Inflammatory Response to Different Toxins in Experimental Sepsis Models

Sepsis is defined as life-threatening organ dysfunction caused by the dysregulated host response to infection. Despite serious mortality and morbidity, no sepsis-specific drugs exist. Endotoxemia is often used to model the hyperinflammation associated with early sepsis. This model classically uses lipopolysaccharide (LPS) from Gram-negative pathogens to activate the immune system, leading to hyperinflammation, microcirculatory disturbances and death. Other toxins may also be used to activate the immune system including Gram-positive peptidoglycan (PG) and lipoteichoic acid (LTA). In addition to these standard toxins, other bacterial components can induce inflammation. These molecules activate different signaling pathways and produce different physiological responses which can be taken advantage of for sepsis modeling. Endotoxemia modeling can provide information on pathways to inflammation in sepsis and contribute to preclinical drug development.

ENDOTOXIN PRETREATMENT IMPROVES BACTERIAL CLEARANCE AND DECREASES MORTALITY IN MICE CHALLENGED WITH STAPHYLOCOCCUS AUREUS

We studied the effects of tolerance induced by Escherichia coli-derived LPS on the innate immune response to a subsequent Staphylococcus aureus bacterial challenge. LPS tolerance was induced in wild-type mice by either intraperitoneal or intravenous injection of 2 microg of LPS on 2 consecutive days. Mice were challenged with an intravenous injection of live S. aureus (5 x 10(8) colony-forming units) 2 days after the second LPS dose. LPS-tolerant mice had a diminished serum interferon-gamma response to the bacterial challenge. Bacterial counts in liver and spleen tissues were decreased, and survival was improved after the Staphylococcus challenge in LPS-tolerant mice compared with saline-pretreated control mice. LPS pretreatment by the intravenous route was also associated with a decreased number of bacterial colonies in lung tissue in addition to liver and spleen, suggesting that induction of LPS tolerance was somewhat compartmentalized after intraperitoneal LPS pretreatment. Induction of tolerance seemed to be due to LPS-specific signaling because LPS pretreatment of LPS-nonresponsive C3H/HeJ mice did not provide similar effects after bacterial challenge. Flow cytometric analysis of spleens from LPS-tolerant mice revealed an increase in phagocytic cells (neutrophiles and macrophages) compared with control mice. Ex vivo culture of splenocytes from LPS-tolerant mice demonstrated increased uptake of fluorescein isothiocyanate-tagged ovalbumin, but no difference in either phagocytosis of fluorescein isothiocyanate-labeled Staphylococcus or bactericidal activity could be demonstrated on a per-cell basis. These results show that attenuation of inflammation and mortality during LPS tolerance extends to gram-positive bacterial organisms and suggests that LPS-induced enhancement of the innate immune response may be attributed to increased numbers of phagocytic cells.

Staphylococcus aureus and Lipopolysaccharide Induce Homologous Tolerance but Heterologous Priming: Role of Interferon-??

Lipopolysaccharide (LPS), the gram-negative bacterial cell wall component, induces tolerance to a secondary challenge of LPS in macrophages (Mphi) as evidenced by reduced inflammatory mediator production. However, it is uncertain if heat-killed (HK) gram-positive bacteria Staphylococcus aureus (Sa) can induce a similar tolerance and alter responses to LPS. We hypothesized that HKSa induces homologous tolerance and cross tolerance to LPS stimulation in human promonocytic THP-1 cells. We measured TNF-alpha, TxB2, and IFN-gamma production and the phosphorylation of p38, JNK, and ERK-1/2 in human promonocytic THP-1 cells. HKSa (10 microg/mL) significantly stimulated naive (nonpretreated) cell TNF-alpha (P<0.05) and TxB2 production (P<0.05). However, HKSa-pretreated cells challenged secondarily with HKSa (10 microg/mL) exhibited a decrease in the production of TNF-alpha (89 +/- 5%, P<0.05) and TxB2 (85 +/- 3%, P<0.05) compared with HKSa-stimulated naive cells. By contrast, secondary LPS challenge of HKSa-pretreated cells augmented TNF-alpha (41 +/- 3%, P<0.05) and TxB2 (42 +/- 6%, P<0.05) compared with LPS-stimulated naive cells. In naive cells, HKSa and LPS stimulation also significantly phosphorylated the mitogen-activated kinases (MAPKs) p38, JNK, and ERK-1/2 (P<0.005) compared with basal levels. HKSa and LPS induced homologous tolerance as evidenced by the down-regulation of the three MAPK (P<0.05), thus paralleling data on mediator production. HKSa-pretreated cells' priming responses to LPS correlated with augmented phosphorylation of JNK and p38 (P<0.05), whereas ERK-1/2 phosphorylation remained down-regulated. In contrast to TNF-alpha and TxB2 production, HKSa-induced IFN-gamma was up-regulated (26 +/- 5%) in HKSa-pretreated cells compared with HKSa-stimulated naive cells. IFN-gamma antibody exhibited reversed priming in HKSa-pretreated cells as evidenced by a reduction in TNF-alpha. Exogenous human IFN-gamma- (1 microg/mL) and HKSa-pretreated cells secondarily stimulated with HKSa did not prevent the induction of tolerance. In contrast, exogenous IFN-gamma pretreatment prevented the induction of LPS homologous tolerance resulting in an increase in TNF-alpha production. The data demonstrate that HKSa induces homologous tolerance but causes priming to LPS.