Csóka Balázs, Németh Zoltán H, Mukhopadhyay Partha, Spolarics Zoltán, Rajesh Mohanraj, Federici Stephanie, Deitch Edwin A, Bátkai Sándor, Pacher Pál, Haskó György
Department of Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey, United States of America.
PLoS One. 2009 Jul 29;4(7):e6409. doi: 10.1371/journal.pone.0006409.
Sepsis is a major healthcare problem and current estimates suggest that the incidence of sepsis is approximately 750,000 annually. Sepsis is caused by an inability of the immune system to eliminate invading pathogens. It was recently proposed that endogenous mediators produced during sepsis can contribute to the immune dysfunction that is observed in sepsis. Endocannabinoids that are produced excessively in sepsis are potential factors leading to immune dysfunction, because they suppress immune cell function by binding to G-protein-coupled CB(2) receptors on immune cells. Here we examined the role of CB(2) receptors in regulating the host's response to sepsis.
The role of CB(2) receptors was studied by subjecting CB(2) receptor wild-type and knockout mice to bacterial sepsis induced by cecal ligation and puncture. We report that CB(2) receptor inactivation by knockout decreases sepsis-induced mortality, and bacterial translocation into the bloodstream of septic animals. Furthermore, CB(2) receptor inactivation decreases kidney and muscle injury, suppresses splenic nuclear factor (NF)-kappaB activation, and diminishes the production of IL-10, IL-6 and MIP-2. Finally, CB(2) receptor deficiency prevents apoptosis in lymphoid organs and augments the number of CD11b(+) and CD19(+) cells during CLP.
Taken together, our results establish for the first time that CB(2) receptors are important contributors to septic immune dysfunction and mortality, indicating that CB(2) receptors may be therapeutically targeted for the benefit of patients suffering from sepsis.
脓毒症是一个重大的医疗保健问题,目前的估计表明,脓毒症的年发病率约为75万例。脓毒症是由免疫系统无法清除入侵病原体所致。最近有人提出,脓毒症期间产生的内源性介质可能导致脓毒症中观察到的免疫功能障碍。脓毒症中过度产生的内源性大麻素是导致免疫功能障碍的潜在因素,因为它们通过与免疫细胞上的G蛋白偶联CB(2)受体结合来抑制免疫细胞功能。在此,我们研究了CB(2)受体在调节宿主对脓毒症反应中的作用。
通过对CB(2)受体野生型和基因敲除小鼠进行盲肠结扎和穿刺诱导的细菌性脓毒症,研究了CB(2)受体的作用。我们报告称,基因敲除导致的CB(2)受体失活可降低脓毒症诱导的死亡率以及细菌向脓毒症动物血流中的移位。此外,CB(2)受体失活可减轻肾脏和肌肉损伤,抑制脾脏核因子(NF)-κB激活,并减少IL-10、IL-6和MIP-2的产生。最后,CB(2)受体缺陷可防止淋巴器官中的细胞凋亡,并在盲肠结扎穿孔术期间增加CD11b(+)和CD19(+)细胞的数量。
综上所述,我们的结果首次证实CB(2)受体是脓毒症免疫功能障碍和死亡率的重要促成因素,表明CB(2)受体可能是脓毒症患者治疗的靶向目标。