Montecucco Fabrizio, Bianchi Giordano, Gnerre Paola, Bertolotto Maria, Dallegri Franco, Ottonello Luciano
First Clinic of Internal Medicine, Department of Internal Medicine, University of Genova Medical School, Genova, Italy.
Ann N Y Acad Sci. 2006 Jun;1069:463-71. doi: 10.1196/annals.1351.045.
Leptin is involved in energy homeostasis, hematopoiesis, inflammation, and immunity. Although hypoleptinemia characterizing malnutrition has been strictly related to increased susceptibility to infection, other hyperleptinemic conditions, such as end-stage renal disease (ESRD), are highly susceptible to bacterial infections. On the other hand, ESRD is characterized by neutrophil functional defects crucial for infectious morbidity, and several uremic toxins capable of depressing neutrophil functions have been identified. In the present study, we investigated leptin's effects on neutrophil function. Our results show that leptin inhibits neutrophil migration in response to classical chemoattractants. Otherwise, leptin is endowed with chemotactic activity toward neutrophils. The two activities, inhibition of the cell response to chemokines and stimulation of neutrophil migration, could be detected at similar concentrations. On the contrary, neutrophils exposed to leptin did not display detectable [Ca2+]i mobilization, oxidant production, or beta2-integrin upregulation. The results demonstrate that leptin is a pure chemoattractant devoid of secretagogue properties but capable of inhibiting neutrophil chemotaxis to classical neutrophilic chemoattractants. This effect is dependent on the activation of intracellular kinases involved in F-actin polymerization and neutrophil locomotion. Indeed, p38 mitogen-activated protein kinase (MAPK) and Src kinase, but not extracellular-regulated kinase (ERK), were activated by short-term incubation with leptin. Moreover, p38 MAPK inhibitor SB203580 and Src kinase inhibitor PP1, but not MEK inhibitor PD98059, blocked neutrophil chemotaxis toward leptin. Serum from patients with ESRD inhibits migration of normal neutrophils in response to N-formyl-methionine-leucyl-phenylalanine (FMLP) with a strict correlation between serum leptin levels and serum ability to suppress neutrophil locomotion. The serum inhibitory activity can be effectively prevented by immune-depletion of leptin. Taking into account the crucial role of neutrophils in host defense, we show that leptin-mediated ability of ERSD serum to inhibit neutrophil chemotaxis appears to be a mechanism contributing to neutrophil dysfunction in ESRD.
瘦素参与能量稳态、造血、炎症和免疫过程。尽管营养不良所特有的低瘦素血症与感染易感性增加密切相关,但其他高瘦素血症情况,如终末期肾病(ESRD),也极易发生细菌感染。另一方面,ESRD的特征是对感染性发病至关重要的中性粒细胞功能缺陷,并且已经鉴定出几种能够抑制中性粒细胞功能的尿毒症毒素。在本研究中,我们调查了瘦素对中性粒细胞功能的影响。我们的结果表明,瘦素抑制中性粒细胞对经典趋化因子的迁移。此外,瘦素对中性粒细胞具有趋化活性。这两种活性,即抑制细胞对趋化因子的反应和刺激中性粒细胞迁移,可在相似浓度下检测到。相反,暴露于瘦素的中性粒细胞未显示出可检测到的细胞内钙离子浓度([Ca2+]i)动员、氧化剂产生或β2整合素上调。结果表明,瘦素是一种纯趋化因子,缺乏促分泌特性,但能够抑制中性粒细胞对经典嗜中性趋化因子的趋化作用。这种作用依赖于参与F-肌动蛋白聚合和中性粒细胞运动的细胞内激酶的激活。实际上,短期与瘦素孵育可激活p38丝裂原活化蛋白激酶(MAPK)和Src激酶,但不激活细胞外调节激酶(ERK)。此外,p38 MAPK抑制剂SB203580和Src激酶抑制剂PP1可阻断中性粒细胞对瘦素的趋化作用,而MEK抑制剂PD98059则不能。ESRD患者的血清抑制正常中性粒细胞对N-甲酰甲硫氨酰-亮氨酰-苯丙氨酸(FMLP)的迁移,血清瘦素水平与血清抑制中性粒细胞运动的能力之间存在严格相关性。通过瘦素的免疫耗竭可有效预防血清抑制活性。考虑到中性粒细胞在宿主防御中的关键作用,我们表明瘦素介导的ESRD血清抑制中性粒细胞趋化的能力似乎是导致ESRD中性粒细胞功能障碍的一种机制。