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,||,1
* Department of Biomedical Research, TNO-Quality of Life, Leiden; Departments of
General Internal Medicine,
Vascular Surgery,
Infectious Diseases, and
|| Cardiology, Leiden University Medical Center, Leiden, The Netherlands;
¶ Department of Internal Medicine, Division of Infectious Diseases, UT Southwestern Medical Center, Dallas, Texas, USA; and
** Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
1Correspondence: Leiden University Medical Center, Department Endocrinology and Metabolism, C4-R81, Albinusdreef 2, P.O. Box 9600, 2300 RC Leiden, The Netherlands. E-mail: p.c.n.rensen{at}lumc.nl
ABSTRACT
Gram-negative sepsis is a major death cause in intensive care units. Accumulating evidence indicates the protective role of plasma lipoproteins such as high-density lipoprotein (HDL) in sepsis. It has recently been shown that septic HDL is almost depleted from apolipoprotein CI (apoCI), suggesting that apoCI may be a protective factor in sepsis. Sequence analysis revealed that apoCI possesses a highly conserved consensus KVKEKLK binding motif for lipopolysaccharide (LPS), an outer-membrane component of Gram-negative bacteria. Through avid binding to LPS involving this motif, apoCI improved the presentation of LPS to macrophages in vitro and in mice, thereby stimulating the inflammatory response to LPS. Moreover, apoCI dose-dependently increased the early inflammatory response to Klebsiella pneumoniae-induced pneumonia, reduced the number of circulating bacteria, and protected mice against fatal sepsis. Our data support the hypothesis that apoCI is a physiological protector against infection by enhancing the early inflammatory response to LPS and suggest that timely increase of apoCI levels could be used to efficiently prevent and treat early sepsis.—Berbée, J. F. P., van der Hoogt, C. C., Kleemann, R., Schippers, E. F., Kitchens, R. L., van Dissel, J. T., Bakker-Woudenberg, I. A. J. M., Havekes, L. M., Rensen, P. C. N. Apolipoprotein CI stimulates the response to lipopolysaccharide and reduces mortality in Gram-negative sepsis.
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