Abstract
The pathogenesis of sepsis is complex. Mitochondrial dysfunction, which is responsible for energy metabolism, intrinsic apoptotic pathway, oxidative stress, and systemic inflammatory responses, is closely related with severe sepsis induced death. Mitochondria DNA (mtDNA) contain un-methylated cytosine phosphate guanine (CpG) motifs, which exhibit immune stimulatory capacities. The aim of this study was to investigate the role and mechanism of mtDNA release on lipopolysaccharide (LPS) induced acute lung injury (ALI) and systemic inflammation. Following LPS injection, plasma mtDNA copies peak at 8 h. Compared with wild-type (WT) mice, mtDNA in toll like receptor 4 knockout (TLR4 KO) mice were significantly decreased. MtDNA intra-peritoneal administration causes apparent ALI as demonstrated by increased lung injury score, bronchoalveolar lavage fluid (BALF) total protein and wet/dry (W/D) ratio; mtDNA injection also directly provokes systemic inflammation, as demonstrated by increased IL-1β, IL-6, high-mobility group protein B1 (HMGB1) level; while nuclear DNA (nDNA) could not induce apparent ALI and systemic inflammation. However, compared with WT mice, TLR4 KO could not protect from mtDNA induced ALI and systemic inflammation. Specific TLR9 inhibitor, ODN 2088 pretreatment can significantly attenuate mtDNA induced ALI and systemic inflammation, as demonstrated by improved lung injury score, decreased lung wet/dry ratio, BALF total protein concentration, and decreased systemic level of IL-1β, IL-6 and HMGB1. MtDNA administration activates the expression of p-P38 mitogen-activated protein kinases (MAPK) in lung tissue and specific TLR9 inhibitor pretreatment can attenuate this activation. Thus, LPS-induced mtDNA release occurs in a TLR4-dependent manner, and mtDNA causes acute lung injury and systemic inflammation in a TLR9-dependent and TLR4-independent manner.
Highlights
Severe sepsis, associated with systemic inflammatory response syndrome (SIRS) and multi-organ failure (MOF), remains a leading cause of death in intensive care units (ICUs) [1,2]
The pathogenesis of sepsis is complex, but a substantial number of studies indicate that mitochondrial dysfunction, which is responsible for energy metabolism, the intrinsic apoptotic pathway, oxidative stress, and systemic inflammatory responses, is closely related with severe sepsis-induced MOF and death [4,5,6]
Certain molecules released from impaired mitochondria function as danger-associated molecular patterns (DAMPs) [7]
Summary
Severe sepsis, associated with systemic inflammatory response syndrome (SIRS) and multi-organ failure (MOF), remains a leading cause of death in intensive care units (ICUs) [1,2]. The pathogenesis of sepsis is complex, but a substantial number of studies indicate that mitochondrial dysfunction, which is responsible for energy metabolism, the intrinsic apoptotic pathway, oxidative stress, and systemic inflammatory responses, is closely related with severe sepsis-induced MOF and death [4,5,6]. In addition to disruption of energy production and initiation of the intrinsic apoptotic pathway, emerging investigations have implicated the mitochondria as playing a critical role in the regulation of inflammation. The role of mtDNA as DAMPs in inflammation initiation has garnered much attention
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