Abstract
Sepsis is characterized by organ dysfunction due to a dysregulated immune response to infection. Currently, no effective treatment for sepsis exists. Platelets are recognized as mediators of the immune response and may be a potential therapeutic target for the treatment of sepsis. We previously demonstrated that NLRP3 inflammasome activation in sepsis-induced activated platelets was associated with multi-organ injury in the cecal-ligation puncture (CLP) rat model of sepsis. In this study, we tested the hypothesis that inhibition of NLRP3 would inhibit platelet activation and attenuate multi-organ injury in the CLP rat. CLP (n = 10) or Sham (n = 10) surgery were performed in male and female Sprague-Dawley rats. A subset of CLP rats were treated with MCC950 (50mg/kg/d), a specific NLRP3 inhibitor (CLP+MCC950, n = 10). At 72 hrs. post-CLP, blood and organs were harvested for analysis of platelet activation, NLRP3 activation, inflammation and end organ damage. Platelet activation increased from 8±0.8% in Sham to 16±1% in CLP, and was reduced to 9±1% in CLP+M rats (p<0.05). NLRP3 activation was also increased in platelets of CLP vs Sham. NLRP3 expression was unchanged in kidney and lung after CLP, but Caspase 1 expression and IL-1β were increased. MCC950 treatment attenuated NLRP3 activation in platelets. Plasma, kidney, and lung levels of NLRP3 inflammasome associated cytokines, IL-1ß and IL-18, were significantly increased in CLP compared to Sham rats. Inhibition of NLRP3 normalized cytokine levels. Glomerular injury, pulmonary edema, and endothelial dysfunction markers were increased in CLP rats vs Sham. MCC950 treatment significantly decreased renal and pulmonary injury and endothelial dysfunction in CLP+M. Our results demonstrate a role for NLRP3 in contributing to platelet activation and multi-organ injury in sepsis.
Highlights
Sepsis is a life-threatening syndrome of organ dysfunction caused by an exaggerated host immune response to infection [1]
We have recently shown that NOD-like receptor protein 3 inflammasome (NLRP3) inflammasome activation occurs in platelets and is associated with renal glomerular injury and pulmonary edema in the cecal-ligation and puncture (CLP) rat model of sepsis [23]
Septic patients with increased platelet activation are at increased risk of developing multiple organ dysfunction and have increased 90-day mortality [1, 19,20,21,22]
Summary
Sepsis is a life-threatening syndrome of organ dysfunction caused by an exaggerated host immune response to infection [1]. Because of the dysregulated immune response that leads to organ injury, trials to identify novel therapies have targeted inflammatory cytokines. Therapies, targeting a single component of the inflammatory cascade have failed to reduce the multiple organ injury/dysfunction or mortality rate associated with sepsis [10]. It is imperative to identity novel therapeutic targets for treatment of sepsis with more effective clinical impact
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