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Nanishi M, Fujiogi M, Freishtat RJ, Hoptay CE, Bauer CS, Stevenson MD, Camargo CA, Hasegawa K. Serum periostin among infants with severe bronchiolitis and risk of developing asthma: A prospective multicenter cohort study. Allergy 2022; 77:2121-2130. [PMID: 35000210 DOI: 10.1111/all.15216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Infants hospitalized for bronchiolitis (severe bronchiolitis) are at high risk for developing childhood asthma. However, the pathobiological link between these conditions remains unclear. We examined the longitudinal relationship of periostin (an extracellular matrix protein upregulated in response to type 2 inflammation) during bronchiolitis with the subsequent development of asthma. METHODS In a 17-center prospective cohort study of infants (aged <1 year) with severe bronchiolitis, we measured the serum periostin level at hospitalization and grouped infants into 3 groups: low, intermediate, and high levels. We examined their association with asthma development by age 6 years and investigated effect modification by allergic predisposition (eg, infant's IgE sensitization). RESULTS The analytic cohort consists of 847 infants with severe bronchiolitis (median age, 3 months). Overall, 28% developed asthma by age 6 years. In the multivariable model adjusting for nine patient-level factors, compared to the low periostin group, the asthma risk was significantly higher among infants in the intermediate group (23% vs. 32%, OR 1.68, 95%CI 1.12-2.51, p = .01) and non-significantly higher in the high-level group (28%, OR 1.29, 95%CI 0.86-1.95, p = .22). In the stratified analysis, infants with IgE sensitization had a significantly higher risk for developing asthma (intermediate group, OR 4.76, 95%CI 1.70-13.3, p = .002; high group, OR 3.19, 95%CI 1.08-9.36, p = .04). By contrast, infants without IgE sensitization did not have a significantly higher risk (p > .15). CONCLUSIONS In infants with severe bronchiolitis, serum periostin level at bronchiolitis hospitalization was associated with asthma risk by age 6 years, particularly among infants with an allergic predisposition.
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Affiliation(s)
- Makiko Nanishi
- Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Michimasa Fujiogi
- Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Robert J. Freishtat
- Department of Genomics and Precision Medicine George Washington University Washington District of Columbia USA
- Division of Emergency Medicine Children’s National Hospital Washington District of Columbia USA
| | - Claire E. Hoptay
- Children's Research Institute Children's National Hospital Washington District of Columbia USA
| | - Cindy S. Bauer
- Division of Allergy and Immunology Phoenix Children’s Hospital Phoenix Arizona USA
| | - Michelle D. Stevenson
- Department of Pediatrics, Emergency Medicine Norton Children’s HospitalUniversity of Louisville School of Medicine Louisville Kentucky USA
| | - Carlos A. Camargo
- Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Kohei Hasegawa
- Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
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Patregnani JT, Fujiogi M, Camargo CA, Brooks BA, Hoptay CE, Mansbach JM, Teach SJ, Freishtat RJ, Hasegawa K. Serum soluble receptor for advanced glycation end-products (sRAGE) in infants with bronchiolitis: Associations with acute severity and recurrent wheeze. Clin Infect Dis 2020; 73:e2665-e2672. [PMID: 33173945 DOI: 10.1093/cid/ciaa1700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/04/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although bronchiolitis contributes to substantial acute (e.g., intensive care use) and chronic (e.g., recurrent wheeze and infections) morbidities in young children, the pathobiology remains uncertain. We examined relations of serum soluble receptor for advanced glycation end-products (sRAGE) with acute and chronic morbidities of bronchiolitis and whether the effect of serum sRAGE on development of recurrent wheeze is mediated through acute severity. METHODS A multi-center, multi-year, prospective cohort study of infants hospitalized for bronchiolitis was analyzed. We measured serum sRAGE level at acute hospitalization and examined its association with intensive care use (use of mechanical ventilation and/or admission to intensive care unit) and development of recurrent wheeze by age 3 years. We performed causal mediation analysis to estimate indirect (mediation) and direct effects of sRAGE on recurrent wheeze. RESULTS In 886 infants with bronchiolitis, median age was 2.9 months. Overall, 15% underwent intensive care and 32% developed recurrent wheeze by age 3 years. In the multivariable model adjusting for 11 confounders, higher presenting sRAGE level was associated with significantly lower risk of intensive care use (OR for each one-log increment, 0.39; 95%CI 0.16-0.91; P=0.03) and significantly lower rate of recurrent wheeze (HR 0.58; 95%CI 0.36-0.94; P=0.03). In mediation analysis, the direct effect was significant (HR 0.60; 95%CI 0.37-0.97; P=0.04) while the indirect effect was not (P=0.30). CONCLUSIONS Serum sRAGE levels were inversely associated with acute and chronic morbidities of bronchiolitis. Effect of sRAGE on development of recurrent wheeze is potentially driven through pathways other than acute severity of bronchiolitis.
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Affiliation(s)
- Jason T Patregnani
- Division of Cardiac Critical Care Medicine, Children's National Hospital, Washington, DC, United States.,Department of Genomics and Precision Medicine, George Washington University, Washington, DC, United States.,Division of Pediatric Critical Care Medicine, Maine Medical Center, Portland, Maine; Tufts University, Medford, MA, United States
| | - Michimasa Fujiogi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Bonnie A Brooks
- Division of Cardiac Critical Care Medicine, Children's National Hospital, Washington, DC, United States
| | - Claire E Hoptay
- Department of Genomics and Precision Medicine, George Washington University, Washington, DC, United States
| | - Jonathan M Mansbach
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Stephen J Teach
- Division of Emergency Medicine, Children's National Hospital, Washington, DC, United States
| | - Robert J Freishtat
- Department of Genomics and Precision Medicine, George Washington University, Washington, DC, United States.,Division of Emergency Medicine, Children's National Hospital, Washington, DC, United States
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Hasegawa K, Hoptay CE, Harmon B, Celedón JC, Mansbach JM, Piedra PA, Freishtat RJ, Camargo CA. Association of type 2 cytokines in severe rhinovirus bronchiolitis during infancy with risk of developing asthma: A multicenter prospective study. Allergy 2019; 74:1374-1377. [PMID: 30656708 DOI: 10.1111/all.13723] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kohei Hasegawa
- Department of Emergency Medicine; Massachusetts General Hospital; Harvard Medical School; Boston Massachusetts
| | - Claire E. Hoptay
- Center for Genetic Medicine Research; Children's National Health System; Washington District of Columbia
| | - Brennan Harmon
- Center for Genetic Medicine Research; Children's National Health System; Washington District of Columbia
| | - Juan C. Celedón
- Division of Pulmonary Medicine; Department of Pediatrics; UPMC Children's Hospital of Pittsburgh; University of Pittsburgh; Pittsburgh Pennsylvania
| | | | - Pedro A. Piedra
- Department of Molecular Virology and Microbiology and Pediatrics; Baylor College of Medicine; Houston Texas
| | - Robert J. Freishtat
- Center for Genetic Medicine Research; Children's National Health System; Washington District of Columbia
- Division of Emergency Medicine; Children's National Health System; Washington District of Columbia
- Departments of Pediatrics and Integrative Systems Biology and Pediatrics; George Washington University School of Medicine and Health Sciences; Washington District of Columbia
| | - Carlos A. Camargo
- Department of Emergency Medicine; Massachusetts General Hospital; Harvard Medical School; Boston Massachusetts
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Pérez-Losada M, Authelet KJ, Hoptay CE, Kwak C, Crandall KA, Freishtat RJ. Pediatric asthma comprises different phenotypic clusters with unique nasal microbiotas. Microbiome 2018; 6:179. [PMID: 30286807 PMCID: PMC6172741 DOI: 10.1186/s40168-018-0564-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 09/25/2018] [Indexed: 05/25/2023]
Abstract
BACKGROUND Pediatric asthma is the most common chronic childhood disease in the USA, currently affecting ~ 7 million children. This heterogeneous syndrome is thought to encompass various disease phenotypes of clinically observable characteristics, which can be statistically identified by applying clustering approaches to patient clinical information. Extensive evidence has shown that the airway microbiome impacts both clinical heterogeneity and pathogenesis in pediatric asthma. Yet, so far, airway microbiotas have been consistently neglected in the study of asthma phenotypes. Here, we couple extensive clinical information with 16S rRNA high-throughput sequencing to characterize the microbiota of the nasal cavity in 163 children and adolescents clustered into different asthma phenotypes. RESULTS Our clustering analyses identified three statistically distinct phenotypes of pediatric asthma. Four core OTUs of the pathogenic genera Moraxella, Staphylococcus, Streptococcus, and Haemophilus were present in at least 95% of the studied nasal microbiotas. Phyla (Proteobacteria, Actinobacteria, and Bacteroidetes) and genera (Moraxella, Corynebacterium, Dolosigranulum, and Prevotella) abundances, community composition, and structure varied significantly (0.05 < P ≤ 0.0001) across asthma phenotypes and one of the clinical variables (preterm birth). Similarly, microbial networks of co-occurrence of bacterial genera revealed different bacterial associations across asthma phenotypes. CONCLUSIONS This study shows that children and adolescents with different clinical characteristics of asthma also show different nasal bacterial profiles, which is indicative of different phenotypes of the disease. Our work also shows how clinical and microbial information could be integrated to validate and refine asthma classification systems and develop biomarkers of disease.
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Affiliation(s)
- Marcos Pérez-Losada
- Computational Biology Institute, Milken Institute School of Public Health,, George Washington University, Innovation Hall, Suite 305, 45085 University Drive, Ashburn, VA 20147 USA
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052 USA
- CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus Agrário de Vairão, 4485-661 Vairão, Portugal
| | - Kayla J Authelet
- Division of Emergency Medicine, Children’s National Medical Center, Washington, DC, 20010 USA
| | - Claire E Hoptay
- Division of Emergency Medicine, Children’s National Medical Center, Washington, DC, 20010 USA
| | - Christine Kwak
- Division of Emergency Medicine, Children’s National Medical Center, Washington, DC, 20010 USA
| | - Keith A Crandall
- Computational Biology Institute, Milken Institute School of Public Health,, George Washington University, Innovation Hall, Suite 305, 45085 University Drive, Ashburn, VA 20147 USA
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052 USA
| | - Robert J Freishtat
- Division of Emergency Medicine, Children’s National Medical Center, Washington, DC, 20010 USA
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Hasegawa K, Pérez-Losada M, Hoptay CE, Epstein S, Mansbach JM, Teach SJ, Piedra PA, Camargo CA, Freishtat RJ. RSV vs. rhinovirus bronchiolitis: difference in nasal airway microRNA profiles and NFκB signaling. Pediatr Res 2018; 83:606-614. [PMID: 29244796 PMCID: PMC6174252 DOI: 10.1038/pr.2017.309] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 11/25/2017] [Indexed: 01/03/2023]
Abstract
BackgroundAlthough rhinovirus infection is associated with increased risks of acute and chronic respiratory outcomes during childhood compared with respiratory syncytial virus (RSV), the underlying mechanisms remain unclear. We aimed to determine the differences in nasal airway microRNA profiles and their downstream effects between infants with rhinovirus and RSV bronchiolitis.MethodsAs part of a multicenter cohort study of infants hospitalized for bronchiolitis, we examined nasal samples obtained from 16 infants with rhinovirus and 16 infants with RSV. We tested nasal airway samples using microarrays to profile global microRNA expression and determine the predicted regulation of targeted transcripts. We also measured gene expression and cytokines for NFκB pathway components.ResultsBetween the virus groups, 386 microRNAs were differentially expressed (false discovery rate (FDR)<0.05). In infants with rhinovirus, the NFκB pathway was highly ranked as a predicted target for these differentially expressed microRNAs compared with RSV. Pathway analysis using measured mRNA expression data validated that rhinovirus infection had upregulation of NFκB family (RelA and NFκB2) and downregulation of inhibitor κB family. Infants with rhinovirus had higher levels of NFκB-induced type-2 cytokines (IL-10 and IL-13; FDR<0.01).ConclusionIn infants with bronchiolitis, rhinovirus and RSV infections had different nasal airway microRNA profiles associated with NFκB signaling.
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Affiliation(s)
- Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Marcos Pérez-Losada
- Computational Biology Institute, George Washington University, Ashburn, VA;,Department of Pediatrics, George Washington University School of Medicine and Health Sciences and the Division of Emergency Medicine, Children’s National Health System, Washington, DC;,CIBIO-InBIO, Universidade do Porto, Campus Agrário de Vairão, Vairão, Portugal
| | - Claire E. Hoptay
- Center for Genetic Medicine Research, Children’s National Health System, Washington, DC
| | - Samuel Epstein
- Center for Genetic Medicine Research, Children’s National Health System, Washington, DC
| | | | - Stephen J. Teach
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences and the Division of Emergency Medicine, Children’s National Health System, Washington, DC
| | - Pedro A. Piedra
- Department of Molecular Virology and Microbiology and Pediatrics, Baylor College of Medicine, Houston, TX
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Robert J. Freishtat
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences and the Division of Emergency Medicine, Children’s National Health System, Washington, DC;,Center for Genetic Medicine Research, Children’s National Health System, Washington, DC;,Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC;,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC
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Hackett TL, Ferrante SC, Hoptay CE, Engelhardt JF, Ingram JL, Zhang Y, Alcala SE, Shaheen F, Matz E, Pillai DK, Freishtat RJ. A Heterotopic Xenograft Model of Human Airways for Investigating Fibrosis in Asthma. Am J Respir Cell Mol Biol 2017; 56:291-299. [PMID: 27788019 DOI: 10.1165/rcmb.2016-0065ma] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Limited in vivo models exist to investigate the lung airway epithelial role in repair, regeneration, and pathology of chronic lung diseases. Herein, we introduce a novel animal model in asthma-a xenograft system integrating a differentiating human asthmatic airway epithelium with an actively remodeling rodent mesenchyme in an immunocompromised murine host. Human asthmatic and nonasthmatic airway epithelial cells were seeded into decellularized rat tracheas. Tracheas were ligated to a sterile cassette and implanted subcutaneously in the flanks of nude mice. Grafts were harvested at 2, 4, or 6 weeks for tissue histology, fibrillar collagen, and transforming growth factor-β activation analysis. We compared immunostaining in these xenografts to human lungs. Grafted epithelial cells generated a differentiated epithelium containing basal, ciliated, and mucus-expressing cells. By 4 weeks postengraftment, asthmatic epithelia showed decreased numbers of ciliated cells and decreased E-cadherin expression compared with nonasthmatic grafts, similar to human lungs. Grafts seeded with asthmatic epithelial cells had three times more fibrillar collagen and induction of transforming growth factor-β isoforms at 6 weeks postengraftment compared with nonasthmatic grafts. Asthmatic epithelium alone is sufficient to drive aberrant mesenchymal remodeling with fibrillar collagen deposition in asthmatic xenografts. Moreover, this xenograft system represents an advance over current asthma models in that it permits direct assessment of the epithelial-mesenchymal trophic unit.
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Affiliation(s)
- Tillie-Louise Hackett
- 1 Department of Anesthesiology, Pharmacology, and Therapeutics, Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Claire E Hoptay
- 3 Children's Research Institute: Center for Genetic Medicine Research
| | - John F Engelhardt
- 4 Department of Anatomy and Cell Biology, University of Iowa, Iowa City, Iowa; and
| | - Jennifer L Ingram
- 5 Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Health System, Durham, North Carolina
| | - Yulong Zhang
- 4 Department of Anatomy and Cell Biology, University of Iowa, Iowa City, Iowa; and
| | - Sarah E Alcala
- 3 Children's Research Institute: Center for Genetic Medicine Research
| | - Furquan Shaheen
- 1 Department of Anesthesiology, Pharmacology, and Therapeutics, Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ethan Matz
- 2 Department of Integrative Systems Biology and
| | - Dinesh K Pillai
- 2 Department of Integrative Systems Biology and.,7 Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, D.C.,6 Division of Pulmonary and Sleep Medicine, and
| | - Robert J Freishtat
- 2 Department of Integrative Systems Biology and.,7 Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, D.C.,8 Division of Emergency Medicine, Children's National Health System, Washington, D.C
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Hoptay CE, Alcala S, Hoffman E, Freishtat RJ. 4: REGENERATIVE ASYNCHRONY IS A DRIVER IN CHRONIC INFLAMMATION IN AGING. J Investig Med 2016. [DOI: 10.1136/jim-2016-000080.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Purpose of StudyAge-associated chronic diseases are associated with a pro-inflammatory state. It has been challenging to determine cause and effect – do age-associated pathologies increase inflammation or does inflammation induce age-associated pathologies or both? We previously showed that disease-related regenerative asynchrony in repairing lung is the cause of chronic inflammation and fibrosis. Thus, we hypothesized that the aged lung is itself asynchronously regenerating leading to a pro-inflammatory pulmonary milieu.Methods UsedTracheas and intra-cardiac blood were harvested from C57BL6 mice in two age groups of both genders. Young mice were between 8 and 20 weeks of age. Aged mice were between 23 and 33 months of age. Tracheal epithelial progenitor cells were isolated and cultured for 6 days with continuous exposure to BrdU. Cellular regeneration was analyzed by flow cytometry for 7-AAD DNA staining in BrdU+ cells. Concentrations of an initial screening set of cytokines in plasma and cell culture supernatants from days 2 and 6 of culture were measured using magnetic bead-based assays.Summary of ResultsFewer airway epithelial progenitors underwent mitosis from the aged than the young mice (16.9±10.4% vs. 62.2±9.4% of the cultured cells at 6 days). The tracheal epithelial progenitors from aged mice were asynchronously distributed along the cell cycle (G1, S, G2/M: 44, 25, and 31%) compared to those from young mice (62, 14, and 24%). Plasma concentrations of IL-1β, IL-6, TNFα and TGFβ were not significantly different between age groups. Concentrations of TGFβ were significantly different between age groups in supernatant from day 2 (aged=112.43±16.31 pg/mL, young=171.23±13.70 pg/mL; p<0.05) but not from day 6 of culture (aged=159.60±29.83 pg/mL, young=214.15±.94 pg/mL; p=NS). Concentrations of IL-1β were not significantly different between age groups in supernatant from day 2 of culture (aged=2.01±0.23 pg/mL, young=2.10±0.24 pg/mL; p=NS) but remained higher in aged compared to young progenitors on day 6 (aged: 2.17±0.31 pg/mL, young: 1.26±0.10 pg/mL; p<0.05).ConclusionsOur data support the concept that aging induces progenitor cell mitotic asynchrony. It is possible that this epithelial mitotic asynchrony contributes to the pro-inflammatory state associated with aging, as seen in other chronic inflammatory states.
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Sharron M, Hoptay CE, Wiles AA, Garvin LM, Geha M, Benton AS, Nagaraju K, Freishtat RJ. Platelets induce apoptosis during sepsis in a contact-dependent manner that is inhibited by GPIIb/IIIa blockade. PLoS One 2012; 7:e41549. [PMID: 22844498 PMCID: PMC3406039 DOI: 10.1371/journal.pone.0041549] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 06/27/2012] [Indexed: 01/08/2023] Open
Abstract
Purpose End-organ apoptosis is well-described in progressive sepsis and Multiple Organ Dysfunction Syndrome (MODS), especially where platelets accumulate (e.g. spleen and lung). We previously reported an acute sepsis-induced cytotoxic platelet phenotype expressing serine protease granzyme B. We now aim to define the site(s) of and mechanism(s) by which platelet granzyme B induces end-organ apoptosis in sepsis. Methods End-organ apoptosis in murine sepsis (i.e. polymicrobial peritonitis) was analyzed by immunohistochemistry. Platelet cytotoxicity was measured by flow cytometry following 90 minute ex vivo co-incubation with healthy murine splenocytes. Sepsis progression was measured via validated preclinical murine sepsis score. Measurements and Main Results There was evident apoptosis in spleen, lung, and kidney sections from septic wild type mice. In contrast, there was a lack of TUNEL staining in spleens and lungs from septic granzyme B null mice and these mice survived longer following induction of sepsis than wild type mice. In co-incubation experiments, physical separation of septic platelets from splenocytes by a semi-permeable membrane reduced splenocyte apoptosis to a rate indistinguishable from negative controls. Chemical separation by the platelet GPIIb/IIIa receptor inhibitor eptifibatide decreased apoptosis by 66.6±10.6% (p = 0.008). Mice treated with eptifibatide in vivo survived longer following induction of sepsis than vehicle control mice. Conclusions In sepsis, platelet granzyme B-mediated apoptosis occurs in spleen and lung, and absence of granzyme B slows sepsis progression. This process proceeds in a contact-dependent manner that is inhibited ex vivo and in vivo by the platelet GPIIb/IIIa receptor inhibitor eptifibatide. The GPIIb/IIIa inhibitors and other classes of anti-platelet drugs may be protective in sepsis.
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Affiliation(s)
- Matthew Sharron
- Division of Critical Care Medicine, Children’s National Medical Center, Washington, D.C., United States of America
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
- Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
| | - Claire E. Hoptay
- Research Center for Genetic Medicine, Children’s National Medical Center, Washington, D.C., United States of America
- Department of Microbiology, Immunology, and Tropical Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
| | - Andrew A. Wiles
- Research Center for Genetic Medicine, Children’s National Medical Center, Washington, D.C., United States of America
| | - Lindsay M. Garvin
- Research Center for Genetic Medicine, Children’s National Medical Center, Washington, D.C., United States of America
- Department of Microbiology, Immunology, and Tropical Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
| | - Mayya Geha
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
| | - Angela S. Benton
- Research Center for Genetic Medicine, Children’s National Medical Center, Washington, D.C., United States of America
| | - Kanneboyina Nagaraju
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
- Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
- Research Center for Genetic Medicine, Children’s National Medical Center, Washington, D.C., United States of America
| | - Robert J. Freishtat
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
- Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, D.C., United States of America
- Research Center for Genetic Medicine, Children’s National Medical Center, Washington, D.C., United States of America
- Division of Emergency Medicine, Children’s National Medical Center, Washington, D.C., United States of America
- * E-mail:
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