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Multiple triggers of cell death in sepsis: death receptor and mitochondrial-mediated apoptosis
Katherine C Chang1, Jacqueline Unsinger, Christopher G Davis
1Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Abstract:
Lymphocyte apoptosis plays a central role in the pathophysiology of sepsis. Lymphocyte apoptosis was examined in mice with defective death receptor pathways due to transgenic expression of a dominant negative mutant of Fas-associated death domain (FADD-DN) or Bid-/- and in mice with defective mitochondrial-mediated pathways due to loss of Bim-/-, Puma-/-, or Noxa-/-. FADD-DN transgenic and Bid-/- mice had significant albeit incomplete protection, and this protection was associated with increased survival. Surprisingly, splenic B cells were also protected in FADD-DN mice although transgene expression was confined to T cells, providing evidence for an indirect protective mechanism. Bim-/- provided virtually complete protection against lymphocyte apoptosis whereas Puma-/- and Noxa-/- mice had modest or no protection, respectively. Bim-/- mice had improved survival, and adoptive transfer of splenocytes from Bim-/- mice into Rag 1-/- mice demonstrated that this was a lymphocyte intrinsic effect. The improved survival was associated with decreased interleukin (IL) -10 and IL-6 cytokines. Collectively, these data indicate that numerous death stimuli are generated during sepsis, and it therefore appears unlikely that blocking a single "trigger" can inhibit apoptosis. If siRNA becomes practical therapeutically, proapoptotic proteins would be potential targets.
Insights
Sepsis triggers lymphocyte apoptosis through multiple pathways. Targeting the Bim protein offered significant protection against this cell death and improved survival in mice.
Area of Science:
- Immunology
- Cell Biology
- Pathophysiology
Background:
- Lymphocyte apoptosis is critical in sepsis pathophysiology.
- Understanding the pathways of lymphocyte apoptosis is key to developing treatments.
Purpose of the Study:
- To investigate the roles of death receptor and mitochondrial pathways in sepsis-induced lymphocyte apoptosis.
- To evaluate the therapeutic potential of targeting specific apoptosis-regulating proteins.
Main Methods:
- Used genetically modified mice lacking key proteins in death receptor (FADD-DN, Bid-/-) and mitochondrial (Bim-/-, Puma-/-, Noxa-/-) pathways.
- Assessed lymphocyte apoptosis, survival rates, and cytokine levels (IL-10, IL-6).
- Performed adoptive transfer experiments using splenocytes from Bim-/- mice.
Main Results:
- Defects in death receptor pathways (FADD-DN, Bid-/-) offered incomplete protection against lymphocyte apoptosis and increased survival.
- Loss of Bim (Bim-/-) provided near-complete protection against lymphocyte apoptosis and improved survival, linked to reduced IL-10 and IL-6.
- Mice lacking Puma or Noxa showed minimal protection.
- Protection in Bim-/- mice was intrinsic to lymphocytes and associated with reduced pro-inflammatory cytokines.
Conclusions:
- Sepsis involves multiple death stimuli, making single-target inhibition of apoptosis unlikely.
- The Bim protein is a crucial mediator of sepsis-induced lymphocyte apoptosis.
- Targeting proapoptotic proteins, potentially via siRNA, could be a therapeutic strategy for sepsis.
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