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Renieris G, Droggiti DE, Katrini K, Koufargyris P, Gkavogianni T, Karakike E, Antonakos N, Damoraki G, Karageorgos A, Sabracos L, Katsouda A, Jentho E, Weis S, Wang R, Bauer M, Szabo C, Platoni K, Kouloulias V, Papapetropoulos A, Giamarellos-Bourboulis EJ. Host cystathionine-γ lyase derived hydrogen sulfide protects against Pseudomonas aeruginosa sepsis. PLoS Pathog 2021; 17:e1009473. [PMID: 33770141 PMCID: PMC8051778 DOI: 10.1371/journal.ppat.1009473] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 10/22/2020] [Revised: 04/16/2021] [Accepted: 03/12/2021] [Indexed: 11/18/2022] Open
Abstract
Hydrogen sulfide (H2S) has recently been recognized as a novel gaseous transmitter with several anti-inflammatory properties. The role of host- derived H2S in infections by Pseudomonas aeruginosa was investigated in clinical and mouse models. H2S concentrations and survival was assessed in septic patients with lung infection. Animal experiments using a model of severe systemic multidrug-resistant P. aeruginosa infection were performed using mice with a constitutive knock-out of cystathionine-γ lyase (Cse) gene (Cse-/-) and wild-type mice with a physiological expression (Cse+/+). Experiments were repeated in mice after a) treatment with cyclophosphamide; b) bone marrow transplantation (BMT) from a Cse+/+ donor; c) treatment with H2S synthesis inhibitor aminooxyacetic acid (ΑΟΑΑ) or propargylglycine (PAG) and d) H2S donor sodium thiosulfate (STS) or GYY3147. Bacterial loads and myeloperoxidase activity were measured in tissue samples. The expression of quorum sensing genes (QS) was determined in vivo and in vitro. Cytokine concentration was measured in serum and incubated splenocytes. Patients survivors at day 28 had significantly higher serum H2S compared to non-survivors. A cut- off point of 5.3 μΜ discriminated survivors with sensitivity 92.3%. Mortality after 28 days was 30.9% and 93.7% in patients with H2S higher and less than 5.3 μΜ (p = 7 x 10-6). In mice expression of Cse and application of STS afforded protection against infection with multidrug-resistant P. aeruginosa. Cyclophosphamide pretreatment eliminated the survival benefit of Cse+/+ mice, whereas BMT increased the survival of Cse-/- mice. Cse-/- mice had increased pathogen loads compared to Cse+/+ mice. Phagocytic activity of leukocytes from Cse-/- mice was reduced but was restored after H2S supplementation. An H2S dependent down- regulation of quorum sensing genes of P.aeruginosa could be demonstrated in vivo and in vitro. Endogenous H2S is a potential independent parameter correlating with the outcome of P. aeruginosa. H2S provides resistance to infection by MDR bacterial pathogens.
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Affiliation(s)
- Georgios Renieris
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dionysia-Eirini Droggiti
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Konstantina Katrini
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Panagiotis Koufargyris
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Theologia Gkavogianni
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Eleni Karakike
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Nikolaos Antonakos
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Georgia Damoraki
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Athanasios Karageorgos
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Labros Sabracos
- 4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Antonia Katsouda
- Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Elisa Jentho
- Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena, Germany
- Institute for Infectious Disease and Infection Control, Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - Sebastian Weis
- Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena, Germany
- Institute for Infectious Disease and Infection Control, Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - Rui Wang
- Department of Biology, York University, Toronto, Canada
| | - Michael Bauer
- Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena, Germany
| | - Csaba Szabo
- Department of Anaesthesiology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Chair of Pharmacology, Department of Medicine, University of Fribourg, Fribourg, Switzerland
| | - Kalliopi Platoni
- 2 Department of Radiology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Vasilios Kouloulias
- 2 Department of Radiology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Andreas Papapetropoulos
- Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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