Department of Biochemistry and Genetics, La Trobe Institute of Molecular Science, La Trobe University, Kingsbury Dr. Victoria 3086, Australia.
The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia.
Sci Rep. 2016 Oct 3;6:34702. doi: 10.1038/srep34702.
Sepsis-induced lymphopenia is a major cause of morbidities in intensive care units and in populations with chronic conditions such as renal failure, diabetes, HIV and alcohol abuse. Currently, other than supportive care and antibiotics, there are no treatments for this condition. We developed an in vitro assay to understand the role of the ER-stress-mediated apoptosis process in lymphocyte death during polymicrobial sepsis, which was reproducible in in vivo mouse models. Modulating ER stress using chemical chaperones significantly reduced the induction of the pro-apoptotic protein Bim both in vitro and in mice. Furthermore, in a 'two-hit' pneumonia model in mice, we have been able to demonstrate that administration of the chemical chaperone TUDCA helped to maintain lymphocyte homeostasis by significantly reducing lymphocyte apoptosis and this correlated with four-fold improvement in survival. Our results demonstrate a novel therapeutic opportunity for treating sepsis-induced lymphopenia in humans.
脓毒症引起的淋巴细胞减少症是重症监护病房和患有慢性疾病(如肾衰竭、糖尿病、HIV 和酗酒)人群发病和死亡的主要原因。目前,除了支持性护理和抗生素外,这种疾病没有治疗方法。我们开发了一种体外测定法来了解内质网应激介导的凋亡过程在多微生物脓毒症期间淋巴细胞死亡中的作用,该方法在体内小鼠模型中具有可重复性。使用化学伴侣物调节内质网应激可显著降低体外和小鼠中促凋亡蛋白 Bim 的诱导。此外,在小鼠的“双打击”肺炎模型中,我们已经能够证明,化学伴侣物 TUDCA 的给药通过显著减少淋巴细胞凋亡有助于维持淋巴细胞稳态,这与存活率提高四倍相关。我们的结果为治疗人类脓毒症引起的淋巴细胞减少症提供了一种新的治疗机会。