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Molecular Mechanisms and Pathological Consequences of Endotoxin Tolerance and Priming

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Archivum Immunologiae et Therapiae Experimentalis Aims and scope

Abstract

Lipopolysaccharide (LPS), a component of Gram-negative bacteria, is a potent inflammatory stimulant, with high doses due to disseminated bacterial infection resulting in systemic inflammatory response syndrome and death. Lower doses can induce a state of tolerance to subsequent toxic doses of LPS, but extremely low doses have an opposite effect, priming the immune system for an even more violent response to subsequent challenge. A substantial body of research exists on the phenomenon of endotoxin tolerance, which appears to be a state of generalized dampening of inflammatory pathways. Comparatively little is known about the mechanisms or indeed the phenomenon of priming, particularly regarding the shift from a priming to a tolerizing response. Our aim is to review recent findings in the field of the inflammatory response to endotoxin, with a focus on highlighting the gaps in current understanding and attempting to reconcile the competing tolerance and priming phenomena.

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References

  • Albrecht V, Hofer TP, Foxwell B et al (2008) Tolerance induced via TLR2 and TLR4 in human dendritic cells: role of IRAK-1. BMC Immunol 9:69

    Article  PubMed  Google Scholar 

  • Arora M, Poe SL, Ray A et al (2011) LPS-induced CD11b(+)Gr1(int)F4/80(+) regulatory myeloid cells suppress allergen-induced airway inflammation. Int Immunopharmacol 11:827–832

    Article  PubMed  CAS  Google Scholar 

  • Berg DJ, Kühn R, Rajewsky K et al (1995) Interleukin-10 is a central regulator of the response to LPS in murine models of endotoxic shock and the Shwartzman reaction but not endotoxin tolerance. J Clin Invest 96:2339–2347

    Article  PubMed  CAS  Google Scholar 

  • Biswas SK, Lopez-Collazo E (2009) Endotoxin tolerance: new mechanisms, molecules and clinical significance. Trends Immunol 30:475–487

    Article  PubMed  CAS  Google Scholar 

  • Cavaillon J-M, Adrie C, Fitting C et al (2003) Endotoxin tolerance: is there a clinical relevance? J Endotoxin Res 9:101–107

    PubMed  CAS  Google Scholar 

  • Chaurasia B, Mauer J, Koch L et al (2010) Phosphoinositide-dependent kinase 1 provides negative feedback inhibition to Toll-like receptor-mediated NF-kappaB activation in macrophages. Mol Cell Biol 30:4354–4366

    Article  PubMed  CAS  Google Scholar 

  • Chen X, Yoza BK, El Gazzar M et al (2009) RelB sustains IkappaBalpha expression during endotoxin tolerance. Clin Vaccine Immunol 16:104–110

    Article  PubMed  CAS  Google Scholar 

  • Covert MW, Leung TH, Gaston JE et al (2005) Achieving stability of lipopolysaccharide-induced NF-kappaB activation. Science 309:1854–1857

    Article  PubMed  CAS  Google Scholar 

  • Eisenbarth SC, Piggott Da, Huleatt JW et al (2002) Lipopolysaccharide-enhanced, toll-like receptor 4-dependent T helper cell type 2 responses to inhaled antigen. J Exp Med 196:1645–1651

    Article  PubMed  CAS  Google Scholar 

  • Eken C, Martin PJ, Sadallah S et al (2010) Ectosomes released by polymorphonuclear neutrophils induce a MerTK-dependent anti-inflammatory pathway in macrophages. J Biol Chem 285:39914–39921

    Article  PubMed  CAS  Google Scholar 

  • Fan W, Morinaga H, Kim JJ et al (2010) FoxO1 regulates Tlr4 inflammatory pathway signalling in macrophages. EMBO J 29:4223–4236

    Article  PubMed  CAS  Google Scholar 

  • Ferrero E, Jiai D, Tsuberi BZ et al (1993) Transgenic mice expressing human CD14 are hypersensitive to lipopolysaccharide. Proc Natl Acad Sci USA 90:2380–2384

    Article  PubMed  CAS  Google Scholar 

  • Foster SL, Hargreaves DC, Medzhitov R (2007) Gene-specific control of inflammation by TLR-induced chromatin modifications. Nature 447:972–978

    PubMed  CAS  Google Scholar 

  • Galanos C, Freudenberg MA, Reutter W (1979) Galactosamine-induced sensitization to the lethal effects of endotoxin. Proc Natl Acad Sci USA 76:5939–5943

    Article  PubMed  CAS  Google Scholar 

  • Gasparini C, Foxwell BM, Feldmann M (2009) RelB/p50 regulates CCL19 production, but fails to promote human DC maturation. Eur J Immunol 39:2215–2223

    Article  PubMed  CAS  Google Scholar 

  • Gilchrist M, Thorsson V, Li B et al (2006) Systems biology approaches identify ATF3 as a negative regulator of toll-like receptor 4. Nature 441:173–178

    Article  PubMed  CAS  Google Scholar 

  • González-Navajas JM, Fine S, Law JE et al (2010) TLR4 signaling in effector CD4+ T cells regulates TCR activation and experimental colitis in mice. J Clin Invest 120:570–581

    Article  PubMed  Google Scholar 

  • Henricson BE, Manthey CL, Perera PY et al (1993) Dissociation of lipopolysaccharide (LPS)-inducible gene expression in murine macrophages pretreated with smooth LPS versus monophosphoryl lipid A. Infect Immun 61:2325–2333

    PubMed  CAS  Google Scholar 

  • Heremans H, Van Damme J, Dillen C et al (1990) Interferon gamma, a mediator of lethal lipopolysaccharide-induced Shwartzman-like shock reactions in mice. J Exp Med 171:1853–1869

    Article  PubMed  CAS  Google Scholar 

  • Hirohashi N, Morrison DC (1996) Low-dose lipopolysaccharide (LPS) pretreatment of mouse macrophages modulates LPS-dependent interleukin-6 production in vitro. Infect Immun 64:1011–1015

    PubMed  CAS  Google Scholar 

  • Hotchkiss RS, Tinsley KW, Swanson PE et al (2002) Depletion of dendritic cells, but not macrophages, in patients with sepsis. J Immunol 168:2493–2500

    PubMed  CAS  Google Scholar 

  • Huang W, Ghisletti S, Perissi V et al (2009) Transcriptional integration of TLR2 and TLR4 signaling at the NCoR derepression checkpoint. Mol Cell 35:48–57

    Article  PubMed  Google Scholar 

  • Jacinto R, Hartung T, McCall C, Li L (2002) Lipopolysaccharide- and lipoteichoic acid-induced tolerance and cross-tolerance: distinct alterations in IL-1 receptor-associated kinase. J Immunol 168:6136–6141

    PubMed  CAS  Google Scholar 

  • Jiang Z, Georgel P, Li C et al (2006) Details of toll-like receptor: adapter interaction revealed by germ-line mutagenesis. Proc Natl Acad Sci USA 103:10961–10966

    Article  PubMed  CAS  Google Scholar 

  • Kawasaki T, Ogata M, Kawasaki C et al (2001) Surgical stress induces endotoxin hyporesponsiveness and an early decrease of monocyte mCD14 and HLA-DR expression during surgery. Anesth Analg 92:1322–1326

    Article  PubMed  CAS  Google Scholar 

  • Li Y, Wei H (2009) Lipopolysaccharide “two-hit” induced refractory hypoxemia acute respiratory distress model in rats. J Huazhong Univ Sci Technolog Med Sci 29:470–475

    Article  PubMed  Google Scholar 

  • Li L, Cousart S, Hu J et al (2000) Characterization of interleukin-1 receptor-associated kinase in normal and endotoxin-tolerant cells. J Biol Chem 275:23340–23345

    Article  PubMed  CAS  Google Scholar 

  • Maitra U, Gan L, Chang S et al (2011) Low-dose endotoxin induces inflammation by selectively removing nuclear receptors and activating CCAAT/enhancer-binding protein {delta}. J Immunol 186:4467–4473

    Article  PubMed  CAS  Google Scholar 

  • McPhail LC, Clayton CC, Snyderman R (1984) The NADPH oxidase of human polymorphonuclear leukocytes. Evidence for regulation by multiple signals. J Biol Chem 259:5768–5775

    PubMed  CAS  Google Scholar 

  • Medina EA, Morris IR, Berton MT (2010) Phosphatidylinositol 3-kinase activation attenuates the TLR2-mediated macrophage proinflammatory cytokine response to Francisella tularensis live vaccine strain. J Immunol 185:7562–7572

    Article  PubMed  CAS  Google Scholar 

  • Medvedev AE, Kopydlowski KM, Vogel SN (2000) Inhibition of lipopolysaccharide-induced signal transduction in endotoxin-tolerized mouse macrophages: dysregulation of cytokine, chemokine, and toll-like receptor 2 and 4 gene expression. J Immunol 164:5564–5574

    PubMed  CAS  Google Scholar 

  • Motegi A, Kinoshita M, Sato K et al (2006) An in vitro Shwartzman reaction-like response is augmented age-dependently in human peripheral blood mononuclear cells. J Leukoc Biol 79:463–472

    Article  PubMed  CAS  Google Scholar 

  • Munford RS (2010) Murine responses to endotoxin: another dirty little secret? J Infect Dis 201:175–177

    Article  PubMed  CAS  Google Scholar 

  • Nimah M, Zhao B, Denenberg AG et al (2005) Contribution of MKP-1 regulation of p38 to endotoxin tolerance. Shock 23:80–87

    Article  PubMed  CAS  Google Scholar 

  • O’Dea KP, Wilson MR, Dokpesi JO et al (2009) Mobilization and margination of bone marrow Gr-1 high monocytes during subclinical endotoxemia predisposes the lungs toward acute injury. J Immunol 182:1155–1166

    PubMed  Google Scholar 

  • Pacquelet S, Johnson JL, Ellis BA et al (2007) Cross-talk between IRAK-4 and the NADPH oxidase. Biochem J 403:451–461

    Article  PubMed  CAS  Google Scholar 

  • Porta C, Rimoldi M, Raes G et al (2009) Tolerance and M2 (alternative) macrophage polarization are related processes orchestrated by p50 nuclear factor kappaB. Proc Natl Acad Sci USA 106:14978–14983

    Article  PubMed  CAS  Google Scholar 

  • Rocksén D, Koch B, Sandström T et al (2004) Lung effects during a generalized Shwartzman reaction and therapeutic intervention with dexamethasone or vitamin E. Shock 22:482–490

    Article  PubMed  Google Scholar 

  • Rodríguez D, Keller AC, Faquim-Mauro EL et al (2003) Bacterial lipopolysaccharide signaling through Toll-like receptor 4 suppresses asthma-like responses via nitric oxide synthase 2 activity. J Immunol 171:1001–1008

    PubMed  Google Scholar 

  • Rothlin CV, Ghosh S, Zuniga EI et al (2007) TAM receptors are pleiotropic inhibitors of the innate immune response. Cell 131:1124–1136

    Article  PubMed  CAS  Google Scholar 

  • Sivapalaratnam S, Farrugia R, Nieuwdorp M et al (2011) Identification of candidate genes linking systemic inflammation to atherosclerosis; results of a human in vivo LPS infusion study. BMC Med Genomics 4:64

    Article  PubMed  CAS  Google Scholar 

  • Slofstra SH, ten Cate H, Spek CA (2006) Low dose endotoxin priming is accountable for coagulation abnormalities and organ damage observed in the Shwartzman reaction. A comparison between a single-dose endotoxemia model and a double-hit endotoxin-induced Shwartzman reaction. Thromb J 4:13

    Article  PubMed  Google Scholar 

  • Sly LM, Rauh MJ, Kalesnikoff J et al (2004) LPS-induced upregulation of SHIP is essential for endotoxin tolerance. Immunity 21:227–239

    Article  PubMed  CAS  Google Scholar 

  • Steiner AA, Romanovsky AA (2007) Leptin: at the crossroads of energy balance and systemic inflammation. Prog Lipid Res 46:89–107

    Article  PubMed  CAS  Google Scholar 

  • Terawaki H, Yokoyama K, Yamada Y et al (2010) Low-grade endotoxemia contributes to chronic inflammation in hemodialysis patients: examination with a novel lipopolysaccharide detection method. Ther Apher Dial 14:477–482

    Article  PubMed  Google Scholar 

  • Vaknin I, Blinder L, Wang L et al (2008) A common pathway mediated through toll-like receptors leads to T- and natural killer-cell immunosuppression. Blood 111:1437–1447

    Article  PubMed  CAS  Google Scholar 

  • Wiersinga WJ, van’t Veer C, van den Pangaart PS et al (2009) Immunosuppression associated with interleukin-1R-associated-kinase-M upregulation predicts mortality in Gram-negative sepsis (melioidosis). Crit Care Med 37:569–576

    Article  PubMed  CAS  Google Scholar 

  • Xiong Y, Qiu F, Piao W et al (2011) Endotoxin tolerance impairs IL-1 receptor-associated kinase (IRAK) 4 and TGF-beta-activated kinase 1 activation, K63-linked polyubiquitination and assembly of IRAK1, TNF receptor-associated factor 6, and IkappaB kinase gamma and increases A20 expression. J Biol Chem 286:7905–7916

    Article  PubMed  CAS  Google Scholar 

  • Yoza BK, McCall CE (2011) Facultative heterochromatin formation at the IL-1 beta promoter in LPS tolerance and sepsis. Cytokine 53:145–152

    Article  PubMed  CAS  Google Scholar 

  • Yoza BK, Hu JY, Cousart SL et al (2006) Induction of RelB participates in endotoxin tolerance. J Immunol 177:4080–4085

    PubMed  CAS  Google Scholar 

  • Zhong B, Ma HY, Yang Q et al (2008) Decrease in toll-like receptors 2 and 4 in the spleen of mouse with endotoxic tolerance. Inflamm Res 57:252–259

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Liwu Li.

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Morris, M., Li, L. Molecular Mechanisms and Pathological Consequences of Endotoxin Tolerance and Priming. Arch. Immunol. Ther. Exp. 60, 13–18 (2012). https://doi.org/10.1007/s00005-011-0155-9

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  • DOI: https://doi.org/10.1007/s00005-011-0155-9

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