Abstract

Peritonitis and peritonitis-associated sepsis are characterized by an increased formation of platelet–neutrophil complexes (PNCs), which contribute to an excessive migration of polymorphonuclear neutrophils (PMN) into the inflamed tissue. An important neutrophilic mechanism to capture and kill invading pathogens is the formation of neutrophil extracellular traps (NETs). Formation of PNCs and NETs are essential to eliminate pathogens, but also lead to aggravated tissue damage. The chemokine receptors CXCR4 and CXCR7 on platelets and PMNs have been shown to play a pivotal role in inflammation. Thereby, CXCR4 and CXCR7 were linked with functional adenosine A2B receptor (Adora2b) signaling. We evaluated the effects of selective CXCR4 and CXCR7 inhibition on PNCs and NETs in zymosan- and fecal-induced sepsis. We determined the formation of PNCs in the blood and, in addition, their infiltration into various organs in wild-type and Adora2b−/− mice by flow cytometry and histological methods. Further, we evaluated NET formation in both mouse lines and the impact of Adora2b signaling on it. We hypothesized that the protective effects of CXCR4 and CXCR7 antagonism on PNC and NET formation are linked with Adora2b signaling. We observed an elevated CXCR4 and CXCR7 expression in circulating platelets and PMNs during acute inflammation. Specific CXCR4 and CXCR7 inhibition reduced PNC formation in the blood, respectively, in the peritoneal, lung, and liver tissue in wild-type mice, while no protective anti-inflammatory effects were observed in Adora2b−/− animals. In vitro, CXCR4 and CXCR7 antagonism dampened PNC and NET formation with human platelets and PMNs, confirming our in vivo data. In conclusion, our study reveals new protective aspects of the pharmacological modulation of CXCR4 and CXCR7 on PNC and NET formation during acute inflammation.

Highlights

  • Peritonitis and peritonitis-related sepsis are characterized by an excessive immune response leading to high mortality [1]

  • We determined the expression of the stromal cell-derived factor (SDF)-1 receptors CXCR4 and CXCR7 in neutrophils, platelets, and platelet–neutrophil complexes with and without inflammation

  • polymorphonuclear neutrophils (PMN) with an additional CD42b positive signal were determined as platelet–neutrophil complexes (PNCs)

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Summary

Introduction

Peritonitis and peritonitis-related sepsis are characterized by an excessive immune response leading to high mortality [1]. Peritonitis and peritonitis-related sepsis are mainly triggered by microbial invasion into various tissues or body fluids (1). Despite advances in supportive care and intense basic research, new specific therapies remain elusive for septic patients [2]. During acute inflammation, circulating inflammatory cytokines activate platelets and polymorphonuclear neutrophils (PMNs), resulting in the formation of platelet–neutrophil complexes (PNCs). PNCs promote the migration of PMNs into the inflamed tissue. The migrated PMNs release neutrophil extracellular traps (NETs) to capture and kill invading pathogens [3,4]

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