title: Circulating Extracellular Histones Are Clinically Relevant Mediators of Multiple Organ Injury.
abstract: Extracellular histones are a damage-associated molecular pattern (DAMP) involved in the pathogenesis of various diseases. The mechanisms of histone-mediated injury in certain organs have been extensively studied, but an understanding of the pathophysiological role of histone-mediated injury in multiple organ injury remains elusive. To elucidate this role, we systemically subjected C57BL/6 mice to various doses of histones and performed a chronological evaluation of the morphological and functional changes in the lungs, liver, and kidneys. Notably, histone administration ultimately led to death after a dose-dependent aggravation of multiple organ injury. In chronological studies, pulmonary and hepatic injuries occurred within 15 minutes, whereas renal injuries presented at a later phase, suggesting that susceptibility to extracellular histones varies among organs. Histones bound to pulmonary and hepatic endothelial cells immediately after administration, leading to endothelial damage, which could be ameliorated by pretreatment with heparin. Furthermore, release of another DAMP, high-mobility group protein box 1, followed the histone-induced tissue damage, and an antibody against the molecule ameliorated hepatic and renal failure in a late phase. These findings indicate that extracellular histones induce multiple organ injury in two progressive stages-direct injury to endothelial cells and the subsequent release of other DAMPs-and that combination therapies against extracellular histones and high-mobility group protein box 1 may be a promising strategy for treating multiple organ injury.
authors.affiliation: Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kawai
authors.affiliation: Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: kotani@fp.med.kyoto-u.ac.jp.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kotani
authors.affiliation: Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Miyao
authors.affiliation: Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Tokiko
authors.initials: T
authors.lastname: Ishida
authors.affiliation: Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Leila
authors.initials: L
authors.lastname: Jemail
authors.affiliation: Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Abiru
authors.affiliation: Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Tamaki
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005109:Extracellular Matrix / Q000378:metabolism; D024243:HMGB1 Protein / Q000378:metabolism; D022781:Hepatocytes / Q000378:metabolism*; D006657:Histones / Q000378:metabolism*; D007249:Inflammation / Q000378:metabolism*; D008099:Liver / Q000293:injuries / Q000378:metabolism*; D008168:Lung / Q000378:metabolism*; D055370:Lung Injury / Q000209:etiology*; D008297:Male; D008810:Mice, Inbred C57BL
chemical_list: D024243:HMGB1 Protein; D006657:Histones