From the Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Anesthesiology. 2020 Jun;132(6):1503-1515. doi: 10.1097/ALN.0000000000003192.
Sepsis is the overwhelming inflammatory response to infection, in which nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3) inflammasome plays a crucial role. Shingosine-1-phosphate is reported to evoke NLRP3 inflammasome activation. Sphingosine kinase 1 (SphK1) is the major kinase that catalyzes bioactive lipid shingosine-1-phosphate formation and its role in sepsis remains uncertain. The authors hypothesize that SphK1 elicits NLRP3 inflammasome activation and exacerbates sepsis.
Peripheral blood mononuclear cells were isolated from septic patients and healthy volunteers to measure messenger RNA (mRNA) expression. In mice, sepsis was induced by cecal ligation and puncture. Bone marrow-derived macrophages were prepared from C57BL/6J wild-type, Casp1, Nlrp3 and SphK1 mice. PF-543 was used as the specific inhibitor of SphK1. Mortality, peripheral perfusion, lung Evan's blue dye index, lung wet/dry ratio, lung injury score, lung myeloperoxidase activity, NLRP3 activation, and function of endothelial adherens junction were measured.
SphK1 mRNA expression was higher in cells from septic patients versus healthy volunteers (septic patients vs. healthy volunteers: 50.9 ± 57.0 fold change vs. 1.2 ± 0.1 fold change, P < 0.0001) and was positively correlated with IL-1β mRNA expression in these cells (r = 0.537, P = 0.012) and negatively correlated with PaO2/FIO2 ratios (r = 0.516, P = 0.017). In mice that had undergone cecal ligation and puncture, the 5-day mortality was 30% in PF-543-treated group and 80% in control group (n = 10 per group, P = 0.028). Compared with controls, PF-543-treated mice demonstrated improved peripheral perfusion and alleviated extravascular Evan's blue dye effusion (control vs. PF-543: 25.5 ± 3.2 ng/g vs. 18.2 ± 1.4 ng/g, P < 0.001), lower lung wet/dry ratio (control vs. PF-543: 8.0 ± 0.2 vs. 7.1 ± 0.4, P < 0.0001), descending lung injury score, and weaker lung myeloperoxidase activity. Inhibition of SphK1 suppressed caspase-1 maturation and interleukin-1β release through repressing NLRP3 inflammasome activation, and subsequently stabilized vascular endothelial cadherin through suppressing interleukin-1β-evoked Src-mediated phosphorylation of vascular endothelial cadherin.
SphK1 plays a crucial role in NLRP3 inflammasome activation and contributes to lung injury and mortality in mice polymicrobial sepsis.
脓毒症是感染引起的过度炎症反应,核苷酸结合寡聚化结构域样受体含吡咯并嘧啶结构域 3(NLRP3)炎症小体在此过程中起着至关重要的作用。据报道,神经鞘氨醇-1-磷酸可引发 NLRP3 炎症小体的激活。鞘氨醇激酶 1(SphK1)是催化生物活性脂质神经鞘氨醇-1-磷酸形成的主要激酶,但其在脓毒症中的作用尚不确定。作者假设 SphK1 引发 NLRP3 炎症小体的激活并加重脓毒症。
从脓毒症患者和健康志愿者中分离外周血单核细胞,以测量信使 RNA(mRNA)表达。通过盲肠结扎和穿刺术诱导小鼠脓毒症。从 C57BL/6J 野生型、Casp1、Nlrp3 和 SphK1 小鼠中制备骨髓来源的巨噬细胞。PF-543 被用作 SphK1 的特异性抑制剂。测量死亡率、外周灌注、肺伊文思蓝染料指数、肺湿/干比、肺损伤评分、肺髓过氧化物酶活性、NLRP3 激活和内皮细胞黏附连接的功能。
与健康志愿者相比,脓毒症患者细胞中的 SphK1 mRNA 表达更高(脓毒症患者与健康志愿者相比:50.9 ± 57.0 倍变化与 1.2 ± 0.1 倍变化相比,P < 0.0001),并且与这些细胞中的 IL-1β mRNA 表达呈正相关(r = 0.537,P = 0.012),与 PaO2/FIO2 比值呈负相关(r = 0.516,P = 0.017)。在接受盲肠结扎和穿刺术的小鼠中,PF-543 治疗组的 5 天死亡率为 30%,而对照组为 80%(每组 10 只,P = 0.028)。与对照组相比,PF-543 治疗组的外周灌注得到改善,血管外伊文思蓝染料渗出减轻(对照组与 PF-543 组:25.5 ± 3.2 ng/g 与 18.2 ± 1.4 ng/g,P < 0.001),肺湿/干比降低(对照组与 PF-543 组:8.0 ± 0.2 与 7.1 ± 0.4,P < 0.0001),肺损伤评分降低,肺髓过氧化物酶活性减弱。抑制 SphK1 通过抑制 NLRP3 炎症小体的激活来抑制半胱氨酸蛋白酶-1 的成熟和白细胞介素-1β的释放,随后通过抑制白细胞介素-1β诱导的Src 介导的血管内皮钙黏蛋白磷酸化来稳定血管内皮钙黏蛋白。
SphK1 在 NLRP3 炎症小体的激活中起着至关重要的作用,并有助于小鼠多微生物脓毒症中的肺损伤和死亡率。