Abstract

Necroptosis, a form of programmed lytic cell death, has emerged as a driving factor in the pathogenesis of acute lung injury (ALI). As ALI is often associated with a cytokine storm, we determined whether pro-inflammatory cytokines modulate the susceptibility of lung cells to necroptosis and which mediators dominate to control necroptosis. In this study, we pretreated/primed mouse primary lung epithelial and endothelial cells with various inflammatory mediators and assessed cell type-dependent responses to different necroptosis inducers and their underlying mechanisms. We found that interferon-γ (IFNγ) as low as 1 ng/mL preferentially promoted necroptosis and accelerated the release of damage-associated molecular patterns from primary alveolar and airway epithelial cells but not lung microvascular endothelial cells. Type-I IFNα was about fifty-fold less effective than IFNγ. Conversely, TNFα or agonists of Toll-like receptor-3 (TLR3), TLR4, TLR7 and TLR9 had a minor effect. The enhanced necroptosis in IFNγ-activated lung epithelial cells was dependent on IFNγ signaling and receptor-interacting protein kinase-3. We further showed that necroptosis effector mixed lineage kinase domain-like protein (MLKL) was predominantly induced by IFNγ, contributing to the enhanced necroptosis in lung epithelial cells. Collectively, our findings indicate that IFNγ is a potent enhancer of lung epithelial cell susceptibility to necroptosis.

Highlights

  • Acute respiratory distress syndrome (ARDS) is a form of life-threatening respiratory failure that is associated with high morbidity and mortality [1,2]

  • We determined whether lung epithelial cells that are pre-activated by pro-inflammatory mediators preferentially undergo necroptosis

  • The present study provides compelling evidence that IFNγ preferentially among various inflammatory mediators promotes necroptosis in primary alveolar and airway epithelial cells but not in lung microvascular endothelial cells

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Summary

Introduction

Acute respiratory distress syndrome (ARDS) is a form of life-threatening respiratory failure that is associated with high morbidity and mortality [1,2]. ARDS can develop following various types of acute lung injuries (ALI) resulting from pulmonary (e.g., pneumonia, aspiration) or nonpulmonary (e.g., sepsis, pancreatitis, trauma) insults [2]. ARDS affects approximately 3 million patients annually and accounts for 10% of intensive care unit admissions [3]. Due to the ongoing coronavirus disease 2019 (COVID-19) pandemic, the number of patients diagnosed with ARDS/ALI increased substantially [4,5]. ALI/ARDS manifests as hypoxemia, lung edema, decreased lung compliance and diffuse pulmonary infiltrates [1,2,4]. Despite decades of efforts on research, the pathogenesis of ALI/ARDS is not fully elucidated and treatment options are limited as a result. Supportive care with mechanical ventilation remains the mainstay of management for ALI/ARDS [2,4]

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