Department of Surgery, University of Cincinnati College of Medicine, Cincinnati Ohio, USA.
Division of Critical Care Medicine.
Shock. 2023 Jul 1;60(1):64-74. doi: 10.1097/SHK.0000000000002134. Epub 2023 Apr 21.
Introduction: Despite therapeutic advances in hemorrhagic shock, mortality from multiple organ failure remains high. We previously showed that the α1 subunit of AMP-activated protein kinase (AMPK), a crucial regulator of mitochondrial function, exerts a protective role in hemorrhagic shock. Humanin is a mitochondrial peptide with cytoprotective properties against cellular stress. Here, we investigated whether AMPKα1 influences systemic levels of endogenous humanin in hemorrhagic shock and whether treatment with the synthetic analog humanin-G affords beneficial effects. Methods: AMPKα1 wild-type (WT) and knockout (KO) female mice were subjected to hemorrhagic shock followed by resuscitation with blood and lactated Ringer's solution. In short-term studies, mice were treated with humanin-G or vehicle and sacrificed at 3 h after resuscitation; in survival studies, mice were treated with PEGylated humanin-G and monitored for 7 days. Results: Compared with the vehicle WT group, KO mice exhibited severe hypotension, cardiac mitochondrial damage, and higher plasma levels of Th17 cytokines but had similar lung injury and similar plasma elevation of endogenous humanin. Treatment with humanin-G improved lung injury, mean arterial blood pressure, and survival in both WT and KO mice, without affecting systemic cytokine or humanin levels. Humanin-G also ameliorated cardiac mitochondrial damage and increased adenosine triphosphate levels in KO mice. Beneficial effects of humanin-G were associated with lung cytoplasmic and nuclear activation of the signal transducer and activator of transcription-3 (STAT3) in AMPKα1-independent manner with marginal or no effects on mitochondrial STAT3 and complex I subunit GRIM-19. Conclusions: Our data indicate that circulating levels of humanin increase during hemorrhagic shock in AMPKα1-independent fashion as a defense mechanism to counteract metabolic derangement and that administration of humanin-G affords beneficial effects through STAT3 activation even in the absence of a functional AMPKα1.
尽管在失血性休克治疗方面取得了进展,但多器官衰竭导致的死亡率仍然很高。我们之前的研究表明,三磷酸腺苷激活蛋白激酶(AMPK)的α1 亚基是线粒体功能的关键调节剂,在失血性休克中发挥保护作用。人源神经保护因子是一种具有细胞应激保护作用的线粒体肽。在这里,我们研究了 AMPKα1 是否会影响失血性休克时系统内源性人源神经保护因子的水平,以及合成类似物人源神经保护因子-G 的治疗是否会带来有益的效果。方法:对 AMPKα1 野生型(WT)和敲除(KO)雌性小鼠进行失血性休克,然后用血液和乳酸林格氏液复苏。在短期研究中,用人源神经保护因子-G 或载体处理小鼠,在复苏后 3 小时处死;在生存研究中,用聚乙二醇化人源神经保护因子-G 处理小鼠,并监测 7 天。结果:与 WT 载体组相比,KO 小鼠表现出严重的低血压、心脏线粒体损伤和更高的 Th17 细胞因子血浆水平,但肺损伤相似,内源性人源神经保护因子的血浆水平也相似。人源神经保护因子-G 改善了 WT 和 KO 小鼠的肺损伤、平均动脉血压和存活率,而不影响系统细胞因子或人源神经保护因子水平。人源神经保护因子-G 还改善了 KO 小鼠的心脏线粒体损伤并增加了三磷酸腺苷水平。人源神经保护因子-G 的有益作用与 AMPKα1 非依赖性的信号转导和转录激活因子 3(STAT3)的肺细胞质和核激活有关,对线粒体 STAT3 和复合物 I 亚基 GRIM-19 的影响较小或没有影响。结论:我们的数据表明,人源神经保护因子在失血性休克期间以 AMPKα1 非依赖性的方式增加循环水平,作为一种抵抗代谢紊乱的防御机制,而人源神经保护因子-G 的给药通过 STAT3 激活提供有益的效果,即使在缺乏功能性 AMPKα1 的情况下也是如此。