Abstract

The pathological mechanism underlying heat stroke (HS) is associated with the dysbalanced inflammation and coagulation cascade. Cell-derived circulating extracellular vesicles (EVs), as a novel pathway mediating intercellular communication, are associated with the immune response and inflammation in critical inflammatory syndromes, such as sepsis. Although these vesicles contain genetic material correlated with their biological function, their molecular cargo during HS remains unknown. In this study, we evaluate the presence of microRNAs (miRNAs) and messenger RNAs (mRNAs) associated with inflammatory responses and coagulation cascade in exosomes of patients with HS. Blood samples were collected from three patients with HS at the time of admission to the intensive care unit; three healthy volunteers were selected as control. Exosomes were isolated using ultracentrifugation, and their miRNA content was profiled using next-generation sequencing; mRNA content was evaluated using qPCR array. Compared with those from healthy volunteers, exosomes from patients with HS showed substantial changes in the expression of 202 exosomal miRNAs (154 upregulated and 48 downregulated miRNAs). The most upregulated miRNAs included miR-511-3p, miR-122-5p, miR-155-3p, miR-1290, and let7-5p, whereas the most downregulated ones included miR-150-3p, 146a-5p, and 151a-3p. Gene ontology enrichment of the miRNAs of patients with HS compared with control subjects were associated mostly with inflammatory response, including T cell activation, B cell receptor signaling, dendritic cell chemotaxis and leukocyte migration, and platelet activation and blood coagulation. The identified miRNAs were primarily enriched to the signal transduction pathways namely, T cell receptor signaling, Ras signaling, chemokine signaling, platelet activation, and leukocyte transendothelial migration, all of which are associated with inflammation and hemostasis. Multiple targeted mRNAs associated with the inflammatory response, blood coagulation, and platelet activation were further verified in serum exosomes. Exosomes from patients with HS convey miRNAs and mRNAs associated with pathogenic pathways, including inflammatory response and coagulation cascade. Exosomes may represent a novel mechanism for intercellular communication during HS.

Highlights

  • Heatstroke (HS) is a severe condition with limited treatment options that can even be fatal

  • Ages were comparable between healthy controls and patients with HS (25 ± 6 vs. 21 ± 4 years, respectively)

  • The results suggested that, HS changed certain miRNA levels within plasma extracellular vesicles (EVs), and this was correlated with the biological effect

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Summary

Introduction

Heatstroke (HS) is a severe condition with limited treatment options that can even be fatal. The molecular mechanism underlying HS pathogenesis is complicated and poorly investigated [3]. Evidence has suggested that the HS mechanism is associated with dysbalanced inflammation and coagulation cascade [4]. Cell-derived circulating extracellular vesicles (EVs) shed from different cell types during acute inflammatory syndromes such as sepsis. The roles of EVs in disease pathophysiology have been extensively investigated, especially those associated with immune responses and inflammation [5, 6]. We have previously demonstrated that hepatocyte-derived EVs from patients with HS correlate with liver dysfunction, which is associated with activation of EV-induced inflammatory NOD-like receptor pathway and necrosis in hepatocytes [7, 8]

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