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Bruno MEC, Mukherjee S, Sturgill JL, Cornea V, Yeh P, Hawk GS, Saito H, Starr ME. PAI-1 as a critical factor in the resolution of sepsis and acute kidney injury in old age. Front Cell Dev Biol 2024; 11:1330433. [PMID: 38304613 PMCID: PMC10830627 DOI: 10.3389/fcell.2023.1330433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/27/2023] [Indexed: 02/03/2024] Open
Abstract
Elevated plasma levels of plasminogen activator inhibitor type 1 (PAI-1) are documented in patients with sepsis and levels positively correlate with disease severity and mortality. Our prior work demonstrated that PAI-1 in plasma is positively associated with acute kidney injury (AKI) in septic patients and mice. The objective of this study was to determine if PAI-1 is causally related to AKI and worse sepsis outcomes using a clinically-relevant and age-appropriate murine model of sepsis. Sepsis was induced by cecal slurry (CS)-injection to wild-type (WT, C57BL/6) and PAI-1 knockout (KO) mice at young (5-9 months) and old (18-22 months) age. Survival was monitored for at least 10 days or mice were euthanized for tissue collection at 24 or 48 h post-insult. Contrary to our expectation, PAI-1 KO mice at old age were significantly more sensitive to CS-induced sepsis compared to WT mice (24% vs. 65% survival, p = 0.0037). In comparison, loss of PAI-1 at young age had negligible effects on sepsis survival (86% vs. 88% survival, p = 0.8106) highlighting the importance of age as a biological variable. Injury to the kidney was the most apparent pathological consequence and occurred earlier in aged PAI-1 KO mice. Coagulation markers were unaffected by loss of PAI-1, suggesting thrombosis-independent mechanisms for PAI-1-mediated protection. In summary, although high PAI-1 levels are clinically associated with worse sepsis outcomes, loss of PAI-1 rendered mice more susceptible to kidney injury and death in a CS-induced model of sepsis using aged mice. These results implicate PAI-1 as a critical factor in the resolution of sepsis in old age.
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Affiliation(s)
- Maria E. C. Bruno
- Department of Surgery, University of Kentucky, Lexington, KY, United States
| | - Sujata Mukherjee
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - Jamie L. Sturgill
- Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky, Lexington, KY, United States
| | - Virgilius Cornea
- Department of Pathology, University of Kentucky, Lexington, KY, United States
| | - Peng Yeh
- Department of Statistics, University of Kentucky, Lexington, KY, United States
| | - Gregory S. Hawk
- Department of Statistics, University of Kentucky, Lexington, KY, United States
| | - Hiroshi Saito
- Department of Surgery, University of Kentucky, Lexington, KY, United States
- Department of Physiology, University of Kentucky, Lexington, KY, United States
- Department of Pharmacology and Nutritional Sciences, Graduate Faculty of Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - Marlene E. Starr
- Department of Surgery, University of Kentucky, Lexington, KY, United States
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
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Accumulation of γδ T cells in visceral fat with aging promotes chronic inflammation. GeroScience 2022; 44:1761-1778. [PMID: 35477832 PMCID: PMC9213615 DOI: 10.1007/s11357-022-00572-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/12/2022] [Indexed: 11/25/2022] Open
Abstract
Adipose tissue dysfunction is strongly linked to the development of chronic inflammation and cardiometabolic disorders in aging. While much attention has been given to the role of resident adipose tissue immune cells in the disruption of homeostasis in obesity, age-specific effects remain understudied. Here, we identified and characterized a population of γδ T cells, which show unique age-dependent accumulation in the visceral adipose tissue (VAT) of both mice and humans. Diet-induced obesity likewise increased γδ T cell numbers; however, the effect was greater in the aged where the increase was independent of fat mass. γδ T cells in VAT express a tissue-resident memory T cell phenotype (CD44hiCD62LlowCD69+) and are predominantly IL-17A-producing cells. Transcriptome analyses of immunomagnetically purified γδ T cells identified significant age-associated differences in expression of genes related to inflammation, immune cell composition, and adipocyte differentiation, suggesting age-dependent qualitative changes in addition to the quantitative increase. Genetic deficiency of γδ T cells in old age improved the metabolic phenotype, characterized by increased respiratory exchange ratio, and lowered levels of IL-6 both systemically and locally in VAT. Decreased IL-6 was predominantly due to reduced production by non-immune stromal cells, primarily preadipocytes, and adipose-derived stem cells. Collectively, these findings suggest that an age-dependent increase of tissue-resident γδ T cells in VAT contributes to local and systemic chronic inflammation and metabolic dysfunction in aging.
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Li M, Zhu P, Wang SX. Risk for Cardiovascular Death Associated With Waist Circumference and Diabetes: A 9-Year Prospective Study in the Wan Shou Lu Cohort. Front Cardiovasc Med 2022; 9:856517. [DOI: 10.3389/fcvm.2022.856517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIt has been reported that obesity and diabetes are both risk factors for the development of cardiovascular diseases (CVDs). However, recent articles reported that compared with body mass index, waist circumference (WC) can better reflect obesity, more closely related to visceral fat tissue which is positively associated with an increased risk of cardiovascular death. Moreover, few studies have investigated the prognostic value of both WC and diabetes during a long-term follow-up. We aimed to investigate whether the higher level of WC measurements and diabetes were able to predict cardiovascular mortality in the general population.MethodsIn this prospective cohort study, a total of 1,521 consecutive subjects free of clinical CVD were included. The endpoint was cardiovascular death. The Kaplan–Meier method and Cox regression models were used to evaluate the cumulative risk of the outcome at different WC levels with or without diabetes.ResultsDuring a median follow-up of 9.2 years, 265 patients died due to cardiovascular conditions. Kaplan–Meier survival estimates indicated that the patients with higher levels of WC (WC > 94 cm) coexisted with diabetes had a significantly increased risk of cardiovascular death (log-rank p < 0.05). After adjustment for potential confounders, multiple COX regression models showed that the incidence of cardiovascular death was significantly higher when patients with high WC coexisted with diabetes mellitus (hazard ratio: 3.78; 95% CI: 3.35–3.98; p < 0.001).ConclusionPatients with high WC and diabetes represent a high-risk population for cardiovascular death. WC and diabetes may provide incremental prognostic value beyond traditional risks factors.
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