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利用纳米颗粒包裹 siRNA 沉默 CSF-1 轴可减轻病毒性和自身免疫性心肌炎。

Silencing the CSF-1 Axis Using Nanoparticle Encapsulated siRNA Mitigates Viral and Autoimmune Myocarditis.

机构信息

Internal Medicine III, University Hospital Heidelberg, Heidelberg, Germany.

DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg-Mannheim, Heidelberg, Germany.

出版信息

Front Immunol. 2018 Oct 8;9:2303. doi: 10.3389/fimmu.2018.02303. eCollection 2018.

Abstract

Myocarditis is an inflammatory disease of the heart muscle most commonly caused by viral infection and often maintained by autoimmunity. Virus-induced tissue damage triggers chemokine production and, subsequently, immune cell infiltration with pro-inflammatory and pro-fibrotic cytokine production follows. In patients, the overall inflammatory burden determines the disease outcome. Following the aim to define specific molecules that drive both immunopathology and/or autoimmunity in inflammatory heart disease, here we report on increased expression of colony stimulating factor 1 (CSF-1) in patients with myocarditis. CSF-1 controls monocytes originating from hematopoietic stem cells and subsequent progenitor stages. Both, monocytes and macrophages are centrally involved in mediating tissue damage and fibrotic scarring in the heart. CSF-1 influences monocytes via engagement of CSF-1 receptor, and it is also produced by cells of the mononuclear phagocyte system themselves. Based on this, we sought to modulate the virus-triggered inflammatory response in an experimental model of Coxsackievirus B3-induced myocarditis by silencing the CSF-1 axis in myeloid cells using nanoparticle-encapsulated siRNA. siCSF-1 inverted virus-mediated immunopathology as reflected by lower troponin T levels, a reduction of accumulating myeloid cells in heart tissue and improved cardiac function. Importantly, pathogen control was maintained and the virus was efficiently cleared from heart tissue. Since viral heart disease triggers heart-directed autoimmunity, in a second approach we investigated the influence of CSF-1 upon manifestation of heart tissue inflammation during experimental autoimmune myocarditis (EAM). EAM was induced in Balb/c mice by immunization with a myocarditogenic myosin-heavy chain-derived peptide dissolved in complete Freund's adjuvant. siCSF-1 treatment initiated upon established disease inhibited monocyte infiltration into heart tissue and this suppressed cardiac injury as reflected by diminished cardiac fibrosis and improved cardiac function at later states. Mechanistically, we found that suppression of CSF-1 production arrested both differentiation and maturation of monocytes and their precursors in the bone marrow. In conclusion, during viral and autoimmune myocarditis silencing of the myeloid CSF-1 axis by nanoparticle-encapsulated siRNA is beneficial for preventing inflammatory tissue damage in the heart and preserving cardiac function without compromising innate immunity's critical defense mechanisms.

摘要

心肌炎是一种心肌炎症性疾病,最常见的病因是病毒感染,且常由自身免疫引起。病毒引起的组织损伤会触发趋化因子的产生,随后,免疫细胞浸润并产生促炎和促纤维化细胞因子。在患者中,整体炎症负担决定了疾病的结局。为了明确在炎症性心脏病中驱动免疫病理和/或自身免疫的特定分子,我们在此报告心肌炎患者中集落刺激因子 1(CSF-1)的表达增加。CSF-1 控制源自造血干细胞及其后续祖细胞阶段的单核细胞。单核细胞和巨噬细胞均在介导心脏组织损伤和纤维化瘢痕形成中发挥核心作用。CSF-1 通过与 CSF-1 受体结合来影响单核细胞,它也由单核吞噬细胞系统本身的细胞产生。基于这一点,我们试图通过使用纳米颗粒包裹的 siRNA 沉默髓样细胞中的 CSF-1 轴,来调节柯萨奇病毒 B3 诱导的心肌炎实验模型中的病毒触发的炎症反应。siCSF-1 逆转了病毒介导的免疫病理,表现为肌钙蛋白 T 水平降低、心脏组织中累积的髓样细胞减少以及心功能改善。重要的是,病原体的控制得以维持,病毒从心脏组织中被有效清除。由于病毒性心脏病会引发针对心脏的自身免疫,在第二种方法中,我们研究了 CSF-1 对实验性自身免疫性心肌炎(EAM)期间心脏组织炎症表现的影响。通过用溶解在完全弗氏佐剂中的心肌炎相关肌球蛋白重链衍生肽免疫 Balb/c 小鼠来诱导 EAM。在疾病确立后开始用 siCSF-1 治疗,抑制了单核细胞浸润到心脏组织中,这抑制了心脏损伤,表现为心脏纤维化减少和后期心功能改善。从机制上讲,我们发现抑制 CSF-1 的产生阻止了骨髓中单核细胞及其前体的分化和成熟。总之,在病毒性和自身免疫性心肌炎中,通过纳米颗粒包裹的 siRNA 沉默髓样细胞 CSF-1 轴有利于预防心脏的炎症性组织损伤并保持心功能,而不会损害固有免疫的关键防御机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7432/6186826/0a4d00083a22/fimmu-09-02303-g0001.jpg

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