Center for Immunology and Inflammation, The Feinstein Institutes for Medical Research, Manhasset, New York.
Shock. 2024 Apr 1;61(4):630-637. doi: 10.1097/SHK.0000000000002309. Epub 2024 Jan 6.
Hemorrhagic shock (HS) is accompanied by a pronounced activation of the inflammatory response in which acute lung injury (ALI) is one of the most frequent consequences. Among the pivotal orchestrators of this inflammatory cascade, extracellular cold-inducible RNA-binding protein (eCIRP) emerges as a noteworthy focal point, rendering it as a promising target for the management of inflammation and tissue injury. Recently, we have reported that oligonucleotide poly(A) mRNA mimic termed A 12 selectively binds to the RNA binding region of eCIRP and inhibits eCIRP binding to its receptor TLR4. Furthermore, in vivo administration of eCIRP induces lung injury in healthy mice and that mouse deficient in CIRP showed protection from inflammation-associated lung injury. We hypothesize that A 12 inhibits systemic inflammation and ALI in HS. To test the impacts of A 12 on systemic and lung inflammation, extent of inflammatory cellular infiltration and resultant lung damage were evaluated in a mouse model of HS. Male mice were subjected to controlled hemorrhage with a mean arterial pressure of 30 mm Hg for 90 min and then resuscitated with Ringer's lactate solution containing phosphate-buffered saline (vehicle) or A 12 at a dose of 4 nmol/g body weight (treatment). The infusion volume was twice that of the shed blood. At 4 h after resuscitation, mice were euthanized, and blood and lung tissues were harvested. Blood and tissue markers of inflammation and injury were evaluated. Serum markers of injury (lactate dehydrogenase, alanine transaminase, and blood urea nitrogen) and inflammation (TNF-α, IL-6) were increased after HS and A 12 treatment significantly decreased their levels. A 12 treatment also decreased lung levels of TNF-α, MIP-2, and KC mRNA expressions. Lung histological injury score, neutrophil infiltration (Ly6G staining and myeloperoxidase activity), and lung apoptosis were significantly attenuated after A 12 treatment. Our study suggests that the capacity of A 12 in attenuating HS-induced ALI and may provide novel perspectives in developing efficacious pharmaceutics for improving hemorrhage prognosis.
失血性休克(HS)伴随着炎症反应的明显激活,其中急性肺损伤(ALI)是最常见的后果之一。在这个炎症级联反应的关键协调者中,细胞外冷诱导 RNA 结合蛋白(eCIRP)成为一个值得关注的焦点,使其成为炎症和组织损伤管理的有前途的靶点。最近,我们报道了一种称为 A12 的寡核苷酸 poly(A)mRNA 模拟物,它选择性地结合 eCIRP 的 RNA 结合区,并抑制 eCIRP 与其受体 TLR4 的结合。此外,体内给予 eCIRP 可诱导健康小鼠肺损伤,而 CIRP 缺失的小鼠对炎症相关肺损伤表现出保护作用。我们假设 A12 可抑制 HS 中的全身炎症和 ALI。为了测试 A12 对全身和肺炎症的影响,我们在 HS 小鼠模型中评估了系统和肺炎症的程度、炎症细胞浸润的程度以及由此产生的肺损伤。雄性小鼠接受平均动脉压为 30mmHg 的控制性出血 90min,然后用含有磷酸盐缓冲盐水(载体)或 A12(剂量为 4nmol/g 体重)的林格氏乳酸盐溶液复苏。输注量是失血的两倍。在复苏后 4 小时,处死小鼠,采集血液和肺组织。评估血液和组织的炎症和损伤标志物。HS 后血清损伤标志物(乳酸脱氢酶、丙氨酸转氨酶和血尿素氮)和炎症标志物(TNF-α、IL-6)升高,A12 治疗显著降低其水平。A12 治疗还降低了肺 TNF-α、MIP-2 和 KCmRNA 表达水平。A12 治疗后肺组织损伤评分、中性粒细胞浸润(Ly6G 染色和髓过氧化物酶活性)和肺细胞凋亡明显减轻。我们的研究表明,A12 减轻 HS 诱导的 ALI 的能力,并可能为开发有效的止血药以改善出血预后提供新的视角。