1
|
Mulder PPG, Hooijmans CR, Vlig M, Middelkoop E, Joosten I, Koenen HJPM, Boekema BKHL. Kinetics of Inflammatory Mediators in the Immune Response to Burn Injury: Systematic Review and Meta-Analysis of Animal Studies. J Invest Dermatol 2024; 144:669-696.e10. [PMID: 37806443 DOI: 10.1016/j.jid.2023.09.269] [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] [Received: 05/25/2023] [Revised: 08/31/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023]
Abstract
Burns are often accompanied by a dysfunctional immune response, which can lead to systemic inflammation, shock, and excessive scarring. The objective of this study was to provide insight into inflammatory pathways associated with burn-related complications. Because detailed information on the various inflammatory mediators is scattered over individual studies, we systematically reviewed animal experimental data for all reported inflammatory mediators. Meta-analyses of 352 studies revealed a strong increase in cytokines, chemokines, and growth factors, particularly 19 mediators in blood and 12 in burn tissue. Temporal kinetics showed long-lasting surges of proinflammatory cytokines in blood and burn tissue. Significant time-dependent effects were seen for IL-1β, IL-6, TGF-β1, and CCL2. The response of anti-inflammatory mediators was limited. Burn technique had a profound impact on systemic response levels. Large burn size and scalds further increased systemic, but not local inflammation. Animal characteristics greatly affected inflammation, for example, IL-1β, IL-6, and TNF-α levels were highest in young, male rats. Time-dependent effects and dissimilarities in response demonstrate the importance of appropriate study design. Collectively, this review presents a general overview of the burn-induced immune response exposing inflammatory pathways that could be targeted through immunotherapy for burn patients and provides guidance for experimental set-ups to advance burn research.
Collapse
Affiliation(s)
- Patrick P G Mulder
- Preclinical Research, Association of Dutch Burn Centres (ADBC), Beverwijk, The Netherlands; Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Carlijn R Hooijmans
- Meta-Research Team, Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel Vlig
- Preclinical Research, Association of Dutch Burn Centres (ADBC), Beverwijk, The Netherlands
| | - Esther Middelkoop
- Preclinical Research, Association of Dutch Burn Centres (ADBC), Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Tissue Function and Regeneration, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Irma Joosten
- Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans J P M Koenen
- Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bouke K H L Boekema
- Preclinical Research, Association of Dutch Burn Centres (ADBC), Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
2
|
Weaver AJ, Brandenburg KS, Smith BW, Leung KP. Comparative Analysis of the Host Response in a Rat Model of Deep-Partial and Full-Thickness Burn Wounds With Pseudomonas aeruginosa Infection. Front Cell Infect Microbiol 2020; 9:466. [PMID: 31998665 PMCID: PMC6967395 DOI: 10.3389/fcimb.2019.00466] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/17/2019] [Indexed: 12/12/2022] Open
Abstract
Burn wound injury affects soldiers and civilians alike, often resulting in a dynamic, but un-orchestrated, host response that can lead to infection, scarring, and potentially death. To mitigate these factors, it is important to have a clinically relevant model of burn wound infection that can be utilized for advancing burn wound treatments. Our previous reports have demonstrated the ability of Pseudomonas aeruginosa to generate a biofilm infection within a modified Walker-Mason rat burn model of deep-partial (DPT) and full-thickness (FT) burn wounds (10% total body surface area) in male Sprague-Dawley rats (350–450 g). Here, we further define this model with respect to the host response when challenged with P. aeruginosa infection between the two burn types. Following burn injury and immediate surface exposure to P. aeruginosa, inflammation at the local and systemic levels were monitored for an 11 days period. Compared to burn-only groups, infection with P. aeruginosa further promoted local inflammation in both DPT and FT burn wounds, which was evident by enhanced cellular influx (including neutrophils and monocytes), increased levels of several pro-inflammatory cytokines (IL-1β, IL-6, GRO/KC, andMIP-1α), and reduced IL-10. Systemically, only minor changes were seen in circulating white blood cells and cytokines; however, increases in high mobility group box-1 (HMGB-1) and hyaluronan, as well as decreases in fibronectin were noted particularly in FT burns. Compared to the burn-only group, P. aeruginosa infection resulted in sustained and/or higher levels of HMGB-1 and hyaluronan. Combined with our previous work that defined the burn depth and development of P. aeruginosa biofilms within the wound, this study further establishes this model by defining the host response to the burn and biofilm-infection. Furthermore, this characterization shows several similarities to what is clinically seen and establishes this model for future use in the development and testing of novel therapeutics for burn wound treatment at home and on the battlefield.
Collapse
Affiliation(s)
- Alan J Weaver
- Department of Dental and Craniofacial Trauma Research, United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX, United States
| | - Kenneth S Brandenburg
- Department of Dental and Craniofacial Trauma Research, United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX, United States
| | - Brian W Smith
- Research Support Division, United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX, United States
| | - Kai P Leung
- Department of Dental and Craniofacial Trauma Research, United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX, United States
| |
Collapse
|
3
|
Brandenburg KS, Weaver AJ, Karna SLR, You T, Chen P, Stryk SV, Qian L, Pineda U, Abercrombie JJ, Leung KP. Formation of Pseudomonas aeruginosa Biofilms in Full-thickness Scald Burn Wounds in Rats. Sci Rep 2019; 9:13627. [PMID: 31541159 PMCID: PMC6754504 DOI: 10.1038/s41598-019-50003-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/31/2019] [Indexed: 12/14/2022] Open
Abstract
Using Sprague-Dawley rats (350-450 g; n = 61) and the recently updated Walker-Mason rat scald burn model, we demonstrated that Pseudomonas aeruginosa readily formed biofilms within full-thickness burn wounds. Following the burn, wounds were surface-inoculated with P. aeruginosa in phosphate-buffered saline (PBS), while sterile PBS was used for controls. On post-burn days 1, 3, 7, and 11, animals were euthanized and samples collected for quantitative bacteriology, bacterial gene expression, complete blood cell counts, histology, and myeloperoxidase activity. Robust biofilm infections developed in the full-thickness burn wounds inoculated with 1 × 104 CFU of P. aeruginosa. Both histology and scanning electron microscopy showed the pathogen throughout the histologic cross-sections of burned skin. Quantigene analysis revealed significant upregulation of alginate and pellicle biofilm matrix genes of P. aeruginosa within the burn eschar. Additionally, expression of P. aeruginosa proteases and siderophores increased significantly in the burn wound environment. Interestingly, the host's neutrophil response to the pathogen was not elevated in either the eschar or circulating blood when compared to the control burn. This new full-thickness burn biofilm infection model will be used to test new anti-biofilm therapies that may be deployed with soldiers in combat for immediate use at the site of burn injury on the battlefield.
Collapse
Affiliation(s)
- Kenneth S Brandenburg
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Alan J Weaver
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - S L Rajasekhar Karna
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Tao You
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Ping Chen
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Shaina Van Stryk
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Liwu Qian
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Uzziel Pineda
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Johnathan J Abercrombie
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA
| | - Kai P Leung
- Dental and Craniofacial Trauma Research and Tissue Regeneration Department, United States Army Institute of Surgical Research, 3650 Chambers Pass, Bldg 3610, JBSA Fort Sam, Houston, Texas, 78234, USA.
| |
Collapse
|
4
|
Malone M, Bjarnsholt T, McBain A, James G, Stoodley P, Leaper D, Tachi M, Schultz G, Swanson T, Wolcott R. The prevalence of biofilms in chronic wounds: a systematic review and meta-analysis of published data. J Wound Care 2017; 26:20-25. [DOI: 10.12968/jowc.2017.26.1.20] [Citation(s) in RCA: 255] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- M. Malone
- Head of Department, Podiatric Medicine, Global Wound Biofilm Expert Panel; Liverpool Hospital, South West Sydney LHD, Australia; and Ingham Institute of Applied Medical Research, Sydney, Australia
| | - T. Bjarnsholt
- University of Copenhagen, Costerton Biofilm Center, Denmark; and Department of Clinical Microbiology, Rigshospitalet, Denmark
| | - A.J. McBain
- Faculty of Biology, Medicine and Health, University of Manchester
| | - G.A. James
- Center for Biofilm Engineering, Montana State University, US
| | - P. Stoodley
- Center for Microbial Interface Biology and Department of Microbial infection, Immunity and Orthopaedics, Ohio State University, US
| | - D. Leaper
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, UK; and Imperial College, London, UK
| | - M. Tachi
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - G. Schultz
- Institute of Wound Research, Department of Obstetrics and Gynecology, College of Medicine, University of Florida
| | - T. Swanson
- South West Healthcare, Warrnambool, Victoria, Australia
| | - R.D. Wolcott
- Southwest Regional Wound Care Centre, Lubbock Texas, US
| |
Collapse
|
5
|
Gómez-Zorrilla S, Calatayud L, Juan C, Cabot G, Tubau F, Oliver A, Dominguez MA, Ariza J, Peña C. Understanding the acute inflammatory response to Pseudomonas aeruginosa infection: differences between susceptible and multidrug-resistant strains in a mouse peritonitis model. Int J Antimicrob Agents 2016; 49:198-203. [PMID: 27939091 DOI: 10.1016/j.ijantimicag.2016.10.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/23/2016] [Accepted: 10/01/2016] [Indexed: 12/15/2022]
Abstract
The increasing emergence of multidrug-resistant (MDR) Pseudomonas aeruginosa strains is associated with the spread of a few international epidemic clones called high-risk clones. The existence of a fitness cost associated with multidrug resistance remains unclear, and little is known about the host inflammatory response in acute P. aeruginosa infections. This study aimed to investigate how the inflammatory response occurs in the most relevant high-risk clones and to compare the process with that recorded in clinical susceptible isolates. Nine P. aeruginosa strains were studied, including the most relevant MDR high-risk clones (ST111, ST175 and ST235) circulating worldwide. The inflammatory response in terms of the release of interleukins in serum was investigated in a mouse peritonitis-sepsis model at three time points (4, 8 and 12 h). TNFα and interleukin-10 (IL-10) levels were significantly higher at all time points in mice inoculated with clinical susceptible strains compared with those inoculated with MDR strains. IL-6 levels were significantly higher in the clinical susceptible strain group at 8 h and 12 h (P = 0.036 and P = 0.007, respectively). Bacterial counts (log CFU/mL) in peritoneal fluid were higher in the clinical susceptible strain group compared with the MDR strain group at 8 h [6.00 (4.30-6.90) vs. 4.46 (3.30-5.34); P = 0.005] and 12 h [7.75 (4.00-7.97) vs. 4.04 (2.58-4.94); P = 0.003]. MDR P. aeruginosa strains elicited a weaker inflammatory response than susceptible strains in an experimental mouse model, suggesting the existence of a fitness cost associated with multidrug resistance.
Collapse
Affiliation(s)
- Silvia Gómez-Zorrilla
- Infectious Diseases Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Calatayud
- Microbiology Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Carlos Juan
- Microbiology Service, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Palma (IdiSPa), Ctra. Valldemossa 79, 07010 Palma de Mallorca, Spain
| | - Gabriel Cabot
- Microbiology Service, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Palma (IdiSPa), Ctra. Valldemossa 79, 07010 Palma de Mallorca, Spain
| | - Fe Tubau
- Microbiology Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Antonio Oliver
- Microbiology Service, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Palma (IdiSPa), Ctra. Valldemossa 79, 07010 Palma de Mallorca, Spain
| | - Maria Angeles Dominguez
- Microbiology Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Javier Ariza
- Infectious Diseases Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Carmen Peña
- Infectious Diseases Service, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain.
| |
Collapse
|
6
|
A novel siderophore system is essential for the growth of Pseudomonas aeruginosa in airway mucus. Sci Rep 2015; 5:14644. [PMID: 26446565 PMCID: PMC4597187 DOI: 10.1038/srep14644] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 09/02/2015] [Indexed: 12/25/2022] Open
Abstract
Pseudomonas aeruginosa establishes airway infections in Cystic Fibrosis patients. Here, we investigate the molecular interactions between P. aeruginosa and airway mucus secretions (AMS) derived from the primary cultures of normal human tracheal epithelial (NHTE) cells. PAO1, a prototype strain of P. aeruginosa, was capable of proliferating during incubation with AMS, while all other tested bacterial species perished. A PAO1 mutant lacking PA4834 gene became susceptible to AMS treatment. The ΔPA4834 mutant was grown in AMS supplemented with 100 μM ferric iron, suggesting that the PA4834 gene product is involved in iron metabolism. Consistently, intracellular iron content was decreased in the mutant, but not in PAO1 after the AMS treatment. Importantly, a PAO1 mutant unable to produce both pyoverdine and pyochelin remained viable, suggesting that these two major siderophore molecules are dispensable for maintaining viability during incubation with AMS. The ΔPA4834 mutant was regrown in AMS amended with 100 μM nicotianamine, a phytosiderophore whose production is predicted to be mediated by the PA4836 gene. Infectivity of the ΔPA4834 mutant was also significantly compromised in vivo. Together, our results identify a genetic element encoding a novel iron acquisition system that plays a previously undiscovered role in P. aeruginosa airway infection.
Collapse
|
7
|
Gupta P, Gupta RK, Harjai K. Quorum sensing signal molecules produced by Pseudomonas aeruginosa cause inflammation and escape host factors in murine model of urinary tract infection. Inflammation 2014; 36:1153-9. [PMID: 23636638 DOI: 10.1007/s10753-013-9650-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Quorum sensing (QS) is well established for its role in pathogenesis of various infections of Pseudomonas aeruginosa. However, its role in local tissue damage during urinary tract infection (UTI) is not yet fully established. To have insight in this, the present study was planned. UTI was established in mice using standard strain PAO1 and its isogenic QS mutant JP2. One group was challenged only with QS signals. Damage was assessed in terms of histopathology and pathology markers, malondialdehyde (MDA) and reactive nitrogen intermediates (RNI). Effect on pathogen motility, uroepithelial adhesion, and host serum sensitivity was also ascertained. PAO1-infected mice showed severe inflammation and tissue destruction, while mice infected with JP2 showed no significant destruction. JP2 was also unable to mount any tissue pathology markers, MDA and RNI, whereas PAO1 showed significantly higher levels of these two. Presence of only QS signals also showed considerable renal pathology. Strain JP2 also showed less motility, reduced uroepithelial cell adhesion, and increased serum sensitivity. Result highlights that QS signals induce local tissue pathology along with interference of host protective mechanisms during UTI.
Collapse
Affiliation(s)
- Parul Gupta
- Department of Microbiology, BMS Block, Panjab University, Chandigarh, India, 160014
| | | | | |
Collapse
|
8
|
Negative pressure wound therapy decreases mortality in a murine model of burn-wound sepsis involving Pseudomonas aeruginosa infection. PLoS One 2014; 9:e90494. [PMID: 24587379 PMCID: PMC3938770 DOI: 10.1371/journal.pone.0090494] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 02/01/2014] [Indexed: 12/30/2022] Open
Abstract
Background The colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT) would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality. Methods Thermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected to either NPWT or wet-to-dry (WTD) treatment protocols. The bacterial loads on the wound surface were assessed during 7 d of treatment, as were the concentrations of inflammatory cytokines in the peripheral blood samples. Survival was monitored daily for 14 d after burn induction. Finally, samples of wounded skin, lung, liver, and kidney were collected and subjected to histopathological examination. Results Applying P. aeruginosa to the burn wound surface led to sepsis. During early stages of treatment, NPWT reduced the mortality of the septic animals and levels of P. aeruginosa within the burn wound compared with WTD-treated animals. Circulating levels of cytokines and cytoarchitectural abnormalities were also significantly reduced via NPWT. Conclusions Our data indicate that NPWT inhibits the invasion and proliferation of P. aeruginosa in burn-wounded tissue and decreases early mortality in a murine model of burn-wound sepsis. These therapeutic benefits likely result from the ability of NPWT to decrease bacterial proliferation on the wound surface, reduce cytokine serum concentrations, and prevent damage to internal organs.
Collapse
|
9
|
Choosing an appropriate infection model to study quorum sensing inhibition in Pseudomonas infections. Int J Mol Sci 2013; 14:19309-40. [PMID: 24065108 PMCID: PMC3794835 DOI: 10.3390/ijms140919309] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 09/13/2013] [Accepted: 09/17/2013] [Indexed: 02/07/2023] Open
Abstract
Bacteria, although considered for decades to be antisocial organisms whose sole purpose is to find nutrients and multiply are, in fact, highly communicative organisms. Referred to as quorum sensing, cell-to-cell communication mechanisms have been adopted by bacteria in order to co-ordinate their gene expression. By behaving as a community rather than as individuals, bacteria can simultaneously switch on their virulence factor production and establish successful infections in eukaryotes. Understanding pathogen-host interactions requires the use of infection models. As the use of rodents is limited, for ethical considerations and the high costs associated with their use, alternative models based on invertebrates have been developed. Invertebrate models have the benefits of low handling costs, limited space requirements and rapid generation of results. This review presents examples of such models available for studying the pathogenicity of the Gram-negative bacterium Pseudomonas aeruginosa. Quorum sensing interference, known as quorum quenching, suggests a promising disease-control strategy since quorum-quenching mechanisms appear to play important roles in microbe-microbe and host-pathogen interactions. Examples of natural and synthetic quorum sensing inhibitors and their potential as antimicrobials in Pseudomonas-related infections are discussed in the second part of this review.
Collapse
|
10
|
Farina JA, Rosique MJ, Rosique RG. Curbing inflammation in burn patients. Int J Inflam 2013; 2013:715645. [PMID: 23762773 PMCID: PMC3671671 DOI: 10.1155/2013/715645] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Revised: 04/24/2013] [Accepted: 04/26/2013] [Indexed: 12/15/2022] Open
Abstract
Patients who suffer from severe burns develop metabolic imbalances and systemic inflammatory response syndrome (SIRS) which can result in multiple organ failure and death. Research aimed at reducing the inflammatory process has yielded new insight into burn injury therapies. In this review, we discuss strategies used to curb inflammation in burn injuries and note that further studies with high quality evidence are necessary.
Collapse
Affiliation(s)
- Jayme A. Farina
- Department of Surgery and Anatomy, Division of Plastic Surgery, School of Medicine of Ribeirão Preto-SP, University of São Paulo, Avenida Bandeirantes 3900, 9.°andar, 14048-900 Ribeirão Preto SP, Brazil
| | - Marina Junqueira Rosique
- Department of Surgery and Anatomy, Division of Plastic Surgery, School of Medicine of Ribeirão Preto-SP, University of São Paulo, Avenida Bandeirantes 3900, 9.°andar, 14048-900 Ribeirão Preto SP, Brazil
| | - Rodrigo G. Rosique
- Department of Surgery and Anatomy, Division of Plastic Surgery, School of Medicine of Ribeirão Preto-SP, University of São Paulo, Avenida Bandeirantes 3900, 9.°andar, 14048-900 Ribeirão Preto SP, Brazil
| |
Collapse
|
11
|
Li J, Liu YH, Ou S, Dai XM, Wang JP, Su YP. Steroid receptor coactivator-3 differentially regulates the inflammatory response in peritoneal macrophages. Mol Med Rep 2012; 5:1099-105. [PMID: 22245955 PMCID: PMC3493053 DOI: 10.3892/mmr.2012.750] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 01/03/2012] [Indexed: 12/14/2022] Open
Abstract
Steroid receptor coactivator-3 (SRC-3) is a transcriptional coactivator that plays an important role in the regulation of cytokine mRNA translation. In the present study, SCR-3 gene knockout mice were used to study the effects of SCR-3 on the regulation of the inflammatory response in peritoneal macrophages induced by lipopolysaccharides (LPS). Peritoneal macrophages (PMs) of SRC-3−/− mice showed a decrease in the release of TNF-α, IL-1β and IL-6, and an increase in the release of IL-10. Furthermore, results of RT-PCR also showed that levels of TNF-α, IL-1β and IL-6 mRNA expression were significantly lower, while the level of IL-10 mRNA expression was higher in the SRC-3−/− mice, compared to those of wild-type mice, following treatment with LPS (p<0.01). In addition, western blotting revealed that: i) the extent of reduction of the glucocorticoid receptor in PMs from SRC-3−/− mice was significantly lower than that in wild-type mice (p<0.01); ii) the extent of increase of AP-1 in PMS from SRC-3−/− mice was significantly lower than that in wild-type mice (p<0.01); iii) the extent of increase of NF-κB p65 in PMs from SRC-3−/− mice was significantly higher than that in wild-type mice (p<0.01). Collectively, our studies revealed that SRC-3 may play a key role in the maintenance of innate immunity. Furthermore, absence of the SRC-3 protein may result in the partial loss of inflammation and phagocytosis barrier function, including suppression of LPS-induced transcriptional activity, release of TNF-α, IL-1β and IL-6, and obstruction of the function of phagocytes and elimination of bacteria, as well as their production.
Collapse
Affiliation(s)
- Jun Li
- Department of Anesthesia, General Hospital of Chengdu Military Command Area, Chengdu, Sichuan 610083, PR China
| | | | | | | | | | | |
Collapse
|
12
|
Romano AA, Hahn T, Davis N, Lowery CA, Struss AK, Janda KD, Böttger LH, Matzanke BF, Carrano CJ. The Fe(III) and Ga(III) coordination chemistry of 3-(1-hydroxymethylidene) and 3-(1-hydroxydecylidene)-5-(2-hydroxyethyl)pyrrolidine-2,4-dione: novel tetramic acid degradation products of homoserine lactone bacterial quorum sensing molecules. J Inorg Biochem 2011; 107:96-103. [PMID: 22178671 DOI: 10.1016/j.jinorgbio.2011.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 10/14/2011] [Accepted: 10/20/2011] [Indexed: 11/26/2022]
Abstract
Bacteria use small diffusible molecules to exchange information in a process called quorum sensing (QS). An important class of quorum sensing molecules used by Gram-negative bacteria is the family of N-acylhomoserine lactones (HSL). It was recently discovered that a degradation product of the QS molecule 3-oxo-C(12)-homoserine lactone, the tetramic acid 3-(1-hydroxydecylidene)-5-(2-hydroxyethyl)pyrrolidine-2,4-dione, is a potent antibacterial agent, thus implying roles for QS outside of simply communication. Because these tetramic acids also appear to bind iron with appreciable affinity it was suggested that metal binding might contribute to their biological activity. Here, using a variety of spectroscopic tools, we describe the coordination chemistry of both the methylidene and decylidene tetramic acid derivatives with Fe(III) and Ga(III) and discuss the potential biological significance of such metal binding.
Collapse
Affiliation(s)
- Ariel A Romano
- Department of Chemistry and Biochemistry, San Diego State University, San Diego, CA 92182-1030, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Lowery CA, Salzameda NT, Sawada D, Kaufmann GF, Janda KD. Medicinal chemistry as a conduit for the modulation of quorum sensing. J Med Chem 2010; 53:7467-89. [PMID: 20669927 DOI: 10.1021/jm901742e] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Colin A Lowery
- Department of Chemistry and Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The Scripps Research Institute, 10550 N Torrey Pines Road, La Jolla, California 92037, USA
| | | | | | | | | |
Collapse
|
14
|
Yang Q, Berthiaume F, Androulakis IP. A quantitative model of thermal injury-induced acute inflammation. Math Biosci 2010; 229:135-48. [PMID: 20708022 DOI: 10.1016/j.mbs.2010.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 06/02/2010] [Accepted: 08/04/2010] [Indexed: 01/01/2023]
Abstract
Severe burns are among the most common causes of death from unintentional injury. The induction and resolution of the burn-induced systemic inflammatory response are mediated by a network of factors and regulatory proteins. Numerous mechanisms operate simultaneously, thus requiring a systems level approach to characterize their overall impact. Towards this goal, we propose an in silico semi-mechanistic model of burn-induced systemic inflammation using liver-specific gene expression from a rat burn model. Transcriptional responses are coupled with extracellular signals through a receptor mediated indirect response (IDR) and transit compartment model. The activation of the innate immune system in response to the burn stimulus involves the interaction between extracellular signals and critical receptors which triggers downstream signal transduction cascades leading to transcriptional changes. The resulting model consists of fifteen (15) coupled ordinary differential equations capturing key aspects of inflammation such as pro-inflammation, anti-inflammation and hypermetabolism. The model was then evaluated through a series of biologically relevant scenarios aiming at revealing the non-linear behavior of acute inflammation including: investigating the implication of effect of different severity of thermal injury; examining possible mechanistic dysregulation of IKK-NF-κB system which may reflect secondary effects that lead to potential malfunction of the response; and exploring the outcome of administration of receptor antagonist or anti-body to significant cytokines.
Collapse
Affiliation(s)
- Qian Yang
- Chemical Engineering, Rutgers University, 98 Brett Road, Piscataway, NJ 08854, USA
| | | | | |
Collapse
|
15
|
Gallium maltolate treatment eradicates Pseudomonas aeruginosa infection in thermally injured mice. Antimicrob Agents Chemother 2009; 53:1331-7. [PMID: 19188381 DOI: 10.1128/aac.01330-08] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Gallium (Ga) is a semimetallic element that has demonstrated therapeutic and diagnostic-imaging potential in a number of disease settings, including cancer and infectious diseases. Gallium's biological actions stem from its ionic radius being almost the same as that of ferric iron (Fe(3+)), whereby it can replace iron (Fe) in Fe(3+)-dependent biological systems, such as bacterial and mammalian Fe transporters and Fe(3+)-containing enzymes. Unlike Fe(3+), ionic gallium (Ga(3+)) cannot be reduced, and when incorporated, it inactivates Fe(3+)-dependent reduction and oxidation processes that are necessary for bacterial and mammalian cell proliferation. Most pathogenic bacteria require Fe for growth and function, and the availability of Fe in the host or environment can greatly enhance virulence. We examined whether gallium maltolate (GaM), a novel formulation of Ga, had antibacterial activity in a thermally injured acute infection mouse model. Dose-response studies indicated that a GaM dose as low as 25 mg/kg of body weight delivered subcutaneously was sufficient to provide 100% survival in a lethal P. aeruginosa-infected thermally injured mouse model. Mice treated with 100 mg/kg GaM had undetectable levels of Pseudomonas aeruginosa in their wounds, livers, and spleens, while the wounds of untreated mice were colonized with over 10(8) P. aeruginosa CFU/g of tissue and their livers and spleens were colonized with over 10(5) P. aeruginosa CFU/g of tissue. GaM also significantly reduced the colonization of Staphylococcus aureus and Acinetobacter baumannii in the wounds of thermally injured mice. Furthermore, GaM was also therapeutically effective in preventing preestablished P. aeruginosa infections at the site of the injury from spreading systemically. Taken together, our data suggest that GaM is potentially a novel antibacterial agent for the prevention and treatment of wound infections following thermal injury.
Collapse
|
16
|
Barnea Y, Carmeli Y, Kuzmenko B, Gur E, Hammer-Munz O, Navon-Venezia S. The establishment of a Pseudomonas aeruginosa-infected burn-wound sepsis model and the effect of imipenem treatment. Ann Plast Surg 2006; 56:674-9. [PMID: 16721084 DOI: 10.1097/01.sap.0000203984.62284.7a] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION We present a standardized Pseudomonas aeruginosa (PA) infected burn-wound model in mice for evaluating new antimicrobials and therapy strategies for PA infections and demonstrate the effect of the antibiotic imipenem in this model. METHODS A 6%-8% total body surface area, full-thickness, scald-burn wound was induced in anesthetized mice. Two study groups (PA-infected burn) were compared with 1 treatment group (systemic imipenem) and 3 control groups (noninfected burn, infected nonburned, and burn with distant infection). Seven-day mortality, quantitative culture from eschars and from spleens, weight loss, and time to healing were compared. RESULTS The 25%-100% mortality rate in the nontreated PA-infected burn group was directly related to the infecting inoculum. Imipenem treatment reduced the mortality rate to 0-17%. No control animal died. Systemic bacterial dissemination at 48 hours was significantly higher in the study group. Morbidity paralleled survival results. Wound healing was quicker in the imipenem-treated group and control groups compared with the infected nontreated group. CONCLUSIONS The mice model is a useful tool for evaluating new antibacterial agents and strategies for treating PA-infected burn injuries. Imipenem was found to be efficacious in the treatment of severe PA sepsis.
Collapse
Affiliation(s)
- Yoav Barnea
- Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | | | | | | | | | | |
Collapse
|
17
|
Sakallioglu AE, Basaran O, Karakayali H, Ozdemir BH, Yucel M, Arat Z, Haberal M. Interactions of systemic immune response and local wound healing in different burn depths: an experimental study on rats. J Burn Care Res 2006; 27:357-66. [PMID: 16679907 DOI: 10.1097/01.bcr.0000216330.93056.06] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to clarify the local and systemic immune responses at different burn depths. Thirty female Sprague-Dawley rats were divided into three groups: full-thickness (F), partial-thickness (P), and Sham (S). Burns were induced on three separate areas on the dorsums of rats. Serum levels of interferon (IFN)-gamma; tumor necrosis factor-alpha; interleukin (IL)-1, IL-6, and IL-10 were measured once in controls and 1 hour after burn, 48 hours after burn, and 7 days after burn in F and P groups. Neutrophils, CD68-positive macrophages, HLA-DR-positive cells, and CD3-positive lymphocytes were graded semiquantitatively, and the wounds were examined once in shams and at 1 hour after burn, 48 hours after burn, and 7 days after burn in F and P groups. IL-6 levels were highest in F group, followed by P group 1 hour after burn. IFN-gamma levels were higher in the F group; IL-1 levels were higher in F and P groups at 1 hour after burn. Local accumulation of macrophages was similar in F and P groups. Lymphocytes were denser in P group at 1 hour after burn, and neutrophils were denser in F group at 7 days after burn. We suggest that early elevations of IL-6 and IFN-gamma prolong inflammation in full-thickness burns. Modulation of proinflammatory cytokines may improve burn wound treatment.
Collapse
Affiliation(s)
- A Ebru Sakallioglu
- Department of General Surgery, Başkent University, Faculty of Medicine, Ankara, Turkey
| | | | | | | | | | | | | |
Collapse
|
18
|
Affiliation(s)
- Ruben Zamora
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | | |
Collapse
|
19
|
Haynes A, Ruda F, Oliver J, Hamood AN, Griswold JA, Park PW, Rumbaugh KP. Syndecan 1 shedding contributes to Pseudomonas aeruginosa sepsis. Infect Immun 2006; 73:7914-21. [PMID: 16299282 PMCID: PMC1307082 DOI: 10.1128/iai.73.12.7914-7921.2005] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The innate immune system is comprised of many components that function coordinately to prevent bacterial sepsis. However, thermal injury suppresses many of these factors, and the opportunistic pathogen Pseudomonas aeruginosa takes advantage of this condition, making it one of the leading causes of morbidity and mortality in the setting of thermal injury. P. aeruginosa is extremely efficient at colonizing burn wounds, spreading systemically, and causing sepsis, which often results in a systemic inflammatory response, multiple-organ failure, and death. The pathogenicity of P. aeruginosa is due to the arsenal of virulence factors produced by the pathogen and the immunocompromised state of the host. Syndecan 1 is a major heparan sulfate proteoglycan present on many host cells involved in thermal injury. Syndecan 1 anchored to the cell surface can be cleaved in a process termed ectodomain shedding. Syndecan 1 shedding results in the release of intact, soluble proteoglycan ectodomains that have diverse roles in innate immunity. Here we show for the first time that thermal injury results in shedding of syndecan 1 from host tissue. Our data show that syndecan 1 null mice are significantly less susceptible to P. aeruginosa infection than their wild-type counterparts, as demonstrated by (i) significantly lower mortality; (ii) absence of systemic spread of P. aeruginosa; and (iii) significant reductions in some proinflammatory cytokines. These results suggest that shed syndecan 1 plays an important role in the pathogenesis of P. aeruginosa infection of thermal injury and that syndecan 1-neutralizing agents may be effective supplements to current P. aeruginosa treatments.
Collapse
Affiliation(s)
- Allan Haynes
- Texas Tech University Health Sciences Center, Department of Surgery, 3601 4th Street, Lubbock, TX 79430, USA
| | | | | | | | | | | | | |
Collapse
|
20
|
Valdéz JC, Peral MC, Rachid M, Santana M, Perdigón G. Interference of Lactobacillus plantarum with Pseudomonas aeruginosa in vitro and in infected burns: the potential use of probiotics in wound treatment. Clin Microbiol Infect 2005; 11:472-9. [PMID: 15882197 DOI: 10.1111/j.1469-0691.2005.01142.x] [Citation(s) in RCA: 175] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study evaluated the ability of the probiotic organism Lactobacillus plantarum to inhibit the pathogenic activity of Pseudomonas aeruginosa, both in vitro and in vivo, and investigated the mechanisms involved in such protection. L. plantarum whole cultures, culture filtrates (acid filtrate and neutralised acid filtrate) and isolated, washed cells were tested in vitro for their effects on the production of the P. aeruginosa quorum-sensing signal molecules, acyl-homoserine-lactones (AHLs), and two virulence factors controlled by these signal molecules, elastase and biofilm. All were inhibited by L. plantarum cultures and filtrates, but not by isolated, washed cells. The acid L. plantarum growth medium itself had some inhibitory activity, but the greatest activity was exerted by the whole culture. To test the in-vivo activity of L. plantarum, a burned-mouse model was used in which burns infected with P. aeruginosa were treated with L. plantarum at 3, 4, 5, 7 and 9 days post-infection. Samples from skin, liver and spleen taken after 5, 10 and 15 days demonstrated inhibition of P. aeruginosa colonisation by L. plantarum. There was also an improvement in tissue repair, enhanced phagocytosis of P. aeruginosa by tissue phagocytes, and a decrease in apoptosis at 10 days. These results indicate that L. plantarum and/or its by-products are potential therapeutic agents for the local treatment of P. aeruginosa burn infections.
Collapse
Affiliation(s)
- J C Valdéz
- Cátedra de Inmunología, Facultad de Bioquímica, Química y Farmacia, Argentina.
| | | | | | | | | |
Collapse
|
21
|
Bannerman DD, Chockalingam A, Paape MJ, Hope JC. The bovine innate immune response during experimentally-induced Pseudomonas aeruginosa mastitis. Vet Immunol Immunopathol 2005; 107:201-15. [PMID: 15970335 DOI: 10.1016/j.vetimm.2005.04.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Revised: 04/15/2005] [Accepted: 04/27/2005] [Indexed: 01/15/2023]
Abstract
Almost half of all clinical cases of mastitis are caused by Gram-negative bacteria. Among these bacteria, intramammary infection by Pseudomonas aeruginosa remains one of the most refractory to antibiotic therapy. The ability to recognize potentially harmful pathogens whether previously encountered or not, as well as the induction of an initial pro-inflammatory response to these pathogens, are critical components of host innate immunity. Although the innate immune response to another Gram-negative mastitis-causing pathogen, Escherichia coli, has been well-characterized, little is known about the response to other Gram-negative bacteria, including P. aeruginosa. The objective of the current study was to characterize the systemic and localized bovine innate immune response to intramammary infection with P. aeruginosa. The contralateral quarters of ten mid-lactating Holstein cows were challenged with either saline or P. aeruginosa. Following the establishment of infection, milk samples were collected and assayed for changes in cytokine and growth factor concentrations, complement activation, and changes in the levels of soluble CD14 (sCD14) and lipopolysaccharide (LPS)-binding protein (LBP), two accessory molecules involved in host recognition of Gram-negative bacteria. Initial increases in milk somatic cell counts were evident within 12h of experimental challenge and remained elevated for >or=3 weeks. Increased permeability of the mammary gland vasculature, as evidenced by elevated milk levels of BSA, was initially observed 20 h post-infection and persisted for 2 weeks. Within 32 h of challenge, increased levels of IL-8, TNF-alpha, IL-10, and IL-12 were detected, however, the elevated levels of these cytokines were not sustained for longer than a 24h period. In contrast, elevations in IL-1beta, IFN-gamma, TGF-alpha, TGF-beta1, TGF-beta2, sCD14, LBP, and activated complement factor 5 (C5a) were sustained for periods of >48 h. Systemic changes were characterized by elevated body temperature, induction of the acute phase protein synthesis of serum amyloid A and LBP, and a transient decrease in circulating neutrophils and lymphocytes. Together, these data demonstrate the capability of the mammary gland to mount a robust innate immune response to P. aeruginosa that is characterized by the induction of pro-inflammatory cytokines, complement activation, and increased levels of accessory molecules involved in Gram-negative bacterial recognition.
Collapse
Affiliation(s)
- Douglas D Bannerman
- Bovine Functional Genomics Laboratory, USDA-Agricultural Research Service, ANRI, BARC-East, Bldg. 1040, Room #2, Beltsville, MD 20705-2350, USA.
| | | | | | | |
Collapse
|
22
|
Haynes A, Rumbaugh KP, Park PW, Hamood AN, Griswold JA. Protamine sulfate reduces the susceptibility of thermally injured mice to Pseudomonas aeruginosa infection. J Surg Res 2005; 123:109-17. [PMID: 15652958 DOI: 10.1016/j.jss.2004.07.251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND In this study, we investigated the ability of protamine sulfate, at sub-bactericidal dosing, to interfere with the in vivo virulence of Pseudomonas aeruginosa (PAO1) during burn wound infection. MATERIALS AND METHODS The study was conducted using the murine model of thermal injury. Preliminary experiments determined a protocol for administration of protamine sulfate that had no in vivo bactericidal effects. Based on this, the effect of local injection of protamine sulfate on the in vivo virulence of PAO1 was assessed using these parameters: (1) the percent mortality among PAO1-infected, thermally injured mice; (2) the local proliferation and spread of PAO1 within the infected burned tissue; (3) the systemic spread of PAO1 within thermally injured/infected mice; and (4) the local cytokine response elicited by PAO1 thermally injured/infected mice. RESULTS Injection of protamine sulfate into the thermally injured tissue of PAO1-infected/thermally injured mice significantly decreased the percent mortality and inhibited the systemic dissemination of PAO1 microorganisms to the liver and spleen. It had no effect, however, on the ability of the bacteria to proliferate and spread within the thermally injured tissue. It also was determined that protamine sulfate was ineffective at preventing mouse death at the dose administered if injected intramuscularly instead of directly into burned tissue. Protamine sulfate reduced the expression of the proinflammatory cytokines IL-6 and LIF in the injured/infected tissue. Heparan sulfate given in conjunction with protamine sulfate returned mortality levels to those of untreated mice. CONCLUSIONS Our results suggest that: (1) local injection of sub-bactericidal doses of protamine sulfate reduces the virulence of P. aeruginosa; (2) this effect is due to interference with the systemic rather than local spread of P. aeruginosa; and (3) local application of protamine sulfate may have potential as supportive therapy for prevention of systemic P. aeruginosa infection in severely burned patients.
Collapse
Affiliation(s)
- Allan Haynes
- University of Washington Health Sciences Center, 1959 NE Pacific St., Seattle, WA 98195, USA
| | | | | | | | | |
Collapse
|
23
|
Carey AL, Febbraio MA. Interleukin-6 and insulin sensitivity: friend or foe? Diabetologia 2004; 47:1135-1142. [PMID: 15241593 DOI: 10.1007/s00125-004-1447-y] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2004] [Accepted: 04/19/2004] [Indexed: 02/03/2023]
Affiliation(s)
- A L Carey
- The Skeletal Muscle Research Laboratory, School of Medical Sciences, RMIT University, PO Box 71, Bundoora 3083, Victoria, Australia
| | - M A Febbraio
- The Skeletal Muscle Research Laboratory, School of Medical Sciences, RMIT University, PO Box 71, Bundoora 3083, Victoria, Australia.
| |
Collapse
|
24
|
Giamarellos-Bourboulis EJ, Plachouras D, Tzivra A, Kousoulas V, Bolanos N, Raftogiannis M, Galani I, Dontas I, Dionyssiou-Asteriou A, Giamarellou H. Stimulation of innate immunity by susceptible and multidrug-resistant Pseudomonas aeruginosa: an in vitro and in vivo study. Clin Exp Immunol 2004; 135:240-6. [PMID: 14738451 PMCID: PMC1808952 DOI: 10.1111/j.1365-2249.2003.02365.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In attempt to investigate the stimulatory effect of Pseudomonas aeruginosa on innate immunity and to correlate it to its level of resistance to antimicrobials, 20 isolates were applied; 8 isolates were susceptible and 12 multidrug-resistant. Genetic diversity was defined by PFGE. Human monocytes of two healthy volunteers were in vitro stimulated by the isolates for the production of pro-inflammatory (TNF-alpha, IL-1beta, IL-6, IL-8 and IL-12) and anti-inflammatory cytokines (IL-10), of malondialdehyde and of procalcitonin. Cytokines were estimated by EIA, malondialdehyde by the thiobarbiturate assay and procalcitonin by an immunochemiluminometric assay. Survival of 48 Wistar rats was recorded after induction of sepsis by the intraperitoneal injection of three susceptible and three multidrug-resistant isolates. To test whether comparative effect of the latter isolates on survival correlates with any difference of monocyte-mediated release of pro-inflammatory mediators, monocytes of two rats were in vitro stimulated for the production of TNF-alpha and of malondialdehyde. In vitro stimulation of human monocytes by the susceptible isolates elicited elevated production of malondiadeheyde, of IL-1beta and of IL-6 compared to stimulation by multidrug-resistant isolates. Similar differences were found for TNF-alpha and IL-8, but they were not statistically significant. Production of IL-10 and IL-12 was not detected after stimulation with any isolate. Levels of procalcitonin were similar after induction with either susceptible or multidrug-resistant isolates. Mean survival of animals was 7.56, 21.80 and 55.20 h, respectively, after challenge by the susceptible isolates and 28.89, 61.8 and more than 120 h, respectively, after challenge by the multidrug-resistant isolates. Differences of survival were accompanied by greater rodent monocyte-release of TNF-alpha and malondialdehyde after stimulation by the susceptible isolates compared to multidrug-resistant ones. It is concluded that considerable differences are encountered on the stimulation of human monocytes by susceptible and resistant isolates of Pseudomonas aeruginosa. These results correlate with in vivo evidence and might influence decision on therapeutics.
Collapse
|
25
|
Rumbaugh KP, Hamood AN, Griswold JA. Cytokine induction by the P. aeruginosa quorum sensing system during thermal injury. J Surg Res 2004; 116:137-44. [PMID: 14732360 DOI: 10.1016/j.jss.2003.08.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Pseudomonas aeruginosa causes serious infections in severely burned patients due to its ability to produce numerous virulence factors. The production of most of these factors is controlled by the cell-to-cell communication system called quorum sensing (QS). We have recently shown that several proinflammatory and hematopoietic cytokines are produced during infection of the burn wound with P. aeruginosa strain PAO1. Most of these cytokines were not produced during either thermal injury or P. aeruginosa infection alone. MATERIALS AND METHODS AND RESULTS In this study, we tried to determine if the QS systems play a role in the production of cytokines during P. aeruginosa infection of burn wounds. This was accomplished using the murine model of thermal injury, the P. aeruginosa strain PAO1 and its QS defective mutant (PAO-JP2), and the Multi-probe RNase protection assay. The mRNA for TNF-alpha, IL-6, TGF-beta, and G-CSF was detected within the skin of PAO1 infected/thermally injured mice. In contrast, the expression of these cytokines was not detected in PAO-JP2 infected/thermally injured mice. In comparison with the parent strain, PAO-JP2 was not defective either in its growth or in its spread within the thermally injured skin. A complementation experiment, using a plasmid that carries the intact QS gene, was conducted to confirm these results. In the presence of the complementing plasmid, PAO-JP2 produced the mRNA for the above cytokines. CONCLUSIONS These results suggest that: 1) the QS system is involved in the induction of cytokine expression during P. aeruginosa infection of burn wounds; and 2) this effect may be caused by either a component of the QS system or a QS-controlled virulence factor.
Collapse
Affiliation(s)
- Kendra P Rumbaugh
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA
| | | | | |
Collapse
|
26
|
Febbraio MA, Ott P, Nielsen HB, Steensberg A, Keller C, Krustrup P, Secher NH, Pedersen BK. Hepatosplanchnic clearance of interleukin-6 in humans during exercise. Am J Physiol Endocrinol Metab 2003; 285:E397-402. [PMID: 12857677 DOI: 10.1152/ajpendo.00134.2003] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The cytokine interleukin (IL)-6 can increase markedly in the circulation during exercise, but whether the liver is a source of this increase is unknown. The aim of this study was to measure IL-6 flux across the hepatosplanchnic tissues in humans. To elevate systemic concentrations of IL-6, six healthy male subjects performed 120 min of semirecumbent cycling, and blood samples were simultaneously obtained from a brachial artery and the hepatic vein before and during exercise for the analysis of IL-6. Hepatosplanchnic blood flow (HBF) was measured using the indocyanine green infusion technique. Net hepatosplanchnic IL-6 balance was calculated from these measures. HBF was 1.3 +/- 0.1 l/min at rest and was not reduced throughout exercise, averaging 1.1 +/- 0.2 l/min. Arterial plasma IL-6 markedly increased (P < 0.05) from 1.8 +/- 0.6 ng/l at rest to 14.3 +/- 3.2 ng/l after 120 min of exercise. The hepatosplanchnic viscera did not contribute to this increase, since there was a net hepatosplanchnic IL-6 uptake (0.8 +/- 0.3 vs. 5.5 +/- 1.9 ng/min, rest vs. 120 min; P < 0.05). These data demonstrate that the hepatosplanchnic viscera remove IL-6 from the circulation in humans. This removal may constitute a mechanism limiting the negative chronic metabolic action of chronically elevated circulating IL-6.
Collapse
Affiliation(s)
- Mark A Febbraio
- Skeletal Muscle Research Laboratory, School of Medical Sciences, RMIT Univ., Bundoora, Victoria 3083, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
The activation of a pro-inflammatory cascade after burn injury appears to be important in the development of subsequent immune dysfunction, susceptibility to sepsis and multiple organ failure. Macrophages are major producers of pro-inflammatory mediators and their productive capacity for these mediators is markedly enhanced following thermal injury. Thus, macrophage hyperactivity (as defined by increased productive capacity for pro-inflammatory mediators) appears to be of critical importance in the development of post-burn immune dysfunction. This review will focus on the current state of knowledge with regards to the role of macrophages in the development of post-burn immune dysfunction. Particular areas of discussion include: nitric oxide synthase (NOS) and cyclooxygenase (COX) enzyme systems, macrophages and the T-helper (Th)-1/Th-2 cytokine responses, alterations in macrophages signal transduction and a potential role for gamma/delta T-cells in the development of macrophage hyperactivity following thermal injury. A more comprehensive understanding of the relationship between macrophage activity and post-burn immune dysfunction will hopefully provide the basis for improved therapeutic regimes in the treatment of burn patients.
Collapse
Affiliation(s)
- Martin G Schwacha
- Center for Surgical Research, University of Alabama at Birmingham, G094 Volker Hall, 1670 University Boulevard, Birmingham, AL 35294-0019, USA.
| |
Collapse
|
28
|
Fogle MR, Griswold JA, Oliver JW, Hamood AN. Anti-ETA IgG neutralizes the effects of Pseudomonas aeruginosa exotoxin A. J Surg Res 2002; 106:86-98. [PMID: 12127813 DOI: 10.1006/jsre.2002.6433] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The opportunistic pathogen Pseudomonas aeruginosa causes severe infections in immunocompromised hosts. Among P. aeruginosa-infected burn patients, mortality may reach as high as 50%. Due to their immunocompromised status, burn patients may benefit from passive immunotherapy against infection. As a potential multivalent immunoglobulin therapy, specific polyclonal antibodies against four P. aeruginosa virulence factors, including exotoxin A (ETA), were prepared. MATERIALS AND METHODS AND RESULTS In this study, we analyzed the ability of ETA antibody (ETA-Ab) to neutralize the in vivo effects of ETA. Adult mice injected with purified ETA suffered 100% mortality. The cytosolic DNA of their hepatocytes was fragmented, indicating ETA induction of apoptosis. In addition, multiprobe RNase protection assays showed that ETA upregulates the expression of the genes for proinflammatory cytokines as well as apoptosis genes in the livers of ETA-injected mice. Treatment with ETA-Ab prior to ETA injection prevented mortality, ETA-induced hepatocyte DNA fragmentation, and upregulation of the cytokine and apoptosis-related genes. The role of ETA during P. aeruginosa infection of the burn wound was examined by determining the in vivo virulence of P. aeruginosa PA103 and its isogenic, ETA-deficient mutant PA103Omega::toxA using the thermally injured mouse model. The lethality, local spread, and systemic spread of PA103Omega::toxA were significantly reduced compared to PA103. CONCLUSION These results suggest that (1) ETA induces apoptosis in hepatocytes, (2) specific cytokines are produced in response to ETA, (3) ETA-Ab neutralizes these effects, and (4) ETA contributes to the spread of P. aeruginosa during burn wound infection.
Collapse
Affiliation(s)
- Matthew R Fogle
- Department of Microbiology and Immunology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | | | | | | |
Collapse
|