From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Anesthesiology. 2014 Dec;121(6):1258-69. doi: 10.1097/ALN.0000000000000398.
Myeloid differentiation factor 88 (MyD88) is an adaptor molecule critical for host innate immunity. Studies have shown that signaling via MyD88 contributes to cytokine storm, cardiac dysfunction, and high mortality during endotoxin shock.However, the specific contribution of MyD88 signaling of immune and cardiac origins to endotoxin shock remains unknown.
Tissue-specific MyD88 deletion models: Cre-recombinase transgenic mice with α-myosin heavy chain (α-MHC) or lysozyme M promoters were cross-bred with MyD88-loxP (MyD88fl/fl) mice, respectively, to generate cardiomyocyte- (α-MHCMyD88−/−) or myeloid-specific (Lyz-MyD88−/−) MyD88 deletion models and their respective MyD88fl/fl littermates. Endotoxin shock model: Mice were subjected to 15 mg/kg lipopolysaccharide (intraperitoneal injection). Cardiac function was measured by echocardiography and cytokines by multiplex assay and quantitative reverse transcription-polymerase chain reaction.
α-MHC-MyD88−/− mice had 61 and 87% reduction in MyD88 gene and protein expression in cardiomyocytes,respectively, whereas Lyz-MyD88−/− had 73 and 67% decrease, respectively, in macrophages (n=3 per group). After lipopolysaccharide treatment, the two groups of MyD88fl/fl littermates had 46% (n=10) and 60% (n=15) of mortality, respectively.Both α-MHC-MyD88−/− and Lyz-MyD88−/− mice had markedly improved survival. Compared with the MyD88fl/fl littermates, Lyz-MyD88−/− mice had warmer body temperature, attenuated systemic and cardiac inflammatory cytokine production,and significantly improved cardiac function, whereas α-MHC-MyD88−/− mice had decreased myocardial inducible nitricoxide synthase induction and modestly preserved cardiac function.
Both cardiomyocyte- and myeloid-MyD88 signaling play a role in cardiac dysfunction and mortality during endotoxin shock. Myeloid-MyD88 signaling plays a predominant role in systemic and cardiac inflammation after endotoxin challenge.
髓样分化因子 88(MyD88)是宿主固有免疫的一种衔接分子,对于宿主固有免疫至关重要。研究表明,MyD88 信号转导会导致细胞因子风暴、心脏功能障碍和内毒素休克时的高死亡率。然而,免疫和心脏来源的 MyD88 信号对内毒素休克的具体贡献仍不清楚。
组织特异性 MyD88 缺失模型:分别用肌球蛋白重链(α-MHC)或溶酶体酶 M 启动子的 Cre 重组酶转基因小鼠与 MyD88-loxP(MyD88fl/fl)小鼠杂交,分别产生心肌细胞特异性(α-MHCMyD88−/−)或髓系特异性(Lyz-MyD88−/−)MyD88 缺失模型及其相应的 MyD88fl/fl 同窝仔鼠。内毒素休克模型:小鼠接受 15mg/kg 脂多糖(腹腔注射)。通过超声心动图和多指标检测试剂盒以及定量逆转录聚合酶链反应检测心功能和细胞因子。
α-MHC-MyD88−/− 小鼠心肌细胞中的 MyD88 基因和蛋白表达分别减少 61%和 87%,而 Lyz-MyD88−/− 小鼠的巨噬细胞中分别减少 73%和 67%(每组 n=3)。脂多糖处理后,两组 MyD88fl/fl 同窝仔鼠的死亡率分别为 46%(n=10)和 60%(n=15)。与 MyD88fl/fl 同窝仔鼠相比,Lyz-MyD88−/− 小鼠的存活率明显提高。与 MyD88fl/fl 同窝仔鼠相比,Lyz-MyD88−/− 小鼠的体温更高,全身和心脏的炎症细胞因子产生减少,心功能明显改善,而 α-MHC-MyD88−/− 小鼠的心肌诱导型一氧化氮合酶诱导减少,心功能仅得到适度改善。
心肌细胞和髓系细胞中的 MyD88 信号在内毒素休克时的心脏功能障碍和死亡率中均发挥作用。髓系细胞中的 MyD88 信号在脂多糖刺激后在全身和心脏炎症中起主要作用。