Nuclear histones: major virulence factors or just additional early sepsis markers? A comment.
In 2009, Xu et al. and Chaput et al. in Nature Medicine had argued that the main cause of death in sepsis is the release from neutrophil nets of nuclear histone, highly toxic to endothelial cells and that these polycations are major and unique virulence factors. Since 2009, numerous researchers have also suggested the involvement of histones in the pathophysiology of many clinical disorders. If histones are indeed major unique virulence toxic agents, then heparin, activated protein C and antibodies to histone should prove excellent antisepsis agents. However, this is provided that these agents are administered to patients early enough before the activation of the cytokine storms, immune responses and the coagulation cascades are irreversibly unleashed. This may not be practical, since a diagnosis of sepsis is usually made much later. Future identifications of novel early markers are therefore needed and a compilation of cocktails of antagonists may replace the faulty single antagonists tried for many years, but in vain, to prevent death in sepsis.
Faculty of Dental Medicine, Institute of Dental Sciences, Hebrew University of Jerusalem, Jerusalem, Israel. Ginsburg@mail.huji.ac.il.
Isaac
I
Ginsburg
Faculty of Dental Medicine, Institute of Dental Sciences, Hebrew University of Jerusalem, Jerusalem, Israel.|Institute for Drug Research, School of Pharmacy, Hebrew University of Jerusalem, Jerusalem, Israel.|Teva Pharmaceuticals Ltd, Kfar Saba, Israel.
Erez
E
Koren
Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
James
J
Varani
Institute for Drug Research, School of Pharmacy, Hebrew University of Jerusalem, Jerusalem, Israel.
Ron
R
Kohen
D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D002467:Cell Nucleus / Q000378:metabolism*; D006657:Histones / Q000378:metabolism*; D006801:Humans; D018805:Sepsis / Q000175:diagnosis* / Q000378:metabolism*; D037521:Virulence Factors / Q000378:metabolism*
D015415:Biomarkers; D006657:Histones; D037521:Virulence Factors
Nuclear histone; Post-infectious sequelae; Sepsis; Septic shock; Synergistic mechanisms