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Anthracyclines induce DNA damage response-mediated protection against severe sepsis
Nuno Figueiredo1, Angelo Chora, Helena Raquel
1Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; Clínica Universitária de Cirurgia I, Centro Hospitalar Lisboa Norte, EPE, 1649-028 Lisboa, Portugal; Gulbenkian Programme for Advanced Medical Education, 2780-156 Oeiras, Portugal; Champalimaud Foundation, 1400-038 Lisboa, Portugal.
Abstract:
Severe sepsis remains a poorly understood systemic inflammatory condition with high mortality rates and limited therapeutic options in addition to organ support measures. Here we show that the clinically approved group of anthracyclines acts therapeutically at a low dose regimen to confer robust protection against severe sepsis in mice. This salutary effect is strictly dependent on the activation of DNA damage response and autophagy pathways in the lung, as demonstrated by deletion of the ataxia telangiectasia mutated (Atm) or the autophagy-related protein 7 (Atg7) specifically in this organ. The protective effect of anthracyclines occurs irrespectively of pathogen burden, conferring disease tolerance to severe sepsis. These findings demonstrate that DNA damage responses, including the ATM and Fanconi Anemia pathways, are important modulators of immune responses and might be exploited to confer protection to inflammation-driven conditions, including severe sepsis.
Insights
Low-dose anthracyclines protect against severe sepsis in mice by activating DNA damage response and autophagy in the lungs. This approach offers disease tolerance, independent of pathogen load, highlighting new therapeutic potential.
Area of Science:
- Immunology
- Cellular Biology
- Pharmacology
Background:
- Severe sepsis is a life-threatening systemic inflammatory condition with high mortality.
- Current therapeutic options are limited, primarily focusing on organ support.
- Understanding the underlying mechanisms of sepsis is crucial for developing novel treatments.
Purpose of the Study:
- To investigate the therapeutic potential of anthracyclines in treating severe sepsis.
- To elucidate the molecular pathways involved in anthracycline-mediated protection against sepsis.
- To explore the role of DNA damage response and autophagy in sepsis pathogenesis and treatment.
Main Methods:
- Utilized a mouse model of severe sepsis.
- Administered a low-dose regimen of clinically approved anthracyclines.
- Assessed the impact of anthracyclines on sepsis severity and mortality.
- Investigated the role of ataxia telangiectasia mutated (Atm) and autophagy-related protein 7 (Atg7) by gene deletion in lung tissue.
- Evaluated pathogen burden and disease tolerance.
Main Results:
- Low-dose anthracyclines conferred robust protection against severe sepsis in mice.
- The protective effect was critically dependent on the activation of DNA damage response and autophagy pathways specifically in the lung.
- Deletion of Atm or Atg7 in the lung abrogated the protective effects of anthracyclines.
- Anthracycline treatment conferred disease tolerance, irrespective of pathogen burden.
Conclusions:
- Clinically approved anthracyclines, at low doses, represent a promising therapeutic strategy for severe sepsis.
- Activation of DNA damage response and autophagy in the lung is essential for anthracycline-mediated sepsis protection.
- DNA damage response pathways, including ATM, are key modulators of immune responses and could be targeted for treating inflammatory conditions like sepsis.
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