Department of Clinical Sciences, Section for Surgery, Lund University, Malmö, Sweden.
J Thromb Haemost. 2013 Jul;11(7):1385-98. doi: 10.1111/jth.12273.
Platelet-derived CD40L is known to regulate neutrophil recruitment and lung damage in sepsis. However, the mechanism regulating shedding of CD40L from activated platelets is not known. We hypothesized that matrix metalloproteinase (MMP)-9 might cleave surface-expressed CD40L and regulate pulmonary accumulation of neutrophils in sepsis.
Abdominal sepsis was induced by cecal ligation and puncture (CLP) in wild-type and MMP-9-deficient mice. Edema formation, CXC chemokine levels, myeloperoxidase levels, neutrophils in the lung and plasma levels of CD40L and MMP-9 were quantified.
CLP increased plasma levels of MMP-9 but not MMP-2. The CLP-induced decrease in platelet surface CD40L and increase in soluble CD40L levels were significantly attenuated in MMP-9 gene-deficient mice. Moreover, pulmonary myeloperoxidase (MPO) activity and neutrophil infiltration in the alveolar space, as well as edema formation and lung injury, were markedly decreased in septic mice lacking MMP-9. In vitro studies revealed that inhibition of MMP-9 decreased platelet shedding of CD40L. Moreover, recombinant MMP-9 was capable of cleaving surface-expressed CD40L on activated platelets. In human studies, plasma levels of MMP-9 were significantly increased in patients with septic shock as compared with healthy controls, although MMP-9 levels did not correlate with organ injury score.
Our novel data propose a role of MMP-9 in regulating platelet-dependent infiltration of neutrophils and tissue damage in septic lung injury by controlling CD40L shedding from platelets. We conclude that targeting MMP-9 may be a useful strategy to limit acute lung injury in abdominal sepsis.
已知血小板衍生的 CD40L 可调节脓毒症中的中性粒细胞募集和肺损伤。然而,调节激活血小板表面 CD40L 脱落的机制尚不清楚。我们假设基质金属蛋白酶(MMP)-9 可能会切割表面表达的 CD40L,并调节脓毒症中中性粒细胞在肺部的积聚。
通过盲肠结扎和穿刺(CLP)在野生型和 MMP-9 缺陷型小鼠中诱导腹部脓毒症。量化水肿形成、CXC 趋化因子水平、髓过氧化物酶水平、肺中的中性粒细胞和血浆中的 CD40L 和 MMP-9 水平。
CLP 增加了血浆中 MMP-9 的水平,但不增加 MMP-2 的水平。MMP-9 基因缺陷小鼠中,CLP 诱导的血小板表面 CD40L 减少和可溶性 CD40L 水平增加明显减弱。此外,缺乏 MMP-9 的脓毒症小鼠的肺髓过氧化物酶(MPO)活性和肺泡空间中的中性粒细胞浸润、水肿形成和肺损伤明显减少。体外研究表明,抑制 MMP-9 可减少血小板 CD40L 的脱落。此外,重组 MMP-9 能够切割激活血小板表面表达的 CD40L。在人类研究中,与健康对照组相比,脓毒症休克患者的血浆 MMP-9 水平显着升高,尽管 MMP-9 水平与器官损伤评分无关。
我们的新数据表明,MMP-9 通过控制血小板表面 CD40L 的脱落,在调节血小板依赖性中性粒细胞浸润和脓毒症性肺损伤中的组织损伤中起作用。我们得出结论,靶向 MMP-9 可能是限制腹部脓毒症中急性肺损伤的有效策略。