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Gauthier AG, Lin M, Zefi S, Kulkarni A, Thakur GA, Ashby CR, Mantell LL. GAT107-mediated α7 nicotinic acetylcholine receptor signaling attenuates inflammatory lung injury and mortality in a mouse model of ventilator-associated pneumonia by alleviating macrophage mitochondrial oxidative stress via reducing MnSOD-S-glutathionylation. Redox Biol 2023; 60:102614. [PMID: 36717349 PMCID: PMC9950665 DOI: 10.1016/j.redox.2023.102614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Supraphysiological concentrations of oxygen (hyperoxia) can compromise host defense and increase susceptibility to bacterial and viral infections, causing ventilator-associated pneumonia (VAP). Compromised host defense and inflammatory lung injury are mediated, in part, by high extracellular concentrations of HMGB1, which can be decreased by GTS-21, a partial agonist of α7 nicotinic acetylcholine receptor (α7nAChR). Here, we report that a novel α7nAChR agonistic positive allosteric modulator (ago-PAM), GAT107, at 3.3 mg/kg, i.p., significantly decreased animal mortality and markers of inflammatory injury in mice exposed to hyperoxia and subsequently infected with Pseudomonas aeruginosa. The incubation of macrophages with 3.3 μM of GAT107 significantly decreased hyperoxia-induced extracellular HMGB1 accumulation and HMGB1-induced macrophage phagocytic dysfunction. Hyperoxia-compromised macrophage function was correlated with impaired mitochondrial membrane integrity, increased superoxide levels, and decreased manganese superoxide dismutase (MnSOD) activity. This compromised MnSOD activity is due to a significant increase in its level of glutathionylation. The incubation of hyperoxic macrophages with 3.3 μM of GAT107 significantly decreases the levels of glutathionylated MnSOD, and restores MnSOD activity and mitochondrial membrane integrity. Thus, GAT107 restored hyperoxia-compromised phagocytic functions by decreasing HMGB1 release, most likely via a mitochondrial-directed pathway. Overall, our results suggest that GAT107 may be a potential treatment to decrease acute inflammatory lung injury by increasing host defense in patients with VAP.
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Affiliation(s)
- Alex G. Gauthier
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Mosi Lin
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Sidorela Zefi
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | | | | | - Charles R. Ashby
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Lin L. Mantell
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA,Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA,Corresponding author. Department of Pharmaceutical Sciences, St. John's University College of Pharmacy and Health Sciences, 128 St. Albert Hall, 8000 Utopia Parkway, Queens, NY, 11439, USA.
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Pinilla-Gonzalez A, Lara-Cantón I, Torrejón-Rodríguez L, Parra-Llorca A, Aguar M, Kuligowski J, Piñeiro-Ramos JD, Sánchez-Illana Á, Navarro AG, Vento M, Cernada M. Early molecular markers of ventilator-associated pneumonia in bronchoalveolar lavage in preterm infants. Pediatr Res 2022; 93:1559-1565. [PMID: 36071239 PMCID: PMC9451119 DOI: 10.1038/s41390-022-02271-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Ventilator-associated pneumonia (VAP) constitutes a serious nosocomial infection. Our aim was to evaluate the reliability of cytokines and oxidative stress/inflammation biomarkers in bronchoalveolar lavage fluid (BALF) and tracheal aspirates (TA) as early biomarkers of VAP in preterm infants. METHODS Two cohorts were enrolled, one to select candidates and the other for validation. In both, we included preterms with suspected VAP, according to BALF culture, they were classified into confirmed VAP and no VAP. Concentration of 16 cytokines and 8 oxidative stress/inflammation biomarkers in BALF and TA was determined in all patients. RESULTS In the first batch, IL-17A and TNF-α in BALF, and in the second one IL-10, IL-6, and TNF-α in BALF were significantly higher in VAP patients. BALF TNF-α AUC in both cohorts was 0.86 (sensitivity 0.83, specificity 0.88). No cytokine was shown to be predictive of VAP in TA. A statistically significant increase in the VAP group was found for glutathione sulfonamide (GSA) in BALF and TA. CONCLUSIONS TNF-α in BALF and GSA in BALF and TA were associated with VAP in preterm newborns; thus, they could be used as early biomarkers of VAP. Further studies with an increased number of patients are needed to confirm these results. IMPACT We found that TNF-α BALF and GSA in both BALF and TA are capable of discriminating preterm infants with VAP from those with pulmonary pathology without infection. This is the first study in preterm infants aiming to evaluate the reliability of cytokines and oxidative stress/inflammation biomarkers in BALF and TA as early diagnostic markers of VAP. We have validated these results in two independent cohorts of patients. Previously studies have focused on full-term neonates and toddlers and determined biomarkers mostly in TA, but none was exclusively conducted in preterm infants.
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Affiliation(s)
- Alejandro Pinilla-Gonzalez
- grid.84393.350000 0001 0360 9602Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain ,grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Inmaculada Lara-Cantón
- grid.84393.350000 0001 0360 9602Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain ,grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Laura Torrejón-Rodríguez
- grid.84393.350000 0001 0360 9602Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain ,grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Anna Parra-Llorca
- grid.84393.350000 0001 0360 9602Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain ,grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Marta Aguar
- grid.84393.350000 0001 0360 9602Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain ,grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Julia Kuligowski
- grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - José David Piñeiro-Ramos
- grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Ángel Sánchez-Illana
- grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain ,grid.5338.d0000 0001 2173 938XPresent Address: Analytical Chemistry Department, University of Valencia, Burjassot, Spain
| | - Ana Gimeno Navarro
- grid.84393.350000 0001 0360 9602Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain ,grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Máximo Vento
- grid.84393.350000 0001 0360 9602Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain ,grid.84393.350000 0001 0360 9602Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain ,National Coordinator of the Spanish Maternal and Infant Health and Development Network, Health Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness (RD12/0026), Valencia, Spain
| | - María Cernada
- Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE), Valencia, Spain. .,Neonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain.
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Davis MD, Winters BR, Madden MC, Pleil JD, Sessler CN, Wallace MAG, Ward-Caviness CK, Montpetit AJ. Exhaled breath condensate biomarkers in critically ill, mechanically ventilated patients. J Breath Res 2020; 15:016011. [DOI: 10.1088/1752-7163/abc235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Strouvalis I, Routsi C, Adamopoulou M, Raftogiannis M, Renieris G, Orfanos SE, Kotanidou A, Sabracos L, Giamarellos-Bourboulis EJ. Early increase of VEGF-A is associated with resolution of ventilator-associated pneumonia: Clinical and experimental evidence. Respirology 2018; 23:942-949. [PMID: 29741298 DOI: 10.1111/resp.13320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 02/12/2018] [Accepted: 03/29/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVE The role of vascular endothelial growth factor (VEGF)-A in the resolution of ventilator-associated pneumonia (VAP) was investigated in clinical and mouse pneumonia models. METHODS VEGF-A was measured for seven consecutive days by an immunosorbent assay in sera of 82 patients with VAP and changes from baseline were correlated with the resolution of VAP. Experimental animals were challenged intratracheally with Pseudomonas aeruginosa. Mouse bronchoalveolar lavage (BAL) samples and segments of lung tissue were obtained at 24, 48 and 124 h after bacterial challenge. Levels of VEGF-A, tumour Necrosis Factor alpha (TNF-α), interleukin (IL)-1β, interferon-gamma (IFNγ) and myeloperoxidase (MPO) activity were measured in these samples. RESULTS VAP resolved in 36.1% of patients with a less than 45% increase of VEGF-A on day 5 compared to 65.2% of patients with a more than 45% increase (P = 0.014). This was also accompanied by an earlier resolution of VAP (log-rank: 7.99; P = 0.005) and it was not pathogen-specific. The increase of VEGF-A was an independent variable associated with VAP resolution in forward logistic regression analysis where Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were included as independent variables. VEGF-A in mouse BAL and lung tissue increased significantly at 124 h but not with the other mediators. In mice pre-treated with bevacizumab, VEGF-A concentrations decreased while TNF-α and MPO significantly increased. CONCLUSION In patients, an association between increased levels of circulating VEGF-A and VAP resolution was observed. The mouse study suggests that elevated VEGF-A levels may be associated with lung inflammation resolution. CLINICAL TRIAL REGISTRATION NCT00297674 at www.clinicaltrials.gov.
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Affiliation(s)
- Ioannis Strouvalis
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Routsi
- 1st Department of Critical Care Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Adamopoulou
- Department of Medical Laboratories, Molecular Microbiology Laboratory, Technological Institution of Athens, Athens, Greece
| | - Maria Raftogiannis
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Renieris
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stylianos E Orfanos
- 2nd Department of Critical Care Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Kotanidou
- 1st Department of Critical Care Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Labros Sabracos
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Hashemian SMR, Mortaz E, Tabarsi P, Jamaati H, Maghsoomi Z, Khosravi A, Garssen J, Masjedi MR, Velayati AA, Folkerts G, Barnes PJ, Adcock IM. Elevated CXCL-8 expression in bronchoalveolar lavage correlates with disease severity in patients with acute respiratory distress syndrome resulting from tuberculosis. JOURNAL OF INFLAMMATION-LONDON 2014; 11:21. [PMID: 25110464 PMCID: PMC4126912 DOI: 10.1186/1476-9255-11-21] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 07/07/2014] [Indexed: 01/09/2023]
Abstract
Background Tuberculosis (TB) is a rare but known cause of acute respiratory distress syndrome (ARDS). The role of inflammatory cytokines in the progression of ARDS in TB patients is unknown. Objectives In this study we investigated the possible link between the levels of inflammatory cytokines in bronchoalveolar lavage (BAL) in patients with TB or ARDS alone or in patients with TB-induced ARDS (ARDS + TB). Methods 90 patients were studied: 30 with TB alone, 30 with ARDS alone and 30 with ARDS + TB. BAL was collected by fiberoptic bronchoscopy and the concentrations of interleukin(IL)-6, CXCL8, TNF-α and IL-1β and the amounts of total protein were measured by ELISA and bicinchoninic acid assay (BCA) methods respectively. The correlation between disease severity measured by Murray scores, SOFA and APACHE II analysis and BAL mediators and cells was also determined. Results CXCL8 levels in BAL were significantly higher in the ARDS + TB group compared to TB and ARDS alone groups. Disease severity in the ARDS + TB group as determined by Murray score correlated with BAL CXCL8 and neutrophils but not with IL-6, IL-1β and TNF-α concentrations. In addition, CXCL8 levels and neutrophils were increased in non-miliary TB versus miliary TB. This difference in CXCL8 was lost in the presence of ARDS. Conclusions BAL CXCL8 levels were significantly higher in patients with ARDS induced by TB and could suggest an important role of CXCL8 in the pathogenesis of this form of ARDS. This further suggests that CXCL8 inhibitors or blockers may be useful to control the onset and/or development of these combined diseases.
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Affiliation(s)
- Seyed Mohamad Reza Hashemian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mortaz
- Division of Pharmacology and Pathophysiology Utrecht Institute for Pharmaceutical Sciences, Faculty of Sciences, Utrecht University, Utrecht, The Netherlands ; Department of Infectious Diseases, Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Tabarsi
- Department of Infectious Diseases, Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Jamaati
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Maghsoomi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Adnan Khosravi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Johan Garssen
- Division of Pharmacology and Pathophysiology Utrecht Institute for Pharmaceutical Sciences, Faculty of Sciences, Utrecht University, Utrecht, The Netherlands ; Danone Research Centre for Specialised Nutrition, Wageningen, The Netherlands
| | - Mohamad Reza Masjedi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Velayati
- Department of Infectious Diseases, Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gert Folkerts
- Division of Pharmacology and Pathophysiology Utrecht Institute for Pharmaceutical Sciences, Faculty of Sciences, Utrecht University, Utrecht, The Netherlands
| | - Peter J Barnes
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Ian M Adcock
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
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Hill DM, Schroeppel TJ, Magnotti LJ, Clement LP, Sharpe JP, Fischer PE, Weinberg JA, Croce MA, Fabian TC. Methicillin-Resistant Staphylococcus aureus in Early Ventilator-Associated Pneumonia: Cause for Concern? Surg Infect (Larchmt) 2013; 14:520-4. [DOI: 10.1089/sur.2012.166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- David M. Hill
- Department of Pharmacy, the Regional Medical Center, Memphis, Tennessee
| | - Thomas J. Schroeppel
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Louis J. Magnotti
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - L. Paige Clement
- Department of Pharmacy, the Regional Medical Center, Memphis, Tennessee
| | - John P. Sharpe
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Peter E. Fischer
- Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Jordan A. Weinberg
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Martin A. Croce
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Timothy C. Fabian
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
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Raymondos K, Martin MU, Schmudlach T, Baus S, Weilbach C, Welte T, Krettek C, Frink M, Hildebrand F. Early alveolar and systemic mediator release in patients at different risks for ARDS after multiple trauma. Injury 2012; 43:189-95. [PMID: 21703617 DOI: 10.1016/j.injury.2011.05.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 05/25/2011] [Indexed: 02/02/2023]
Abstract
Alveolar IL-8 has been reported to early identify patients at-risk to develop ARDS. However, it remains unknown how alveolar IL-8 is related to pulmonary and systemic inflammation in patients predisposed for ARDS. We studied 24 patients 2-6h after multiple trauma. Patients with IL-8 >200 pg/ml in bronchoalveolar lavage (BAL) were assigned to the group at high risk for ARDS (H, n = 8) and patients with BAL IL-8 <200 pg/ml to the group at low risk for ARDS (L, n = 16). ARDS developed within 24h after trauma in 5 patients at high and at least after 1 week in 2 patients at low risk for ARDS (p = 0.003). High-risk patients had also increased BAL IL-6, TNF-α, IL-1β, IL-10 and IL-1ra levels (p<0.05). BAL neutrophil counts did not differ between patient groups (H vs. L, 12% (3-73%) vs. 6% (2-32%), p = 0.1) but correlated significantly with BAL IL-8, IL-6 and IL-1ra. High-risk patients had increased plasma levels of pro- but not anti-inflammatory mediators. The enhanced alveolar and systemic inflammation associated with alveolar IL-8 release should be considered to identify high-risk patients for pulmonary complications after multiple trauma to adjust surgical and other treatment strategies to the individual risk profile.
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