Sumi Yuka, Woehrle Tobias, Chen Yu, Bao Yi, Li Xiaoou, Yao Yongli, Inoue Yoshiaki, Tanaka Hiroshi, Junger Wolfgang G
*Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; †Department of Emergency and Critical Care Medicine, Juntendo University, Urayasu Hospital, Chiba, Japan; ‡Department of Anesthesiology, Ludwig Maximilian University, Munich, Germany; and §Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria.
Shock. 2014 Aug;42(2):142-7. doi: 10.1097/SHK.0000000000000180.
Our previous work has shown that polymorphonuclear neutrophils (PMNs) require cellular adenosine triphosphate (ATP) release and autocrine purinergic signaling for their activation. Here we studied in a mouse model of cecal ligation and puncture (CLP) whether sepsis affects this purinergic signaling process and thereby alters PMN responses after sepsis. Using high-performance liquid chromatography, we found that plasma ATP, adenosine diphosphate (ADP), and adenosine monophosphate (AMP) concentrations increased up to 6-fold during the first 8 h after CLP, reaching top levels that were significantly higher than those in sham control animals without CLP. Although leukocyte and PMN counts in sham animals increased significantly after 4 h, these blood cell counts decreased in sepsis animals. CD11b expression on the cell surface of PMNs of septic animals was significantly higher compared with sham and untreated control animals. These findings suggest increased PMN activation and sequestration of PMN from the circulation after sepsis. Plasma ATP levels correlated with CD11b expression, suggesting that increased ATP concentrations in plasma contribute to PMN activation. We found that treatment of septic mice with the ATP receptor antagonist suramin diminished CD11b expression, indicating that plasma ATP contributes to PMN activation by stimulating P2 receptors of PMNs. Increased PMN activation can protect the host from invading microorganisms. However, increased PMN activation can also be detrimental by promoting secondary organ damage. We conclude that pharmacological targeting of P2 receptors may allow modulation of PMN responses in sepsis.
我们之前的研究表明,多形核中性粒细胞(PMNs)的激活需要细胞释放三磷酸腺苷(ATP)并进行自分泌嘌呤能信号传导。在此,我们在盲肠结扎和穿刺(CLP)小鼠模型中研究了脓毒症是否会影响这种嘌呤能信号传导过程,进而改变脓毒症后的PMN反应。通过高效液相色谱法,我们发现CLP后最初8小时内,血浆ATP、二磷酸腺苷(ADP)和一磷酸腺苷(AMP)浓度增加了6倍,达到的峰值水平显著高于未进行CLP的假手术对照动物。虽然假手术动物的白细胞和PMN计数在4小时后显著增加,但脓毒症动物的这些血细胞计数却下降了。与假手术和未处理的对照动物相比,脓毒症动物PMN细胞表面的CD11b表达显著更高。这些发现表明脓毒症后PMN激活增加且PMN从循环中被隔离。血浆ATP水平与CD11b表达相关,表明血浆中ATP浓度升高有助于PMN激活。我们发现用ATP受体拮抗剂苏拉明治疗脓毒症小鼠可降低CD11b表达,这表明血浆ATP通过刺激PMN的P2受体来促进PMN激活。增加PMN激活可保护宿主免受入侵微生物的侵害。然而,增加PMN激活也可能因促进继发性器官损伤而有害。我们得出结论,对P2受体进行药物靶向治疗可能有助于调节脓毒症中的PMN反应。