1
|
Murthy P, Singhi AD, Ross MA, Loughran P, Paragomi P, Papachristou GI, Whitcomb DC, Zureikat AH, Lotze MT, Zeh Iii HJ, Boone BA. Enhanced Neutrophil Extracellular Trap Formation in Acute Pancreatitis Contributes to Disease Severity and Is Reduced by Chloroquine. Front Immunol 2019; 10:28. [PMID: 30733719 PMCID: PMC6353831 DOI: 10.3389/fimmu.2019.00028] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/08/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Neutrophil extracellular traps (NETs) are generated when activated neutrophils, driven by PAD4, release their DNA, histones, HMGB1, and other intracellular granule components. NETs play a role in acute pancreatitis, worsening pancreatic inflammation, and promoting pancreatic duct obstruction. The autophagy inhibitor chloroquine (CQ) inhibits NET formation; therefore, we investigated the impact of CQ mediated NET inhibition in murine models of pancreatitis and human correlative studies. Methods: L-arginine and choline deficient ethionine supplemented (CDE) diet models of acute pancreatitis were studied in wild type and PAD4−/− mice, incapable of forming NETs. Isolated neutrophils were stimulated to induce NET formation and visualized with fluorescence microscopy. CQ treatment (0.5 mg/ml PO) was initiated after induction of pancreatitis. Biomarkers of NET formation, including cell-free DNA, citrullinated histone H3 (CitH3), and MPO-DNA conjugates were measured in murine serum and correlative human patient serum samples. Results: We first confirmed the role of NETs in the pathophysiology of acute pancreatitis by demonstrating that PAD4−/− mice had decreased pancreatitis severity and improved survival compared to wild-type controls. Furthermore, patients with severe acute pancreatitis had elevated levels of cell-free DNA and MPO-DNA conjugates, consistent with NET formation. Neutrophils from mice with pancreatitis were more prone to NET formation and CQ decreased this propensity to form NETs. CQ significantly reduced serum cell-free DNA and citrullinated histone H3 in murine models of pancreatitis, increasing survival in both models. Conclusions: Inhibition of NETs with CQ decreases the severity of acute pancreatitis and improves survival. Translating these findings into clinical trials of acute pancreatitis is warranted.
Collapse
Affiliation(s)
- Pranav Murthy
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Aatur D Singhi
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mark A Ross
- Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, PA, United States
| | - Patricia Loughran
- Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, PA, United States
| | - Pedram Paragomi
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Georgios I Papachristou
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - David C Whitcomb
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Amer H Zureikat
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Michael T Lotze
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Herbert J Zeh Iii
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Surgery, UT Southwestern Medical Center, Dallas, TX, United States
| | - Brian A Boone
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Surgery, West Virginia University, Morgantown, WV, United States
| |
Collapse
|
2
|
Matsukura A, Otani T, Takamoto T, Usui H, Goto Y, Makuuchi M. Intracellular activation of trypsinogen in rat pancreatic acini after supramaximal secretagogue stimulation: cysteine protease and serine protease activity. Pancreas 2006; 32:197-204. [PMID: 16552341 DOI: 10.1097/01.mpa.0000202958.25859.8a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE The aim of the study was to explore the mechanism by which trypsinogen becomes activated during acute pancreatitis. METHODS Given the ability of cholecystokinin (CCK) to induce pancreatitis in vivo, the effects of high-dose CCK on preparations of isolated pancreatic acini were examined using immunofluorescence techniques for the detection of trypsinogen activation. Acini were pretreated with weak base or serine or cysteine protease inhibitors before CCK hyperstimulation. RESULTS CCK was found to stimulate the generation of trypsinogen activation peptide (TAP), a marker for trypsinogen processing. The generation of TAP was inhibited by pretreatment with a weak base, chloroquine (40 micromol/L). TAP generation was also inhibited by pretreatment with serine protease inhibitor FUT-175 (1 micromol/L) but not cysteine protease inhibitor E64 (0.1 mmol/L) or E64-d (0.1 mmol/L). Although treatment with a high dose of E64-d (1 mmol/L) reduced activation, it also caused cell injury. CONCLUSIONS High-dose CCK stimulated the intracellular activation of trypsinogen within isolated pancreatic acini. This event appears to require an acidic subcellular compartment and serine protease activity. The role for thiol proteases in this model remains unclear.
Collapse
|
3
|
Seyama Y, Otani T, Matsukura A, Makuuchi M. The pH modulator chloroquine blocks trypsinogen activation peptide generation in cerulein-induced pancreatitis. Pancreas 2003; 26:15-7. [PMID: 12499911 DOI: 10.1097/00006676-200301000-00003] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION AND AIMS We examined the effects of a weak base, chloroquine, on the trypsinogen processing in cerulein-induced pancreatitis. METHODOLOGY Immunofluorescence studies were performed using newly generated affinity-purified antibodies to the trypsinogen activation peptide (TAP). RESULTS The present study showed that chloroquine pretreatment blocked intracellular TAP generation in cerulein-induced pancreatitis. CONCLUSION These results indicate that intracellular trypsinogen activation, which plays an important role in acute pancreatitis, requires a low-pH compartment, as well as serine protease activity.
Collapse
Affiliation(s)
- Yasuji Seyama
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, University of Tokyo, Tokyo, Japan
| | | | | | | |
Collapse
|
4
|
Tajima H, Ohta T, Elnemr A, Yasui T, Kitagawa H, Fushida S, Kayahara M, Miwa K, Wakayama T, Iseki S, Yokoyama S. Enhanced invasiveness of pancreatic adenocarcinoma cells stably transfected with cationic trypsinogen cDNA. Int J Cancer 2001; 94:699-704. [PMID: 11745465 DOI: 10.1002/ijc.1531] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Various studies have described increased expression of cationic trypsinogen in malignant tumor cells. To explore the role of secreted cationic trypsinogen in invasion by cancer cells, we introduced cationic trypsinogen cDNA into Panc-1, a pancreatic adenocarcinoma-derived cell line that lacks expression of endogeneous trypsinogen. Four independent clones (designated Panc-1-Try-7, -9, -11 and -24) stably expressing cationic trypsinogen mRNA were isolated and processed for further study. In a zymographic analysis, gelatinolytic activity for cationic trypsinogen was detectable in serum-free conditioned media obtained from all 4 transfectants but not in media from mock-transfected or parental Panc-1 cells. A Matrigel invasion assay revealed that all trypsinogen-expressing transfectants acquired significantly greater invasive ability than that shown by mock-transfected and parental Panc-1 cells. In addition, enhanced invasiveness of the transfectants was suppressed by FUT-175, a serine protease inhibitor, to the level seen in parental cells. These results provide direct evidence that cationic trypsinogen can increase the invasive ability of carcinoma cells.
Collapse
Affiliation(s)
- H Tajima
- Department of Surgery (II), Kanazawa University School of Medicine, Kanazawa, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|