Skip to main content
Top
Published in: Journal of Inflammation 1/2019

Open Access 01-12-2019 | Septicemia | Research

LDK378 improves micro- and macro-circulation via alleviating STING-mediated inflammatory injury in a Sepsis rat model induced by Cecal ligation and puncture

Authors: Weiwei Ge, Qiaohua Hu, Xiangshao Fang, Juanhua Liu, Jing Xu, Juntao Hu, Xuefen Liu, Qin Ling, Yue Wang, He Li, Ming Gao, Longyuan Jiang, Zhengfei Yang, Wanchun Tang

Published in: Journal of Inflammation | Issue 1/2019

Login to get access

Abstract

Background

Sepsis is a systemic inflammatory response syndrome caused by severe infections. LDK378, a second-generation ALK inhibitor, exhibits a potential anti-inflammatory function against sepsis. Micro- and macro-circulatory dysfunctions are pivotal elements of the pathogenesis of severe sepsis and septic shock. We hypothesized that LDK378 can improve micro- and macro-circulation of septic rats, therefore improving the outcome of survival via blocking the ALK-STING pathway to attenuate inflammatory injuries.

Methods

A septic rat model was established by the cecal ligation and puncture (CLP) method. A total of 60 rats were randomized into three groups: a sham group, CLP group, and CLP + LDK378 group (n = 20 in each group). Five rats were randomly selected from each group for the mechanism study; the remaining 15 rats in each group were involved in a survival curve examination. A sidestream dark field video microscope was used to record sublingual microcirculation and mean arterial pressure (MAP) and levels of inflammatory cytokine secretion were examined at 6 h, 30 h, and 54 h after CLP surgery. Expressions of TANK binding kinase 1 (TBK1) and its downstream targets were determined, and histological alterations to the heart, lungs, and kidneys were examined at 54 h after CLP surgery.

Results

We found the group that received LDK378 treatment showed increased MAP levels compared to the CLP group at 30 h and 54 h. Meanwhile, LDK378 ameliorated the perfused small vessel density and microvascular flow index, decreased the expression of TNF-a and IL-6, and upregulated the expression of IL-10 in comparison with the CLP group. LDK378 injections also downregulated the expression of TBK1 and its downstream targets. Furthermore, LDK378 treatment significantly reduced sepsis-induced organ injuries, therefore improving survival rates.

Conclusions

These findings demonstrate that LDK378 treatment can improve microcirculation and reduce organ injuries in CLP-induced septic rats via the regulation of inflammatory cytokine secretion and the downstream signaling components of the ALK-STING pathway.
Literature
1.
go back to reference Gul F, Arslantas MK, Cinel I, Kumar A. Changing definitions of Sepsis. Turk J Anaesthesiol Reanim. 2017;45:129–38.CrossRef Gul F, Arslantas MK, Cinel I, Kumar A. Changing definitions of Sepsis. Turk J Anaesthesiol Reanim. 2017;45:129–38.CrossRef
2.
go back to reference Napolitano LM. Sepsis 2018: definitions and guideline changes. Surg Infect. 2018;19:117–25.CrossRef Napolitano LM. Sepsis 2018: definitions and guideline changes. Surg Infect. 2018;19:117–25.CrossRef
3.
go back to reference Wiersinga WJ, Leopold SJ, Cranendonk DR, van der Poll T. Host innate immune responses to sepsis. Virulence. 2014;5:36–44.CrossRef Wiersinga WJ, Leopold SJ, Cranendonk DR, van der Poll T. Host innate immune responses to sepsis. Virulence. 2014;5:36–44.CrossRef
4.
go back to reference Hua T, Wu X, Wang W, Li H, Bradley J, Peberdy MA, et al. Micro- and macrocirculatory changes during Sepsis and septic shock in a rat model. Shock. 2018;49:591–5.CrossRef Hua T, Wu X, Wang W, Li H, Bradley J, Peberdy MA, et al. Micro- and macrocirculatory changes during Sepsis and septic shock in a rat model. Shock. 2018;49:591–5.CrossRef
5.
go back to reference Trzeciak S, Dellinger RP, Parrillo JE, Guglielmi M, Bajaj J, Abate NL, et al. Early microcirculatory perfusion derangements in patients with severe sepsis and septic shock: relationship to hemodynamics, oxygen transport, and survival. Ann Emerg Med. 2007;49:88–98 98 e1–2.CrossRef Trzeciak S, Dellinger RP, Parrillo JE, Guglielmi M, Bajaj J, Abate NL, et al. Early microcirculatory perfusion derangements in patients with severe sepsis and septic shock: relationship to hemodynamics, oxygen transport, and survival. Ann Emerg Med. 2007;49:88–98 98 e1–2.CrossRef
6.
go back to reference De Backer D, Creteur J, Preiser JC, Dubois MJ, Vincent JL. Microvascular blood flow is altered in patients with sepsis. Am J Resp Crit Care. 2002;166:98–104.CrossRef De Backer D, Creteur J, Preiser JC, Dubois MJ, Vincent JL. Microvascular blood flow is altered in patients with sepsis. Am J Resp Crit Care. 2002;166:98–104.CrossRef
7.
go back to reference De Backer D, Donadello K, Sakr Y, Ospina-Tascon G, Salgado D, Scolletta S, et al. Microcirculatory alterations in patients with severe Sepsis: impact of time of assessment and relationship with outcome. Crit Care Med. 2013;41:791–9.CrossRef De Backer D, Donadello K, Sakr Y, Ospina-Tascon G, Salgado D, Scolletta S, et al. Microcirculatory alterations in patients with severe Sepsis: impact of time of assessment and relationship with outcome. Crit Care Med. 2013;41:791–9.CrossRef
8.
go back to reference Suarez De La Rica A, Gilsanz F, Maseda E. Epidemiologic trends of sepsis in western countries. Ann Transl Med. 2016;4:325.CrossRef Suarez De La Rica A, Gilsanz F, Maseda E. Epidemiologic trends of sepsis in western countries. Ann Transl Med. 2016;4:325.CrossRef
9.
go back to reference Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. New Engl J Med. 2003;348:1546–54.CrossRef Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. New Engl J Med. 2003;348:1546–54.CrossRef
10.
go back to reference Hotchkiss RS, Monneret G, Payen D. Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy. Nat Rev Immunol. 2013;13:862–74.CrossRef Hotchkiss RS, Monneret G, Payen D. Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy. Nat Rev Immunol. 2013;13:862–74.CrossRef
11.
go back to reference Hutchins NA, Unsinger J, Hotchkiss RS, Ayala A. The new normal: immunomodulatory agents against sepsis immune suppression. Trends Mol Med. 2014;20:224–33.CrossRef Hutchins NA, Unsinger J, Hotchkiss RS, Ayala A. The new normal: immunomodulatory agents against sepsis immune suppression. Trends Mol Med. 2014;20:224–33.CrossRef
12.
go back to reference Banete A, Seaver K, Bakshi D, Gee K, Basta S. On taking the STING out of immune activation. J Leukoc Biol. 2018. Banete A, Seaver K, Bakshi D, Gee K, Basta S. On taking the STING out of immune activation. J Leukoc Biol. 2018.
13.
go back to reference Mukai K, Konno H, Akiba T, Uemura T, Waguri S, Kobayashi T, et al. Activation of STING requires palmitoylation at the Golgi. Nat Commun. 2016;7. Mukai K, Konno H, Akiba T, Uemura T, Waguri S, Kobayashi T, et al. Activation of STING requires palmitoylation at the Golgi. Nat Commun. 2016;7.
14.
go back to reference Tanaka Y, Chen ZJ. STING specifies IRF3 phosphorylation by TBK1 in the cytosolic DNA signaling pathway. Sci Signal. 2012;5(214):ra20. Tanaka Y, Chen ZJ. STING specifies IRF3 phosphorylation by TBK1 in the cytosolic DNA signaling pathway. Sci Signal. 2012;5(214):ra20.
15.
go back to reference Heipertz EL, Harper J, Walker WE. STING and TRIF contribute to mouse Sepsis, depending on severity of the disease model. Shock. 2017;47:621–31.CrossRef Heipertz EL, Harper J, Walker WE. STING and TRIF contribute to mouse Sepsis, depending on severity of the disease model. Shock. 2017;47:621–31.CrossRef
16.
go back to reference Zeng L, Kang R, Zhu S, Wang X, Cao L, Wang H, Billiar TR, Jiang J, Tang D. ALK is a therapeutic target for lethal sepsis. Sci Transl Med. 2017;9(412). Zeng L, Kang R, Zhu S, Wang X, Cao L, Wang H, Billiar TR, Jiang J, Tang D. ALK is a therapeutic target for lethal sepsis. Sci Transl Med. 2017;9(412).
17.
go back to reference Hubbard WJ, Choudhry M, Schwacha MG, Kerby JD, Rue LW 3rd, Bland KI, et al. Cecal ligation and puncture. Shock. 2005;24(Suppl 1):52–7.CrossRef Hubbard WJ, Choudhry M, Schwacha MG, Kerby JD, Rue LW 3rd, Bland KI, et al. Cecal ligation and puncture. Shock. 2005;24(Suppl 1):52–7.CrossRef
18.
go back to reference Toscano MG, Ganea D, Gamero AM. Cecal ligation puncture procedure. J Vis Exp. 2011;(51). Toscano MG, Ganea D, Gamero AM. Cecal ligation puncture procedure. J Vis Exp. 2011;(51).
19.
go back to reference Schulte W, Bernhagen J, Bucala R. Cytokines in sepsis: potent immunoregulators and potential therapeutic targets--an updated view. Mediat Inflamm. 2013;2013:165974.CrossRef Schulte W, Bernhagen J, Bucala R. Cytokines in sepsis: potent immunoregulators and potential therapeutic targets--an updated view. Mediat Inflamm. 2013;2013:165974.CrossRef
20.
go back to reference Walley KR, Lukacs NW, Standiford TJ, Strieter RM, Kunkel SL. Balance of inflammatory cytokines related to severity and mortality of murine sepsis. Infect Immun. 1996;64:4733–8.PubMedPubMedCentral Walley KR, Lukacs NW, Standiford TJ, Strieter RM, Kunkel SL. Balance of inflammatory cytokines related to severity and mortality of murine sepsis. Infect Immun. 1996;64:4733–8.PubMedPubMedCentral
21.
go back to reference Ouyang S, Song X, Wang Y, Ru H, Shaw N, Jiang Y, et al. Structural analysis of the STING adaptor protein reveals a hydrophobic dimer interface and mode of cyclic di-GMP binding. Immunity. 2012;36:1073–86.CrossRef Ouyang S, Song X, Wang Y, Ru H, Shaw N, Jiang Y, et al. Structural analysis of the STING adaptor protein reveals a hydrophobic dimer interface and mode of cyclic di-GMP binding. Immunity. 2012;36:1073–86.CrossRef
22.
go back to reference Palmer RH, Vernersson E, Grabbe C, Hallberg B. Anaplastic lymphoma kinase: signalling in development and disease. Biochem J. 2009;420:345–61.CrossRef Palmer RH, Vernersson E, Grabbe C, Hallberg B. Anaplastic lymphoma kinase: signalling in development and disease. Biochem J. 2009;420:345–61.CrossRef
23.
go back to reference Ahmed AU, Sarvestani ST, Gantier MP, Williams BR, Hannigan GE. Integrin-linked kinase modulates lipopolysaccharide- and helicobacter pylori-induced nuclear factor kappaB-activated tumor necrosis factor-alpha production via regulation of p65 serine 536 phosphorylation. J Biol Chem. 2014;289:27776–93.CrossRef Ahmed AU, Sarvestani ST, Gantier MP, Williams BR, Hannigan GE. Integrin-linked kinase modulates lipopolysaccharide- and helicobacter pylori-induced nuclear factor kappaB-activated tumor necrosis factor-alpha production via regulation of p65 serine 536 phosphorylation. J Biol Chem. 2014;289:27776–93.CrossRef
24.
go back to reference Walker WE, Bozzi AT, Goldstein DR. IRF3 contributes to sepsis pathogenesis in the mouse cecal ligation and puncture model. J Leukoc Biol. 2012;92:1261–8.CrossRef Walker WE, Bozzi AT, Goldstein DR. IRF3 contributes to sepsis pathogenesis in the mouse cecal ligation and puncture model. J Leukoc Biol. 2012;92:1261–8.CrossRef
25.
go back to reference Colbert JF, Schmidt EP. Endothelial and microcirculatory function and dysfunction in Sepsis. Clin Chest Med. 2016;37:263–75.CrossRef Colbert JF, Schmidt EP. Endothelial and microcirculatory function and dysfunction in Sepsis. Clin Chest Med. 2016;37:263–75.CrossRef
26.
go back to reference Marsilje TH, Pei W, Chen B, Lu W, Uno T, Jin Y, et al. Synthesis, structure–activity relationships, and in vivo efficacy of the novel potent and selective anaplastic lymphoma kinase (ALK) inhibitor 5-Chloro-N2-(2-isopropoxy-5-methyl-4-(piperidin-4-yl)phenyl)-N4-(2-(isopropylsulfonyl)phenyl)pyrimidine-2,4-diamine (LDK378) currently in phase 1 and phase 2 clinical trials. J Med Chem. 2013;56:5675–90.CrossRef Marsilje TH, Pei W, Chen B, Lu W, Uno T, Jin Y, et al. Synthesis, structure–activity relationships, and in vivo efficacy of the novel potent and selective anaplastic lymphoma kinase (ALK) inhibitor 5-Chloro-N2-(2-isopropoxy-5-methyl-4-(piperidin-4-yl)phenyl)-N4-(2-(isopropylsulfonyl)phenyl)pyrimidine-2,4-diamine (LDK378) currently in phase 1 and phase 2 clinical trials. J Med Chem. 2013;56:5675–90.CrossRef
27.
go back to reference De Backer D, Hollenberg S, Boerma C, Goedhart P, Buchele G, Ospina-Tascon G, et al. How to evaluate the microcirculation: report of a round table conference. Crit Care. 2007;11. De Backer D, Hollenberg S, Boerma C, Goedhart P, Buchele G, Ospina-Tascon G, et al. How to evaluate the microcirculation: report of a round table conference. Crit Care. 2007;11.
28.
go back to reference Zhai X, Yang Z, Zheng G, Yu T, Wang P, Liu X, et al. Lactate as a potential biomarker of Sepsis in a rat Cecal ligation and puncture model. Mediat Inflamm. 2018;2018:8352727.CrossRef Zhai X, Yang Z, Zheng G, Yu T, Wang P, Liu X, et al. Lactate as a potential biomarker of Sepsis in a rat Cecal ligation and puncture model. Mediat Inflamm. 2018;2018:8352727.CrossRef
29.
go back to reference Pinson DM, Schoeb TR, Lindsey JR, Davis JK. Evaluation by scoring and computerized morphometry of lesions of early mycoplasma pulmonis infection and ammonia exposure in F344/N rats. Vet Pathol. 1986;23:550–5.CrossRef Pinson DM, Schoeb TR, Lindsey JR, Davis JK. Evaluation by scoring and computerized morphometry of lesions of early mycoplasma pulmonis infection and ammonia exposure in F344/N rats. Vet Pathol. 1986;23:550–5.CrossRef
30.
go back to reference Hu B, Wu Y, Liu J, Shen X, Tong F, Xu G, et al. GSK-3beta inhibitor induces expression of Nrf2/TrxR2 signaling pathway to protect against renal ischemia/reperfusion injury in diabetic rats. Kidney Blood Press Res. 2016;41:937–46.CrossRef Hu B, Wu Y, Liu J, Shen X, Tong F, Xu G, et al. GSK-3beta inhibitor induces expression of Nrf2/TrxR2 signaling pathway to protect against renal ischemia/reperfusion injury in diabetic rats. Kidney Blood Press Res. 2016;41:937–46.CrossRef
31.
go back to reference Qin-Wei Z, Yong-Guang LI. Berberine attenuates myocardial ischemia reperfusion injury by suppressing the activation of PI3K/AKT signaling. Exp Ther Med. 2016;11:978–84.CrossRef Qin-Wei Z, Yong-Guang LI. Berberine attenuates myocardial ischemia reperfusion injury by suppressing the activation of PI3K/AKT signaling. Exp Ther Med. 2016;11:978–84.CrossRef
Metadata
Title
LDK378 improves micro- and macro-circulation via alleviating STING-mediated inflammatory injury in a Sepsis rat model induced by Cecal ligation and puncture
Authors
Weiwei Ge
Qiaohua Hu
Xiangshao Fang
Juanhua Liu
Jing Xu
Juntao Hu
Xuefen Liu
Qin Ling
Yue Wang
He Li
Ming Gao
Longyuan Jiang
Zhengfei Yang
Wanchun Tang
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Inflammation / Issue 1/2019
Electronic ISSN: 1476-9255
DOI
https://doi.org/10.1186/s12950-019-0208-0

Other articles of this Issue 1/2019

Journal of Inflammation 1/2019 Go to the issue