Reduced peroxisome proliferator-activated receptor α expression is associated with decreased survival and increased tissue bacterial load in sepsis.

The peroxisome proliferator-activated receptor α (PPAR-α) is a member of the nuclear receptor family with many important physiologic roles related to metabolism and inflammation. Previous research in pediatric patients with septic shock revealed that genes corresponding to the PPAR-α signaling pathway are significantly downregulated in a subgroup of children with more severe disease. In this study, PPAR-α expression analysis using whole-blood derived RNA revealed that PPAR-α expression was decreased in patients with septic shock and that the magnitude of that decrement correlated with the severity of disease. In a mouse model of sepsis, induced by cecal ligation and puncture, knockout mice lacking PPAR-α had decreased survival compared with wild-type animals. Plasma cytokine analysis demonstrated decreased levels of interleukin 1β (IL-1β), IL-6, IL-17, keratinocyte-derived cytokine, macrophage chemoattractant protein 1, macrophage inflammatory protein 2, and tumor necrosis factor α at 24 h in PPAR-α knockout animals. Cell surface markers of activation on splenic dendritic cells, macrophages, and CD8 T cells were reduced in PPAR-α null animals, and the bacterial load in lung and splenic tissues was increased. These data indicate that reduced or absent PPAR-α expression confers a survival disadvantage in sepsis and that PPAR-α plays a role in maintaining appropriate immune functions during the sepsis response.