McHugh Walker M, Russell William W, Fleszar Andrew J, Rodenhouse Paul E, Rietberg Skyler P, Sun Lei, Shanley Thomas P, Cornell Timothy T
Division of Pediatric Critical Care Medicine, Department of Pediatrics and Communicable Diseases, University of Michigan School of Medicine, and C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
Division of Pediatric Critical Care Medicine, Department of Pediatrics and Communicable Diseases, University of Michigan School of Medicine, and C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan
Am J Physiol Lung Cell Mol Physiol. 2016 Nov 1;311(5):L903-L912. doi: 10.1152/ajplung.00007.2016. Epub 2016 Sep 16.
Acute respiratory distress syndrome (ARDS) remains a leading cause of morbidity and mortality in both adult and pediatric intensive care units. A key event in the development of ARDS is neutrophil recruitment into the lungs leading to tissue damage and destruction. Interleukin-8 (IL-8) is the major human chemokine responsible for neutrophil recruitment into the lungs. Protein phosphatase 2A (PP2A) has been shown to be a key regulator of the mitogen-activated protein kinase (MAPK) cascades, which control the production of IL-8. Previously, our laboratory employed an in vitro model to show that inhibition of PP2A results in an increase in IL-8 production in human alveolar epithelial cells. The objective of this study was to determine whether PP2A regulated this response in vivo by investigating the impact of pharmacologic activation of PP2A on chemokine production and activation of the MAPK cascade and lung injury using endotoxin- and bacterial-challenge models of ARDS in mice. N-cyclopentyladenosine (N-CPA) increased PP2A activity and inhibited endotoxin-induced cytokine production in a murine alveolar macrophage cell line. N-CPA pretreatment in mice challenged with intratracheal endotoxin decreased chemokine production, reduced neutrophil infiltration, and attenuated lung injury. Following initiation of lung injury with live Pseudomonas aeruginosa, mice that received N-CPA 4 h following bacterial challenge showed attenuated chemokine production and reduced neutrophil infiltration compared with control mice. Pharmacologic PP2A activation both limited and prevented inflammation and tissue injury in two direct injury models of ARDS. These results suggest modulation of PP2A activity as a therapeutic target in ARDS.
急性呼吸窘迫综合征(ARDS)仍是成人和儿童重症监护病房发病和死亡的主要原因。ARDS发生过程中的一个关键事件是中性粒细胞募集到肺中,导致组织损伤和破坏。白细胞介素-8(IL-8)是负责中性粒细胞募集到肺中的主要人类趋化因子。蛋白磷酸酶2A(PP2A)已被证明是丝裂原活化蛋白激酶(MAPK)级联反应的关键调节因子,该级联反应控制IL-8的产生。此前,我们实验室采用体外模型表明,抑制PP2A会导致人肺泡上皮细胞中IL-8产生增加。本研究的目的是通过使用小鼠ARDS的内毒素和细菌攻击模型,研究PP2A的药理学激活对趋化因子产生、MAPK级联反应激活和肺损伤的影响,来确定PP2A在体内是否调节这种反应。N-环戊基腺苷(N-CPA)增加了PP2A活性,并抑制了鼠肺泡巨噬细胞系中内毒素诱导的细胞因子产生。用气管内内毒素攻击的小鼠经N-CPA预处理后,趋化因子产生减少,中性粒细胞浸润减少,肺损伤减轻。在用活的铜绿假单胞菌引发肺损伤后,与对照小鼠相比,在细菌攻击后4小时接受N-CPA的小鼠趋化因子产生减弱,中性粒细胞浸润减少。在ARDS的两种直接损伤模型中,药理学激活PP2A既限制又预防了炎症和组织损伤。这些结果表明,调节PP2A活性可作为ARDS的治疗靶点。