The effect of ghrelin upon the early immune response in lean and obese mice during sepsis.

INTRODUCTION: It is well established that obesity-related hormones can have modulatory effects associated with the immune response. Ghrelin, a hormone mainly derived from endocrine cells of the gastric mucosa, regulates appetite, energy expenditure and body weight counteracting leptin, a hormone mainly derived from adipocytes. Additionally, receptors of both have been detected on immune cells and demonstrated an immune regulatory function during sepsis. METHODS: In the present study, the effect of peripheral ghrelin administration on early immune response and survival was investigated with lean mice and mice with diet-induced obesity using cecal ligation and puncture to induce sepsis. RESULTS: In the obese group, we found that ghrelin treatment improved survival, ameliorated hypothermia, and increased hyperleptinemia as compared to the lean controls. We also observed that ghrelin treatment divergently regulated serum IL-1ß and TNF-α concentrations in both lean and obese septic mice. Ghrelin treatment initially decreased but later resulted in increased bacteriaemia in lean mice while having no impact upon obese mice. Similarly, ghrelin treatment increased early neutrophil oxidative burst while causing a decrease 48 hours after sepsis inducement. CONCLUSION: In conclusion, as the immune response to sepsis temporally changes, ghrelin treatment differentially mediates this response. Specifically, we observed that ghrelin conferred protective effects during the early phase of sepsis, but during the later phase deteriorated immune response and outcome. These adverse effects were more pronounced upon lean mice as compared to obese mice.

IL-7 promotes T cell viability, trafficking, and functionality and improves survival in sepsis.

Sepsis is a highly lethal disorder characterized by widespread apoptosis-induced depletion of immune cells and the development of a profound immunosuppressive state. IL-7 is a potent antiapoptotic cytokine that enhances immune effector cell function and is essential for lymphocyte survival. In this study, recombinant human IL-7 (rhIL-7) efficacy and potential mechanisms of action were tested in a murine peritonitis model. Studies at two independent laboratories showed that rhIL-7 markedly improved host survival, blocked apoptosis of CD4 and CD8 T cells, restored IFN-gamma production, and improved immune effector cell recruitment to the infected site. Importantly, rhIL-7 also prevented a hallmark of sepsis (i.e., the loss of delayed-type hypersensitivity), which is an IFN-gamma- and T cell-dependent response. Mechanistically, rhIL-7 significantly increased the expression of the leukocyte adhesion markers LFA-1 and VLA-4, consistent with its ability to improve leukocyte function and trafficking to the infectious focus. rhIL-7 also increased the expression of CD8. The potent antiapoptotic effect of rhIL-7 was due to increased Bcl-2, as well as to a dramatic decrease in sepsis-induced PUMA, a heretofore unreported effect of IL-7. If additional animal studies support its efficacy in sepsis and if current clinical trials continue to confirm its safety in diverse settings, rhIL-7 should be strongly considered for clinical trials in sepsis.

Lymphocyte function during hepatic ischemia/reperfusion injury.

The liver is the primary organ affected by ischemia/reperfusion (I/R) injury after shock, surgical resection, or transplantation. The actions of myeloid leukocytes have been well studied and are thought to be the primary cells responsible for propagating the injury response. However, there is an emerging view that T lymphocytes can also regulate liver I/R-induced inflammation. Resident lymphocytes found within the liver include conventional alphabeta TCR cells as well as unconventional NK and gammadelta T cells. These lymphocytes can alter inflammation through the secretion of soluble mediators such as cytokines and chemokines or through cognate interactions in an antigen-dependent manner. Expression of these mediators will then result in the recruitment of more lymphocytes and neutrophils. There is evidence to suggest that T cell activation in the liver during I/R can be driven by antigenic or nonantigenic mechanisms. Finally, immune cells are exposed to different oxygen tensions, including hypoxia, as they migrate and function within tissues. The hypoxic environment during liver ischemia likely modulates T cell function, at least in part through the actions of hypoxia-inducible factor-1alpha. Further, this hypoxic environment leads to the increased concentration of extracellular adenosine, which is generally known to suppress T cell proinflammatory function. Altogether, the elucidation of T lymphocyte actions during liver I/R will likely allow for novel targets for therapeutic intervention.