Klinik & Poliklinik für Innere Medizin I, Klinikum Rechts der Isar, TU Munich, Munich, Germany.
DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
Thromb Haemost. 2021 Mar;121(3):341-350. doi: 10.1055/s-0040-1716844. Epub 2020 Oct 4.
The high mortality seen in sepsis is caused by a systemic hypotension in part owing to a drastic increase in vascular permeability accompanied by a loss of pericytes. As has been shown previously, pericyte retention in the perivascular niche during sepsis can enhance the integrity of the vasculature and promote survival via recruitment of adhesion proteins such as VE-cadherin and N-cadherin. Sphingosine-1-phosphate (S1P) represents a lipid mediator regulating the deposition of the crucial adhesion molecule VE-cadherin at sites of interendothelial adherens junctions and of N-cadherin at endothelial-pericyte adherens junctions. Furthermore, in septic patients, S1P plasma levels are decreased and correlate with mortality in an indirectly proportional way. In the present study, we investigated the potential of S1P to ameliorate a lipopolysaccharide-induced septic hypercirculation in mice. Here we establish S1P as an antagonist of pericyte loss, vascular hyperpermeability, and systemic hypotension, resulting in an increased survival in mice. During sepsis S1P preserved VE-cadherin and N-cadherin deposition, mediated by a reduction of Src and cadherin phosphorylation. At least in part, this effect is mediated by a reduction of globular actin and a subsequent increase in nuclear translocation of MRTF-A (myocardin-related transcription factor A). These findings indicate that S1P may counteract pericyte loss and microvessel disassembly during sepsis and additionally emphasize the importance of pericyte-endothelial interactions to stabilize the vasculature.
脓毒症中高死亡率的部分原因是全身低血压,这主要是由于血管通透性急剧增加,伴随周细胞丧失。如先前所示,在脓毒症期间周细胞保留在血管周围龛位中可以通过募集粘附蛋白(如 VE-钙粘蛋白和 N-钙粘蛋白)增强血管完整性并促进存活。鞘氨醇-1-磷酸(S1P)是一种调节关键粘附分子 VE-钙粘蛋白在血管内皮细胞间黏附连接点和 N-钙粘蛋白在血管内皮-周细胞黏附连接点沉积的脂质介质。此外,在脓毒症患者中,S1P 血浆水平降低,并与死亡率呈反比相关。在本研究中,我们研究了 S1P 改善小鼠脂多糖诱导的脓毒症高循环的潜力。在这里,我们确定 S1P 是周细胞丢失、血管高通透性和全身低血压的拮抗剂,导致小鼠存活率增加。在脓毒症期间,S1P 通过减少Src 和钙粘蛋白磷酸化来保留 VE-钙粘蛋白和 N-钙粘蛋白的沉积。至少部分是通过减少球状肌动蛋白和随后核易位肌球蛋白相关转录因子 A(myocardin-related transcription factor A,MRTF-A)来介导的。这些发现表明,S1P 可能在脓毒症期间对抗周细胞丢失和微血管解体,并强调周细胞-内皮细胞相互作用对于稳定血管的重要性。