title: Protease-activated receptor-4 inhibition protects from multiorgan failure in a murine model of systemic inflammation.
abstract: Coagulation proteases may act as cell signaling molecules via protease-activated receptor (PAR) cleavage, subsequently affecting cellular and inflammatory responses. Activation of PARs in the setting of systemic inflammation and disseminated intravascular coagulation (DIC) might thus exacerbate the inflammatory response contributing to tissue and organ damage. To investigate the role of PAR-4 in these processes, we subjected mice to a model of systemic inflammation and DIC (Shwartzman reaction) in the absence or presence of a cell-penetrating pepducin antagonist of PAR-4 (P4pal-10). P4pal-10 dose-dependently diminished the severity of endotoxemia and preserved liver, kidney, as well as lung function. Moreover, systemic inflammation and local (neutrophilic) inflammatory responses were attenuated. In vitro migration assays and P4pal-10 treatment in neutropenic mice suggest an essential role for neutrophils in PAR-4-mediated pathology. P4pal-10 treatment of thrombocytopenic mice excluded the involvement of platelets in this phenomenon. These results uncover an important role for PAR-4 in the Shwartzman reaction and suggest that inhibition of PAR-4 signaling in neutrophils could be protective in systemic inflammation and DIC.
authors.affiliation: Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibregdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Sjoukje H
authors.initials: SH
authors.lastname: Slofstra
authors.forename: Maarten F
authors.initials: MF
authors.lastname: Bijlsma
authors.forename: Angelique P
authors.initials: AP
authors.lastname: Groot
authors.forename: Pieter H
authors.initials: PH
authors.lastname: Reitsma
authors.forename: Theo
authors.initials: T
authors.lastname: Lindhout
authors.forename: Hugo
authors.initials: H
authors.lastname: ten Cate
authors.forename: C Arnold
authors.initials: CA
authors.lastname: Spek
mesh_terms: D000818:Animals; D001792:Blood Platelets / Q000187:drug effects / Q000473:pathology; D004195:Disease Models, Animal; D005260:Female; D051379:Mice; D008810:Mice, Inbred C57BL; D009102:Multiple Organ Failure / Q000209:etiology / Q000517:prevention & control*; D020556:Neutrophil Infiltration / Q000187:drug effects; D009504:Neutrophils / Q000187:drug effects / Q000473:pathology; D009842:Oligopeptides / Q000494:pharmacology*; D010446:Peptide Fragments / Q000494:pharmacology; D018179:Receptors, Thrombin / Q000037:antagonists & inhibitors* / Q000502:physiology; D012790:Shwartzman Phenomenon / Q000150:complications / Q000401:mortality / Q000473:pathology*; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000473:pathology* / Q000517:prevention & control
chemical_list: D009842:Oligopeptides; D010446:Peptide Fragments; D018179:Receptors, Thrombin; C524864:palmitoyl-seryl-glycyl-arginyl-arginyl-tyrosyl-glycyl-histidyl-alanyl-leucyl-arginine; C112908:protease-activated receptor 4