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高分泌色氨酰 tRNA 合成酶 1 作为细胞因子风暴性脓毒症的潜在治疗靶点。

Highly secreted tryptophanyl tRNA synthetase 1 as a potential theranostic target for hypercytokinemic severe sepsis.

机构信息

Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, Republic of Korea.

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

EMBO Mol Med. 2024 Jan;16(1):40-63. doi: 10.1038/s44321-023-00004-y. Epub 2023 Dec 14.

Abstract

Despite intensive clinical and scientific efforts, the mortality rate of sepsis remains high due to the lack of precise biomarkers for patient stratification and therapeutic guidance. Secreted human tryptophanyl-tRNA synthetase 1 (WARS1), an endogenous ligand for Toll-like receptor (TLR) 2 and TLR4 against infection, activates the genes that signify the hyperinflammatory sepsis phenotype. High plasma WARS1 levels stratified the early death of critically ill patients with sepsis, along with elevated levels of cytokines, chemokines, and lactate, as well as increased numbers of absolute neutrophils and monocytes, and higher Sequential Organ Failure Assessment (SOFA) scores. These symptoms were recapitulated in severely ill septic mice with hypercytokinemia. Further, injection of WARS1 into mildly septic mice worsened morbidity and mortality. We created an anti-human WARS1-neutralizing antibody that suppresses proinflammatory cytokine expression in marmosets with endotoxemia. Administration of this antibody into severe septic mice attenuated cytokine storm, organ failure, and early mortality. With antibiotics, the antibody almost completely prevented fatalities. These data imply that blood-circulating WARS1-guided anti-WARS1 therapy may provide a novel theranostic strategy for life-threatening systemic hyperinflammatory sepsis.

摘要

尽管临床和科学界进行了深入的研究,但由于缺乏精确的生物标志物来进行患者分层和治疗指导,脓毒症的死亡率仍然很高。分泌的人色氨酰-tRNA 合成酶 1(WARS1)是一种内源性 Toll 样受体(TLR)2 和 TLR4 的配体,可对抗感染,激活标志着过度炎症性脓毒症表型的基因。高血浆 WARS1 水平分层了危重病患者的早期死亡,同时伴有细胞因子、趋化因子和乳酸水平升高,绝对中性粒细胞和单核细胞数量增加,以及更高的序贯器官衰竭评估(SOFA)评分。这些症状在患有高细胞因子血症的严重脓毒症小鼠中得到了重现。此外,将 WARS1 注射到轻度脓毒症小鼠中会加重发病率和死亡率。我们创建了一种抗人 WARS1 的中和抗体,可抑制内毒素血症狨猴中的促炎细胞因子表达。将该抗体施用于严重脓毒症小鼠可减轻细胞因子风暴、器官衰竭和早期死亡。联合使用抗生素,该抗体几乎完全阻止了死亡。这些数据表明,血液中循环的 WARS1 指导的抗 WARS1 治疗可能为危及生命的全身性过度炎症性脓毒症提供一种新的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc81/10883277/8b44a1c3befd/44321_2023_4_Fig1_HTML.jpg

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