Abstract

Lung endothelial dysfunction is a key feature of acute lung injury (ALI) and clinical acute respiratory distress syndrome (ARDS). Previous studies have identified the lipid-generating enzyme, group V phospholipase A2 (gVPLA2), as a mediator of lung endothelial barrier disruption and inflammation. The current study aimed to determine the role of gVPLA2 in mediating lung endothelial responses to methicillin-resistant Staphylococcus aureus (MRSA, USA300 strain), a major cause of ALI/ARDS. In vitro studies assessed the effects of gVPLA2 inhibition on lung endothelial cell (EC) permeability after exposure to heat-killed (HK) MRSA. In vivo studies assessed the effects of intratracheal live or HK-MRSA on multiple indices of ALI in wild-type (WT) and gVPLA2-deficient (KO) mice. In vitro, HK-MRSA increased gVPLA2 expression and permeability in human lung EC. Inhibition of gVPLA2 with either the PLA2 inhibitor, LY311727, or with a specific monoclonal antibody, attenuated the barrier disruption caused by HK-MRSA. LY311727 also reduced HK-MRSA-induced permeability in mouse lung EC isolated from WT but not gVPLA2-KO mice. In vivo, live MRSA caused significantly less ALI in gVPLA2 KO mice compared to WT, findings confirmed by intravital microscopy assessment in HK-MRSA-treated mice. After targeted delivery of gVPLA2 plasmid to lung endothelium using ACE antibody-conjugated liposomes, MRSA-induced ALI was significantly increased in gVPLA2-KO mice, indicating that lung endothelial expression of gVPLA2 is critical in vivo. In summary, these results demonstrate an important role for gVPLA2 in mediating MRSA-induced lung EC permeability and ALI. Thus, gVPLA2 may represent a novel therapeutic target in ALI/ARDS caused by bacterial infection.

Highlights

  • Acute respiratory distress syndrome (ARDS) is a severe inflammatory disorder of the lungs which causes high mortality and significant lifelong medical challenges in survivors [1,2]

  • We assessed the effects of methicillin-resistant strains (MRSA) on group V phospholipase A2 (gVPLA2) expression in lung endothelial cell (EC)

  • A significant increase in gVPLA2 protein expression was observed in lung EC after 8 or 24 h treatment with heat-killed MRSA USA300 (HK-MRSA) (Figure 1C,D)

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Summary

Introduction

Acute respiratory distress syndrome (ARDS) is a severe inflammatory disorder of the lungs which causes high mortality (up to 45%) and significant lifelong medical challenges in survivors [1,2]. Advanced ventilator management and supportive therapies have improved mortality over time, no effective pharmacologic therapy is available that targets the underlying acute lung injury (ALI) process [1,3,4]. Pneumonia and sepsis are the most common causes of ARDS [1,2], with antibiotic-resistant organisms frequently being involved [5]. The first penicillin-resistant S. aureus strain emerged in 1942, with methicillin-resistant strains (MRSA) identified several years later in 1960 [6]. MRSA infections are difficult to treat due to their resistance to various antibiotics and are a major burden on the health care system [6,7].

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