Peak, and Last Lactate Measurements in Septic Shock. J Clin Med 2024; 13:3505. [PMID: 38930034 PMCID: PMC11204458 DOI: 10.3390/jcm13123505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/09/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Background/Objectives: Septic shock is a severe condition with high mortality necessitating precise prognostic tools for improved patient outcomes. This study aimed to evaluate the collective predictive value of the Simplified Acute Physiology Score 3 (SAPS-3) and lactate measurements (initial, peak, last, and clearance rates within the first 24 h) in patients with septic shock. Specifically, it sought to determine how these markers enhance predictive accuracy for 28-day mortality beyond SAPS-3 alone. Methods: This retrospective cohort study analyzed data from 66 septic shock patients at two ICUs of Vienna General Hospital (2017-2019). SAPS-3 and lactate levels (initial, peak, last measurement within 24 h, and 24 h clearance) were obtained from electronic health records. Logistic regression models were constructed to identify predictors of 28-day mortality, and receiver operating characteristic (ROC) curves assessed predictive accuracy. Results: Among 66 patients, 36 (55%) died within 28 days. SAPS-3 scores significantly differed between survivors and non-survivors (76 vs. 85 points; p = 0.016). First, last, and peak lactate were significantly higher in non-survivors compared to survivors (all p < 0.001). The combination of SAPS-3 and first lactate produced the highest predictive accuracy (AUC = 80.6%). However, 24 h lactate clearance was not predictive of mortality. Conclusions: Integrating SAPS-3 with lactate measurements, particularly first lactate, improves predictive accuracy for 28-day mortality in septic shock patients. First lactate serves as an early, robust prognostic marker, providing crucial information for clinical decision-making and care prioritization. Further large-scale studies are needed to refine these predictive tools and validate their efficacy in guiding treatment strategies.
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Affiliation(s)
- Arthur Stoiber
- Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Alexander Hermann
- Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Sophie-Theres Wanka
- Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Gottfried Heinz
- Department of Cardiology, Medical University of Vienna, 1090 Vienna, Austria
| | - Walter S. Speidl
- Department of Cardiology, Medical University of Vienna, 1090 Vienna, Austria
| | | | | | - Thomas Staudinger
- Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Robert Zilberszac
- Department of Cardiology, Medical University of Vienna, 1090 Vienna, Austria
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Leduc-Gaudet JP, Miguez K, Cefis M, Faitg J, Moamer A, Chaffer TJ, Reynaud O, Broering FE, Shams A, Mayaki D, Huck L, Sandri M, Gouspillou G, Hussain SN. Autophagy ablation in skeletal muscles worsens sepsis-induced muscle wasting, impairs whole-body metabolism, and decreases survival. iScience 2023; 26:107475. [PMID: 37588163 PMCID: PMC10425945 DOI: 10.1016/j.isci.2023.107475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 05/18/2023] [Accepted: 07/21/2023] [Indexed: 08/18/2023] Open
Abstract
Septic patients frequently develop skeletal muscle wasting and weakness, resulting in severe clinical consequences and adverse outcomes. Sepsis triggers sustained induction of autophagy, a key cellular degradative pathway, in skeletal muscles. However, the impact of enhanced autophagy on sepsis-induced muscle dysfunction remains unclear. Using an inducible and muscle-specific Atg7 knockout mouse model (Atg7iSkM-KO), we investigated the functional importance of skeletal muscle autophagy in sepsis using the cecal ligation and puncture model. Atg7iSkM-KO mice exhibited a more severe phenotype in response to sepsis, marked by severe muscle wasting, hypoglycemia, higher ketone levels, and a decreased in survival as compared to mice with intact Atg7. Sepsis and Atg7 deletion resulted in the accumulation of mitochondrial dysfunction, although sepsis did not further worsen mitochondrial dysfunction in Atg7iSkM-KO mice. Overall, our study demonstrates that autophagy inactivation in skeletal muscles triggers significant worsening of sepsis-induced muscle and metabolic dysfunctions and negatively impacts survival.
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Affiliation(s)
- Jean-Philippe Leduc-Gaudet
- Research Group in Cellular Signaling, Department of Medical Biology, Université du Québec À Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada
- Department of Critical Care and Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre (MUHC), Montréal, QC H3H 2R9, Canada
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
- Département des sciences de l’activité physique, Faculté des sciences, Université du Québec à Montréal (UQAM), Montréal, QC H2X 1Y4, Canada
| | - Kayla Miguez
- Department of Critical Care and Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre (MUHC), Montréal, QC H3H 2R9, Canada
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
| | - Marina Cefis
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
- Département des sciences de l’activité physique, Faculté des sciences, Université du Québec à Montréal (UQAM), Montréal, QC H2X 1Y4, Canada
| | - Julie Faitg
- Département des sciences de l’activité physique, Faculté des sciences, Université du Québec à Montréal (UQAM), Montréal, QC H2X 1Y4, Canada
- Amazentis SA, EPFL Innovation Park, 1015 Lausanne, Switzerland
| | - Alaa Moamer
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
| | - Tomer Jordi Chaffer
- Department of Critical Care and Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre (MUHC), Montréal, QC H3H 2R9, Canada
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
| | - Olivier Reynaud
- Département des sciences de l’activité physique, Faculté des sciences, Université du Québec à Montréal (UQAM), Montréal, QC H2X 1Y4, Canada
| | - Felipe E. Broering
- Department of Critical Care and Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre (MUHC), Montréal, QC H3H 2R9, Canada
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
| | - Anwar Shams
- Department of Pharmacology, Faculty of Medicine, Taif University, P.O.BOX 11099, Taif 21944, Saudi Arabia
| | - Dominique Mayaki
- Department of Critical Care and Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre (MUHC), Montréal, QC H3H 2R9, Canada
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
| | - Laurent Huck
- Department of Critical Care and Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre (MUHC), Montréal, QC H3H 2R9, Canada
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
| | - Marco Sandri
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
- Veneto Institute of Molecular Medicine (VIMM) and Department of Biomedical Science, Università di Padova, 35129 Padova, Italy
| | - Gilles Gouspillou
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
- Département des sciences de l’activité physique, Faculté des sciences, Université du Québec à Montréal (UQAM), Montréal, QC H2X 1Y4, Canada
| | - Sabah N.A. Hussain
- Department of Critical Care and Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre (MUHC), Montréal, QC H3H 2R9, Canada
- Meakins-Christie Laboratories, Department of Medicine, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada
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Dominguini D, Michels M, Wessler LB, Streck EL, Barichello T, Dal-Pizzol F. Mitochondrial protective effects caused by the administration of mefenamic acid in sepsis. J Neuroinflammation 2022; 19:268. [PMID: 36333747 PMCID: PMC9636698 DOI: 10.1186/s12974-022-02616-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
The pathophysiology of sepsis may involve the activation of the NOD-type receptor containing the pyrin-3 domain (NLPR-3), mitochondrial and oxidative damages. One of the primary essential oxidation products is 8-oxoguanine (8-oxoG), and its accumulation in mitochondrial DNA (mtDNA) induces cell dysfunction and death, leading to the hypothesis that mtDNA integrity is crucial for maintaining neuronal function during sepsis. In sepsis, the modulation of NLRP-3 activation is critical, and mefenamic acid (MFA) is a potent drug that can reduce inflammasome activity, attenuating the acute cerebral inflammatory process. Thus, this study aimed to evaluate the administration of MFA and its implications for the reduction of inflammatory parameters and mitochondrial damage in animals submitted to polymicrobial sepsis. To test our hypothesis, adult male Wistar rats were submitted to the cecal ligation and perforation (CLP) model for sepsis induction and after receiving an injection of MFA (doses of 10, 30, and 50 mg/kg) or sterile saline (1 mL/kg). At 24 h after sepsis induction, the frontal cortex and hippocampus were dissected to analyze the levels of TNF-α, IL-1β, and IL-18; oxidative damage (thiobarbituric acid reactive substances (TBARS), carbonyl, and DCF-DA (oxidative parameters); protein expression (mitochondrial transcription factor A (TFAM), NLRP-3, 8-oxoG; Bax, Bcl-2 and (ionized calcium-binding adaptor molecule 1 (IBA-1)); and the activity of mitochondrial respiratory chain complexes. It was observed that the septic group in both structures studied showed an increase in proinflammatory cytokines mediated by increased activity in NLRP-3, with more significant oxidative damage and higher production of reactive oxygen species (ROS) by mitochondria. Damage to mtDNA it was also observed with an increase in 8-oxoG levels and lower levels of TFAM and NGF-1. In addition, this group had an increase in pro-apoptotic proteins and IBA-1 positive cells. However, MFA at doses of 30 and 50 mg/kg decreased inflammasome activity, reduced levels of cytokines and oxidative damage, increased bioenergetic efficacy and reduced production of ROS and 8-oxoG, and increased levels of TFAM, NGF-1, Bcl-2, reducing microglial activation. As a result, it is suggested that MFA induces protection in the central nervous system early after the onset of sepsis.
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Affiliation(s)
- Diogo Dominguini
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil.
| | - Monique Michels
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Leticia B Wessler
- Laboratory of Bioenergetics, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Emilio L Streck
- Laboratory of Bioenergetics, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
| | - Tatiana Barichello
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77054, USA
| | - Felipe Dal-Pizzol
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, 88806-000, Brazil
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Laudanski K. Persistence of Lipoproteins and Cholesterol Alterations after Sepsis: Implication for Atherosclerosis Progression. Int J Mol Sci 2021; 22:ijms221910517. [PMID: 34638860 PMCID: PMC8508791 DOI: 10.3390/ijms221910517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Sepsis is one of the most common critical care illnesses with increasing survivorship. The quality of life in sepsis survivors is adversely affected by several co-morbidities, including increased incidence of dementia, stroke, cardiac disease and at least temporary deterioration in cognitive dysfunction. One of the potential explanations for their progression is the persistence of lipid profile abnormalities induced during acute sepsis into recovery, resulting in acceleration of atherosclerosis. (2) Methods: This is a targeted review of the abnormalities in the long-term lipid profile abnormalities after sepsis; (3) Results: There is a well-established body of evidence demonstrating acute alteration in lipid profile (HDL-c ↓↓, LDL-C -c ↓↓). In contrast, a limited number of studies demonstrated depression of HDL-c levels with a concomitant increase in LDL-C -c in the wake of sepsis. VLDL-C -c and Lp(a) remained unaltered in few studies as well. Apolipoprotein A1 was altered in survivors suggesting abnormalities in lipoprotein metabolism concomitant to overall lipoprotein abnormalities. However, most of the studies were limited to a four-month follow-up and patient groups were relatively small. Only one study looked at the atherosclerosis progression in sepsis survivors using clinical correlates, demonstrating an acceleration of plaque formation in the aorta, and a large metanalysis suggested an increase in the risk of stroke or acute coronary event between 3% to 9% in sepsis survivors. (4) Conclusions: The limited evidence suggests an emergence and persistence of the proatherogenic lipid profile in sepsis survivors that potentially contributes, along with other factors, to the clinical sequel of atherosclerosis.
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Affiliation(s)
- Krzysztof Laudanski
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA 19104, USA; ; Tel.: +1-215-662-8200
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard Davis Institute of Healthcare Economics, Philadelphia, PA 19104, USA
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Regulation of the Nfkbiz Gene and Its Protein Product IkBζ in Animal Models of Sepsis and Endotoxic Shock. Infect Immun 2021; 89:IAI.00674-20. [PMID: 33431705 DOI: 10.1128/iai.00674-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/28/2020] [Indexed: 12/14/2022] Open
Abstract
Sepsis is a life-threatening condition that arises from a poorly regulated inflammatory response to pathogenic organisms. Current treatments are limited to antibiotics, fluid resuscitation, and other supportive therapies. New targets for monitoring disease progression and therapeutic interventions are therefore critically needed. We previously reported that lipocalin-2 (Lcn2), a bacteriostatic mediator with potent proapoptotic activities, was robustly induced in sepsis. Other studies showed that Lcn2 was a predictor of mortality in septic patients. However, how Lcn2 is regulated during sepsis is poorly understood. We evaluated how IkBζ, an inducer of Lcn2, was regulated in sepsis using both the cecal ligation and puncture (CLP) and endotoxemia (lipopolysaccharide [LPS]) animal models. We show that Nfkbiz, the gene encoding IkBζ, was rapidly stimulated but, unlike Lcn2, whose expression persists during sepsis, mRNA levels of Nfkbiz decline to near basal levels several hours after its induction. In contrast, we observed that IkBζ expression remained highly elevated in septic animals following CLP but not LPS, indicating the occurrence of a CLP-specific mechanism that extends IkBζ half-life. By using an inhibitor of IkBζ, we determined that the expression of Lcn2 was largely controlled by IkBζ. Altogether, these data indicate that the high IkBζ expression in tissues likely contributes to the elevated expression of Lcn2 in sepsis. Since IkBζ is also capable of promoting or repressing other inflammatory genes, it might exert a central role in sepsis.
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Affiliation(s)
- Barry G Hall
- Bellingham Research Institute, Portland, OR, USA.
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8
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De Maio A, Hightower LE. COVID-19, acute respiratory distress syndrome (ARDS), and hyperbaric oxygen therapy (HBOT): what is the link? Cell Stress Chaperones 2020; 25:717-720. [PMID: 32424591 PMCID: PMC7232923 DOI: 10.1007/s12192-020-01121-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Antonio De Maio
- Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of California San Diego, La Jolla, San Diego, CA, 92093, USA
- Department of Neurosciences, University of California San Diego, La Jolla, San Diego, CA, 92093, USA
- Center for Investigations of Health and Education Disparities, School of Medicine, University of California San Diego, La Jolla, San Diego, CA, 92093, USA
| | - Lawrence E Hightower
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, Mansfield, CT, 06269, USA.
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Abstract
The omentum is a large mesenchymal fibro-fatty tissue with remarkable healing capability. It is also rich in immune cells, including macrophages and lymphocytes, within particular structures named milky spots. Clinical observations indicate a high incidence of peritonitis after the removal of the omentum suggesting that it may play a role in sepsis. To test this possibility, male CD-1 mice underwent simultaneous omentectomy and cecal ligation and puncture (CLP), omentectomy-sham operation and CLP alone, and mortality was documented within 72 h post the insults. A significant increase in mortality was observed in mice subjected to omentectomy and CLP in comparison with CLP alone. Mortality was correlated with an increase in cytokine gene expression within the lung after omentectomy and CLP as opposed to CLP alone. However, no differences in bacterial load were observed within the peritoneum or blood between groups. To test the long-term effect of omentectomy, mice were subjected to omentum removal or sham operation, allowed to recover from surgery for 14 or 28 days, and then both were subjected to CLP. In these cases, no differences in mortality were observed between the groups suggesting that the lack of omentum triggers a compensatory mechanism. Finally, omentectomy and sham operation altered the composition of peritoneal immune cells with the disappearance of F4/80 macrophages and the appearance of a new population of F4/80 macrophages within 1 or 14 days post-surgery. The F4/80 positive cells reappeared after 28 days following the procedures. All of these observations suggest that the omentum plays an early role in the outcome from sepsis.
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Ruiz S, Vardon-Bounes F, Buléon M, Guilbeau-Frugier C, Séguelas MH, Conil JM, Girolami JP, Tack I, Minville V. Kinin B1 receptor: a potential therapeutic target in sepsis-induced vascular hyperpermeability. J Transl Med 2020; 18:174. [PMID: 32306971 PMCID: PMC7168845 DOI: 10.1186/s12967-020-02342-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/10/2020] [Indexed: 12/14/2022] Open
Abstract
Background In sepsis, the endothelial barrier becomes incompetent, with the leaking of plasma into interstitial tissues. VE-cadherin, an adherens junction protein, is the gatekeeper of endothelial cohesion. Kinins, released during sepsis, induce vascular leakage and vasodilation. They act via two G-protein coupled receptors: B1 (B1R) and B2 (B2R). B1R is inducible in the presence of pro-inflammatory cytokines, endotoxins or after tissue injury. It acts at a later stage of sepsis and elicits a sustained inflammatory response. The aim of our study was to investigate the relationships between B1R and VE-cadherin destabilization in vivo in a later phase of sepsis. Methods Experimental, prospective study in a university research laboratory. We used a polymicrobial model of septic shock by cecal ligation and puncture in C57BL6 male mice or C57BL6 male mice that received a specific B1R antagonist (R-954). We studied the influence of B1R on sepsis-induced vascular permeability 30 h after surgery for several organs, and VE-cadherin expression in the lung and kidneys by injecting R-954 just before surgery. The 96-h survival was determined in mice without treatment or in animals receiving R-954 as a “prophylactic” regimen (a subcutaneous injection of 200 µg/kg, prior to CLP and 24 h after CLP), or as a “curative” regimen (injection of 100 µg/kg at H6, H24 and H48 post-surgery). Results B1R inactivation helps to maintain MAP above 65 mmHg but induces different permeability profiles depending on whether or not organ perfusion is autoregulated. In our model, VE-cadherin was destabilized in vivo during septic shock. At a late stage of sepsis, the B1R blockade reduced the VE-cadherin disruption by limiting eNOS activation. The survival rate for mice that received R-954 after sepsis induction was higher than in animals that received an antagonist as a prophylactic treatment. Conclusions B1R antagonizing reduced mortality in our model of murine septic shock by limiting the vascular permeability induced by VE-cadherin destabilization through maintenance of the macrohemodynamics, consequently limiting organ dysfunctions.
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Affiliation(s)
- Stéphanie Ruiz
- Department of Anesthesiology and Intensive Care, Rangueil Hospital-University Hospital of Toulouse, 1 Avenue du Professeur Jean Poulhès TSA 50032, 31059, Toulouse Cedex 9, France. .,Institute of Metabolic and Cardiovascular Diseases, INSERM/UPS UMR, 1048-I2MC, Equipe 3, Paul Sabatier University, Toulouse, France.
| | - Fanny Vardon-Bounes
- Department of Anesthesiology and Intensive Care, Rangueil Hospital-University Hospital of Toulouse, 1 Avenue du Professeur Jean Poulhès TSA 50032, 31059, Toulouse Cedex 9, France.,Institute of Metabolic and Cardiovascular Diseases, INSERM/UPS UMR, 1048-I2MC, Equipe 3, Paul Sabatier University, Toulouse, France
| | - Marie Buléon
- Institute of Metabolic and Cardiovascular Diseases, INSERM/UPS UMR, 1048-I2MC, Equipe 3, Paul Sabatier University, Toulouse, France
| | - Céline Guilbeau-Frugier
- Institute of Metabolic and Cardiovascular Diseases, INSERM/UPS UMR, 1048-I2MC, Equipe 3, Paul Sabatier University, Toulouse, France.,Department of Forensic Medicine, Rangueil Hospital-University Hospital of Toulouse, 1 Avenue du Professeur Jean Poulhès TSA 50032, 31059, Toulouse Cedex 9, France.,Biological Electron Microscopy Center, Rangueil Faculty of Medicine, Toulouse University, Toulouse, France
| | - Marie-Hélène Séguelas
- Institute of Metabolic and Cardiovascular Diseases, INSERM/UPS UMR, 1048-I2MC, Equipe 3, Paul Sabatier University, Toulouse, France
| | - Jean-Marie Conil
- Department of Anesthesiology and Intensive Care, Rangueil Hospital-University Hospital of Toulouse, 1 Avenue du Professeur Jean Poulhès TSA 50032, 31059, Toulouse Cedex 9, France
| | - Jean-Pierre Girolami
- Institute of Metabolic and Cardiovascular Diseases, INSERM/UPS UMR, 1048-I2MC, Equipe 3, Paul Sabatier University, Toulouse, France
| | - Ivan Tack
- Institute of Metabolic and Cardiovascular Diseases, INSERM/UPS UMR, 1048-I2MC, Equipe 3, Paul Sabatier University, Toulouse, France.,Department of Physiology, Rangueil Hospital-University Hospital of Toulouse, 1 Avenue du Professeur Jean Poulhès TSA 50032, 31059, Toulouse Cedex 9, France
| | - Vincent Minville
- Department of Anesthesiology and Intensive Care, Rangueil Hospital-University Hospital of Toulouse, 1 Avenue du Professeur Jean Poulhès TSA 50032, 31059, Toulouse Cedex 9, France.,Institute of Metabolic and Cardiovascular Diseases, INSERM/UPS UMR, 1048-I2MC, Equipe 3, Paul Sabatier University, Toulouse, France
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Zhou M, Aziz M, Denning NL, Yen HT, Ma G, Wang P. Extracellular CIRP induces macrophage endotoxin tolerance through IL-6R-mediated STAT3 activation. JCI Insight 2020; 5:133715. [PMID: 32027619 PMCID: PMC7141386 DOI: 10.1172/jci.insight.133715] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/30/2020] [Indexed: 12/12/2022] Open
Abstract
Extracellular cold-inducible RNA-binding protein (eCIRP) is a damage-associated molecular pattern, whose effect on macrophages is not entirely elucidated. Here we identified that eCIRP promotes macrophage endotoxin tolerance. Septic mice had higher serum levels of eCIRP; this was associated with a reduced ex vivo immune response of their splenocytes to LPS. Pretreatment of macrophages with recombinant murine CIRP (rmCIRP) resulted in a tolerance to LPS stimulation as demonstrated by a reduction of TNF-α production. We found that eCIRP increased phosphorylated STAT3 (p-STAT3) in macrophages. A STAT3 inhibitor, Stattic, rescued macrophages from rmCIRP-induced tolerance by restoring the release of TNF-α in response to LPS stimulation. We discovered strong binding affinity between eCIRP and IL-6 receptor (IL-6R) as revealed by Biacore, fluorescence resonance energy transfer (FRET), and their colocalization in macrophages by immunostaining assays. Blockade of IL-6R with its neutralizing Ab inhibited eCIRP-induced p-STAT3 and restored LPS-stimulated TNF-α release in macrophages. Incubation of macrophages with rmCIRP skewed them toward an M2 phenotype, while treatment with anti-IL-6R Ab prevented rmCIRP-induced M2 polarization. Thus, we have demonstrated that eCIRP activates p-STAT3 via a novel receptor, IL-6R, to promote macrophage endotoxin tolerance. Targeting eCIRP appears to be a new therapeutic option to correct immune tolerance in sepsis.
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Affiliation(s)
- Mian Zhou
- Center for Immunology and Inflammation, the Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | - Monowar Aziz
- Center for Immunology and Inflammation, the Feinstein Institutes for Medical Research, Manhasset, New York, USA.,Elmezzi Graduate School of Molecular Medicine, Manhasset, New York, USA
| | - Naomi-Liza Denning
- Center for Immunology and Inflammation, the Feinstein Institutes for Medical Research, Manhasset, New York, USA.,Elmezzi Graduate School of Molecular Medicine, Manhasset, New York, USA.,Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
| | - Hao-Ting Yen
- Center for Immunology and Inflammation, the Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | - Gaifeng Ma
- Center for Immunology and Inflammation, the Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | - Ping Wang
- Center for Immunology and Inflammation, the Feinstein Institutes for Medical Research, Manhasset, New York, USA.,Elmezzi Graduate School of Molecular Medicine, Manhasset, New York, USA.,Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
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Halbach JL, Prieto JM, Wang AW, Hawisher D, Cauvi DM, Reyes T, Okerblom J, Ramirez-Sanchez I, Villarreal F, Patel HH, Bickler SW, Perdrizet GA, De Maio A. Early hyperbaric oxygen therapy improves survival in a model of severe sepsis. Am J Physiol Regul Integr Comp Physiol 2019; 317:R160-R168. [PMID: 31091156 PMCID: PMC6692752 DOI: 10.1152/ajpregu.00083.2019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/06/2019] [Accepted: 05/08/2019] [Indexed: 12/20/2022]
Abstract
Sepsis is a major clinical challenge, with therapy limited to supportive interventions. Therefore, the search for novel remedial approaches is of great importance. We addressed whether hyperbaric oxygen therapy (HBOT) could improve the outcome of sepsis using an acute experimental mouse model. Sepsis was induced in male CD-1 mice by cecal ligation and puncture (CLP) tailored to result in 80-90% mortality within 72 h of the insult. After CLP, mice were randomized into two groups receiving HBOT or not at different times after the initial insult or subjected to multiple HBOT treatments. HBOT conditions were 98% oxygen pressurized to 2.4 atmospheres for 1 h. HBOT within 1 h after CLP resulted in 52% survival in comparison with mice that did not receive the treatment (13% survival). Multiple HBOT at 1 and 6 h or 1, 6, and 21 h displayed an increase in survival of >50%, but they were not significantly different from a single treatment after 1 h of CLP. Treatments at 6 or 21 h after CLP, excluding the 1 h of treatment, did not show any protective effect. Early HBO treatment did not modify bacterial counts after CLP, but it was associated with decreased expression of TNF-α, IL-6, and IL-10 expression in the liver within 3 h after CLP. The decrease of cytokine expression was reproduced in cultured macrophages after exposure to HBOT. Early HBOT could be of benefit in the treatment of sepsis, and the protective mechanism may be related to a reduction in the systemic inflammatory response.
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Affiliation(s)
- Jonathan L Halbach
- Department of Surgery, Naval Medical Center San Diego , San Diego, California
| | - James M Prieto
- Department of Surgery, Naval Medical Center San Diego , San Diego, California
| | - Andrew W Wang
- Department of Surgery, Naval Medical Center San Diego , San Diego, California
| | - Dennis Hawisher
- Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, School of Medicine, University of California San Diego , La Jolla, California
| | - David M Cauvi
- Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, School of Medicine, University of California San Diego , La Jolla, California
| | - Tony Reyes
- Univeristy of California San Diego Initiative for Maximizing Student Development Program, University of California San Diego , La Jolla, California
| | - Jonathan Okerblom
- Department of Anesthesiology, School of Medicine, University of California San Diego, and Veterans Affairs San Diego Healthcare System, La Jolla, California
| | - Israel Ramirez-Sanchez
- Department of Medicine, School of Medicine, University of California San Diego , La Jolla, California
| | - Francisco Villarreal
- Department of Medicine, School of Medicine, University of California San Diego , La Jolla, California
| | - Hemal H Patel
- Department of Anesthesiology, School of Medicine, University of California San Diego, and Veterans Affairs San Diego Healthcare System, La Jolla, California
| | - Stephen W Bickler
- Division of Pediatric Surgery, Rady Children's Hospital , San Diego, California
| | - George A Perdrizet
- Department of Emergency Medicine, School of Medicine, University of California San Diego , La Jolla, California
| | - Antonio De Maio
- Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, School of Medicine, University of California San Diego , La Jolla, California
- Department of Neurosciences, School of Medicine, University of California San Diego , La Jolla, California
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13
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Cauvi DM, Hawisher D, Dores-Silva PR, Lizardo RE, De Maio A. Macrophage reprogramming by negatively charged membrane phospholipids controls infection. FASEB J 2019; 33:2995-3009. [PMID: 30325674 PMCID: PMC6338646 DOI: 10.1096/fj.201801579r] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/24/2018] [Indexed: 12/14/2022]
Abstract
Extracellular vesicles (ECVs) are heterogeneous membrane-enclosed structures containing proteins, nucleic acids, and lipids that participate in intercellular communication by transferring their contents to recipient cells. Although most of the attention has been directed at the biologic effect of proteins and microRNA, the contribution of phospholipids present in ECVs on cellular activation has not been extensively addressed. We investigated the biologic effect of phosphatidylserine (PS) and phosphatidylcholine (PC), 2 phospholipids highly abundant in ECVs. A transcriptomic analysis revealed that ∼4700 genes were specifically modified by exposing peritoneal macrophages to PS or PC liposomes in vivo. Among them, the expression of several chemokines and cytokines was highly upregulated by PS liposome treatment, translating into a massive neutrophil infiltration of the peritoneum capable of neutralizing a septic polymicrobial insult. Both the l and d stereoisomers of PS induced the same response, suggesting that the effect was related to the negative charge of the phospholipid head. We concluded that an increase in the internal negative charge of the cell triggers a signaling cascade activating an innate immune response capable of controlling infection.-Cauvi, D. M., Hawisher, D., Dores-Silva, P. R., Lizardo, R. E., De Maio, A. Macrophage reprogramming by negatively charged membrane phospholipids controls infection.
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Affiliation(s)
- David M. Cauvi
- Department of Surgery, School of Medicine, University of California San Diego, La Jolla, California, USA; and
| | - Dennis Hawisher
- Department of Surgery, School of Medicine, University of California San Diego, La Jolla, California, USA; and
| | - Paulo R. Dores-Silva
- Department of Surgery, School of Medicine, University of California San Diego, La Jolla, California, USA; and
| | - Radhames E. Lizardo
- Department of Surgery, Naval Medical Center San Diego, San Diego, California, USA
| | - Antonio De Maio
- Department of Surgery, School of Medicine, University of California San Diego, La Jolla, California, USA; and
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14
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Zhang Y, Wang L, Lv Y, Jiang C, Wu G, Dull RO, Minshall RD, Malik AB, Hu G. The GTPase Rab1 Is Required for NLRP3 Inflammasome Activation and Inflammatory Lung Injury. THE JOURNAL OF IMMUNOLOGY 2018; 202:194-206. [PMID: 30455398 DOI: 10.4049/jimmunol.1800777] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/23/2018] [Indexed: 12/22/2022]
Abstract
Uncontrolled inflammatory response during sepsis predominantly contributes to the development of multiorgan failure and lethality. However, the cellular and molecular mechanisms for excessive production and release of proinflammatory cytokines are not clearly defined. In this study, we show the crucial role of the GTPase Ras-related protein in brain (Rab)1a in regulating the nucleotide binding domain-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome activation and lung inflammatory injury. Expression of dominant negative Rab1 N124I plasmid in bone marrow-derived macrophages prevented the release of IL-1β and IL-18, NLRP3 inflammasome activation, production of pro-IL-1β and pro-IL-18, and attenuated TLR4 surface expression and NF-кB activation induced by bacterial LPS and ATP compared with control cells. In alveolar macrophage-depleted mice challenged with cecal ligation and puncture, pulmonary transplantation of Rab1a-inactivated macrophages by expression of Rab1 N124I plasmid dramatically reduced the release of IL-1β and IL-18, neutrophil count in bronchoalveolar lavage fluid, and inflammatory lung injury. Rab1a activity was elevated in alveolar macrophages from septic patients and positively associated with severity of sepsis and respiratory dysfunction. Thus, inhibition of Rab1a activity in macrophages resulting in the suppression of NLRP3 inflammasome activation may be a promising target for the treatment of patients with sepsis.
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Affiliation(s)
- Yuehui Zhang
- Department of Anesthesiology, University of Illinois College of Medicine, Chicago, IL 60612.,Department of Critical Care Medicine, Affiliated Bao'an Hospital of Shenzhen, Southern Medical University, Shenzhen, Guangdong 518101, China
| | - Lijun Wang
- Department of Critical Care Medicine, Affiliated Bao'an Hospital of Shenzhen, Southern Medical University, Shenzhen, Guangdong 518101, China
| | - Yang Lv
- Department of Anesthesiology, University of Illinois College of Medicine, Chicago, IL 60612
| | - Chunling Jiang
- Department of Anesthesiology, University of Illinois College of Medicine, Chicago, IL 60612
| | - Guangyu Wu
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912
| | - Randal O Dull
- Department of Anesthesiology, University of Illinois College of Medicine, Chicago, IL 60612
| | - Richard D Minshall
- Department of Anesthesiology, University of Illinois College of Medicine, Chicago, IL 60612.,Department of Pharmacology, University of Illinois College of Medicine, Chicago, IL 60612; and
| | - Asrar B Malik
- Department of Pharmacology, University of Illinois College of Medicine, Chicago, IL 60612; and
| | - Guochang Hu
- Department of Anesthesiology, University of Illinois College of Medicine, Chicago, IL 60612; .,Department of Pharmacology, University of Illinois College of Medicine, Chicago, IL 60612; and.,Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221008, China
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15
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Halbach JL, Wang AW, Hawisher D, Cauvi DM, Lizardo RE, Rosas J, Reyes T, Escobedo O, Bickler SW, Coimbra R, De Maio A. Why Antibiotic Treatment Is Not Enough for Sepsis Resolution: an Evaluation in an Experimental Animal Model. Infect Immun 2017; 85:e00664-17. [PMID: 28947644 PMCID: PMC5695106 DOI: 10.1128/iai.00664-17] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 09/17/2017] [Indexed: 12/27/2022] Open
Abstract
Sepsis remains a major health problem at the levels of mortality, morbidity, and economic burden to the health care system, a condition that is aggravated by the development of secondary conditions such as septic shock and multiple-organ failure. Our current understanding of the etiology of human sepsis has advanced, at least in part, due to the use of experimental animal models, particularly the model of cecum ligation and puncture (CLP). Antibiotic treatment has been commonly used in this model to closely mirror the treatment of human septic patients. However, whether their use may obscure the elucidation of the cellular and molecular mechanisms involved in the septic response is questionable. The objective of the present study was to determine the effect of antibiotic treatment in the outcome of a fulminant model of CLP. Various dosing strategies were used for the administration of imipenem, which has broad-spectrum coverage of enteric bacteria. No statistically significant differences in the survival of mice were observed between the different antibiotic dosing strategies and no treatment, suggesting that live bacteria may not be the only factor inducing septic shock. To further investigate this hypothesis, mice were challenged with sterilized or unsterilized cecal contents. We found that exposure of mice to sterilized cecal contents also resulted in a high mortality rate. Therefore, it is possible that bacterial debris, apart from bacterial proliferation, triggers a septic response and contributes to mortality in this model, suggesting that additional factors are involved in the development of septic shock.
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Affiliation(s)
- Jonathan L Halbach
- Department of Surgery, Naval Medical Center San Diego, San Diego, California, USA
| | - Andrew W Wang
- Department of Surgery, Naval Medical Center San Diego, San Diego, California, USA
| | - Dennis Hawisher
- Division of Trauma, Critical Care, Burns and Acute Injury, Department of Surgery, School of Medicine, University of California, La Jolla, California, USA
| | - David M Cauvi
- Division of Trauma, Critical Care, Burns and Acute Injury, Department of Surgery, School of Medicine, University of California, La Jolla, California, USA
| | - Radhames E Lizardo
- Department of Surgery, Naval Medical Center San Diego, San Diego, California, USA
| | - Joseph Rosas
- Center for Investigations of Health and Education Disparities, University of California, San Diego, La Jolla, California, USA
| | - Tony Reyes
- Center for Investigations of Health and Education Disparities, University of California, San Diego, La Jolla, California, USA
| | - Omar Escobedo
- Center for Investigations of Health and Education Disparities, University of California, San Diego, La Jolla, California, USA
| | - Stephen W Bickler
- Division of Trauma, Critical Care, Burns and Acute Injury, Department of Surgery, School of Medicine, University of California, La Jolla, California, USA
- Division of Pediatric Surgery, Rady Children's Hospital, San Diego, California, USA
| | - Raul Coimbra
- Division of Trauma, Critical Care, Burns and Acute Injury, Department of Surgery, School of Medicine, University of California, La Jolla, California, USA
| | - Antonio De Maio
- Division of Trauma, Critical Care, Burns and Acute Injury, Department of Surgery, School of Medicine, University of California, La Jolla, California, USA
- Center for Investigations of Health and Education Disparities, University of California, San Diego, La Jolla, California, USA
- Department of Neurosciences, School of Medicine, University of California, San Diego, La Jolla, California, USA
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16
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Lauková L, Konečná B, Bábíčková J, Wagnerová A, Melišková V, Vlková B, Celec P. Exogenous deoxyribonuclease has a protective effect in a mouse model of sepsis. Biomed Pharmacother 2017. [DOI: 10.1016/j.biopha.2017.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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17
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Wang X, Zhang D, Sjölinder M, Wan Y, Sjölinder H. CD46 accelerates macrophage-mediated host susceptibility to meningococcal sepsis in a murine model. Eur J Immunol 2016; 47:119-130. [DOI: 10.1002/eji.201646397] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 09/04/2016] [Accepted: 10/26/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Xiao Wang
- Department of Molecular Biosciences, the Wenner-Gren Institute; Stockholm University; Stockholm Sweden
| | - Ding Zhang
- College of Animal Science and Veterinary Medicine; Shanxi Agricultural University; Taigu China
| | - Mikael Sjölinder
- Department of Molecular Biosciences, the Wenner-Gren Institute; Stockholm University; Stockholm Sweden
| | - Yi Wan
- Department of Molecular Biosciences, the Wenner-Gren Institute; Stockholm University; Stockholm Sweden
| | - Hong Sjölinder
- Department of Molecular Biosciences, the Wenner-Gren Institute; Stockholm University; Stockholm Sweden
- Cancer Center; Mälar Hospital; Eskilstuna Sweden
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18
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Morphology-Independent Virulence of Candida Species during Polymicrobial Intra-abdominal Infections with Staphylococcus aureus. Infect Immun 2015; 84:90-8. [PMID: 26483410 DOI: 10.1128/iai.01059-15] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/10/2015] [Indexed: 01/04/2023] Open
Abstract
Intra-abdominal polymicrobial infections cause significant morbidity and mortality. An experimental mouse model of Candida albicans-Staphylococcus aureus intra-abdominal infection (IAI) results in 100% mortality by 48 to 72 h postinoculation, while monomicrobial infections are avirulent. Mortality is associated with robust local and systemic inflammation without a requirement for C. albicans morphogenesis. However, the contribution of virulence factors coregulated during the yeast-to-hypha transition is unknown. This also raised the question of whether other Candida species that are unable to form hyphae are as virulent as C. albicans during polymicrobial IAI. Therefore, the purpose of this study was to evaluate the ability of non-albicans Candida (NAC) species with various morphologies and C. albicans transcription factor mutants (efg1/efg1 and cph1/cph1) to induce synergistic mortality and the accompanying inflammation. Results showed that S. aureus coinoculated with C. krusei or C. tropicalis was highly lethal, similar to C. albicans, while S. aureus-C. dubliniensis, S. aureus-C. parapsilosis, and S. aureus-C. glabrata coinoculations resulted in little to no mortality. Local and systemic interleukin-6 (IL-6) and prostaglandin E2 (PGE2) levels were significantly elevated during symptomatic and/or lethal coinfections, and hypothermia strongly correlated with mortality. Coinoculation with C. albicans strains deficient in the transcription factor Efg1 but not Cph1 reversed the lethal outcome. These results support previous findings and demonstrate that select Candida species, without reference to any morphological requirement, induce synergistic mortality, with IL-6 and PGE2 acting as key inflammatory factors. Mechanistically, signaling pathways controlled by Efg1 are critical for the ability of C. albicans to induce mortality from an intra-abdominal polymicrobial infection.
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Elevated expression of IL-23/IL-17 pathway-related mediators correlates with exacerbation of pulmonary inflammation during polymicrobial sepsis. Shock 2015; 42:246-55. [PMID: 24978886 DOI: 10.1097/shk.0000000000000207] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sepsis is a leading cause of death in the United States, claiming more than 215,000 lives every year. A primary condition observed in septic patients is the incidence of acute respiratory distress syndrome, which is characterized by the infiltration of neutrophils into the lung. Prior studies have shown differences in pulmonary neutrophil accumulation in C57BL/6J (B6) and A/J mice after endotoxic and septic shock. However, the mechanism by which neutrophils accumulate in the lung after polymicrobial sepsis induced by cecal ligation and puncture still remains to be fully elucidated. We show in this study that lung inflammation, characterized by neutrophil infiltration and expression of inflammatory cytokines, was aggravated in B6 as compared with A/J mice and correlated with a high expression of p19, the interleukin 23 (IL-23)-specific subunit. Furthermore, lipopolysaccharide stimulation of B6- and A/J-derived macrophages, one of the main producers of IL-23 and IL-12, revealed that B6 mice favored the production of IL-23, whereas A/J-derived macrophages expressed higher levels of IL-12. In addition, expression of IL-17, known to be upregulated by IL-23, was also more elevated in the lung of B6 mice when compared with that in the lung of A/J mice. In contrast, pulmonary expression of interferon-γ was much more pronounced in A/J than that in B6 mice, which was most likely a result of a higher production of IL-12. The expression of the IL-17-dependent neutrophil recruitment factors chemokine (CXC motif) ligand 2 and granulocyte colony-stimulating factor was also higher in B6 mice. Altogether, these results suggest that increased activation of the IL-23/IL-17 pathway has detrimental effects on sepsis-induced lung inflammation, whereas activation of the IL-12/interferon-γ pathway may lead, in contrast, to less pronounced inflammatory events. These two pathways may become possible therapeutic targets for the treatment of sepsis-induced acute respiratory distress syndrome.
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Vazquez DE, Niño DF, De Maio A, Cauvi DM. Sustained expression of lipocalin-2 during polymicrobial sepsis. Innate Immun 2014; 21:477-89. [PMID: 25227123 DOI: 10.1177/1753425914548491] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 07/24/2014] [Indexed: 11/17/2022] Open
Abstract
Sepsis is a major healthcare problem and a leading cause of death worldwide. There is no dependable diagnosis, and treatment for this condition remains mainly supportive. The etiology of sepsis is related to an overwhelming inflammatory response. In this regard, the antimicrobial protein lipocalin-2 (Lcn2) has been associated with several inflammatory conditions, but its contribution to polymicrobial sepsis is unclear. Polymicrobial sepsis was induced by cecal ligation and puncture (CLP), and Lcn2 mRNA levels and protein expression were measured in liver and lung tissues. We observed that Lcn2 expression was robustly induced in liver and lung of C57BL/6 J (B6) mice, and remained elevated during the stage of innate immune dysfunction observed in sepsis. This response was different in A/J mice, suggesting a contribution of the genetic background, probably due to differences in IL-10 expression between these two mouse strains. Indeed, IL-10 was found to regulate Lcn2 expression in both primary and J774A.1 macrophages. Thus, Lcn2 expression is highly regulated during CLP-induced sepsis, suggesting that this antimicrobial protein could have a role as a potential biomarker for the diagnosis of sepsis.
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Affiliation(s)
- Daniel E Vazquez
- Department of Surgery, University of California San Diego, La Jolla, CA, USA
| | - Diego F Niño
- Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, CA, USA
| | - Antonio De Maio
- Department of Surgery, University of California San Diego, La Jolla, CA, USA Center for Investigations of Health and Education Disparities, University of California San Diego, La Jolla, CA, USA
| | - David M Cauvi
- Department of Surgery, University of California San Diego, La Jolla, CA, USA
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What can we learn from elegant clinical studies?*. Crit Care Med 2014; 42:972-3. [PMID: 24633091 DOI: 10.1097/ccm.0000000000000157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Egge KH, Thorgersen EB, Lindstad JK, Pharo A, Lambris JD, Barratt-Due A, Mollnes TE. Post challenge inhibition of C3 and CD14 attenuates Escherichia coli-induced inflammation in human whole blood. Innate Immun 2013; 20:68-77. [PMID: 23669326 DOI: 10.1177/1753425913482993] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Combined inhibition of CD14 and complement, two main inducers of the inflammatory response, have proved particularly effective in attenuating Gram-negative bacteria-induced inflammation. Approaching possible clinical relevance, we investigated the effect of such inhibition in a post-challenge setting. Human whole blood was anti-coagulated with lepirudin. Anti-CD14, compstatin (C3 inhibitor) and the combination thereof were added 5 min prior to or 5, 15 or 30 min after adding Escherichia coli. Total incubation time with Escherichia coli was 120 min. Cytokines, myeloperoxidase (MPO) and the terminal complement complex (TCC) were measured using multiplex technology and ELISA. Delayed combined inhibition significantly attenuated the inflammatory response. IL-1β, IL-8 and TNF-α were significantly inhibited in the range of 20-40%, even when adding the inhibitors with up to 30 min delay. IL-6 was significantly inhibited with 15 min delay, and MIP-1α and MPO with 5 min delay. Complement activation (TCC) was blocked completely at each time point compstatin was added, whereas the cytokines and MPO increased steadily between the time points. The combined regimen was significantly more effective than single inhibition in the pre-challenge setting. The attenuation of Escherichia coli-induced inflammation in a post-challenge setting suggests a potential therapeutic window for this treatment in sepsis.
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Affiliation(s)
- Kjetil H Egge
- 1Department of Immunology, Oslo University Hospital Rikshospitalet and University of Oslo, Norway
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A non-lethal traumatic/hemorrhagic insult strongly modulates the compartment-specific PAI-1 response in the subsequent polymicrobial sepsis. PLoS One 2013; 8:e55467. [PMID: 23408987 PMCID: PMC3568129 DOI: 10.1371/journal.pone.0055467] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 12/23/2012] [Indexed: 12/29/2022] Open
Abstract
Introduction Plasminogen activator inhibitor 1 (PAI-1) is a key factor in trauma- and sepsis-induced coagulopathy. We examined how trauma-hemorrhage (TH) modulates PAI-1 responses in subsequent cecal ligation and puncture (CLP)-induced sepsis, and the association of PAI-1 with septic outcomes. Methods Mice underwent TH and CLP 48 h later in three separate experiments. In experiment 1, mice were sacrificed pre- and post-CLP to characterize the trajectory of PAI-1 in plasma (protein) and tissues (mRNA). Post-CLP dynamics in TH-CLP (this study) and CLP-Only mice (prior study) were then compared for modulatory effects of TH. In experiment 2, to relate PAI-1 changes to outcome, mice underwent TH-CLP and were sampled daily and followed for 14 days to compare non-survivors (DEAD) and survivors (SUR). In experiment 3, plasma and tissue PAI-1 expression were compared between mice predicted to die (P-DIE) and to live (P-LIVE). Results In experiment 1, an early post-TH rise of circulating PAI-1 was contrasted by a delayed (post-TH) decrease of PAI-1 mRNA in organs. In the post-CLP phase, profiles of circulating PAI-1 were similar between TH-CLP and CLP-Only mice. Conversely, PAI-1 mRNA declined in the liver and heart of TH-CLP mice versus CLP-Only. In experiment 2, there were no DEAD/SUR differences in circulating PAI-1 prior to CLP. Post-CLP, circulating PAI-1 in DEAD was 2–4-fold higher than in SUR. PAI-1 increase heralded septic deaths up to 48 h prior but DEAD/SUR thrombomodulin (endothelial injury marker) levels were identical. In experiment 3, levels of circulating PAI-1 and its hepatic gene expression were higher in P-DIE versus P-LIVE mice and those increases closely correlated with liver dysfunction. Conclusions Trauma modulated septic PAI-1 responses in a compartment-specific fashion. Only post-CLP increases in circulating PAI-1 predicted septic outcomes. In posttraumatic sepsis, pre-lethal release of PAI-1 was mostly of hepatic origin and was independent of endothelial injury.
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