Abstract

Ischemia-reperfusion injury (IRI) is an inevitable consequence of organ transplant procedure and associated with acute and chronic organ rejection in transplantation. IRI leads to various forms of programmed cell death, which worsens tissue damage and accelerates transplant rejection. We recently demonstrated that necroptosis participates in murine cardiac microvascular endothelial cell (MVEC) death and murine cardiac transplant rejection. However, MVEC death under a more complex IRI model has not been studied. In this study, we found that simulating IRI conditions in vitro by hypoxia, reoxygenation and treatment with inflammatory cytokines induced necroptosis in MVECs. Interestingly, the apoptosis-inducing factor (AIF) translocated to the nucleus during MVEC necroptosis, which is regulated by the mitochondrial permeability molecule cyclophilin D (CypD). Furthermore, CypD deficiency in donor cardiac grafts inhibited AIF translocation and mitigated graft IRI and rejection (n = 7; p = 0.002). Our studies indicate that CypD and AIF play significant roles in MVEC necroptosis and cardiac transplant rejection following IRI. Targeting CypD and its downstream AIF may be a plausible approach to inhibit IRI-caused cardiac damage and improve transplant survival.

Highlights

  • Ischemic heart disease remains a top health problem worldwide and affects around100 million individuals

  • We have found that cyclophilin D (CypD) and apoptosis-induced factor (AIF) are the downstream effectors of necroptosis

  • We wanted to establish an in vitro condition to simulate in vivo Ischemia-reperfusion injury (IRI) in murine cardiac transplantation

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Summary

Introduction

Ischemic heart disease remains a top health problem worldwide and affects around. When heart disease progresses to severe heart failure, transplantation may be the only remaining option. Ischemia-reperfusion injury (IRI) is an inevitable consequence of an organ transplant procedure, as all donor organs, including the heart, kidney, liver and lung, have to be stored and transported before being transplanted into the recipients. IRI leads to primary graft dysfunction and has deleterious long-term effects on graft survival. Premature graft failure has emerged as one of our greatest transplant challenges, as 50% of all heart transplants fail over time. Ischemic time correlates with delayed heart graft function and organ failure, despite the development

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