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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Leukoc+Biol
2014 ; 96
(5
): 785-96
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SIRT1 inhibition during the hypoinflammatory phenotype of sepsis enhances
immunity and improves outcome
#MMPMID25001863
Vachharajani VT
; Liu T
; Brown CM
; Wang X
; Buechler NL
; Wells JD
; Yoza BK
; McCall CE
J Leukoc Biol
2014[Nov]; 96
(5
): 785-96
PMID25001863
show ga
Mechanism-based sepsis treatments are unavailable, and their incidence is rising
worldwide. Deaths occur during the early acute phase of hyperinflammation or
subsequent postacute hypoinflammatory phase with sustained organ failure. The
acute sepsis phase shifts rapidly, and multiple attempts to treat early excessive
inflammation have uniformly failed. We reported in a sepsis cell model and human
sepsis blood leukocytes that nuclear NAD+ sensor SIRT1 deacetylase remodels
chromatin at specific gene sets to switch the acute-phase proinflammatory
response to hypoinflammatory. Importantly, SIRT1 chromatin reprogramming is
reversible, suggesting that inhibition of SIRT1 might reverse postacute-phase
hypoinflammation. We tested this concept in septic mice, using the highly
specific SIRT1 inhibitor EX-527, a small molecule that closes the NAD+ binding
site of SIRT1. Strikingly, when administered 24 h after sepsis, all treated
animals survived, whereas only 40% of untreated mice survived. EX-527 treatment
reversed the inability of leukocytes to adhere at the small intestine MVI,
reversed in vivo endotoxin tolerance, increased leukocyte accumulation in
peritoneum, and improved peritoneal bacterial clearance. Mechanistically, the
SIRT1 inhibitor restored repressed endothelial E-selectin and ICAM-1 expression
and PSGL-1 expression on the neutrophils. Systemic benefits of EX-527 treatment
included stabilized blood pressure, improved microvascular blood flow, and a
shift toward proimmune macrophages in spleen and bone marrow. Our findings reveal
that modifying the SIRT1 NAD+ axis may provide a novel way to treat sepsis in its
hypoinflammatory phase.