代谢适应建立对脓毒症的疾病耐受性。

Metabolic Adaptation Establishes Disease Tolerance to Sepsis.

作者信息

Weis Sebastian, Carlos Ana Rita, Moita Maria Raquel, Singh Sumnima, Blankenhaus Birte, Cardoso Silvia, Larsen Rasmus, Rebelo Sofia, Schäuble Sascha, Del Barrio Laura, Mithieux Gilles, Rajas Fabienne, Lindig Sandro, Bauer Michael, Soares Miguel P

机构信息

Instituto Gulbenkian de Ciência, 2780-156 Oeiras, Portugal; Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, 07747 Jena, Germany.

Instituto Gulbenkian de Ciência, 2780-156 Oeiras, Portugal.

出版信息

Cell. 2017 Jun 15;169(7):1263-1275.e14. doi: 10.1016/j.cell.2017.05.031.

Abstract

Sepsis is an often lethal syndrome resulting from maladaptive immune and metabolic responses to infection, compromising host homeostasis. Disease tolerance is a defense strategy against infection that preserves host homeostasis without exerting a direct negative impact on pathogens. Here, we demonstrate that induction of the iron-sequestering ferritin H chain (FTH) in response to polymicrobial infections is critical to establish disease tolerance to sepsis. The protective effect of FTH is exerted via a mechanism that counters iron-driven oxidative inhibition of the liver glucose-6-phosphatase (G6Pase), and in doing so, sustains endogenous glucose production via liver gluconeogenesis. This is required to prevent the development of hypoglycemia that otherwise compromises disease tolerance to sepsis. FTH overexpression or ferritin administration establish disease tolerance therapeutically. In conclusion, disease tolerance to sepsis relies on a crosstalk between adaptive responses controlling iron and glucose metabolism, required to maintain blood glucose within a physiologic range compatible with host survival.

摘要

脓毒症是一种常由对感染的适应性免疫和代谢反应失调导致的致命综合征,会损害宿主内环境稳态。疾病耐受是一种针对感染的防御策略,可维持宿主内环境稳态,而不对病原体产生直接负面影响。在此,我们证明,对多重微生物感染作出反应而诱导铁螯合铁蛋白H链(FTH)对于建立对脓毒症的疾病耐受至关重要。FTH的保护作用是通过一种机制发挥的,该机制可对抗铁驱动的对肝脏葡萄糖-6-磷酸酶(G6Pase)的氧化抑制作用,并通过肝脏糖异生维持内源性葡萄糖生成。这对于防止低血糖的发生是必需的,否则低血糖会损害对脓毒症的疾病耐受。FTH过表达或给予铁蛋白可在治疗上建立疾病耐受。总之,对脓毒症的疾病耐受依赖于控制铁和葡萄糖代谢的适应性反应之间的相互作用,这是将血糖维持在与宿主存活相容的生理范围内所必需的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/effa/5480394/2484efe85737/fx1.jpg

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