Department of Physiology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Shock. 2011 May;35(5):506-11. doi: 10.1097/SHK.0b013e31820b2f05.
Sepsis develops as a result of the host response to infection, and its mortality rate in ICU remains high. Severe inflammation usually causes overproductions of proinflammatory cytokines, i.e., TNF-α and reactive oxygen species, which lead to mitochondrial damage and energetic depletion. Autophagy is a survival mechanism for eukaryote to recycle intracellular nutrients and maintain energy homeostasis. We hypothesize that autophagy plays a beneficial role in the pathogenesis of organ failure during sepsis. A rat model of cecal ligation and puncture (CLP) that simulate peritonitis-induced sepsis was used, and indicators for liver dysfunction, serum glutamic oxaloacetic, serum glutamic pyruvic, alkaline phosphatase, and bilirubin were measured. Levels of LC3-II and LC3 aggregation were quantified by Western blot analysis and by immunohistochemistry, respectively. The tissue localization of autophagy was identified by immunohistochemistry and transmission electron microscopy. Our results showed that (a) increase in LC3-II level in liver tissue occurs at 3 h, peaks at 6 h, and then surprisingly declines quickly until 18 h after CLP (CLP18h); (b) significant hepatic dysfunction was observed at CLP18h; (c) ratio of LC3 aggregation is significantly higher in hepatocytes than in Kupffer cells, and (d) loss of Atg7, an essential gene for autophagosome formation, exaggerates the TNF-α-induced cell death, depletion of ATP, and decrease of albumin production in hepatocytes. These results indicate that autophagy occurs transiently in hepatocytes at early stage, and the decline in autophagy at late stage may contribute to the functional failure in liver during polymicrobial sepsis.
脓毒症是宿主对感染的反应导致的,其在重症监护病房的死亡率仍然很高。严重的炎症通常会导致促炎细胞因子(如 TNF-α 和活性氧)的过度产生,从而导致线粒体损伤和能量耗竭。自噬是真核生物回收细胞内营养物质并维持能量平衡的一种生存机制。我们假设自噬在脓毒症期间器官衰竭的发病机制中起有益作用。使用模拟腹膜炎诱导的脓毒症的盲肠结扎和穿刺(CLP)大鼠模型,测量肝功能指标、血清谷氨酸草酰乙酸、血清谷氨酸丙酮酸、碱性磷酸酶和胆红素。通过 Western blot 分析和免疫组化分别定量 LC3-II 和 LC3 聚集。通过免疫组化和透射电子显微镜鉴定自噬的组织定位。我们的结果表明:(a)CLP 后 3 h 肝组织中 LC3-II 水平增加,6 h 达到峰值,然后令人惊讶地迅速下降至 CLP18h;(b)CLP18h 时观察到明显的肝功能障碍;(c)LC3 聚集的比例在肝细胞中明显高于库普弗细胞;(d)自噬体形成所必需的基因 Atg7 的缺失会加剧 TNF-α 诱导的细胞死亡、ATP 耗竭和白蛋白产生减少。这些结果表明,自噬在早期阶段短暂发生在肝细胞中,晚期自噬的下降可能导致多微生物脓毒症期间肝脏的功能衰竭。