Fernando Spiller1, Carlotta Costa2, Fabrício O. Souto1, Francesca Vinchi2, Fabíola L. A. C. Mestriner1, Helen J. Laure3,4, José C. Alves-Filho1, Andressa Freitas1, José C. Rosa3–5, Sérgio H. Ferreira1, Fiorella Altruda2, Emilio Hirsch2, Lewis J. Greene3–5, Emanuela Tolosano2,* and Fernando Q. Cunha1,* American Journal of Respiratory and Critical Care Medicine Vol 183. pp. 922-931, (2011). Published ahead of print on October 22, 2010, doi:10.1164/rccm.201002-0223OC
Rationale: The reduction of neutrophil migration to the bacterial focus is associated with poor outcome in sepsis.

Objectives: The objective of this study was to identify soluble substances in the blood of septic mice that inhibit neutrophil migration.

Methods: A pool of serum obtained from mice 2 hours after the induction of severe sepsis by cecal ligation and puncture inhibited the neutrophil migration. The proteins with inhibitory activity on neutrophil migration were isolated by Blue-Sepharose chromatography, high-performance liquid chromatography, and electrophoresis, and identified by mass spectrometry.

Measurements and Main Results: Hemopexin was identified as the serum component responsible for the inhibition of neutrophil migration. In sepsis, the pretreatment of wild-type mice with hemopexin inhibited neutrophil migration to the focus of infection and decreased the survival rate from 87.5 to 50.0%. Hemopexin-null mice subjected to severe sepsis presented normal neutrophil migration, low bacteremia, and an improvement of 40% in survival rate. Moreover, hemopexin inhibited the neutrophil chemotaxis response evoked by C5a or macrophage inflammatory protein-2 and induced a reduction of CXCR2 and L-selectin as well as the up-regulation of CD11b expression in neutrophil membranes. The inhibitory effect of hemopexin on neutrophil chemotaxis was prevented by serine protease inhibitors or ATP. In addition, serum levels of ATP were decreased 2 hours after severe sepsis.

Conclusions: These data demonstrate for the first time the inhibitory role of hemopexin in neutrophil migration during sepsis and suggest that the therapeutic inhibition of hemopexin or its protease activity could improve neutrophil migration to the focus of infection and survival in sepsis.

Weblink here