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      A nanotrap improves survival in severe sepsis by attenuating hyperinflammation

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          Abstract

          Targeting single mediators has failed to reduce the mortality of sepsis. We developed a telodendrimer (TD) nanotrap (NT) to capture various biomolecules via multivalent, hybrid and synergistic interactions. Here, we report that the immobilization of TD-NTs in size-exclusive hydrogel resins simultaneously adsorbs septic molecules, e.g. lipopolysaccharides (LPS), cytokines and damage- or pathogen-associated molecular patterns (DAMPs/PAMPs) from blood with high efficiency (92–99%). Distinct surface charges displayed on the majority of pro-inflammatory cytokines (negative) and anti-inflammatory cytokines (positive) allow for the selective capture via TD NTs with different charge moieties. The efficacy of NT therapies in murine sepsis is both time-dependent and charge-dependent. The combination of the optimized NT therapy with a moderate antibiotic treatment results in a 100% survival in severe septic mice by controlling both infection and hyperinflammation, whereas survival are only 50–60% with the individual therapies. Cytokine analysis, inflammatory gene activation and tissue histopathology strongly support the survival benefits of treatments.

          Abstract

          Sepsis is a difficult to treat condition. Here, the authors present a telodendrimer nanotrap that captures inflammator mediators to improve survival in combination with antibiotic treatment.

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          Most cited references36

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          PAMP s and DAMP s: signal 0s that spur autophagy and immunity

          Summary Pathogen‐associated molecular pattern molecules (PAMPs) are derived from microorganisms and recognized by pattern recognition receptor (PRR)‐bearing cells of the innate immune system as well as many epithelial cells. In contrast, damage‐associated molecular pattern molecules (DAMPs) are cell‐derived and initiate and perpetuate immunity in response to trauma, ischemia, and tissue damage, either in the absence or presence of pathogenic infection. Most PAMPs and DAMPs serve as so‐called ‘Signal 0s’ that bind specific receptors [Toll‐like receptors, NOD‐like receptors, RIG‐I‐like receptors, AIM2‐like receptors, and the receptor for advanced glycation end products (RAGE)] to promote autophagy. Autophagy, a conserved lysosomal degradation pathway, is a cell survival mechanism invoked in response to environmental and cellular stress. Autophagy is inferred to have been present in the last common eukaryotic ancestor and only to have been lost by some obligatory intracellular parasites. As such, autophagy represents a unifying biology, subserving survival and the earliest host defense strategies, predating apoptosis, within eukaryotes. Here, we review recent advances in our understanding of autophagic molecular mechanisms and functions in emergent immunity.
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            Innate immune sensing and its roots: the story of endotoxin.

            How does the host sense pathogens? Our present concepts grew directly from longstanding efforts to understand infectious disease: how microbes harm the host, what molecules are sensed and, ultimately, the nature of the receptors that the host uses. The discovery of the host sensors--the Toll-like receptors--was rooted in chemical, biological and genetic analyses that centred on a bacterial poison, termed endotoxin.
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              Cecal ligation and puncture: the gold standard model for polymicrobial sepsis?

              Sepsis is a serious medical condition characterized by dysregulated systemic inflammatory responses followed by immunosuppression. To study the pathophysiology of sepsis, diverse animal models have been developed. Polymicrobial sepsis induced by cecal ligation and puncture (CLP) is the most frequently used model because it closely resembles the progression and characteristics of human sepsis. Here we summarize the role of several immune components in the pathogenesis of sepsis induced by CLP. However, several therapies proposed on the basis of promising results obtained by CLP could not be translated to the clinic. This demonstrates that experimental sepsis models do not completely mimic human sepsis. We propose several strategies to narrow the gap between experimental sepsis models and clinical sepsis, including targeting factors that contribute to the immunosuppressive phase of sepsis, and reproducing the heterogeneity of human patients. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                luoj@upstate.edu
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                7 July 2020
                7 July 2020
                2020
                : 11
                : 3384
                Affiliations
                [1 ]ISNI 0000 0000 9159 4457, GRID grid.411023.5, Department of Pharmacology, , State University of New York Upstate Medical University, ; Syracuse, NY 13210 USA
                [2 ]ISNI 0000 0000 9159 4457, GRID grid.411023.5, Department of Surgery, , State University of New York Upstate Medical University, ; Syracuse, NY 13210 USA
                [3 ]Department of Pathology, Baylor Scott and White Medical Center, Temple, TX 76508 USA
                [4 ]ISNI 0000 0000 9159 4457, GRID grid.411023.5, Sepsis Interdisciplinary Research Center, , State University of New York Upstate Medical University, ; Syracuse, NY 13210 USA
                [5 ]ISNI 0000 0000 9159 4457, GRID grid.411023.5, Upstate Cancer Center, , State University of New York Upstate Medical University, ; Syracuse, NY 13210 USA
                [6 ]ISNI 0000 0004 1936 9094, GRID grid.40263.33, Present Address: Brown University, ; Providence, RI 02912 USA
                Author information
                http://orcid.org/0000-0002-3288-8572
                http://orcid.org/0000-0002-3538-9453
                Article
                17153
                10.1038/s41467-020-17153-0
                7341815
                32636379
                ab96f4a8-a096-4091-9568-b934cb936f5e
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 22 March 2018
                : 8 June 2020
                Funding
                Funded by: FundRef https://doi.org/10.13039/100000057, U.S. Department of Health & Human Services | NIH | National Institute of General Medical Sciences (NIGMS);
                Award ID: 1R01GM130941-01
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/100000050, U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI);
                Award ID: 1R01HL139824-01
                Award Recipient :
                Categories
                Article
                Custom metadata
                © The Author(s) 2020

                Uncategorized
                translational research,molecular medicine
                Uncategorized
                translational research, molecular medicine

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