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补体 C5a 诱导严重创伤患者促炎微囊泡释放。

Complement C5a Induces Pro-inflammatory Microvesicle Shedding in Severely Injured Patients.

机构信息

Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany.

Center for Biomedical Research, Genomics-Core Facility, Ulm University, Ulm, Germany.

出版信息

Front Immunol. 2020 Sep 2;11:1789. doi: 10.3389/fimmu.2020.01789. eCollection 2020.

Abstract

Initially underestimated as platelet dust, extracellular vesicles are continuously gaining interest in the field of inflammation. Various studies addressing inflammatory diseases have shown that microvesicles (MVs) originating from different cell types are systemic transport vehicles carrying distinct cargoes to modulate immune responses. In this study, we focused on the clinical setting of multiple trauma, which is characterized by activation and dysfunction of both, the fluid-phase and the cellular component of innate immunity. Given the sensitivity of neutrophils for the complement anaphylatoxin C5a, we hypothesized that increased C5a production induces alterations in MV shedding of neutrophils resulting in neutrophil dysfunction that fuels posttraumatic inflammation. In a mono-centered prospective clinical study with polytraumatized patients, we found significantly increased granulocyte-derived MVs containing the C5a receptor (C5aR1, CD88) on their surface. This finding was accompanied by a concomitant loss of C5aR1 on granulocytes indicative of an impaired cellular chemotactic and pro-inflammatory neutrophil functions. Furthermore, exposure of human neutrophils (from healthy volunteers) to C5a significantly increased MV shedding and C5aR1 loss on neutrophils, which could be blocked using the C5aR1 antagonist PMX53. Mechanistic analyses revealed that the interaction between C5aR1 signaling and the small GTPase Arf6 acts as a molecular switch for MV shedding. When neutrophil derived, C5a-induced MV were exposed to a complex whole blood model significant pro-inflammatory properties (NADPH activity, ROS and MPO generation) of the MVs became evident. C5a-induced MVs activated resting neutrophils and significantly induced IL-6 secretion. These data suggest a novel role of the C5a-C5aR1 axis: C5a-induced MV shedding from neutrophils results in decreased C5aR1 surface expression on the one hand, on the other hand it leads to profound inflammatory signals which likely are both key drivers of the neutrophil dysfunction which is regularly observed in patients suffering from multiple traumatic injuries.

摘要

最初被低估为血小板尘埃的细胞外囊泡在炎症领域不断引起关注。各种研究表明,源自不同细胞类型的微泡(MVs)是携带不同货物以调节免疫反应的全身运输载体。在这项研究中,我们专注于多创伤的临床环境,其特征是先天免疫的液体相和细胞成分的激活和功能障碍。鉴于中性粒细胞对补体过敏毒素 C5a 的敏感性,我们假设增加的 C5a 产生诱导中性粒细胞 MV 脱落的改变导致中性粒细胞功能障碍,从而助长创伤后炎症。在一项多中心前瞻性临床研究中,我们发现来自多创伤患者的粒细胞衍生 MV 明显增加,其表面含有 C5a 受体(C5aR1,CD88)。这一发现伴随着粒细胞上 C5aR1 的伴随丧失,表明细胞趋化性和促炎中性粒细胞功能受损。此外,C5a 暴露于人中性粒细胞(来自健康志愿者)显著增加 MV 脱落和中性粒细胞上 C5aR1 的丧失,这可以使用 C5aR1 拮抗剂 PMX53 阻断。机制分析表明,C5aR1 信号与小 GTPase Arf6 之间的相互作用作为 MV 脱落的分子开关。当源自中性粒细胞的 C5a 诱导的 MV 暴露于复杂的全血模型中时,MV 的明显促炎特性(NADPH 活性、ROS 和 MPO 生成)变得明显。C5a 诱导的 MV 激活静止的中性粒细胞并显著诱导 IL-6 分泌。这些数据表明 C5a-C5aR1 轴的新作用:一方面,C5a 诱导的中性粒细胞 MV 脱落导致 C5aR1 表面表达减少,另一方面,它导致深刻的炎症信号,这两者可能都是经常在遭受多创伤性损伤的患者中观察到的中性粒细胞功能障碍的关键驱动因素。

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