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2016 ; 44
(12
): e1236-e1245
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Carbon Monoxide Improves Efficacy of Mesenchymal Stromal Cells During Sepsis by
Production of Specialized Proresolving Lipid Mediators
#MMPMID27513357
Tsoyi K
; Hall SR
; Dalli J
; Colas RA
; Ghanta S
; Ith B
; Coronata A
; Fredenburgh LE
; Baron RM
; Choi AM
; Serhan CN
; Liu X
; Perrella MA
Crit Care Med
2016[Dec]; 44
(12
): e1236-e1245
PMID27513357
show ga
OBJECTIVES: Mesenchymal stromal cells are being investigated as a cell-based
therapy for a number of disease processes, with promising results in animal
models of systemic inflammation and sepsis. Studies are ongoing to determine ways
to further improve the therapeutic potential of mesenchymal stromal cells. A gas
molecule that improves outcome in experimental sepsis is carbon monoxide. We
hypothesized that preconditioning of mesenchymal stromal cells with carbon
monoxide ex vivo would promote further therapeutic benefit when cells are
administered in vivo after the onset of polymicrobial sepsis in mice. DESIGN:
Animal study and primary cell culture. SETTING: Laboratory investigation.
SUBJECTS: BALB/c mice. INTERVENTIONS: Polymicrobial sepsis was induced by cecal
ligation and puncture. Mesenchymal stromal cells, mesenchymal stromal
cells-conditioned with carbon monoxide, fibroblasts, or fibroblasts-conditioned
with carbon monoxide were delivered by tail vein injections to septic mice. The
mice were assessed for survival, bacterial clearance, and the inflammatory
response during sepsis in each of the groups. Mesenchymal stromal cells were also
assessed for their ability to promote bacterial phagocytosis by neutrophils, the
production of specialized proresolving lipid mediators, and their importance for
mesenchymal stromal cells function using gene silencing. MEASUREMENTS AND MAIN
RESULTS: Ex vivo preconditioning with carbon monoxide allowed mesenchymal stromal
cells to be administered later after the onset of sepsis (6?hr), and yet maintain
their therapeutic effect with increased survival. Carbon monoxide preconditioned
mesenchymal stromal cells were also able to alleviate organ injury, improve
bacterial clearance, and promote the resolution of inflammation. Mesenchymal
stromal cells exposed to carbon monoxide, with docosahexaenoic acid substrate,
produced specialized proresolving lipid mediators, particularly D-series
resolvins, which promoted survival. Silencing of lipoxygenase pathways
(5-lipoxygenase and 12/15-lipoxygenase), which are important enzymes for
specialized proresolving lipid mediator biosynthesis, resulted in a loss of
therapeutic benefit bestowed on mesenchymal stromal cells by carbon monoxide.
CONCLUSIONS: Taken together, these data suggest that production of specialized
proresolving lipid mediators contribute to improved mesenchymal stromal cell
efficacy when exposed to carbon monoxide, resulting in an improved therapeutic
response during sepsis.