Rahman Milladur, Zhang Su, Chew Michelle, Ersson Anders, Jeppsson Bengt, Thorlacius Henrik
Departments of Surgery, Malmö University Hospital, Lund University, Malmö S-205 02, Sweden.
Ann Surg. 2009 Nov;250(5):783-90. doi: 10.1097/SLA.0b013e3181bd95b7.
To define the role of CD40L in abdominal sepsis.
Platelets promote sepsis-induced pulmonary recruitment of neutrophils. However, the identity of the platelet-derived molecule regulating neutrophil infiltration is not known. The hypothesis of the present study was that platelet-derived CD40L might be responsible for platelet-mediated activation and accumulation of neutrophils in sepsis.
Wild-type C57BL/6 mice and CD40L gene-deficient mice were exposed to cecal ligation and puncture (CLP). Lung edema, bronchoalveolar neutrophils, CD40L and macrophage inflammatory protein-2 (MIP-2) plasma levels, myeloperoxidase activity and Mac-1 expression were determined up to 24 hours after CLP induction. For platelet depletion was an anti-GP1balpha antibody administered before CLP.
Plasma levels of soluble CD40L increased and surface expression of CD40L on platelets decreased in CLP mice. Platelet depletion reduced CLP-induced CD40L levels by 90%. CLP-provoked Mac-1 expression on neutrophils was abolished in CD40L-deficient mice. Interestingly, CLP-induced edema and myeloperoxidase activity in the lung as well as neutrophil infiltration in the broncoalveolar space were markedly reduced in mice lacking CD40L. In vitro experiments showed that CD40L was not capable of directly increasing Mac-1 levels on neutrophils. Instead, CLP-induced plasma levels of MIP-2 were significantly reduced in CD40L-deficient mice and inhibition of the MIP-2 receptor (CXCR2) decreased Mac-1 expression on neutrophils in septic animals.
CD40L derived from platelets is a potent activator of neutrophils and mediates sepsis-induced neutrophil recruitment and lung edema. The neutrophil activating mechanism of CD40L is indirect and mediated via MIP-2 formation and CXCR2 signaling. Targeting CD40L may be an effective approach to limit pulmonary damage in abdominal sepsis.
明确CD40L在腹部脓毒症中的作用。
血小板可促进脓毒症诱导的中性粒细胞在肺部的募集。然而,调节中性粒细胞浸润的血小板衍生分子的身份尚不清楚。本研究的假设是血小板衍生的CD40L可能是脓毒症中血小板介导的中性粒细胞激活和聚集的原因。
将野生型C57BL/6小鼠和CD40L基因缺陷小鼠进行盲肠结扎和穿刺(CLP)。在CLP诱导后24小时内,测定肺水肿、支气管肺泡中性粒细胞、CD40L和巨噬细胞炎性蛋白-2(MIP-2)血浆水平、髓过氧化物酶活性和Mac-1表达。为使血小板耗竭,在CLP前给予抗GP1balpha抗体。
CLP小鼠中可溶性CD40L的血浆水平升高,血小板上CD40L的表面表达降低。血小板耗竭使CLP诱导的CD40L水平降低了90%。在CD40L缺陷小鼠中,CLP诱导的中性粒细胞上Mac-1表达被消除。有趣的是,在缺乏CD40L的小鼠中,CLP诱导的肺水肿和肺髓过氧化物酶活性以及支气管肺泡空间中的中性粒细胞浸润明显减少。体外实验表明,CD40L不能直接增加中性粒细胞上的Mac-1水平。相反,CD40L缺陷小鼠中CLP诱导的MIP-2血浆水平显著降低,抑制MIP-2受体(CXCR2)可降低脓毒症动物中性粒细胞上的Mac-1表达。
血小板衍生的CD40L是中性粒细胞的有效激活剂,介导脓毒症诱导的中性粒细胞募集和肺水肿。CD40L的中性粒细胞激活机制是间接的,通过MIP-2形成和CXCR2信号传导介导。靶向CD40L可能是限制腹部脓毒症中肺损伤的有效方法。