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PCSK9 Promotes Endothelial Dysfunction During Sepsis Via the TLR4/MyD88/NF-κB and NLRP3 Pathways

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Abstract

Endothelial dysfunction often accompanies sepsis. We aimed to explore the role of PCSK9 in septic endothelial dysfunction. Sepsis was induced by lipopolysaccharide (LPS) treatment of human umbilical vein endothelial cells (HUVECs) in vitro and cecal ligation and puncture (CLP) surgery in mice in vivo. Evolocumab (EVC) and Pep 2–8, PCSK9 inhibitors, were subsequently used to determine the role of PCSK9 in sepsis-induced endothelial dysfunction in vitro and in vivo, respectively. In addition, the TLR4 agonist, Kdo2-Lipid A ammonium (KLA), was used to determine the related mechanism. Protein expression of eNOS, VE-cadherin, PCSK9, TLR4, MyD88, p-p65, p65, NLRP3, ASC, and caspase-1 p20 in mice aortas and HUVECs was measured by western blotting, while mRNA expression of TNFα, IL-1β, and IL-18 was determined by qRT-PCR. The level of inflammatory cytokines of mouse aortas was visualized by immunohistochemistry. Vasodilation of the aorta was detected by vascular reactivity experiments. The 96-h survival rate after CLP was assessed. Our findings showed that the expression of eNOS and VE-cadherin decreased, and PCSK9 expression increased, in septic HUVECs or mice. Inhibition of PCSK9 increased eNOS and VE-cadherin expression. Activation of the TLR4/MyD88/NF-κB and NLRP3 pathways may be responsible for PCSK9-induced endothelial dysfunction in sepsis. Vascular reactivity tests and survival studies showed that inhibition of PCSK9 could prevent the decrease in endothelium-dependent vasodilation function and improve the survival rates of septic mice. In summary, our results suggested that increased PCSK9 expression during sepsis activated the TLR4/MyD88/NF-κB and NLRP3 pathways to induce inflammation, which resulted in vascular endothelial dysfunction and decreased survival rates. Thus, inhibition of PCSK9 may be a potential clinical therapeutic target to improve vascular endothelial function in sepsis.

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The data and materials used in this study are available from the corresponding authors upon reasonable request.

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Funding

This work was supported by the National Natural Science Foundation of China (82070238).

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Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

    Longxiang Huang, Yuanjing Li, Suxin Luo & Yong Xia

  2. Department of Cardiology, Chongqing University, Three Gorges Hospital & Chongqing Three Gorges Central Hospital, Chongqing, 404000, China

    Zhe Cheng

  3. Department of Obstetrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China

    Zi Lv

  4. Division of Cardiovascular Medicine, Davis Heart & Lung Research Institute, The Ohio State University College of Medicine, Columbus, OH, 43210, USA

    Yong Xia

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Contributions

SL and YX conceived this idea. LH and ZC performed the experiments in vitro. LH and ZL performed the experiments in vivo. YL participated in the collection, analysis, and interpretation of the data. LH wrote the manuscript. All authors read and approved the final manuscript.

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Correspondence to Suxin Luo or Yong Xia.

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Animal experiments were performed in accordance with the National Animal Protection and Use Guidelines and approved by the local ethical committee of the First Affiliated Hospital of Chongqing Medical University (No: 2021–706). The newborn umbilical cord was obtained from the First Affiliated Hospital of Chongqing Medical University, and the experiments were approved by the local ethical committee of the First Affiliated Hospital of Chongqing Medical University (No: 2021–689).

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Huang, L., Li, Y., Cheng, Z. et al. PCSK9 Promotes Endothelial Dysfunction During Sepsis Via the TLR4/MyD88/NF-κB and NLRP3 Pathways. Inflammation 46, 115–128 (2023). https://doi.org/10.1007/s10753-022-01715-z

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