Elmezzi Graduate School of Molecular Medicine, Manhasset, NY 11030; Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549.
Elmezzi Graduate School of Molecular Medicine, Manhasset, NY 11030; Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549; Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY 11030.
J Pediatr Surg. 2019 Oct;54(10):2053-2060. doi: 10.1016/j.jpedsurg.2018.12.020. Epub 2019 Jan 4.
Neonatal sepsis remains a leading cause of infant mortality. Cold-inducible RNA binding protein (CIRP) is an inflammatory mediator that induces TNF-α production in macrophages. C23 is a CIRP-derived peptide that blocks CIRP from binding its receptor. We therefore hypothesized that treatment with C23 reduces systemic inflammation and protects the lungs in neonatal sepsis.
Sepsis was induced in C56BL/6 mouse pups (5-7 days) by intraperitoneal injection of adult cecal slurry (0.525 mg/g body weight, LD). One hour later pups received retroorbital injection of C23 (8 mg/kg) or vehicle (normal saline). Ten hours after sepsis induction, blood and tissues were collected for analysis.
C23 treatment resulted in a 58% and 69% reduction in serum levels of proinflammatory cytokines IL-6 and IL-1β, respectively, and a 40% and 45% reduction of AST and LDH, as compared to vehicle-treated septic pups. In the lungs, C23 treatment reduced expression of cytokines IL-6 and IL-1β by 78% and 74%. In addition, the mRNA level of neutrophil chemoattractants KC and MIP-2 was reduced by 84% and 74%, respectively. These results corresponded to a reduction in histologic lung injury score. Vehicle-treated pups scored 0.49 ± 0.19, while C23 treatment reduced scores to 0.29 ± 0.12 (p < 0.05; Max = 1). Apoptosis in the lungs, measured by TUNEL assay, was also decreased by 53% with C23 treatment (p < 0.05).
Inhibition of CIRP with C23 treatment is protective in septic neonatal mice as demonstrated by reduced inflammatory markers systemically and in the lung. Therefore, C23 has promising therapeutic potential in treatment of neonatal sepsis.
Level I.
新生儿败血症仍然是婴儿死亡的主要原因。冷诱导 RNA 结合蛋白 (CIRP) 是一种炎症介质,可诱导巨噬细胞产生 TNF-α。C23 是一种由 CIRP 衍生的肽,可阻止 CIRP 与其受体结合。因此,我们假设 C23 治疗可减轻新生儿败血症的全身炎症并保护肺部。
通过腹腔内注射成人盲肠浆液(0.525mg/g 体重,LD)诱导 C56BL/6 幼鼠(5-7 天)发生败血症。1 小时后,幼鼠通过眶后注射 C23(8mg/kg)或载体(生理盐水)。在败血症诱导 10 小时后,收集血液和组织进行分析。
与载体处理的败血症幼鼠相比,C23 治疗分别使血清中促炎细胞因子 IL-6 和 IL-1β 的水平降低了 58%和 69%,AST 和 LDH 分别降低了 40%和 45%。在肺部,C23 治疗使细胞因子 IL-6 和 IL-1β 的表达分别降低了 78%和 74%。此外,中性粒细胞趋化因子 KC 和 MIP-2 的 mRNA 水平分别降低了 84%和 74%。这些结果与组织学肺损伤评分的降低相对应。载体处理的幼鼠评分为 0.49±0.19,而 C23 治疗将评分降低至 0.29±0.12(p<0.05;最大值=1)。通过 TUNEL 测定法测量的肺部细胞凋亡也减少了 53%(p<0.05)。
用 C23 治疗抑制 CIRP 在败血症的新生小鼠中具有保护作用,这表现为全身和肺部的炎症标志物减少。因此,C23 在治疗新生儿败血症方面具有有前景的治疗潜力。
I 级。