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Wang Z, Xiang L, Lin F, Cai Z, Ruan H, Wang J, Liang J, Wang F, Lu M, Cui W. Inhaled ACE2-engineered microfluidic microsphere for intratracheal neutralization of COVID-19 and calming of the cytokine storm. MATTER 2022; 5:336-362. [PMID: 34693277 PMCID: PMC8524658 DOI: 10.1016/j.matt.2021.09.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/10/2021] [Accepted: 09/23/2021] [Indexed: 05/03/2023]
Abstract
The SARS-CoV-2 pandemic spread worldwide unabated. However, achieving protection from the virus in the whole respiratory tract, avoiding blood dissemination, and calming the subsequent cytokine storm remains a major challenge. Here, we develop an inhaled microfluidic microsphere using dual camouflaged methacrylate hyaluronic acid hydrogel microspheres with a genetically engineered membrane from angiotensin-converting enzyme II (ACE2) receptor-overexpressing cells and macrophages. By timely competing with the virus for ACE2 binding, the inhaled microspheres significantly reduce SARS-CoV-2 infective effectiveness over the whole course of the respiratory system in vitro and in vivo. Moreover, the inhaled microspheres efficiently neutralize proinflammatory cytokines, cause an alternative landscape of lung-infiltrated immune cells, and alleviate hyperinflammation of lymph nodes and spleen. In an acute pneumonia model, the inhaled microspheres show significant therapeutic efficacy by regulation of the multisystem inflammatory syndrome and reduce acute mortality, suggesting a powerful synergic strategy for the treatment of patients with severe COVID-19 via non-invasive administration.
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Affiliation(s)
- Zhen Wang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Lei Xiang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Feng Lin
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zhengwei Cai
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Huitong Ruan
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Juan Wang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jing Liang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Fei Wang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Min Lu
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Wenguo Cui
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Mesenchymal stem cells alleviate LPS-induced acute lung injury by inhibiting the proinflammatory function of Ly6C + CD8 + T cells. Cell Death Dis 2020; 11:829. [PMID: 33024074 PMCID: PMC7538431 DOI: 10.1038/s41419-020-03036-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 12/14/2022]
Abstract
Systemic inflammatory processes, including alveolar injury, cytokine induction, and neutrophil accumulation, play key roles in the pathophysiology of acute lung injury (ALI). The immunomodulatory effects of mesenchymal stem cells (MSCs) can contribute to the treatment of inflammatory disorders. In previous studies, the focus was on innate immune cells and the effects of MSCs on ALI through CD8+ T cells remain unclear. In the present study, lipopolysaccharide (LPS) was used to induce ALI in mice. ALI mice were treated with MSCs via intratracheal instillation. Survival rate, histopathological changes, protein levels, total cell count, cytokine levels, and chemokine levels in alveolar lavage fluid were used to determine the efficacy of MSCs. Mass cytometry and single-cell RNA sequencing (scRNA-seq) were used to characterize the CD8+ T cells in the lungs. Ly6C- CD8+ T cells are prevalent in normal mice, whereas a specialized effector phenotype expressing a high level of Ly6C is predominant in advanced disease. MSCs significantly mitigated ALI and improved survival. MSCs decreased the infiltration of CD8+ T cells, especially Ly6C+ CD8+ T cells into the lungs. Mass cytometry revealed that CD8+ T cells expressing high Ly6C and CXCR3 levels caused tissue damage in the lungs of ALI mice, which was alleviated by MSCs. The scRNA-seq showed that Ly6C+ CD8+ T cells exhibited a more activated phenotype and decreased expression of proinflammatory factors that were enriched the most in immune chemotaxis after treatment with MSCs. We showed that CD8+ T cells play an important role in MSC-mediated ALI remission, and both infiltration quantity and proinflammatory function were inhibited by MSCs, indicating a potential mechanism for therapeutic intervention.
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Halter S, Aimade L, Barbié M, Brisson H, Rouby JJ, Langeron O, Klatzmann D, Rosenzwajg M, Monsel A. T regulatory cells activation and distribution are modified in critically ill patients with acute respiratory distress syndrome: A prospective single-centre observational study. Anaesth Crit Care Pain Med 2020; 39:35-44. [DOI: 10.1016/j.accpm.2019.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 07/18/2019] [Accepted: 07/20/2019] [Indexed: 12/28/2022]
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Wong JJM, Leong JY, Lee JH, Albani S, Yeo JG. Insights into the immuno-pathogenesis of acute respiratory distress syndrome. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:504. [PMID: 31728357 DOI: 10.21037/atm.2019.09.28] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Acute respiratory distress syndrome (ARDS) is a clinical syndrome associated with oxygenation failure resulting from a direct pulmonary or indirect systemic insult. It is a complex etiological phenomenon involving an array of immune cells acting in a delicate balance between pathogen clearance and immunopathology. There is emerging evidence of the involvement of different immune cell types in ARDS pathogenesis. This includes polarization of alveolar macrophages (AMs), neutrophil netosis, the pro-inflammatory response of T helper 17 subsets, and the anti-inflammatory and regenerative role of T regulatory cell subsets. Knowledge of these pathogenic mechanisms has led to translational opportunities, for example, research in the use of methylprednisolone, DNAse, aspirin, keratinocyte growth factor and in the development of stem cell therapy for ARDS. Discovering subgroups of patients with ARDS afflicted with homogenous pathologic mechanisms can provide prognostic and/or predictive insight that will enable precision medicine. Lastly, new high dimensional immunomic technologies are promising tools in evaluating the host immune response in ARDS and will be discussed in this review.
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Affiliation(s)
- Judith Ju Ming Wong
- Children's Intensive Care Unit, Department of Pediatric Subspecialty, KK Women's and Children's Hospital, Singapore.,Translational Immunology Institute, Singhealth/Duke-NUS Academic Medical Centre, Singapore
| | - Jing Yao Leong
- Translational Immunology Institute, Singhealth/Duke-NUS Academic Medical Centre, Singapore
| | - Jan Hau Lee
- Children's Intensive Care Unit, Department of Pediatric Subspecialty, KK Women's and Children's Hospital, Singapore
| | - Salvatore Albani
- Translational Immunology Institute, Singhealth/Duke-NUS Academic Medical Centre, Singapore.,Division of Medicine, KK Women's and Children's Hospital, Singapore
| | - Joo Guan Yeo
- Translational Immunology Institute, Singhealth/Duke-NUS Academic Medical Centre, Singapore.,Division of Medicine, KK Women's and Children's Hospital, Singapore
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Hartmann JP, Mottelson MN, Berg RMG, Plovsing RR. Changes in ventilatory capacity and pulmonary gas exchange during systemic and pulmonary inflammation in humans. APMIS 2016; 125:11-15. [DOI: 10.1111/apm.12626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 08/30/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Jacob P. Hartmann
- Department of Cardiology; University Hospital Rigshospitalet; Copenhagen Denmark
| | - Mathis N. Mottelson
- Department of Clinical Physiology, Nuclear Medicine and PET; University Hospital Rigshospitalet; Copenhagen Denmark
| | - Ronan M. G. Berg
- Department of Clinical Physiology and Nuclear Medicine; Bispebjerg and Frederiksberg Hospitals; Copenhagen Denmark
| | - Ronni R. Plovsing
- Department of Intensive Care; University Hospital Rigshospitalet; Copenhagen Denmark
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Li Q, Gu Y, Tu Q, Wang K, Gu X, Ren T. Blockade of Interleukin-17 Restrains the Development of Acute Lung Injury. Scand J Immunol 2016; 83:203-11. [PMID: 26709006 DOI: 10.1111/sji.12408] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 12/17/2015] [Indexed: 12/14/2022]
Abstract
The acute respiratory distress syndrome (ARDS), a clinical complication of severe acute lung injury (ALI) in humans, is a leading cause of morbidity and mortality in critically ill patients. Here, we explored the association between IL-17 and development of ALI using LPS-induced murine model. We found that IL-17 level was elevated in bronchoalveolar lavage (BAL) fluid of ALI mice. Upregulation of IL-17 resulted in increased severity of ALI as evidenced by decreased body weight and survival rate, elevated level of total protein and albumin in BAL fluid, as well as more apparent histopathology changes of lung. Induction of ALI was impaired in IL-17-deficient mice. Management of IL-17 could modulate LPS-induced pulmonary inflammation, as reflected by the total cell and neutrophil counts, proinflammatory cytokines, as well as chemokines in BAL fluid. Of note, blockade of IL-17 effectively inhibited the lung inflammation and alleviated ALI severity. Finally, we confirmed the clinical relevance and found that IL-17 expression was elevated and associated with the disease severity in patients with ARDS. In essence, IL-17 was crucial for development of ALI, suggesting a potential application for IL-17-based therapy in clinical practice.
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Affiliation(s)
- Q Li
- Department of Cardiothoracic Surgery, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Y Gu
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Q Tu
- Department of Respiratory Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - K Wang
- Department of Respiratory Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - X Gu
- Department of Respiratory Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - T Ren
- Department of Respiratory Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
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Plovsing RR, Berg RMG, Munthe-Fog L, Konge L, Iversen M, Møller K, Garred P. Alveolar recruitment of ficolin-3 in response to acute pulmonary inflammation in humans. Immunobiology 2016; 221:690-7. [PMID: 26868430 DOI: 10.1016/j.imbio.2015.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 11/21/2015] [Accepted: 11/22/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Ficolins serve as soluble recognition molecules in the lectin pathway of complement. They are known to participate in the systemic host-response to infection but their role in local pulmonary defence is still incompletely understood. The purpose of this study was to clarify whether acute lung and systemic inflammation induce recruitment of lectins in humans. METHODS Fifteen healthy volunteers received LPS intravenously (IV) or in a lung subsegment on two different occasions. Volunteers were evaluated by consecutive blood samples and by bronchoalveolar lavage 2, 4, 6, 8, or 24h after LPS (n=3 in all groups), and gene expression patterns and protein levels of mannose-binding lectin (MBL) and ficolins were determined. RESULTS Endobronchial LPS was associated with an increase in alveolar ficolin-3 and MBL levels (p<0.04 and p<0.001, respectively). IV LPS elicited a pronounced acute phase response with an increase in CRP (p<0.001) and plasma ficolin-1 protein levels (p<0.001), whereas no changes were observed in ficolin-1 gene expression patterns (p=0.11) or plasma protein levels of MBL, ficolin-2, or ficolin-3. CONCLUSIONS LPS induces a tissue-specific recruitment of ficolin-3 and ficolin-1 in the lung and systemic compartment, respectively, suggesting an important role of distinct lectin complement pathway initiators in the local pulmonary and systemic host defence.
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Affiliation(s)
- Ronni R Plovsing
- Department of Intensive Care, University Hospital Rigshospitalet, Copenhagen Ø, Denmark.
| | - Ronan M G Berg
- Department of Clinical Physiology, Nuclear Medicine & PET, University Hospital Rigshospitalet, Copenhagen Ø, Denmark; Centre of Inflammation and Metabolism, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Lea Munthe-Fog
- Department of Clinical Immunology, Laboratory of Molecular Medicine, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Lars Konge
- Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, Copenhagen, Denmark
| | - Martin Iversen
- Department of Lung Transplantation, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Kirsten Møller
- Department of Neuroanaesthesiology, Neurointensive Care Unit, University Hospital Rigshospitalet, Copenhagen Ø, Denmark; Centre of Inflammation and Metabolism, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Peter Garred
- Department of Clinical Immunology, Laboratory of Molecular Medicine, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
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Ronit A, Plovsing RR, Gaardbo JC, Berg RMG, Hartling HJ, Ullum H, Andersen ÅB, Madsen HO, Møller K, Nielsen SD. Inflammation-Induced Changes in Circulating T-Cell Subsets and Cytokine Production During Human Endotoxemia. J Intensive Care Med 2015; 32:77-85. [PMID: 26392625 DOI: 10.1177/0885066615606673] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 12/14/2022]
Abstract
Observational clinical studies suggest the initial phase of sepsis may involve impaired cellular immunity. In the present study, we investigated temporal changes in T-cell subsets and T-cell cytokine production during human endotoxemia. Endotoxin (Escherichia coli lipopolysaccharide 4 ng/kg) was administered intravenously in 15 healthy volunteers. Peripheral blood and bronchoalveolar lavage fluid (BALF) were collected at baseline and after 2, 4, 6, 8, and 24 hours for flow cytometry. CD4+CD25+CD127lowFoxp3+ regulatory T cells (Tregs), CD4+CD161+ cells, and activated Human leukocyte antigen, HLA-DR+CD38+ T cells were determined. Ex vivo whole-blood cytokine production and Toll-like receptor (TLR)-4 expression on Tregs were measured. Absolute number of CD3+CD4+ (P = .026), CD3+CD8+ (P = .046), Tregs (P = .023), and CD4+CD161+ cells (P = .042) decreased after endotoxin administration. The frequency of anti-inflammatory Tregs increased (P = .033), whereas the frequency of proinflammatory CD4+CD161+ cells decreased (P = .034). Endotoxemia was associated with impaired whole-blood production of tumor necrosis factor-α, interleukin-10, IL-6, IL-17, IL-2, and interferon-γ in response to phytohaemagglutinin but did not affect TLR4 expression on Tregs. No changes in the absolute count or frequency of BALF T cells were observed. Systemic inflammation is associated with lymphopenia, a relative increase in the frequency of anti-inflammatory Tregs, and a functional impairment of T-cell cytokine production.
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Affiliation(s)
- Andreas Ronit
- Department of Infectious Diseases 8632, Viro-immunology Research Unit, University Hospital Rigshospitalet, Copenhagen Ø, Denmark.,Department of Clinical Immunology 2034, Blood Bank, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Ronni R Plovsing
- Department of Intensive Care, University Hospital Rigshospitalet, Copenhagen Ø, Denmark.,Department of Anaesthesia, Køge Hospital, Køge, Denmark
| | - Julie C Gaardbo
- Department of Infectious Diseases 8632, Viro-immunology Research Unit, University Hospital Rigshospitalet, Copenhagen Ø, Denmark.,Department of Clinical Immunology 2034, Blood Bank, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Ronan M G Berg
- Department of Intensive Care, University Hospital Rigshospitalet, Copenhagen Ø, Denmark.,Department of Infectious Diseases 7641, Centre of Inflammation and Metabolism, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Hans J Hartling
- Department of Infectious Diseases 8632, Viro-immunology Research Unit, University Hospital Rigshospitalet, Copenhagen Ø, Denmark.,Department of Clinical Immunology 2034, Blood Bank, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology 2034, Blood Bank, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Åse B Andersen
- Department of Infectious Diseases 8632, Viro-immunology Research Unit, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Hans O Madsen
- Department of Clinical Immunology, Tissue Typing Laboratory 7631, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Kirsten Møller
- Department of Infectious Diseases 7641, Centre of Inflammation and Metabolism, University Hospital Rigshospitalet, Copenhagen Ø, Denmark.,Department of Neuroanaesthesiology, Neurointensive Care Unit 2093, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
| | - Susanne D Nielsen
- Department of Infectious Diseases 8632, Viro-immunology Research Unit, University Hospital Rigshospitalet, Copenhagen Ø, Denmark
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