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Heparin-binding protein is important for vascular leak in sepsis

BACKGROUND: Elevated plasma levels of heparin-binding protein (HBP) are associated with risk of organ dysfunction and mortality in sepsis, but little is known about causality and mechanisms of action of HBP. The objective of the present study was to test the hypothesis that HBP is a key mediator of...

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Autores principales: Bentzer, Peter, Fisher, Jane, Kong, HyeJin Julia, Mörgelin, Mattias, Boyd, John H., Walley, Keith R., Russell, James A., Linder, Adam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050173/
https://www.ncbi.nlm.nih.gov/pubmed/27704481
http://dx.doi.org/10.1186/s40635-016-0104-3
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author Bentzer, Peter
Fisher, Jane
Kong, HyeJin Julia
Mörgelin, Mattias
Boyd, John H.
Walley, Keith R.
Russell, James A.
Linder, Adam
author_facet Bentzer, Peter
Fisher, Jane
Kong, HyeJin Julia
Mörgelin, Mattias
Boyd, John H.
Walley, Keith R.
Russell, James A.
Linder, Adam
author_sort Bentzer, Peter
collection PubMed
description BACKGROUND: Elevated plasma levels of heparin-binding protein (HBP) are associated with risk of organ dysfunction and mortality in sepsis, but little is known about causality and mechanisms of action of HBP. The objective of the present study was to test the hypothesis that HBP is a key mediator of the increased endothelial permeability observed in sepsis and to test potential treatments that inhibit HBP-induced increases in permeability. METHODS: Association between HBP at admission with clinical signs of increased permeability was investigated in 341 patients with septic shock. Mechanisms of action and potential treatment strategies were investigated in cultured human endothelial cells and in mice. RESULTS: Following adjustment for comorbidities and Acute Physiology and Chronic Health Evaluation (APACHE) II, plasma HBP concentrations were weakly associated with fluid overload during the first 4 days of septic shock and the degree of hypoxemia (PaO(2)/FiO(2)) as measures of increased systemic and lung permeability, respectively. In mice, intravenous injection of recombinant human HBP induced a lung injury similar to that observed after lipopolysaccharide injection. HBP increased permeability of vascular endothelial cell monolayers in vitro, and enzymatic removal of luminal cell surface glycosaminoglycans (GAGs) using heparinase III and chondroitinase ABC abolished this effect. Similarly, unfractionated heparins and low molecular weight heparins counteracted permeability increased by HBP in vitro. Intracellular, selective inhibition of protein kinase C (PKC) and Rho-kinase pathways reversed HBP-mediated permeability effects. CONCLUSIONS: HBP is a potential mediator of sepsis-induced acute lung injury through enhanced endothelial permeability. HBP increases permeability through an interaction with luminal GAGs and activation of the PKC and Rho-kinase pathways. Heparins are potential inhibitors of HBP-induced increases in permeability. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40635-016-0104-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-50501732016-10-18 Heparin-binding protein is important for vascular leak in sepsis Bentzer, Peter Fisher, Jane Kong, HyeJin Julia Mörgelin, Mattias Boyd, John H. Walley, Keith R. Russell, James A. Linder, Adam Intensive Care Med Exp Research BACKGROUND: Elevated plasma levels of heparin-binding protein (HBP) are associated with risk of organ dysfunction and mortality in sepsis, but little is known about causality and mechanisms of action of HBP. The objective of the present study was to test the hypothesis that HBP is a key mediator of the increased endothelial permeability observed in sepsis and to test potential treatments that inhibit HBP-induced increases in permeability. METHODS: Association between HBP at admission with clinical signs of increased permeability was investigated in 341 patients with septic shock. Mechanisms of action and potential treatment strategies were investigated in cultured human endothelial cells and in mice. RESULTS: Following adjustment for comorbidities and Acute Physiology and Chronic Health Evaluation (APACHE) II, plasma HBP concentrations were weakly associated with fluid overload during the first 4 days of septic shock and the degree of hypoxemia (PaO(2)/FiO(2)) as measures of increased systemic and lung permeability, respectively. In mice, intravenous injection of recombinant human HBP induced a lung injury similar to that observed after lipopolysaccharide injection. HBP increased permeability of vascular endothelial cell monolayers in vitro, and enzymatic removal of luminal cell surface glycosaminoglycans (GAGs) using heparinase III and chondroitinase ABC abolished this effect. Similarly, unfractionated heparins and low molecular weight heparins counteracted permeability increased by HBP in vitro. Intracellular, selective inhibition of protein kinase C (PKC) and Rho-kinase pathways reversed HBP-mediated permeability effects. CONCLUSIONS: HBP is a potential mediator of sepsis-induced acute lung injury through enhanced endothelial permeability. HBP increases permeability through an interaction with luminal GAGs and activation of the PKC and Rho-kinase pathways. Heparins are potential inhibitors of HBP-induced increases in permeability. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40635-016-0104-3) contains supplementary material, which is available to authorized users. Springer International Publishing 2016-10-04 /pmc/articles/PMC5050173/ /pubmed/27704481 http://dx.doi.org/10.1186/s40635-016-0104-3 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Bentzer, Peter
Fisher, Jane
Kong, HyeJin Julia
Mörgelin, Mattias
Boyd, John H.
Walley, Keith R.
Russell, James A.
Linder, Adam
Heparin-binding protein is important for vascular leak in sepsis
title Heparin-binding protein is important for vascular leak in sepsis
title_full Heparin-binding protein is important for vascular leak in sepsis
title_fullStr Heparin-binding protein is important for vascular leak in sepsis
title_full_unstemmed Heparin-binding protein is important for vascular leak in sepsis
title_short Heparin-binding protein is important for vascular leak in sepsis
title_sort heparin-binding protein is important for vascular leak in sepsis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050173/
https://www.ncbi.nlm.nih.gov/pubmed/27704481
http://dx.doi.org/10.1186/s40635-016-0104-3
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