Abstract

Cardiac dysfunction is correlated with detrimental prognosis of sepsis and contributes to a high risk of mortality. After an initial hyperinflammatory reaction, most patients enter a protracted state of immunosuppression (late sepsis) that alters both innate and adaptive immunity. The changes of cardiac function in late sepsis are not yet known. MicroRNA-155 (miR-155) is previously found to play important roles in both regulations of immune activation and cardiac function. In this study, C57BL/6 mice were operated to develop into early and late sepsis phases, and miR-155 mimic was injected through the tail vein 48 h after cecal ligation and puncture (CLP). The effect of miR-155 on CLP-induced cardiac dysfunction was explored in late sepsis. We found that increased expression of miR-155 in the myocardium protected against cardiac dysfunction in late sepsis evidenced by attenuating sepsis-reduced cardiac output and enhancing left ventricular systolic function. We also observed that miR-155 markedly reduced the infiltration of macrophages and neutrophils into the myocardium and attenuated the inflammatory response via suppression of JNK signaling pathway. Moreover, overexpression of β-arrestin 2 (Arrb2) exacerbated the mice mortality and immunosuppression in late sepsis. Furthermore, transfection of miR-155 mimic reduced Arrb2 expression, and then restored immunocompetence and improved survival in late septic mice. We conclude that increased miR-155 expression through systemic administration of miR-155 mimic attenuates cardiac dysfunction and improves late sepsis survival by targeting JNK associated inflammatory signaling and Arrb2 mediated immunosuppression.

Highlights

  • Sepsis is defined as a systemic inflammatory response to life-threatening infection with the presence of organ failure [1]

  • We found that increased expression of miR-155 in the myocardium protected against cardiac dysfunction in late sepsis evidenced by attenuating sepsis-reduced cardiac output and enhancing left ventricular systolic function

  • To determine whether increased expression of miR-155 in late phase could impact the sepsis outcome, miR-155 mimic was injected through the tail vein 48 h after cecal ligation and puncture (CLP) to allow the initiation of sepsis and mortality was monitored for 28 days

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Summary

Introduction

Sepsis is defined as a systemic inflammatory response to life-threatening infection with the presence of organ failure [1]. Despite progress in antibiotic treatment and prompt institution of life support, sepsis remains the major cause of death in intensive care units [2]. The mechanism involved in the host immune response to sepsis is debated. The immune response was considered to be typified by a hyperinflammatory status with excessive production of pro-inflammatory mediators by macrophages and neutrophils [3, 4]. Most research was focused on ameliorating the hyperinflammatory response of the disorder, clinical trials using anti-inflammatory treatment failed to reduce overall sepsis mortality [5]. There is no effective therapy for late sepsis

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