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Inflammation resolution circuits are uncoupled in acute sepsis and correlate with clinical severity
Bakr Jundi, … , Joel Voldman, Bruce D. Levy
Bakr Jundi, … , Joel Voldman, Bruce D. Levy
Published June 24, 2021
Citation Information: JCI Insight. 2021;6(15):e148866. https://doi.org/10.1172/jci.insight.148866.
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Research Article Inflammation Pulmonology

Inflammation resolution circuits are uncoupled in acute sepsis and correlate with clinical severity

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Abstract

Sepsis is a critical illness characterized by dysregulated inflammatory responses lacking counter-regulation. Specialized proresolving mediators are agonists for antiinflammation and for promoting resolution, and they are protective in preclinical sepsis models. Here, in human sepsis, we mapped resolution circuits for the specialized proresolving mediators resolvin D1 and resolvin D2 in peripheral blood neutrophils and monocytes, their regulation of leukocyte activation and function ex vivo, and their relationships to measures of clinical severity. Neutrophils and monocytes were isolated from healthy subjects and patients with sepsis by inertial microfluidics and resolvin D1 and resolvin D2 receptor expression determined by flow cytometry. The impact of these resolvins on leukocyte activation was determined by isodielectric separation and leukocyte function by stimulated phagolysosome formation. Leukocyte proresolving receptor expression was significantly higher in sepsis. In nanomolar concentrations, resolvin D1 and resolvin D2 partially reversed sepsis-induced changes in leukocyte activation and function. Principal component analyses of leukocyte resolvin receptor expression and responses differentiated sepsis from health and were associated with measures of sepsis severity. These findings indicate that resolvin D1 and resolvin D2 signaling for antiinflammation and resolution are uncoupled from leukocyte activation in early sepsis and suggest that indicators of diminished resolution signaling correlate with clinical disease severity.

Authors

Bakr Jundi, Do-Hyun Lee, Hyungkook Jeon, Melody G. Duvall, Julie Nijmeh, Raja-Elie E. Abdulnour, Mayra Pinilla-Vera, Rebecca M. Baron, Jongyoon Han, Joel Voldman, Bruce D. Levy

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Figure 6

Correlation between leukocyte responses to RvD2 and sepsis clinical severity.

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Correlation between leukocyte responses to RvD2 and sepsis clinical seve...
(A) Schematic diagram of the chemical structure of RvD2 and its receptor (DRV2) on the surface of CD16bright PMN. (B and C) The correlation between clinical severity indicators (SOFA and APACHE II) (other severity indicators such as status of mechanical ventilation and mortality are included in the Supplemental Figures) and expression levels of surface receptor DRV2 (n = 13) (B), and relative increase of frequency of pHrodo+ CD16bright PMN with exogenous RvD2 (n = 10) (C), was determined. (D) Schematic diagram of the chemical structure of RvD2 and its receptor (DRV2) expressed on the surface of intermediate monocyte. (E and F) The correlation between clinical severity indicators (SOFA, APACHE II) (other severity indicators such as status of mechanical ventilation and mortality are included in the Supplemental Figures), and expression levels of surface receptor DRV2 (n = 13) (E), and absolute increase of frequency of pHrodo+ Intermediate monocyte with exogenous RvD2 (n = 10) (F), was determined. The Pearson correlation r value and significance are noted; red indicates significance of P < 0.05 and regression lines are shown. Cell images are from Biorender.

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