LBP vermittelt im Wirtsorganismus die direkte Immunantwort auf bakterielle Liganden wie das Lipopolysaccharid (LPS) von Gram-negativen oder Lipopeptide von Gram-positiven Bakterien. In dieser Arbeit wurde die Funktionsweise von LBP weiter aufgeklärt. Im ersten Teil der Arbeit wurde eine natürlich vorkommende Mutation des LBP (c998t), die an Position 333 zu einem Austausch der Aminosäure Prolin zu Leucin führt, hinsichtlich ihrer Auswirkungen auf Struktur und Funktionalität des Proteins untersucht. Westernblot-Analysen des rekombinant hergestellten Proteins und humaner Seren von Mutationsträgern weisen auf einen Zerfall des mutierten Proteins hin. Es kommt zu einer Beeinträchtigung der Bindung bakterieller Liganden und einer deutlichen Reduktion der LBP-vermittelten Zytokinausschüttung von Immunzellen. Der hier untersuchte Polymorphismus hat eine Allelfrequenz von 0,072 in einer gesunden europäischen Population. Genotypanalysen von Patientengruppen zeigten, dass es durch die Mutation zu einer deutlich erhöhten Mortalität bei Patienten mit septischen Komplikationen und einer durch Gram-negative Erreger verursachten Pneumonie kommt. Unsere Ergebnisse zur eingeschränkten Funktion des LBP-c998t bieten eine erste Erklärung dafür, wie diese Mutation vermutlich die Fähigkeit, Krankheiten zu bewältigen, beeinträchtigt. Innerhalb dieser Arbeit ging es um die Analyse der Bindung von bakteriellen Liganden an LBP. Dabei wurde eine potentiell gemeinsame Bindungsstelle für Liganden untersucht, die von Gram-positiven und Gram-negativen Bakterien stammen und später von den Toll-like Rezeptoren (TLRs) 2 und -4 erkannt werden. Dazu wurden Bindungsversuche zwischen Lipopeptiden und LPS mit einer zweiten LBP-Variante (LBP-E94/95) durchgeführt. Beim LPS führt dies zu einem Bindungsverlust. Auch für die Lipopeptide war durch die Mutationen die Interaktion mit LBP beeinträchtigt, was die These einer gemeinsamen Bindungsstelle von TLR2- und TLR4-Liganden an das Protein weiter unterstützt. / LBP enhances the innate immune reaction against bacterial ligands like LPS from gram negative or lipopeptides from gram positive bacteria in the host. Here we investigated the function of LBP using two recombinant mutants of the protein. The first part of this work examines a natural occurring mutation of LBP (c998t) leading to an amino acid exchange of proline to leucine at position 333 with regard to the impact on structure and function of the protein. Western blot analyses of the recombinant protein and sera obtained from individuals differing in the LBP genotype indicate the disaggregation of the mutated protein. Thereby binding of bacterial ligands to LBP is diminished and the LBP mediated cytokine secretion of immune cells is reduced. The gene polymorphism leading to the occurrence of the mutation is present with an allelic frequence of 0.072. A recent study has shown that this LBP-SNP led to a higher mortality in patients with septic complications and gram negative pneumonia. The results presented here, showing the negative impact on the function of LBP due to the mutation, may therefore be a first explanation on how this mutation affects the ability of people to deal with disease. Within this work binding of ligands to LBP was also explored. It was investigated whether ligands which are later recognized by Toll-like receptors (TLRs) 2 and – 4 share a common binding site on LBP. Assays with immobilized lipopeptides and LPS were performed with a second mutated LBP (LBP-E94/95). LPS binding to LBP is diminished completely. Here we showed that binding of lipopeptide to LBP is affected likewise, furthermore supporting the hypothesis of a common binding site for TLR2- and TLR4- ligands.

Bei neun von vierzehn Serogruppen der Subspezies E. coli Flexneri (SF) konnte ein pHS-2-Plasmid nachgewiesen werden. Es besteht eine positive Korrelation zwischen pHS-2-positiven SF und dem Auftreten einer Reaktiven Arthritis, eine Komplikation der bakteriellen Ruhr. Verschiedene Autoren führen das gehäufte Auftreten der Reaktiven Arthritis bei pHS-2-positiven SF auf eine erhöhte Serumresistenz zurück, die den Bakterien durch das cld(pHS-2)-Gen vermittelt wird. Das cld(pHS-2)-Gen als längstes aller 18 "open reading frames" auf dem pHS-2-Plasmid kodiert für ein 35 kD großes Protein, das aufgrund seiner Funktion als "chain length determinant" (Cld(pHS-2)) bezeichnet wurde. Cld(pHS-2) ist maßgeblich an der Produktion von Lipopolysacchariden vom VL-Typ beteiligt. LPS vom VL-Typ produzieren O-Seitenketten mit mehr als 70 bis 80 Oligosaccharideinheiten und sollen die bakterielle Membran vor einer Komplementbindung und Serum-Antikörpern schützen, wodurch den Bakterien eine erhöhte Serumresistenz vermittelt werde. In dieser Arbeit wurde cld(pHS-2) in einen pHS-2-negativen Stamm der SF Serogruppe 6 integriert, um nachzuweisen, dass cld(pHS-2) das LPS-Muster pHS-2-negativer SF in charakteristischer Weise modifiziert. Während der Expressionsnachweis von cld(pHS-2) als Einzelprotein misslang, war eine Expression von cld(pHS-2) als Fusionsprotein in SF Serogruppe 6 erfolgreich. Im Vergleich zu pHS-2-negativen SF war unsere SF Serogruppe 6-Mutante nun in der Lage, LPS vom VL-Typ in Form einer zusätzlichen Bande mit ca. 80 Oligosaccharideinheiten zu produzieren. Diese phänotypische Veränderung war zwar nur gering ausgeprägt, konnte jedoch den spezifischen Einfluss von cld(pHS-2) als Fusionsprotein auf das LPS-Muster pHS-2-negativer SF nachweisen. / In nine out of fourteen serogroups of E. Coli Flexneri (SF) a pHS-2 plasmid has been isolated. There is a positive correlation between pHS-2-positive SF and the occurence of reactive arthritis (ReA) which is a complication of bacterial dysentery. Different authors reduce the widespread appearance of ReA by pHS-2-positive SF to an increased serum resistance caused by a cld(pHS-2)-gene. The cld(pHS-2)-gene ist the longest of 18 open reading frames in pHS-2 and it is the coding for a 35 kD protein which has been identified as a chain length determinant because of its function. Cld(pHS-2) plays a decisive role in the production of lipopolysaccharides (LPS) of the VL-type. LPS of the VL-type produce O antigen with more than 70-80 repeat units, and protect the bacterial outer membrane from complement factors and serum antibodies by a higher serum resistance. In this research the cld(pHS-2)-gene was integrated in a pHS-2-negative SF serogroup 6 to prove that cld(pHS-2) is able to modify the LPS pattern (destribution) of pHS-2-negative SF in a characteristic manner. The expression of cld(pHS-2) in SF serogroup 6 as an isolated protein failed, but the expression of cld(pHS-2) as a fusion protein was successful. In contrast to the pHS-2-negative SF our SF serogroup 6 mutant was able to produce LPS of the VL-type with 80-90 repeat units. Despite the slight effect, a specific influence of cld(pHS-2) as a fusion protein on LPS pattern and the bacterial phaenotype has to be confirmed.

Salmonella spp. sind fakultative intrazelluläre Pathogene, die gastrointestinale und systemische Erkrankungen in einem umfassenden Wirtsbereich, einschließlich Tier und Mensch, hervorrufen. Salmonella benötigt verschiedene Virulenzgene für die Infektion welche auf sogenannten Salmonella Pathogenitäts-Inseln (SPI) kodiert sind. Hinzu kommt, dass auch zahlreiche im Salmonella Genom verstreuten Gene an verschiedenen Aspekten von Virulenz und Pathogenese beteiligt sind. In der vorliegenden Studie wurde die Funktion eines zuvor nicht beschriebenen putativen transkriptionellen Regulators (STM0029) charakterisiert und definiert. Dieser scheint für die Abwehr von zellulären bakterizid wirkenden Verbindungen und das Überleben des Bakteriums innerhalb einer intrazellulären Nische von entscheidender Bedeutung zu sein. Die STM0029-deletierte Mutante wies eine gesteigerte Sensitivität gegenüber antimikrobiellen Peptiden und bakteriziden Verbindungen auf. Dazu zählten α-Defensin-1, β- Defensin-1, β-Defensin-2, LL-37 und Polymyxin B sowie Komponenten des Komplementsystems. Unerwartet war die Beobachtung, dass die Expression von STM0029 durch das PmrA/B Zwei Komponenten System reprimiert vorlag, während das PhoP/Q Zwei Komponenten System keinen Einfluss auf die Expression von STM0029 zu scheinen hat. Beide Komponent Systeme spielen bekanntlich eine entscheidende Rolle bei der Expressionsregulation von Genen die für das intrazelluläre Überleben von Salmonella wichtig sind. Bemerkenswert ist, dass ein Set von Genen welche an der Biosynthese und/oder der Modifikation für das LPS O-Antigen sowie des Peptidoglykans in der bakteriellen Zellwand beteiligt ist, im STM0029 Deletionshintergrund herab reguliert vorlag. Dieses Ergebnis deutet darauf hin, dass das STM0029 Genprodukt die Persistenz des Pathogen in Wirtszellen beeinflusst. Möglicherweise geschieht dies durch das Umgehen von wirtseigenen Abwehrmechanismen. / Salmonella spp. are facultative intracellular pathogens, which cause gastrointestinal and systemic diseases in a broad range of hosts including animals and humans. In addition to virulence genes clustered within pathogenicity islands, numerous additional genes scattered throughout the genome are also involved in various aspects of Salmoenlla virulence and pathogenesis. In this study, I identified a Salmonella putative transcriptional regulator encoded by a previously uncharacterized open reading frame designated STM0029. Deletion of STM0029 altered the expression of genes involved in both the resistance to host bactericidal challenges, and bacterial cell wall biosynthesis in S. Tyhpimurium. The ΔSTM0029 strain showed a defect in the resistance to host antimicrobial peptides, including α-defensin-1, β-defensin-1, β-defensin-2, LL-37, and polymyxin B as well as serum challenges compared to the wildtype. Unexpectedly, expression of STM0029 was found to be repressed by the PmrA/B two component system, but appeared to be independent of the PhoP/Q two component system, both of which are well-known regulatory systems involved in the regulation of expression of genes involved in Salmonella intracellular survival. Notably, the expression of a set of genes involved in bacterial LPS O-antigen and peptidoglycan biosyntheses and modifications showed decreases in the absence of STM0029. These experimental results indicate that the STM0029 gene product in S. Typhimurium contributes to resistance against host cell defense mechanisms, likely through regulation of genes involved in LPS O-antigen and peptidoglycan biosynthesis and modifications.

A isquemia e reperfusão intestinal (I/R-i) é relevante fator para o desenvolvimento da síndrome do desconforto respiratório agudo (SDRA). A lesão tecidual decorrente da I/R-i pode ser local e em órgãos distante do sitio isquêmico, notadamente o pulmão. Indivíduos submetidos à isquemia intestinal ao tornarem-se vulneráveis, desenvolvem resposta exacerbada a estímulos inflamatórios secundários constituindo assim a percepção de lesão decorrente de uma dupla agressão. Neste estudo desenvolvemos modelo murino de dupla agressão pulmonar ocasionada pela I/R-i seguida de estímulo da instilação nasal de LPS ou de suco gástrico (SG). A fase de caracterização do modelo de I/R-i revelou aumento de IL-6, G-CSF, KC, IP-10 e MCP-1, mas não de TNF-a no soro e em homogeneizados de pulmão e intestino. Anticorpos anti TNF-a e o etanercepte falharam em inibir o aumento de MPO pulmonar e intestinal após a I/R-i. A instilação nasal de LPS após a I/R-i aumentou a atividade pulmonar de MPO e exacerbou a permeabilidade vascular pulmonar. Neste caso, aminoguanidina ou a vimblastina reverterem o aumento da permeabilidade vascular, sugerindo a participação conjunta de neutrófilos e óxido nítrico no processo lesivo causado pela dupla agressão. A instilação nasal de SG induziu aumento inicial (2h) de MPO pulmonar seguido de influxo de neutrófilos (24h) para o espaço alveolar. Tal processo foi acompanhado por expressão inicial e transiente de TNF-a no LBA e contrabalanceada por IL-10. A resposta inflamatória aumentada de camundongos IL-10 KO à instilação de suco gástrico mostra o papel fundamental desta citocina do controle da inflamação. O rolipram ou o composto PKF 241-466 (inibidores de TNF-a) reduziram a inflamação pulmonar induzida pelo SG. A instilação de SG após a I/R-i (I/R-i +SG) exacerbou o aumento da permeabilidade vascular pulmonar. Os dados apresentados sugerem que a exposição do organismo ao trauma intestinal torna o pulmão suscetível a um estímulo secundário como o LPS e o suco gástrico. Visto a gama de estímulos inflamatórios a que indivíduos internados em unidades de terapia intensiva podem ser submetidos, os resultados deste estudo podem contribuir para a compreensão dos mecanismos reguladores do recrutamento de neutrófilos e geração de mediadores inflamatórios na síndrome do desconforto respiratório agudo. / Intestinal ischemia and reperfusion (I/R) is implicated as a prime initiating event in the development of systemic inflammatory syndrome and Acute Respiratory Distress Syndrome (ARDS). Several studies pointed the possibility of massive systemic inflammatory events rendering the lungs more susceptible to an exacerbated inflammatory response, the so called two-hit hypothesis. In this way, minor local inflammatory stimuli could be a trigger for ARDS. In this study we investigated the effects of low-dose LPS or gastric juice (GJ) administered by nasal instillation to mice previously submitted to intestinal I/R. Our data showed that i-I/R alone induced histological signs of edema in lung as well as an increase of lung MPO activity and IL-6, G-CSF, KC, IP-10 and MCP-1 levels. Nasal instillation of LPS following i-I/R increased lung MPO activity and exacerbated lung vascular permeability. In this case, aminoguanidine or vinblastine blocked the increase of vascular permeability, suggesting the role of neutrophils and nitric oxide in injury induced by the two-hit stimuli. Instillation of GJ induced an initial (2h) increase of lung MPO followed by the influx of neutrophils (24h) to the alveolar space. Such process was followed by the transient expression of TNF-a in BAL and balanced by IL-10. The exacerbated inflammatory response of IL-10 KO mice to GJ instillation shows the importance of this cytokine in the control of the inflammation in such model. Treatment with rolipram or PKF 241-466 compound (TNF-a inhibitors) reduced lung inflammation induced by GJ. Nasal instillation of GJ after i-I/R exacerbated the increase in lung vascular permeability. The data shown suggest that the exposition of the organism to mesenteric trauma primes the host organism to a secondary inflammatory stimulus such as LPS or gastric juice. Considering the possible multiple insults to lung to which patients in intensive care units are submitted, the results of this study might contribute to the understanding of the regulatory mechanisms of neutrophils and generation of inflammatory mediators in the context of ARDS.

Endotoxin or Lipopolysaccharide (LPS) is the invariant structural component of gram negative bacterial outer membranes and is the chief causative factor of Sepsis or endotoxic shock. Sepsis is a syndrome that has very high mortality rates even in this age of excellent therapeutics and critical patient care. The treatment for sepsis till date remains nonspecific and supportive due to lack of effective anti-endotoxic drugs. Sepsis is initiated when the circulating bacteria shed LPS from their cell envelopes. Shed LPS aggregates are recognized by LPS binding proteins and receptors, which activate the host's immune system. Uncontrolled and excessive stimulation of the host's immune system precipitates endotoxic shock which in advanced cases involving multiple system organ failure inevitably lead to patient's death. Many strategies have been tested out to combat this deadly affliction. One of the attractive clinical modalities in sepsis treatment is the use of peptides as LPS sequestering anti-endotoxic drugs. A classical peptide antibiotic of this class is Polymyxin B (PMB) a cyclic cationic acylated molecule, that recognizes LPS with a very high affinity. This thesis describes kinetics and thermodynamics of PMB-LPS interactions and applies these parameters over a framework of different models so as to gain insights into the structure-function relationships that govern the interactions of this peptide with endotoxin(s). Classical biophysical techniques like fluorescence, circular dichroism spectroscopy, stopped flow kinetics, titration calorirnetry (ITC) and the relatively new technique of Surface Plasmon Resonance (SPR) have been employed to dissect out the mechanism of the range of non-covalent forces that are involved in peptide-endotoxin recognition. Certain proteins that exhibit LPS binding activity have also been studied to gains insight about their mode of action. Implications of these studies for designing peptides that have better anti-endotoxic properties are also highlighted. The first chapter introduces and highlights the clinical features of sepsis. It also attempts to shed light on the LPS mediated signal transduction pathway that leads to endotoxic shock. This chapter also briefly explains the roles of many LPS receptors that are present in the human system and their specific roles in the signal transduction pathways. The second part of this chapter deals with the role of cationic peptides as anti-endotoxic drugs. Certain key functional aspects of these peptides, which impart in them, the desirable property of LPS recognition have also been discussed The second chapter describes the kinetic studies undertaken to unravel the exact mechanism of LPS-PMB interaction. The studies reveal that PMB recognizes LPS in a biphasic manner, with the second, unimolecular isomerization step of the reaction being the rate-limiting step. The initial reaction is shown to be influenced by the presence of salt in the reaction medium. The dissociation phase of this interaction also shows a biphasic pattern. These data allow us to speculate upon the exact mechanism by which PMB is able to recognize LPS. The studies also shed light on some structural aspects that govern and confer such high LPS binding activity to PMB. Based on these a model has been proposed to explain this recognition (C.J. Thomas et al, 1998). The second chapter discuses the mode of action of various PMB analogs. These analogs have been chosen in terms of their mode of action as well as their structural similarly to PMB. The affinities of these analogs to LPS and lipid A were quantified using the Surface plasmon resonance (SPR) method. SPR, a technique that relies on the quantification of change in mass during a binary binding process occurring between an immobilized entity and a flowing ligand, is a rapid and sensitive method to measure biologically relevant interactions. SPR studies provide us with the binding constants and thermodynamic parameters that allow evaluation of the affinities of these peptides towards LPS (C.J.Thomas and A.Surolia, 1999). The third chapter discusses a hitherto unknown mode by which PMB acts on a LPS lamellae. The results of this study wherein the binding affinities of PMB and its analogs were performed on monolayers and tethered liposomes, show that PMB is able to remove specifically LPS or lipid A from monolayers or bilayer assemblies such as tethered liposomes. The exact mode of action of PMB is deciphered in the light of these new studies, which allow us to posit on the observed efficacy of PMB in neutralizing the endotoxin as compared to peptides with nearly similar affinities for LPS (C.J Thomas et al 1999). In the fourth chapter a series of 23 residue peptides, based on the sequence corresponding to the anti-sense strand of magainin gene have been synthesized. Magainin an amphiphilic helical peptide obtained from frog skins plays a vital role in the innate immune defense mechanisms of these organisms. It also exhibits LPS binding activity that makes it an attractive target as an anti-endotoxic drug. Biochemical and biophysical characterization of these peptides reveal that they have the tendency to perturb both the inner and the outer membranes of E.coli. The peptides are amphiphilic and have helical structure in a membrane bound environment. Three of the peptides tested have high affinities for lipid A that approach the values shown by PMB. The kinetic parameters obtained by stopped flow and SPR studies in conjunction with the therrnodynamic parameters obtained using ITC studies allow us to highlight the key structural features that need to be exhibited by peptides that are designed to be LPS recognizers. The studies also project the fact that ionic forces play an important role in the initial recognition of LPS by these peptides. Fortification of the might of these ionic charges increases affinity for LPS where as the hydrophobic residues that interact at the next phase of binding are more amenable to disruptions in contiguity. These factors are discussed using the helical wheel diagram that shows the clear amphiphilicity displayed by these peptides. (C.J Thomas et al Manuscript under preparation, 2000) Chapter six discusses the mode of action of certain LPS binding proteins. Limulus anti endotoxic factor (LALF) plays a vital role in the innate immune based defense systems of the horseshoe crab. Galectin-3 is a metal ion independent, galactosc binding Icctin of human origin with unknown functions. Both these phylogcntically-unrclatcd proteins exhibit LPS/lipid A recognizing properties. ITC and SPR studies have been used to determine the binding constants displayed by these proteins for lipid A. LALF bind to lipid A with very high affinity than compared to Galectin-3 and is also able to take away selectively lipid A from both monolayers and tethered liposomes. Galectin-3 does not show this property of LALF, which might account for its lowered affinities. Also structurally LALF has amphiphilic nature that confers high lipid A binding activity, which is clearly lacking in Galectin-3. These studies in conjunction with the knowledge gained from the study of LPS-PMB interaction stress on the importance of amphiphilicity in LPS recognition. (C.J Thomas et al Manuscript under preparation, 2000). The final chapter is a general discussion that attempts to collate all these kinetic and thermodynamic observations in the pursuit of designing small easily manipulatable peptides that exhibit high LPS binding activity. These studies are aimed to act as rough guidelines to the design of LPS sequestering peptides that might have better therapeutic and pharmacokinetic properties. The appendix to the main body of work presented in thesis are two pieces of work pertaining to the elucidation the kinetics and mechanism of sugar lectin interactions, when sugars are presented as glycolipids in monolayers or bilaycrs liposomes. Mode of the presentation of sugars at cell-surfaces in the form of glycolipids as ligands influence their recognition by macromolecular receptors like lectins. Appendix 1 is a study of the mode of action of Ulex europeus I lectin binding to H-fucolipid containing tethered liposomes, by SPR. Fucosylated sugars are often used as key markers in histochemical analysis of malignant cancerous tissues. Ulex lectin plays a vital role as a marker for identification of these tissues. The kinetics and thermodynamic parameters that are obtained in this study throw some light on the mode of recognition of glycolipid receptor by Ulex europeus I lectin (C.J Thomas and A. Surolia 2000). Appendix 2 is a study, that attempts to quantify the initial kinetic parameters that correlate the recognition of glycolipid receptors with their inclination at the membrane surface and the influence of charge on them by soyabean agglutinin (SBA), Abrus agglutinin I and II. Studies on the soyabean agglutinin-globoside interaction highlights the divalent cation mediated reorientation of these receptors on their accessibility and recognition to the agglutinin. The divalent cations are speculated to orient the oligosaccharide head groups in a spatial geometry that allows a heightened kinetics of their interaction by SBA. These studies reveal that the reorganization of the binding pocket of a lectin can also have a profound influence on ihc rates of recognition of a glycospingolipid ligand by a lectin as exemplified by Abrus agglutinin II- GM1 interactions (C.J Thomas ct al, Manuscript under preparation).

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A isquemia e reperfusão intestinal (I/R-i) é relevante fator para o desenvolvimento da síndrome do desconforto respiratório agudo (SDRA). A lesão tecidual decorrente da I/R-i pode ser local e em órgãos distante do sitio isquêmico, notadamente o pulmão. Indivíduos submetidos à isquemia intestinal ao tornarem-se vulneráveis, desenvolvem resposta exacerbada a estímulos inflamatórios secundários constituindo assim a percepção de lesão decorrente de uma dupla agressão. Neste estudo desenvolvemos modelo murino de dupla agressão pulmonar ocasionada pela I/R-i seguida de estímulo da instilação nasal de LPS ou de suco gástrico (SG). A fase de caracterização do modelo de I/R-i revelou aumento de IL-6, G-CSF, KC, IP-10 e MCP-1, mas não de TNF-a no soro e em homogeneizados de pulmão e intestino. Anticorpos anti TNF-a e o etanercepte falharam em inibir o aumento de MPO pulmonar e intestinal após a I/R-i. A instilação nasal de LPS após a I/R-i aumentou a atividade pulmonar de MPO e exacerbou a permeabilidade vascular pulmonar. Neste caso, aminoguanidina ou a vimblastina reverterem o aumento da permeabilidade vascular, sugerindo a participação conjunta de neutrófilos e óxido nítrico no processo lesivo causado pela dupla agressão. A instilação nasal de SG induziu aumento inicial (2h) de MPO pulmonar seguido de influxo de neutrófilos (24h) para o espaço alveolar. Tal processo foi acompanhado por expressão inicial e transiente de TNF-a no LBA e contrabalanceada por IL-10. A resposta inflamatória aumentada de camundongos IL-10 KO à instilação de suco gástrico mostra o papel fundamental desta citocina do controle da inflamação. O rolipram ou o composto PKF 241-466 (inibidores de TNF-a) reduziram a inflamação pulmonar induzida pelo SG. A instilação de SG após a I/R-i (I/R-i +SG) exacerbou o aumento da permeabilidade vascular pulmonar. Os dados apresentados sugerem que a exposição do organismo ao trauma intestinal torna o pulmão suscetível a um estímulo secundário como o LPS e o suco gástrico. Visto a gama de estímulos inflamatórios a que indivíduos internados em unidades de terapia intensiva podem ser submetidos, os resultados deste estudo podem contribuir para a compreensão dos mecanismos reguladores do recrutamento de neutrófilos e geração de mediadores inflamatórios na síndrome do desconforto respiratório agudo. / Intestinal ischemia and reperfusion (I/R) is implicated as a prime initiating event in the development of systemic inflammatory syndrome and Acute Respiratory Distress Syndrome (ARDS). Several studies pointed the possibility of massive systemic inflammatory events rendering the lungs more susceptible to an exacerbated inflammatory response, the so called two-hit hypothesis. In this way, minor local inflammatory stimuli could be a trigger for ARDS. In this study we investigated the effects of low-dose LPS or gastric juice (GJ) administered by nasal instillation to mice previously submitted to intestinal I/R. Our data showed that i-I/R alone induced histological signs of edema in lung as well as an increase of lung MPO activity and IL-6, G-CSF, KC, IP-10 and MCP-1 levels. Nasal instillation of LPS following i-I/R increased lung MPO activity and exacerbated lung vascular permeability. In this case, aminoguanidine or vinblastine blocked the increase of vascular permeability, suggesting the role of neutrophils and nitric oxide in injury induced by the two-hit stimuli. Instillation of GJ induced an initial (2h) increase of lung MPO followed by the influx of neutrophils (24h) to the alveolar space. Such process was followed by the transient expression of TNF-a in BAL and balanced by IL-10. The exacerbated inflammatory response of IL-10 KO mice to GJ instillation shows the importance of this cytokine in the control of the inflammation in such model. Treatment with rolipram or PKF 241-466 compound (TNF-a inhibitors) reduced lung inflammation induced by GJ. Nasal instillation of GJ after i-I/R exacerbated the increase in lung vascular permeability. The data shown suggest that the exposition of the organism to mesenteric trauma primes the host organism to a secondary inflammatory stimulus such as LPS or gastric juice. Considering the possible multiple insults to lung to which patients in intensive care units are submitted, the results of this study might contribute to the understanding of the regulatory mechanisms of neutrophils and generation of inflammatory mediators in the context of ARDS.

Lipopolissacarídeos (LPS), pode tanto proteger quanto exacerbar o desenvolvimento da asma. LPS inicia a ativação da resposta imune via ligação da molécula Toll-like receptor 4 (TLR4) que sinaliza por duas vias distintas, as moléculas adaptadoras MyD88 e TRIF. LPS é um adjuvante que induz resposta do tipo Th1, enquanto que o hidróxido de alumínio (Alum) desperta respostas Th2, porém, a mistura de ambos adjuvantes na indução da resposta alérgica pulmonar ainda não foi investigada. No presente estudo, nós determinamos o efeito de dois agonistas de TLR4, um natural (LPS) e outro sintético (ER-803022) adsorvidos ao Alum sobre o desenvolvimento de doença alérgica pulmonar. Os animais foram sensibilizados pela via subcutânea com os antígenos, Ovoalbumina (OVA) ou Toxóide Tetânico (TT) na presença ou ausência de agonistas de TLR4 co-adsorvidos ao Alum e desafiados com os respectivos antígenos pela via intranasal. Nossos resultados mostraram que a sensibilização com OVA ou TT e LPS coadsorvidos ao Alum, impede o estabelecimento da resposta alérgica mediada por linfócitos Th2, tais como, influxo de eosinófilos, produção de citocinas do tipo 2, hiperreatividade brônquica, secreção de muco, e produção de IgE ou IgG1 anafilática. Apesar dos níveis de IgG2a, isotipo associado com as respostas Th1 estarem aumentados, análise da histopatologia pulmonar não revelou um desvio para o padrão Th1 de inflamação. Verificamos que a presença das moléculas TLR4, MyD88, IL-12/IFN-g mas não TRIF foram necessários para LPS exercer seu efeito inibitório. O agonista sintético de TLR4, menos tóxico que LPS, também protegeu contra o desenvolvimento de inflamação alérgica pulmonar. Em conclusão, nosso trabalho esclarece o efeito da sinalização do TLR4 na sensibilização alérgica e indica que agonista sintético de TLR4 com baixa toxicidade, pode ser utilizado para modular a capacidade adjuvante do Alum e conseqüentemente diminuir a indução de alergias. / Epidemiological and experimental data suggest that bacterial lipopolysaccharides (LPS) can either protect from or exacerbate allergic asthma. LPS triggers immune responses through Toll-like receptor (TLR) 4 that in turn activates two major signaling pathways via either MyD88 or TRIF adaptor proteins. LPS is a pro-Th1 adjuvant while aluminum hydroxide (Alum) is a strong Th2 adjuvant, but the effect of mixing both adjuvants on development of lung allergy has not been investigated. We determined whether natural (LPS) or synthetic (ER-803022) TLR4 agonists adsorbed onto alum adjuvant affect allergen sensitization and development of airway allergic disease. To dissect LPS-induced molecular pathways we used TLR4, MyD88, TRIF, or IL-12/IFN-g deficient mice. Mice were sensitized subcutaneously to allergens such as ovalbumin (OVA) or tetanus toxoid (TT) with or without TLR4 agonists coadsorbed onto Alum and challenged twice via intranasal route with the same allergens. The development of type 2 immunity was evaluated 24 h after last allergen challenge. We found that sensitization with OVA or TT plus LPS co-adsorbed onto Alum impaired allergeninduced Th2-mediated responses such as airway eosinophilia, type 2 cytokines secretion, airway hyperreactivity, mucus hyper production and serum levels of IgE or IgG1 anaphylactic antibodies. Although the levels of IgG2a, a Th1 affiliated isotype increased, investigation into the lung-specific effects revealed that LPS did not induce a Th1 pattern of inflammation. LPS impaired the development of Th2 immunity, signaling via TLR4 and MyD88 molecules via the IL-12/IFN-g axis, but not through TRIF pathway. Moreover, the synthetic TLR4 agonists that proved to have a less systemic inflammatory response than LPS also protected against allergic asthma development. TLR4 agonists co-adsorbed with allergen onto Alum down modulate Th2 immunity and prevent the development of polarized T cell-mediated airway inflammation. Thus, our work clarifies the effect of TLR4 signaling in allergic sensitization and indicates that TLR4 agonists with low toxicity might be useful for down regulating the pro-Th2 adjuvant activity of alum and consequently decrease the induction of allergy.