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Koufou EE, Assimakopoulos SF, Bosgana P, de Lastic AL, Grypari IM, Georgopoulou GA, Antonopoulou S, Mouzaki A, Kourea HP, Thomopoulos K, Davlouros P. Altered Expression of Intestinal Tight Junction Proteins in Heart Failure Patients with Reduced or Preserved Ejection Fraction: A Pathogenetic Mechanism of Intestinal Hyperpermeability. Biomedicines 2024; 12:160. [PMID: 38255265 PMCID: PMC10813326 DOI: 10.3390/biomedicines12010160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Although intestinal microbiota alterations (dysbiosis) have been described in heart failure (HF) patients, the possible mechanisms of intestinal barrier dysfunction leading to endotoxemia and systemic inflammation are not fully understood. In this study, we investigated the expression of the intestinal tight junction (TJ) proteins occludin and claudin-1 in patients with HF with reduced (HFrEF) or preserved ejection fraction (HFpEF) and their possible association with systemic endotoxemia and inflammation. Ten healthy controls and twenty-eight patients with HF (HFrEF (n = 14), HFpEF (n = 14)) underwent duodenal biopsy. Histological parameters were recorded, intraepithelial CD3+ T-cells and the expression of occludin and claudin-1 in enterocytes were examined using immunohistochemistry, circulating endotoxin concentrations were determined using ELISA, and concentrations of cytokines were determined using flow cytometry. Patients with HFrEF or HFpEF had significantly higher serum endotoxin concentrations (p < 0.001), a significantly decreased intestinal occludin and claudin-1 expression (in HfrEF p < 0.01 for occludin, p < 0.05 for claudin-1, in HfpEF p < 0.01 occludin and claudin-1), and significantly increased serum concentrations of IL-6, IL-8, and IL-10 (for IL-6 and IL-10, p < 0.05 for HFrEF and p < 0.001 for HFpEF; and for IL-8, p < 0.05 for both groups) compared to controls. Occludin and claudin-1 expression inversely correlated with systemic endotoxemia (p < 0.05 and p < 0.01, respectively). Heart failure, regardless of the type of ejection fraction, results in a significant decrease in enterocytic occludin and claudin-1 expression, which may represent an important cellular mechanism for the intestinal barrier dysfunction causing systemic endotoxemia and inflammatory response.
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Affiliation(s)
| | - Stelios F. Assimakopoulos
- Department of Internal Medicine and Division of Infectious Diseases, University of Patras Medical School, 26504 Patras, Greece;
| | - Pinelopi Bosgana
- Department of Pathology, Medical School of Patras, 26504 Patras, Greece; (P.B.); (H.P.K.)
| | - Anne-Lise de Lastic
- Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, 26504 Patras, Greece; (A.-L.d.L.); (A.M.)
| | - Ioanna-Maria Grypari
- Cytology Department, Aretaieion University Hospital, National Kapodistrian University of Athens, 11528 Athens, Greece;
| | | | | | - Athanasia Mouzaki
- Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, 26504 Patras, Greece; (A.-L.d.L.); (A.M.)
| | - Helen P. Kourea
- Department of Pathology, Medical School of Patras, 26504 Patras, Greece; (P.B.); (H.P.K.)
| | - Konstantinos Thomopoulos
- Division of Gastroenterology, Department of Internal Medicine, Medical School, University of Patras, University Hospital of Patras, 26504 Patras, Greece;
| | - Periklis Davlouros
- Department of Cardiology, Patras University Hospital, 26504 Patras, Greece;
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Atwater AQ, Immergluck LC, Davidson AJ, Castanon-Cervantes O. Shift Work Predicts Increases in Lipopolysaccharide-Binding Protein, Interleukin-10, and Leukocyte Counts in a Cross-Sectional Study of Healthy Volunteers Carrying Low-Grade Systemic Inflammation. Int J Environ Res Public Health 2021; 18:ijerph182413158. [PMID: 34948768 PMCID: PMC8701724 DOI: 10.3390/ijerph182413158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 12/30/2022]
Abstract
The disruption of inflammatory responses is a potential mechanism behind the harmful effects of shift work and is associated with increased risk of hypertension, stroke, obesity, diabetes, and cancer. These responses are linked to the proliferation of leukocytes in shift workers, suggesting a systemic signal as a potential mediator. The purpose of this study was to assess the relationship between systemic inflammation, leukocyte counts, and systemic endotoxemia in samples from a diverse cohort of day workers and shift workers. Participants (normothermic and normotensive) were healthy volunteers, non-smoking, and drug- and medication-free. The following outcomes were measured: C-reactive protein, TNF-α, IL-6, IL-1β, IL-10, leukocyte counts (monocytes, lymphocytes, and neutrophils), and lipopolysaccharide-binding protein (LBP). Risk factors that increase systemic inflammation, such as blood pressure, sleep loss, and cortisol, were also assessed. The results indicated that shift workers slept significantly less than day workers and had significantly increased concentrations of all of the cytokines measured as well as plasma cortisol. Regression models found that after controlling for covariates, shift-work exposure predicted the significant increase observed in IL-10, leukocyte counts, and LBP. Our results suggest that acute increases in low-grade systemic endotoxemia are unresolved during chronic shift-work exposure. This ongoing immune challenge may underlie the disrupted inflammatory responses characteristic of shift-work-related pathologies. Systemic endotoxemia may represent a novel target to investigate the early effects of exposure to shift-work schedules.
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Affiliation(s)
- Aisha Q. Atwater
- Department of Neurobiology and Neuroscience Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA; (A.Q.A.); (A.J.D.)
| | - Lilly Cheng Immergluck
- Department of Microbiology, Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA;
- Pediatric Clinical & Translational Research Unit, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Alec J. Davidson
- Department of Neurobiology and Neuroscience Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA; (A.Q.A.); (A.J.D.)
| | - Oscar Castanon-Cervantes
- Department of Neurobiology and Neuroscience Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA; (A.Q.A.); (A.J.D.)
- Correspondence:
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Jin S, Ding X, Yang C, Li W, Deng M, Liao H, Lv X, Pitt BR, Billiar TR, Zhang LM, Li Q. Mechanical Ventilation Exacerbates Poly (I:C) Induced Acute Lung Injury: Central Role for Caspase-11 and Gut-Lung Axis. Front Immunol 2021; 12:693874. [PMID: 34349759 PMCID: PMC8327178 DOI: 10.3389/fimmu.2021.693874] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background The mechanisms by which moderate tidal volume ventilation (MTV) exacerbates preexisting lung injury are unclear. We hypothesized that systemic endotoxemia via the gut-lung axis would lead to non-canonical and canonical inflammasome activation and pyroptosis in a two-hit model involving polyinosinic-polycytidylic acid (Poly(I:C)), a synthetic analog of dsRNA and MTV and that this would associate with acute lung injury (ALI). Methods Anesthetized mice were administered Poly(I:C) intratracheally and then 6 h later, they were mechanically ventilated for 4 h with otherwise non-injurious MTV (10ml/kg). Changes in intestinal and alveolar capillary permeability were measured. Further documentation of ALI was assessed by evans blue albumin permeability, protein and IL-1 family concentration in bronchoalveolar lavage fluid (BALF) or plasma, and histopathology in cohorts of wildtype (WT), whole body genetically ablated caspase-11 (caspase-11-/-), caspase-1/caspase-11 double knockout (caspase-1/11-/-), gasdermin D (GSDMD)-/-, nucleotide-binding domain leucine-rich repeat-containing protein 3 (NLRP3)-/- and advanced glycosylation end product-specific receptor (RAGE) -/- mice. Results Non-injurious MTV exacerbated the mild lung injury associated with Poly(I:C) administration. This included the disruption of alveolar-capillary barrier and increased levels of interleukin (IL)-6, high mobility group proteins 1 (HMGB-1), IL-1β in BALF and IL-18 in plasma. Combined (Poly(I:C)-MTV) injury was associated with increase in gastrointestinal permeability and endotoxin in plasma and BALF. Poly(I:C)-MTV injury was sensitive to caspase-11 deletion with no further contribution of caspase-1 except for maturation and release of IL-18 (that itself was sensitive to deletion of NLRP3). Combined injury led to large increases in caspase-1 and caspase-11. Genetic ablation of GSDMD attenuated alveolar-capillary disruption and release of cytokines in combined injury model. Conclusions The previously noted exacerbation of mild Poly(I:C)-induced ALI by otherwise non-injurious MTV is associated with an increase in gut permeability resulting in systemic endotoxemia. The gut-lung axis resulted in activation of pulmonary non-canonical (cytosolic mediated caspase-11 activation) and canonical (caspase-1) inflammasome (NLRP3) mediated ALI in this two-hit model resulting in GSDMD sensitive alveolar capillary barrier disruption, pyroptosis (alveolar macrophages) and cytokine maturation and release (IL-1β; IL-18). Pharmacologic strategies aimed at disrupting communication between gut and lung, inhibition of inflammasomes or GSDMD in pyroptosis may be useful in ALI.
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MESH Headings
- Acute Lung Injury/chemically induced
- Acute Lung Injury/enzymology
- Acute Lung Injury/microbiology
- Acute Lung Injury/pathology
- Animals
- Bacteria/metabolism
- Caspases, Initiator/genetics
- Caspases, Initiator/metabolism
- Disease Models, Animal
- Gastrointestinal Microbiome
- Intestines/microbiology
- Intracellular Signaling Peptides and Proteins/genetics
- Intracellular Signaling Peptides and Proteins/metabolism
- Lipopolysaccharides/metabolism
- Lung/enzymology
- Lung/pathology
- Macrophages, Alveolar/enzymology
- Macrophages, Alveolar/pathology
- Male
- Mice, Inbred C57BL
- Mice, Knockout
- NLR Family, Pyrin Domain-Containing 3 Protein/genetics
- NLR Family, Pyrin Domain-Containing 3 Protein/metabolism
- Phosphate-Binding Proteins/genetics
- Phosphate-Binding Proteins/metabolism
- Poly I-C
- Pyroptosis
- Receptor for Advanced Glycation End Products/genetics
- Receptor for Advanced Glycation End Products/metabolism
- Respiration, Artificial
- Signal Transduction
- Ventilator-Induced Lung Injury/enzymology
- Ventilator-Induced Lung Injury/etiology
- Ventilator-Induced Lung Injury/microbiology
- Ventilator-Induced Lung Injury/pathology
- Mice
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Affiliation(s)
- Shuqing Jin
- Department of Anesthesiology, Shanghai Pulmonary Hospital, TongJi University, Shanghai, China
- Department of Surgery, University of Pittsburgh Medical School, Pennsylvania, PA, United States
| | - Xibing Ding
- Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University Medical School, Shanghai, China
| | - Chenxuan Yang
- Department of Surgery, University of Pittsburgh Medical School, Pennsylvania, PA, United States
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenbo Li
- Department of Surgery, University of Pittsburgh Medical School, Pennsylvania, PA, United States
| | - Meihong Deng
- Department of Surgery, The Ohio State University, Ohio, OH, United States
| | - Hong Liao
- Department of Surgery, University of Pittsburgh Medical School, Pennsylvania, PA, United States
| | - Xin Lv
- Department of Anesthesiology, Shanghai Pulmonary Hospital, TongJi University, Shanghai, China
| | - Bruce R. Pitt
- Department of Environmental Occupational Health, University of Pittsburgh Graduate School Public Health, Pennsylvania, PA, United States
| | - Timothy R. Billiar
- Department of Surgery, University of Pittsburgh Medical School, Pennsylvania, PA, United States
| | - Li-Ming Zhang
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pennsylvania, PA, United States
| | - Quan Li
- Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
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Hankir MK, Seyfried F, Schellinger IN, Schlegel N, Arora T. Leaky Gut as a Potential Culprit for the Paradoxical Dysglycemic Response to Gastric Bypass-Associated Ileal Microbiota. Metabolites 2021; 11:metabo11030153. [PMID: 33800456 PMCID: PMC7998592 DOI: 10.3390/metabo11030153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 12/04/2022] Open
Abstract
Altered host-intestinal microbiota interactions are increasingly implicated in the metabolic benefits of Roux-en-Y gastric bypass (RYGB) surgery. We previously found, however, that RYGB-associated ileal microbiota can paradoxically impair host glycemic control when transferred to germ-free mice. Here we present complementary evidence suggesting that this could be due to the heightened development of systemic endotoxemia. Consistently, application of ileal content from RYGB-treated compared with sham-operated rats onto Caco-2 cell monolayers compromised barrier function and decreased expression of the barrier-stabilizing proteins claudin-4 and desmoglein-2. Our findings raise the possibility that RYGB-associated ileal microbiota produce and release soluble metabolites which locally increase intestinal permeability to promote systemic endotoxemia-induced insulin resistance, with potential implications for the treatment of RYGB patients who eventually relapse onto type 2 diabetes.
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Affiliation(s)
- Mohammed K. Hankir
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany; (F.S.); (N.S.)
- Correspondence: (M.K.H.); (T.A.)
| | - Florian Seyfried
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany; (F.S.); (N.S.)
| | - Isabel N. Schellinger
- Department of Endocrinology and Nephrology, University Hospital Leipzig, Liebigstraße 20, 04103 Leipzig, Germany;
| | - Nicolas Schlegel
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany; (F.S.); (N.S.)
| | - Tulika Arora
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, 2200 København, Denmark
- Correspondence: (M.K.H.); (T.A.)
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