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Published ahead of print on September 17, 2009, doi:10.1164/rccm.200810-1552OC

Am. J. Respir. Crit. Care Med., Volume 180, Number 11, December 2009, 1098-1106

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Submitted on October 7, 2008
Accepted on September 16, 2009

Expression and Role of Myeloid-Related Protein-14 in Clinical and Experimental Sepsis

Marieke A.D. van Zoelen1*, Thomas Vogl2, Dirk Foell2, Suzanne Q. Van Veen3, Jan W.O. van Till4, Sandrine Florquin5, Michael W Tanck6, Xavier Wittebole7, Pierre-Francois Laterre7, Marja A. Boermeester4, Johannes Roth8, and Tom van der Poll9

1 Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Center for Experimental and Molecular Medicine (CEMM), Academic Medical Center, University of Amsterdam Amsterdam, the Netherlands, 2 Institute of Immunology, University of Muenster, Muenster, Germany, 3 Sanquin, Amsterdam, the Netherlands, 4 Department of Surgery, Academic Medical Center, University of Amsterdam, the Netherlands, 5 Department of Pathology, Academic Medical Center, University of Amsterdam, the Netherlands, 6 Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, the Netherlands, 7 Department of Critical Care Medicine, St. Luc University, Universite Catholique de Louvain, Brussels, Belgium, 8 Institute of Immunology, Universtity of Muenster, Muenster, Germany, 9 Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, the Netherlands; Center for Experimental and Molecular Medicine (CEMM), Academic Medical Center, University of Amsterdam, the Netherlands

* To whom correspondence should be addressed. E-mail: m.a.vanzoelen{at}amc.uva.nl.

Rationale: Myeloid related protein (MRP) 8 and 14 can form heterodimers that elicit a variety of inflammatory responses. We recently showed that MRP8/14 is a ligand for Toll-like receptor 4, and that mice deficient in MRP8/14 are protected against endotoxic shock-induced lethality. Objectives: To determine 1) the extent of MRP8/14 release in patients with sepsis and/or peritonitis and in healthy humans exposed to lipopolysaccharide (LPS) and 2) the contribution of MRP(8/)14 to the host response in murine abdominal sepsis. Methods: MRP8/14 was measured in 51 severe sepsis patients, 8 subjects after intravenous injection with LPS and 17 patients with peritonitis. Host responses to sepsis were compared in mrp14 gene deficient (and thereby MRP8/14 deficient) and wild-type mice intraperitoneally injected with Escherichia (E.) coli. Measurements and Main Results: Sepsis patients displayed elevated circulating MRP8/14 concentrations at both days 0 and 3, and LPS injection resulted in systemic MRP8/14 release in healthy humans. In patients with peritonitis, MRP8/14 levels in abdominal fluid were >15-fold higher than in plasma. MRP14 deficient mice displayed an improved defense against E. coli abdominal sepsis in an early phase, as indicated by a diminished dissemination of the bacteria at 6 h. In addition, MRP14 deficient mice demonstrated decreased systemic inflammation, as reflected by lower cytokine plasma concentrations, and less severe liver damage. Conclusion: Human sepsis and endotoxemia are associated with enhanced release of MRP8/14. In abdominal sepsis, MRP8/14 likely primarily occurs at the site of the infection, facilitating bacterial dissemination in an early phase and liver injury.


Key words: myeloid related protein 8/14 • S100A8/S100A9 • calgranulin • sepsis • Toll-like receptor 4







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