1. Removal of circulating mitochondrial N-formyl peptides via immobilized antibody therapy restores sepsis-induced neutrophil dysfunction.
- Author
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Kwon WY, Jung YS, Suh GJ, Kim SH, Lee A, Kim JY, Kim H, Park H, Shin J, Kim T, Kim KS, Itagaki K, and Hauser CJ
- Subjects
- Humans, Calcium metabolism, Sepsis immunology, Sepsis drug therapy, Antibodies immunology, Shock, Septic drug therapy, Shock, Septic immunology, N-Formylmethionine Leucyl-Phenylalanine pharmacology, Male, Chemotaxis, Leukocyte drug effects, Neutrophils metabolism, Neutrophils immunology, Neutrophils drug effects, Mitochondria metabolism, Mitochondria drug effects, Receptors, Formyl Peptide metabolism, Receptors, Formyl Peptide immunology
- Abstract
During recovery from septic shock, circulating mitochondrial N-formyl peptides predispose to secondary infection by occupying formyl peptide receptor 1 on the neutrophil (polymorphonuclear leukocyte) membrane, suppressing cytosolic calcium ([Ca2+]i)-dependent responses to secondarily encountered bacteria. However, no study has yet investigated therapeutic clearance of circulating mitochondrial N-formyl peptides in clinical settings. Thus, we studied how to remove mitochondrial N-formyl peptides from septic-shock plasma and whether such removal could preserve cell-surface formyl peptide receptor 1 and restore sepsis-induced polymorphonuclear leukocyte dysfunction by normalizing [Ca2+]i flux. In in vitro model systems, mitochondrial N-formyl peptide removal rescued polymorphonuclear leukocyte formyl peptide receptor 1-mediated [Ca2+]i flux and chemotaxis that had been suppressed by prior mitochondrial N-formyl peptide exposure. However, polymorphonuclear leukocyte functional recovery occurred in a stepwise fashion over 30 to 90 min. Intracellular Ca2+-calmodulin appears to contribute to this delay. In ex vivo model, systems using blood samples obtained from patients with septic shock, antimitochondrial N-formyl peptide antibodies alone failed to eliminate mitochondrial N-formyl peptides from septic-shock plasma or inhibit mitochondrial N-formyl peptide activity. We therefore created a beads-based antimitochondrial N-formyl peptide antibody cocktail by combining protein A/sepharose with antibodies specific for the most potent human mitochondrial N-formyl peptide chemoattractants. The beads-based antimitochondrial N-formyl peptide antibody cocktail treatment successfully removed those active mitochondrial N-formyl peptides from septic-shock plasma. Furthermore, the beads-based antimitochondrial N-formyl peptide antibody cocktail treatment significantly restored chemotactic and bactericidal dysfunction of polymorphonuclear leukocytes obtained from patients with septic shock who developed secondary infections. By clearing circulating mitochondrial N-formyl peptides, the immobilized antimitochondrial N-formyl peptide antibody therapy prevented mitochondrial N-formyl peptide interactions with surface formyl peptide receptor 1, thereby restoring [Ca2+]i-dependent polymorphonuclear leukocyte antimicrobial function in clinical septic-shock environments. This approach may help prevent the development of secondary, nosocomial infections in patients recovering from septic shock., Competing Interests: Conflict of interest statement. W.Y.K., Y.S.J., G.J.S., S.H.K., A.L., J.Y.K., H.Y.K., H.P., T.K., and K.S.K. are inventors on a patent application submitted by Seoul National University that covers “Blood perfusion device to reduce secondary infection in hospital”. The authors have declared no additional conflict of interest exists., (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Leukocyte Biology.)
- Published
- 2024
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