Abstract 447: Deficiency Of Serum Amyloid A Exacerbates Sepsis-induced Acute Lung Injury In Mice

Objectives: Serum Amyloid A (SAA) is a family of proteins whose plasma levels increase > 1000-fold in acute inflammatory states such as sepsis. We and others have demonstrated that SAA plays a causal role in mouse models of atherosclerosis. However, SAA may not be a valid therapeutic target if it is needed for host defense in inflammation. Here, we investigated the role of SAA in sepsis using mice deficient in all three acute-phase SAA isoforms (TKO).

Approach and results: SAA deficiency significantly increased mortality rates in three experimental sepsis models. Survival rates in TKO and wild-type (WT) mice were: 25% and 55% after cecal ligation and puncture (CLP; p=0.02; n=10 each strain/gender); 0% and 45% after cecal slurry injection (p<0.0001; n=9 each strain); and 55% and 90 % after lipopolysaccharide injection (p<0.0001; n=10 each strain/gender). 24-hours after CLP, there were no apparent differences in liver, heart or kidney histology between genotypes. However, TKO mice had exacerbated lung pathology, including consolidation of lung tissues and atelectasis, compared to WT mice. RNAseq analysis of lungs excised 24-hours after CLP identified 664 genes differentially expressed (404 upregulated and 260 downregulated) in TKO compared to WT (p<0.05). Some of the genes that showed profound induction in the lungs of TKO compared to the WT were Proz, Dbp, Cxcl1, Cxcl2, Arg1 and Ackr1 . Gene ontology analysis revealed a significant enrichment of differentially expressed genes associated with chemokine production, chemokine and cytokine-mediated signaling, neutrophil chemotaxis and neutrophil migration in TKO lung tissues compared to WT tissues (p<0.01).

Conclusions: SAA protects mice against sepsis-induced mortality, potentially by protecting the lung from tissue damage. Thus, the risk of infection should be considered when targeting SAA to ameliorate atherosclerosis.

Abstract P101: Suppression Of Serum Amyloid A Limits Progression Of Obesity Associated Abdominal Aortic Aneurysms

Obesity increases the risk for abdominal aortic aneurysms (AAA) in humans, and enhances angiotensin II (AngII)-induced AAA formation in C57BL/6 mice. Obesity is also associated with increases in serum amyloid A (SAA). We previously reported that deficiency of SAA significantly reduces AngII-induced inflammation and AAA in apoE-deficient mice. In this study we investigated whether SAA plays a role in progression of an established AAA in obese C57BL/6 mice.

Approach and Results: Male C57BL/6 mice were fed a high fat diet (60% kcal as fat) throughout the study. After 4 months of diet the mice were infused with angiotensin II (AngII) at 1000ng/kg/min until the end of the study. Ultrasound (US) was performed in all mice before and after 28 days of AngII infusion, and mice that had at least a 25% increase in the luminal diameter of the abdominal aorta were stratified by luminal diameter into 3 groups. Group 1 was killed to establish baseline AAA. Groups 2 and 3 continued to receive AngII for a further 8 weeks along with an antisense oligonucleotide (ASO) that suppresses all 3 acute phase SAA isoforms (SAA-ASO), or a control ASO (5 mg/kg/wk). US was repeated at study end to assess AAA progression. Plasma SAA at the end of the experiment was 89.2±83.2 mg/L in the control ASO group, and 18.6±0.7 mg/L in the SAA-ASO group (mean±SD , p=0.008). There was no impact of SAA suppression on body weight, body fat, or blood pressure. After the first 4 weeks of AngII infusion, the average luminal diameter in all mice was 1.81±0.40 mm (mean±SD). Mice that received the control ASO had continued aortic dilation (average luminal aortic diameter 2.06±0.42 mm), whereas the mice that received the SAA-ASO had a significant reduction in progression of aortic dilation (average luminal diameter 1.64±0.43 mm, p=0.0015 for interaction between time and group).

Conclusions: We demonstrate for the first time that suppression of SAA protects obese C57BL/6 mice from progression of AngII-induced AAA. Suppression of SAA may be a therapeutic approach to limit AAA progression.

HDL remodeling during the acute phase response

OBJECTIVE

The purpose of this study was to examine the interactive action of serum amyloid A (SAA), group IIA secretory phospholipase A(2) (sPLA(2)-IIA), and cholesteryl ester transfer protein (CETP) on HDL remodeling and cholesterol efflux during the acute phase (AP) response elicited in humans after cardiac surgery.

METHODS AND RESULTS

Plasma was collected from patients before (pre-AP), 24 hours after (AP-1 d), and 5 days after cardiac surgery (AP-5 d). SAA levels were increased 16-fold in AP-1 d samples. The activity of sPLA(2)-IIA was increased from 77.7+/-38.3 U/mL (pre-AP) to 281.4+/-57.1 U/mL (AP-1 d; P<0.001). CETP mass and activity reduction was commensurate to the reduction of HDL cholesterol levels. The combined action of SAA, sPLA(2)-IIA, and CETP in vitro markedly remodeled HDL with the generation of lipid-poor apoA-I from both pre-AP and AP-1 d HDL. The net result of this remodeling was a relative preservation of ABCA1- and ABCG1-dependent cholesterol efflux during the acute phase response.

CONCLUSIONS

Our results show that the many and complex changes in plasma proteins during the acute phase response markedly remodel HDL with functional implications, particularly the relative retention of cholesterol efflux capacity.