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Tang F, Zhao XL, Xu LY, Zhang JN, Ao H, Peng C. Endothelial dysfunction: Pathophysiology and therapeutic targets for sepsis-induced multiple organ dysfunction syndrome. Biomed Pharmacother 2024; 178:117180. [PMID: 39068853 DOI: 10.1016/j.biopha.2024.117180] [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: 05/22/2024] [Revised: 07/13/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024] Open
Abstract
Sepsis and septic shock are critical medical conditions characterized by a systemic inflammatory response to infection, significantly contributing to global mortality rates. The progression to multiple organ dysfunction syndrome (MODS) represents the most severe complication of sepsis and markedly increases clinical mortality. Central to the pathophysiology of sepsis, endothelial cells play a crucial role in regulating microcirculation and maintaining barrier integrity across various organs and tissues. Recent studies have underscored the pivotal role of endothelial function in the development of sepsis-induced MODS. This review aims to provide a comprehensive overview of the pathophysiology of sepsis-induced MODS, with a specific focus on endothelial dysfunction. It also compiles compelling evidence regarding potential small molecules that could attenuate sepsis and subsequent multi-organ damage by modulating endothelial function. Thus, this review serves as an essential resource for clinical practitioners involved in the diagnosing, managing, and providing intensive care for sepsis and associated multi-organ injuries, emphasizing the importance of targeting endothelial cells to enhance outcomes of the patients.
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Affiliation(s)
- Fei Tang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Xiao-Lan Zhao
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Li-Yue Xu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Jing-Nan Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Hui Ao
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Cheng Peng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
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He H, Zhang W, Jiang L, Tong X, Zheng Y, Xia Z. Endothelial Cell Dysfunction Due to Molecules Secreted by Macrophages in Sepsis. Biomolecules 2024; 14:980. [PMID: 39199368 PMCID: PMC11352357 DOI: 10.3390/biom14080980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/25/2024] [Accepted: 08/06/2024] [Indexed: 09/01/2024] Open
Abstract
Sepsis is recognized as a syndrome of systemic inflammatory reaction induced by dysregulation of the body's immunity against infection. The multiple organ dysfunction associated with sepsis is a serious threat to the patient's life. Endothelial cell dysfunction has been extensively studied in sepsis. However, the role of macrophages in sepsis is not well understood and the intrinsic link between the two cells has not been elucidated. Macrophages are first-line cells of the immune response, whereas endothelial cells are a class of cells that are highly altered in function and morphology. In sepsis, various cytokines secreted by macrophages and endothelial cell dysfunction are inextricably linked. Therefore, investigating how macrophages affect endothelial cells could offer a theoretical foundation for the treatment of sepsis. This review links molecules (TNF-α, CCL2, ROS, VEGF, MMP-9, and NO) secreted by macrophages under inflammatory conditions to endothelial cell dysfunction (adhesion, permeability, and coagulability), refining the pathophysiologic mechanisms of sepsis. At the same time, multiple approaches (a variety of miRNA and medicines) regulating macrophage polarization are also summarized, providing new insights into reversing endothelial cell dysfunction and improving the outcome of sepsis treatment.
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Affiliation(s)
- Heng He
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China; (H.H.); (W.Z.); (L.J.); (X.T.)
| | - Wei Zhang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China; (H.H.); (W.Z.); (L.J.); (X.T.)
| | - Luofeng Jiang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China; (H.H.); (W.Z.); (L.J.); (X.T.)
| | - Xirui Tong
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China; (H.H.); (W.Z.); (L.J.); (X.T.)
| | - Yongjun Zheng
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China; (H.H.); (W.Z.); (L.J.); (X.T.)
| | - Zhaofan Xia
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China; (H.H.); (W.Z.); (L.J.); (X.T.)
- Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
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Zhu W, Wang F, Hu C, Zhao Q, Zhang D, Wang X, Hu B, Li J. GTS-21 attenuates ACE/ACE2 ratio and glycocalyx shedding in lipopolysaccharide-induced acute lung injury by targeting macrophage polarization derived ADAM-17. Int Immunopharmacol 2024; 129:111603. [PMID: 38310766 DOI: 10.1016/j.intimp.2024.111603] [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: 10/02/2023] [Revised: 11/29/2023] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
Acute lung injury (ALI) has received considerable attention in intensive care owing to its high mortality rate. It has been demonstrated that the selective alpha7 nicotinic acetylcholine receptor agonist Gainesville Tokushima scientists (GTS)-21 is promising for treating ALI caused by lipopolysaccharides (LPS). However, the precise underlying mechanism remains unknown. This study aimed to investigate the potential efficacy of GTS-21 in the treatment of ALI. We developed mouse models of ALI and alveolar epithelial type II cells (AT2s) injury following treatment with LPS and different polarized macrophage supernatants, respectively. Pathological changes, pulmonary edema, and lung compliance were assessed. Inflammatory cells count, protein content, and pro-inflammatory cytokine levels were analysed in the bronchoalveolar lavage fluid. The expression of angiotensin-converting enzyme (ACE), ACE2, syndecan-1 (SDC-1), heparan sulphate (HS), heparanase (HPA), exostosin (EXT)-1, and NF-κB were tested in lung tissues and cells. GTS-21-induced changes in macrophage polarization were verified in vivo and in vitro. Polarized macrophage supernatants with or without recombination a disintegrin and metalloproteinase-17 (ADAM-17) and small interfering (si)RNA ADAM-17 were used to verify the role of ADAM-17 in AT2 injury. By reducing pathological alterations, lung permeability, inflammatory response, ACE/ACE2 ratio, and glycocalyx shedding, as well as by downregulating the HPA and NF-κB pathways and upregulating EXT1 expression in vivo, GTS-21 significantly diminished LPS-induced ALI compared to that of the LPS group. GTS-21 significantly attenuated macrophage M1 polarization and augmented M2 polarization in vitro and in vivo. The destructive effects of M1 polarization supernatant can be inhibited by GTS-21 and siRNA ADAM-17. GTS-21 exerted a protective effect against LPS-induced ALI, which was reversed by recombinant ADAM-17. Collectively, GTS-21 alleviates LPS-induced ALI by attenuating AT2s ACE/ACE2 ratio and glycocalyx shedding through the inhibition of macrophage M1 polarization derived ADAM-17.
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Affiliation(s)
- Weiwei Zhu
- Department of Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China; Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei, China; Department of Critical Care Medicine, Binzhou Medical University Hospital, Binzhou 256600, Shandong, China
| | - Fengyun Wang
- Department of Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China; Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei, China
| | - Chang Hu
- Department of Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China; Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei, China
| | - Qiuyue Zhao
- Department of Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China; Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei, China
| | - Dandan Zhang
- Department of Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China; Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei, China
| | - Xiaozhi Wang
- Department of Critical Care Medicine, Binzhou Medical University Hospital, Binzhou 256600, Shandong, China.
| | - Bo Hu
- Department of Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China; Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei, China.
| | - Jianguo Li
- Department of Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China; Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei, China.
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Gu Z, Sun M, Liu J, Huang Q, Wang Y, Liao J, Shu T, Tao M, Mao G, Pei Z, Meng W, Zhang X, Wei Y, Zhang S, Li S, Xiao K, Lu Y, Xu Q. Endothelium-Derived Engineered Extracellular Vesicles Protect the Pulmonary Endothelial Barrier in Acute Lung Injury. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306156. [PMID: 38062916 PMCID: PMC10853733 DOI: 10.1002/advs.202306156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/17/2023] [Indexed: 02/10/2024]
Abstract
Acute lung injury (ALI) is a severe respiratory disease with a high mortality rate. The integrity of the pulmonary endothelial barrier influences the development and prognosis of ALI. Therefore, it has become an important target for ALI treatment. Extracellular vesicles (EVs) are promising nanotherapeutic agents against ALI. Herein, endothelium-derived engineered extracellular vesicles (eEVs) that deliver microRNA-125b-5p (miRNA-125b) to lung tissues exerting a protective effect on endothelial barrier integrity are reported. eEVs that are modified with lung microvascular endothelial cell-targeting peptides (LET) exhibit a prolonged retention time in lung tissues and targeted lung microvascular endothelial cells in vivo and in vitro. To improve the efficacy of the EVs, miRNA-125b is loaded into EVs. Finally, LET-EVs-miRNA-125b is constructed. The results show that compared to the EVs, miRNA-125b, and EVs-miRNA-125b, LET-EVs-miRNA-125b exhibit the most significant treatment efficacy in ALI. Moreover, LET-EVs-miRNA-125b is found to have an important protective effect on endothelial barrier integrity by inhibiting cell apoptosis, promoting angiogenesis, and protecting intercellular junctions. Sequencing analysis reveals that LET-EVs-miRNA-125b downregulates early growth response-1 (EGR1) levels, which may be a potential mechanism of action. Taken together, these findings suggest that LET-EVs-miRNA-125b can treat ALI by protecting the endothelial barrier integrity.
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Affiliation(s)
- Zhengyan Gu
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
- Department of Pharmaceutical SciencesSchool of PharmacyNaval Medical UniversityShanghai200433P. R. China
| | - Mingxue Sun
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Jihao Liu
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Qi Huang
- School of Traditional Chinese Materia MedicaShenyang Pharmaceutical UniversityShenyang110006P. R. China
| | - Yunqin Wang
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Jun Liao
- Department of Pharmaceutical SciencesSchool of PharmacyNaval Medical UniversityShanghai200433P. R. China
- School of MedicineShanghai UniversityShanghai200444P. R. China
| | - Tingbin Shu
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Min Tao
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Guanchao Mao
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Zhipeng Pei
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Wenqi Meng
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Xinkang Zhang
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Youheng Wei
- State Key Laboratory of Genetic EngineeringInstitute of GeneticsFudan UniversityShanghai200433P. R. China
| | - Shanshan Zhang
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Songling Li
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
| | - Kai Xiao
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
- Marine Biomedical Science and Technology Innovation Platform of Lingang Special AreaShanghai200433P. R. China
| | - Ying Lu
- Department of Pharmaceutical SciencesSchool of PharmacyNaval Medical UniversityShanghai200433P. R. China
| | - Qingqiang Xu
- Lab of Toxicology and PharmacologyFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
- Basic Medical Center for Pulmonary DiseaseFaculty of Naval MedicineNaval Medical UniversityShanghai200433P. R. China
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