Lei Juan, Zhou Yu, Zhao Huakan, Chen Yu, Yan Guifang, Wu Lei, Xu Yanquan, Zhang Jiangang, Zhang Xiao, Wang Jingchun, Li Dingshan, Li Yongsheng
Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing 400030, China.
Clinical Medicine Research Center, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
Theranostics. 2021 Feb 20;11(9):4251-4261. doi: 10.7150/thno.50182. eCollection 2021.
The interaction between coagulation and inflammation resolution remains elusive. We recently highlighted a link between fibrinogen-like protein 2 (Fgl2) and a specialized pro-resolving mediator (SPM)-n-3 docosapentaenoic acid-derived resolvin D5 (RvD5) in sepsis. This study aimed to investigate the functions of commonly used anticoagulants warfarin, dabigatran and heparin in regulating inflammation resolution. Peripheral blood was collected from clinical sepsis patients and healthy control for the determination of indicated indexes. Mouse sepsis models of zymosan-induced peritonitis and cecal ligation and puncture (CLP) were employed for the measurement of inflammation- and coagulation-related indexes. Western-blotting, ELISA and flow cytometry were applied to assess proteins. UPLC-MS/MS was used to evaluate lipid metabolites. Here we report that the transmembrane Fgl2 (mFgl2) was positively associated with coagulation, while soluble Fgl2 (sFgl2) level correlated with the enhanced number of peripheral blood mononuclear cells in the sepsis patients. The anticoagulants dabigatran and warfarin attenuated zymosan-induced peritonitis, which was not shared by heparin, while only dabigatran significantly improved sepsis survival in the CLP sepsis mouse model. Although these anticoagulants consistently inhibited pro-inflammatory mediators including prostaglandin E and leukotriene B, only dabigatran increased sFgl2 at both the initiation and resolution phases of inflammation. Mechanistically, dabigatran elicited the shedding of sFgl2 prothrombin-related metalloproteases, thereby enhanced the subsequent biosynthesis of RvD5 STAT6-ALOX15 axis. Blocking metalloproteases or ALOX15 significantly impaired dabigatran-enhanced macrophage efferocytosis , as well as delayed the dabigatran-accelerated inflammation resolution . Our findings identify the dual anti-inflammatory and pro-resolving actions of dabigatran, through promoting sFgl2-triggered RvD5 production, which has important implications for promoting tissue homeostasis of sepsis.
凝血与炎症消退之间的相互作用仍不明确。我们最近强调了纤维蛋白原样蛋白2(Fgl2)与脓毒症中一种特殊的促消退介质(SPM)——n-3二十二碳五烯酸衍生的消退素D5(RvD5)之间的联系。本研究旨在探讨常用抗凝剂华法林、达比加群和肝素在调节炎症消退中的作用。从临床脓毒症患者和健康对照者中采集外周血,以测定相关指标。采用酵母聚糖诱导的腹膜炎和盲肠结扎穿刺(CLP)小鼠脓毒症模型来测量炎症和凝血相关指标。应用蛋白质免疫印迹法、酶联免疫吸附测定法和流式细胞术评估蛋白质。采用超高效液相色谱-串联质谱法评估脂质代谢产物。在此我们报告,跨膜Fgl2(mFgl2)与凝血呈正相关,而可溶性Fgl2(sFgl2)水平与脓毒症患者外周血单个核细胞数量增加相关。抗凝剂达比加群和华法林减轻了酵母聚糖诱导的腹膜炎,肝素则无此作用,而在CLP脓毒症小鼠模型中,只有达比加群显著提高了脓毒症生存率。尽管这些抗凝剂均能持续抑制包括前列腺素E和白三烯B在内的促炎介质,但只有达比加群在炎症的起始和消退阶段均能增加sFgl2。从机制上讲,达比加群通过凝血酶原相关金属蛋白酶促使sFgl2脱落,从而增强随后RvD5的生物合成以及信号转导和转录激活因子6-花生四烯酸15脂氧合酶(STAT6-ALOX15)轴。阻断金属蛋白酶或ALOX15会显著损害达比加群增强的巨噬细胞胞葬作用,并延缓达比加群加速的炎症消退。我们的研究结果确定了达比加群通过促进sFgl2触发的RvD5产生而具有的双重抗炎和促消退作用,这对促进脓毒症的组织稳态具有重要意义。