1
|
Heffernan DS, Chun TT, Monaghan SF, Chung CS, Ayala A. invariant Natural Killer T Cells Modulate the Peritoneal Macrophage Response to Polymicrobial Sepsis. J Surg Res 2024; 300:211-220. [PMID: 38824851 PMCID: PMC11246799 DOI: 10.1016/j.jss.2024.03.037] [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: 07/31/2023] [Revised: 02/21/2024] [Accepted: 03/22/2024] [Indexed: 06/04/2024]
Abstract
INTRODUCTION A dysregulated immune system is a major driver of the mortality and long-term morbidity from sepsis. With respect to macrophages, it has been shown that phenotypic changes are critical to effector function in response to acute infections, including intra-abdominal sepsis. Invariant natural killer T cells (iNKT cells) have emerged as potential central regulators of the immune response to a variety of infectious insults. Specifically, various iNKT cell:macrophage interactions have been noted across a spectrum of diseases, including acute events such as sepsis. However, the potential for iNKT cells to affect peritoneal macrophages during an abdominal septic event is as yet unknown. METHODS Cecal ligation and puncture (CLP) was performed in both wild type (WT) and invariant natural killer T cell knockout (iNKT-/-) mice. 24 h following CLP or sham operation, peritoneal macrophages were collected for analysis. Analysis of macrophage phenotype and function was undertaken to include analysis of bactericidal activity and cytokine or superoxide production. RESULTS Within iNKT-/- mice, a greater degree of intraperitoneal macrophages in response to the sepsis was noted. Compared to WT mice, within iNKT-/- mice, CLP did induce an increase in CD86+ and CD206+, but no difference in CD11b+. Unlike WT mice, intra-abdominal sepsis within iNKT-/- mice induced an increase in Ly6C-int (5.2% versus 14.9%; P < 0.05) and a decrease in Ly6C-high on peritoneal macrophages. Unlike phagocytosis, iNKT cells did not affect macrophage bactericidal activity. Although iNKT cells did not affect interleukin-6 production, iNKT cells did affect IL-10 production and both nitrite and superoxide production from peritoneal macrophages. CONCLUSIONS The observations indicate that iNKT cells affect specific phenotypic and functional aspects of peritoneal macrophages during polymicrobial sepsis. Given that pharmacologic agents that affect iNKT cell functioning are currently in clinical trial, these findings may have the potential for translation to critically ill surgical patients with abdominal sepsis.
Collapse
Affiliation(s)
- Daithi S Heffernan
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, Rhode Island.
| | - Tristen T Chun
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, Rhode Island
| | - Sean F Monaghan
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, Rhode Island
| | - Chun-Shiang Chung
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, Rhode Island
| | - Alfred Ayala
- Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, Rhode Island
| |
Collapse
|
2
|
Heffernan DS, Chung CS, Ayala A. Severity of critical illness correlates with CD3-low expression on iNKT-cells among septic surgical patients. Inflamm Res 2024; 73:1-4. [PMID: 38147124 DOI: 10.1007/s00011-023-01795-z] [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: 08/01/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND iNKT-cells are innate regulatory lymphocytes capable of directing immune and inflammatory responses to sepsis. Repeat stimulation of iNKT-cells leads to the induction of anergy with the emergence of a hyporesponsive CD3low iNKT-cell subpopulation. METHODS iNKT-cells were isolated from critical ill surgical patients with sepsis and phenotyped for CD3 expression. This was correlated with degree of severity of illness, as denoted by APACHE-II score. RESULTS Comparing healthy volunteers to critically ill septic patients, it was noted that increasing severity of sepsis was associated with increasing frequency of circulating CD3low-iNKT-cell populations. CONCLUSION The emergence of CD3low -iNKT-cells may serve as a clinically translatable marker of degree of sepsis-induced immune dysfunction.
Collapse
Affiliation(s)
- Daithi S Heffernan
- Division of Surgical Research, Department of Surgery, Rhode Island Hospital, Brown University School of Medicine, 593 Eddy Street, Providence, Rhode Island, 02903, USA.
- Division of Surgical Research, Department of Surgery, Rhode Island Hospital, Brown University School of Medicine, Room 205 Middle House, Providence, Rhode Island, 02903, USA.
| | - Chun-Shiang Chung
- Division of Surgical Research, Department of Surgery, Rhode Island Hospital, Brown University School of Medicine, 593 Eddy Street, Providence, Rhode Island, 02903, USA
| | - Alfred Ayala
- Division of Surgical Research, Department of Surgery, Rhode Island Hospital, Brown University School of Medicine, 593 Eddy Street, Providence, Rhode Island, 02903, USA
| |
Collapse
|
3
|
Heffernan DS, Chung CS, Ayala A. SPLENIC INVARIANT NATURAL KILLER T CELLS PLAY A SIGNIFICANT ROLE IN THE RESPONSE TO POLYMICROBIAL SEPSIS. Shock 2023; 60:443-449. [PMID: 37493576 PMCID: PMC10529630 DOI: 10.1097/shk.0000000000002185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
ABSTRACT Background: Sepsis is marked by a dysregulated immune response to an infection. Invariant natural killer T cells ( i NKT cells) are a pluripotent lymphocyte subpopulation capable of affecting and coordinating the immune response to sepsis. The spleen is an important site of immune interactions in response to an infection. Splenic i NKT cells have emerged as important potential frontline mediators of chronic immune response. There are few data addressing the role splenic of i NKT cells in response to intra-abdominal polymicrobial sepsis. Methods: The cecal ligation and puncture model was used to create intra-abdominal sepsis in 8- to 12-week-old wild-type, i NKT -/- , or programmed cell death receptor-1 (PD-1) -/- mice. Twenty-four hours later, spleens were harvested. Flow cytometry was used for phenotyping using monoclonal antibodies. Cell sort was used to isolate i NKT cells. A macrophage cell line was used to assess i NKT cell-phagocyte interactions. Enzyme-linked immunosorbent assay was used for cytokine analysis. Results: Splenic i NKT-cell populations rapidly declined following induction of sepsis. Within i NKT-cell -/- mice, a distinct baseline hyperinflammatory environment was noted. Within wild type, sepsis induced an increase in splenic IL-6 and IL-10, whereas in i NKT -/- mice, there was no change in elevated IL-6 levels and a noted decrease in IL-10 expression. Further, following sepsis, PD-1 expression was increased upon spleen i NKT cells. With respect to PD-1 ligands upon phagocytes, PD-1 ligand expression was unaffected, whereas PD-L2 expression was significantly affected by the presence of PD-1. Conclusions: Invariant natural killer T cells play a distinct role in the spleen response to sepsis, an effect mediated by the checkpoint protein PD-1. Given that modulators are available in clinical trials, this offers a potential therapeutic target in the setting of sepsis-induced immune dysfunction.
Collapse
Affiliation(s)
- Daithi S Heffernan
- Division of Surgical Research, Department of Surgery, Lifespan-Rhode Island Hospital/The Alpert School of Medicine at Brown University, Providence, Rhode Island
| | | | | |
Collapse
|
4
|
Song Z, Meng L, He Z, Huang J, Li F, Feng J, Jia Z, Huang Y, Liu W, Liu A, Fang H. LBP Protects Hepatocyte Mitochondrial Function Via the PPAR-CYP4A2 Signaling Pathway in a Rat Sepsis Model. Shock 2021; 56:1066-1079. [PMID: 33988537 DOI: 10.1097/shk.0000000000001808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To explore the role of LPS binding protein (LBP) in metabolism and optimize sepsis treatment. DESIGN A sepsis model was established by injecting LPS into LBP-/- rats and WT rats and observing changes in the liver over time (0, 1, 6, and 24 h). SETTING Detecting liver inflammation and injury. Optimizing the treatment of sepsis. SUBJECTS WT rats and LBP-/- rats. INTERVENTIONS We established a sepsis model by injecting LPS intravenously. MEASUREMENTS AND MAIN RESULTS First, we induced sepsis in WT and LBP-/- rats with LPS. The rats were sacrificed, and serum and liver samples were collected at 1, 6, and 24 h after LPS injection. We found that the deletion of LBP reduced LPS-induced liver inflammation and injury at 1 and 6 h. Ballooning degeneration was clearly present in LBP-/- rat livers at 24 h after LPS injection. We found that mitochondrial damage and reactive oxygen species (ROS) levels were higher in LBP-/- rat livers than in WT rat livers at 24 h after LPS injection. According to the transcriptomic results, the peroxisome proliferator-activated receptor (PPAR) pathway may be the reason for lesions in LBP-/- rats. To further investigate the function of PPARα in sepsis, we inhibited mTOR with rapamycin and examined mitochondrial injury and ROS levels. The levels of mitochondrial damage and ROS were reduced after LBP-/- rats were pretreated with rapamycin in the context of LPS-induced sepsis. Inhibiting CYP4a2, one of the PPARα-target gene products, reduced the level of LPS-induced ROS in LBP-/- rats. CONCLUSION LBP protects hepatic mitochondria against LPS-induced damage via the LBP-PPARα-CYP4a2 signaling pathway.
Collapse
Affiliation(s)
- Zichen Song
- Department of Pathophysiology, Anhui Medical University, Hefei, China
| | - Leilei Meng
- Department of Pathophysiology, Anhui Medical University, Hefei, China
| | - Zhixiang He
- The First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Jing Huang
- Department of Pathophysiology, Anhui Medical University, Hefei, China
| | - Fang Li
- The First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Jingjing Feng
- The First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Zhuoran Jia
- The First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Yue Huang
- The First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Wei Liu
- Department of Clinical Laboratory, Binhu Hospital, Anhui Medical University, Hefei, China
| | - Anding Liu
- Experimental Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haoshu Fang
- Department of Pathophysiology, Anhui Medical University, Hefei, China
| |
Collapse
|
5
|
Choi J, Mele TS, Porcelli SA, Savage PB, Haeryfar SMM. Harnessing the Versatility of Invariant NKT Cells in a Stepwise Approach to Sepsis Immunotherapy. THE JOURNAL OF IMMUNOLOGY 2020; 206:386-397. [PMID: 33310870 DOI: 10.4049/jimmunol.2000220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 11/11/2020] [Indexed: 11/19/2022]
Abstract
Sepsis results from a heavy-handed response to infection that may culminate in organ failure and death. Many patients who survive acute sepsis become immunosuppressed and succumb to opportunistic infections. Therefore, to be successful, sepsis immunotherapies must target both the initial and the protracted phase of the syndrome to relieve early immunopathology and late immunosuppression, respectively. Invariant NKT (iNKT) cells are attractive therapeutic targets in sepsis. However, repeated treatments with α-galactosylceramide, the prototypic glycolipid ligand of iNKT cells, result in anergy. We designed a double-hit treatment that allows iNKT cells to escape anergy and exert beneficial effects in biphasic sepsis. We tested the efficacy of this approach in the sublethal cecal ligation and puncture mouse model, which mirrors polymicrobial sepsis with progression to an immunosuppressed state. Septic mice were treated with [(C2S, 3S, 4R)-1-O-(α-d-galactopyranosyl)-N-tetracosanoyl-2-amino-1,3,4-nonanetriol] (OCH), a TH2-polarizing iNKT cell agonist, before they received α-galactosylceramide. This regimen reduced the morbidity and mortality of cecal ligation and puncture, induced a transient but robust IFN-γ burst within a proinflammatory cytokine/chemokine landscape, transactivated NK cells, increased MHC class II expression on macrophages, and restored delayed-type hypersensitivity to a model hapten, consistent with recovery of immunocompetence in protracted sepsis. Structurally distinct TH2-polarizing agonists varied in their ability to replace OCH as the initial hit, with their lipid chain length being a determinant of efficacy. The proposed approach effectively exploits iNKT cells' versatility in biphasic sepsis and may have translational potentials in the development of new therapies.
Collapse
Affiliation(s)
- Joshua Choi
- Department of Microbiology and Immunology, Western University, London, Ontario N6A 5C1, Canada
| | - Tina S Mele
- Division of General Surgery, Department of Surgery, Western University, London, Ontario N6A 5A5, Canada.,Division of Critical Care Medicine, Department of Medicine, Western University, London, Ontario N6A 5W9, Canada
| | - Steven A Porcelli
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, New York City, NY 10461
| | - Paul B Savage
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602
| | - S M Mansour Haeryfar
- Department of Microbiology and Immunology, Western University, London, Ontario N6A 5C1, Canada; .,Division of General Surgery, Department of Surgery, Western University, London, Ontario N6A 5A5, Canada.,Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, Ontario N6A 4V2, Canada; and.,Centre for Human Immunology, Western University, London, Ontario N6A 5C1, Canada
| |
Collapse
|
6
|
Lymphocyte Immunosuppression and Dysfunction Contributing to Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PICS). Shock 2020; 55:723-741. [PMID: 33021569 DOI: 10.1097/shk.0000000000001675] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
ABSTRACT Persistent Inflammation, Immune Suppression, and Catabolism Syndrome (PICS) is a disease state affecting patients who have a prolonged recovery after the acute phase of a large inflammatory insult. Trauma and sepsis are two pathologies after which such an insult evolves. In this review, we will focus on the key clinical determinants of PICS: Immunosuppression and cellular dysfunction. Currently, relevant immunosuppressive functions have been attributed to both innate and adaptive immune cells. However, there are significant gaps in our knowledge, as for trauma and sepsis the immunosuppressive functions of these cells have mostly been described in acute phase of inflammation so far, and their clinical relevance for the development of prolonged immunosuppression is mostly unknown. It is suggested that the initial immune imbalance determines the development of PCIS. Additionally, it remains unclear what distinguishes the onset of immune dysfunction in trauma and sepsis and how this drives immunosuppression in these cells. In this review, we will discuss how regulatory T cells (Tregs), innate lymphoid cells, natural killer T cells (NKT cells), TCR-a CD4- CD8- double-negative T cells (DN T cells), and B cells can contribute to the development of post-traumatic and septic immunosuppression. Altogether, we seek to fill a gap in the understanding of the contribution of lymphocyte immunosuppression and dysfunction to the development of chronic immune disbalance. Further, we will provide an overview of promising diagnostic and therapeutic interventions, whose potential to overcome the detrimental immunosuppression after trauma and sepsis is currently being tested.
Collapse
|
7
|
Kim EY, Ner-Gaon H, Varon J, Cullen AM, Guo J, Choi J, Barragan-Bradford D, Higuera A, Pinilla-Vera M, Short SA, Arciniegas-Rubio A, Tamura T, Leaf DE, Baron RM, Shay T, Brenner MB. Post-sepsis immunosuppression depends on NKT cell regulation of mTOR/IFN-γ in NK cells. J Clin Invest 2020; 130:3238-3252. [PMID: 32154791 PMCID: PMC7260006 DOI: 10.1172/jci128075] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 03/04/2020] [Indexed: 12/14/2022] Open
Abstract
As treatment of the early, inflammatory phase of sepsis improves, post-sepsis immunosuppression and secondary infection have increased in importance. How early inflammation drives immunosuppression remains unclear. Although IFN-γ typically helps microbial clearance, we found that increased plasma IFN-γ in early clinical sepsis was associated with the later development of secondary Candida infection. Consistent with this observation, we found that exogenous IFN-γ suppressed macrophage phagocytosis of zymosan in vivo, and antibody blockade of IFN-γ after endotoxemia improved survival of secondary candidemia. Transcriptomic analysis of innate lymphocytes during endotoxemia suggested that NKT cells drove IFN-γ production by NK cells via mTORC1. Activation of invariant NKT (iNKT) cells with glycolipid antigen drove immunosuppression. Deletion of iNKT cells in Cd1d-/- mice or inhibition of mTOR by rapamycin reduced immunosuppression and susceptibility to secondary Candida infection. Thus, although rapamycin is typically an immunosuppressive medication, in the context of sepsis, rapamycin has the opposite effect. These results implicated an NKT cell/mTOR/IFN-γ axis in immunosuppression following endotoxemia or sepsis. In summary, in vivo iNKT cells activated mTORC1 in NK cells to produce IFN-γ, which worsened macrophage phagocytosis, clearance of secondary Candida infection, and mortality.
Collapse
Affiliation(s)
- Edy Y. Kim
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Masachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Hadas Ner-Gaon
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jack Varon
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Masachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Jingyu Guo
- Division of Rheumatology, Inflammation and Immunity and
| | - Jiyoung Choi
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Masachusetts, USA
| | - Diana Barragan-Bradford
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Masachusetts, USA
| | - Angelica Higuera
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Masachusetts, USA
| | - Mayra Pinilla-Vera
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Masachusetts, USA
| | - Samuel A.P. Short
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Tomoyoshi Tamura
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Masachusetts, USA
| | - David E. Leaf
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Rebecca M. Baron
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Masachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Tal Shay
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michael B. Brenner
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Rheumatology, Inflammation and Immunity and
| |
Collapse
|
8
|
Abstract
Sepsis, the 10th leading cause of death, is the most expensive condition in the United States. The immune response in sepsis transitions from hyperinflammatory to a hypoinflammatory and immunosuppressive phase; individual variations regarding timing and overlap between hyper- and hypoinflammation exist in a number of patients. While one third of the sepsis-related deaths occur during hyperinflammation, majority of the sepsis-mortality occurs during the hypoinflammatory phase. Currently, no phase-specific molecular-based therapies exist to treat sepsis. Coordinated epigenetic and metabolic perturbations orchestrate this shift from hyper- to hypoinflammation in innate immune cells during sepsis. These epigenetic and metabolic changes during sepsis progression and therapeutic opportunities they pose are described in this review.
Collapse
Affiliation(s)
- Vidula Vachharajani
- Department of Anesthesiology, Wake Forest School of Medicine,
Winston-Salem, NC, USA,Department of Internal Medicine, Wake Forest School of Medicine,
Winston-Salem, NC, USA,Vidula Vachharajani, Critical Care
Medicine/Respiratory Institute, Inflammation and Immunity/Lerner Research
Institute, Cleveland Lerner College of Medicine, 9500 Euclid Avenue, Cleveland,
OH, USA.
| | - Charles E McCall
- Department of Internal Medicine, Wake Forest School of Medicine,
Winston-Salem, NC, USA
| |
Collapse
|
9
|
Wang R, Qin HM, Liao BY, Yang FL, Wang JL. Genetic polymorphisms in interleukin 13 gene with the susceptibility to nasopharyngeal carcinoma in a Chinese population. Cytokine 2019; 115:121-126. [DOI: 10.1016/j.cyto.2018.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 10/28/2018] [Accepted: 11/19/2018] [Indexed: 12/20/2022]
|
10
|
Kim EY, Oldham WM. Innate T cells in the intensive care unit. Mol Immunol 2019; 105:213-223. [PMID: 30554082 PMCID: PMC6331274 DOI: 10.1016/j.molimm.2018.09.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/22/2018] [Accepted: 09/29/2018] [Indexed: 12/15/2022]
Abstract
Rapid onset of acute inflammation is a hallmark of critical illnesses that bring patients to the intensive care unit (ICU). In critical illness, innate T cells rapidly reach full activation and drive a robust acute inflammatory response. As "cellular adjuvants," innate T cells worsen inflammation and mortality in several common critical illnesses including sepsis, ischemia-reperfusion injury, stroke, and exacerbations of respiratory disease. Interestingly, innate T cell subsets can also promote a protective and anti-inflammatory response in sepsis, ischemia-reperfusion injury, and asthma. Therapies that target innate T cells have been validated in several models of critical illness. Here, we review the role of natural killer T (NKT) cells, mucosal-associated invariant T (MAIT) cells and γδ T cells in clinical and experimental critical illness.
Collapse
Affiliation(s)
- Edy Yong Kim
- Brigham and Women's Hospital, Pulmonary and Critical Care Medicine, Boston, MA, 02115, United States; Harvard Medical School, Boston, MA, 02115, United States.
| | - William M Oldham
- Brigham and Women's Hospital, Pulmonary and Critical Care Medicine, Boston, MA, 02115, United States; Harvard Medical School, Boston, MA, 02115, United States
| |
Collapse
|
11
|
Wang X, Buechler NL, Woodruff AG, Long DL, Zabalawi M, Yoza BK, McCall CE, Vachharajani V. Sirtuins and Immuno-Metabolism of Sepsis. Int J Mol Sci 2018; 19:ijms19092738. [PMID: 30216989 PMCID: PMC6164482 DOI: 10.3390/ijms19092738] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 02/01/2023] Open
Abstract
Sepsis and septic shock are the leading causes of death in non-coronary intensive care units worldwide. During sepsis-associated immune dysfunction, the early/hyper-inflammatory phase transitions to a late/hypo-inflammatory phase as sepsis progresses. The majority of sepsis-related deaths occur during the hypo-inflammatory phase. There are no phase-specific therapies currently available for clinical use in sepsis. Metabolic rewiring directs the transition from hyper-inflammatory to hypo-inflammatory immune responses to protect homeostasis during sepsis inflammation, but the mechanisms underlying this immuno-metabolic network are unclear. Here, we review the roles of NAD+ sensing Sirtuin (SIRT) family members in controlling immunometabolic rewiring during the acute systemic inflammatory response associated with sepsis. We discuss individual contributions among family members SIRT 1, 2, 3, 4 and 6 in regulating the metabolic switch between carbohydrate-fueled hyper-inflammation to lipid-fueled hypo-inflammation. We further highlight the role of SIRT1 and SIRT2 as potential "druggable" targets for promoting immunometabolic homeostasis and increasing sepsis survival.
Collapse
Affiliation(s)
- Xianfeng Wang
- Departments of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Nancy L Buechler
- Departments of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Alan G Woodruff
- Departments of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - David L Long
- Departments of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Manal Zabalawi
- Departments of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Barbara K Yoza
- Departments of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
- Departments of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Charles E McCall
- Departments of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
- Departments of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Vidula Vachharajani
- Departments of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
- Departments of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| |
Collapse
|
12
|
Bolognese AC, Yang WL, Hansen LW, Sharma A, Nicastro JM, Coppa GF, Wang P. Activation of Invariant Natural Killer T Cells Redirects the Inflammatory Response in Neonatal Sepsis. Front Immunol 2018; 9:833. [PMID: 29720984 PMCID: PMC5922987 DOI: 10.3389/fimmu.2018.00833] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/05/2018] [Indexed: 12/20/2022] Open
Abstract
Sepsis is the third leading cause of death in the neonatal population, due to susceptibility to infection conferred by immaturity of both the innate and adaptive components of the immune system. Invariant natural killer T (iNKT) cells are specialized adaptive immune cells that possess important innate-like characteristics and have not yet been well-studied in septic neonates. We hypothesized that iNKT cells would play an important role in mediating the neonatal immune response to sepsis. To study this, we subjected 5- to 7-day-old neonatal C57BL/6 mice to sepsis by intraperitoneal (i.p.) cecal slurry (CS) injection. Thirty hours prior to or immediately following sepsis induction, pups received i.p. injection of the iNKT stimulator KRN7000 (KRN, 0.2 µg/g) or vehicle. Ten hours after CS injection, blood and tissues were collected for various analyses. Thirty-hour pretreatment with KRN resulted in better outcomes in inflammation, lung injury, and survival, while immediate treatment with KRN resulted in worse outcomes compared to vehicle treatment. We further analyzed the activation status of neonatal iNKT cells for 30 h after KRN administration, and showed a peak in frequency of CD69 expression on iNKT cells and serum IFN-γ levels at 5 and 10 h, respectively. We then used CD1d knockout neonatal mice to demonstrate that KRN acts through the major histocompatibility complex-like molecule CD1d to improve outcomes in neonatal sepsis. Finally, we identified that KRN pretreatment exerts its protective effect by increasing systemic levels of TGF-β1. These findings support the importance of iNKT cells for prophylactic immunomodulation in neonates susceptible to sepsis.
Collapse
Affiliation(s)
- Alexandra C Bolognese
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, United States.,Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Weng-Lang Yang
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, United States.,Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| | - Laura W Hansen
- Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Archna Sharma
- Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| | - Jeffrey M Nicastro
- Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Gene F Coppa
- Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Ping Wang
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, United States.,Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| |
Collapse
|
13
|
Abstract
The liver is a key, frontline immune tissue. Ideally positioned to detect pathogens entering the body via the gut, the liver appears designed to detect, capture, and clear bacteria, viruses, and macromolecules. Containing the largest collection of phagocytic cells in the body, this organ is an important barrier between us and the outside world. Importantly, as portal blood also transports a large number of foreign but harmless molecules (e.g., food antigens), the liver's default immune status is anti-inflammatory or immunotolerant; however, under appropriate conditions, the liver is able to mount a rapid and robust immune response. This balance between immunity and tolerance is essential to liver function. Excessive inflammation in the absence of infection leads to sterile liver injury, tissue damage, and remodeling; insufficient immunity allows for chronic infection and cancer. Dynamic interactions between the numerous populations of immune cells in the liver are key to maintaining this balance and overall tissue health.
Collapse
Affiliation(s)
- Paul Kubes
- Calvin, Phoebe & Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta T2N 4N1, Canada; , .,Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Craig Jenne
- Calvin, Phoebe & Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta T2N 4N1, Canada; , .,Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| |
Collapse
|
14
|
Haeryfar SMM, Mallevaey T. Editorial: CD1- and MR1-Restricted T Cells in Antimicrobial Immunity. Front Immunol 2015; 6:611. [PMID: 26697007 PMCID: PMC4666986 DOI: 10.3389/fimmu.2015.00611] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 11/18/2015] [Indexed: 01/08/2023] Open
Affiliation(s)
- S M Mansour Haeryfar
- Department of Microbiology and Immunology, Western University , London, ON , Canada ; Division of Clinical Immunology and Allergy, Department of Medicine, Western University , London, ON , Canada ; Centre for Human Immunology, Western University , London, ON , Canada ; Lawson Health Research Institute , London, ON , Canada
| | - Thierry Mallevaey
- Department of Immunology, University of Toronto , Toronto, ON , Canada
| |
Collapse
|
15
|
Szabo PA, Anantha RV, Shaler CR, McCormick JK, Haeryfar SMM. CD1d- and MR1-Restricted T Cells in Sepsis. Front Immunol 2015; 6:401. [PMID: 26322041 PMCID: PMC4533011 DOI: 10.3389/fimmu.2015.00401] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 07/22/2015] [Indexed: 12/23/2022] Open
Abstract
Dysregulated immune responses to infection, such as those encountered in sepsis, can be catastrophic. Sepsis is typically triggered by an overwhelming systemic response to an infectious agent(s) and is associated with high morbidity and mortality even under optimal critical care. Recent studies have implicated unconventional, innate-like T lymphocytes, including CD1d- and MR1-restricted T cells as effectors and/or regulators of inflammatory responses during sepsis. These cell types are typified by invariant natural killer T (iNKT) cells, variant NKT (vNKT) cells, and mucosa-associated invariant T (MAIT) cells. iNKT and vNKT cells are CD1d-restricted, lipid-reactive cells with remarkable immunoregulatory properties. MAIT cells participate in antimicrobial defense, and are restricted by major histocompatibility complex-related protein 1 (MR1), which displays microbe-derived vitamin B metabolites. Importantly, NKT and MAIT cells are rapid and potent producers of immunomodulatory cytokines. Therefore, they may be considered attractive targets during the early hyperinflammatory phase of sepsis when immediate interventions are urgently needed, and also in later phases when adjuvant immunotherapies could potentially reverse the dangerous state of immunosuppression. We will highlight recent findings that point to the significance or the therapeutic potentials of NKT and MAIT cells in sepsis and will also discuss what lies ahead in research in this area.
Collapse
Affiliation(s)
- Peter A Szabo
- Department of Microbiology and Immunology, Western University , London, ON , Canada
| | - Ram V Anantha
- Department of Microbiology and Immunology, Western University , London, ON , Canada ; Division of General Surgery, Department of Medicine, Western University , London, ON , Canada
| | - Christopher R Shaler
- Department of Microbiology and Immunology, Western University , London, ON , Canada
| | - John K McCormick
- Department of Microbiology and Immunology, Western University , London, ON , Canada ; Centre for Human Immunology, Western University , London, ON , Canada ; Lawson Health Research Institute , London, ON , Canada
| | - S M Mansour Haeryfar
- Department of Microbiology and Immunology, Western University , London, ON , Canada ; Centre for Human Immunology, Western University , London, ON , Canada ; Lawson Health Research Institute , London, ON , Canada ; Division of Clinical Immunology and Allergy, Department of Medicine, Western University , London, ON , Canada
| |
Collapse
|