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Molecular Medicine

, Volume 20, Issue 1, pp 639–648 | Cite as

Toll-like Receptor 4 (TLR4) Antagonist Eritoran Tetrasodium Attenuates Liver Ischemia and Reperfusion Injury through Inhibition of High-Mobility Group Box Protein B1 (HMGB1) Signaling

  • Kerry-Ann McDonald
  • Hai Huang
  • Samer Tohme
  • Patricia Loughran
  • Kimberly Ferrero
  • Timothy Billiar
  • Allan Tsung
Research Article

Abstract

Toll-like receptor 4 (TLR4) is ubiquitously expressed on parenchymal and immune cells of the liver and is the most studied TLR responsible for the activation of proinflammatory signaling cascades in liver ischemia and reperfusion (I/R). Since pharmacological inhibition of TLR4 during the sterile inflammatory response of I/R has not been studied, we sought to determine whether eritoran, a TLR4 antagonist trialed in sepsis, could block hepatic TLR4-mediated inflammation and end organ damage. When C57BL/6 mice were pretreated with eritoran and subjected to warm liver I/R, there was significantly less hepatocellular injury compared to control counterparts. Additionally, we found that eritoran is protective in liver I/R through inhibition of high-mobility group box protein B1 (HMGB1)-mediated inflammatory signaling. When eritoran was administered in conjunction with recombinant HMGB1 during liver I/R, there was significantly less injury, suggesting that eritoran blocks the HMGB1-TLR4 interaction. Not only does eritoran attenuate TLR4-dependent HMGB1 release in vivo, but this TLR4 antagonist also dampened HMGB1’s release from hypoxic hepatocytes in vitro and thereby weakened HMGB1’s activation of innate immune cells. HMGB1 signaling through TLR4 makes an important contribution to the inflammatory response seen after liver I/R. This study demonstrates that novel blockade of HMGB1 by the TLR4 antagonist eritoran leads to the amelioration of liver injury.

Notes

Acknowledgments

This work was supported by a Howard Hughes Medical Institute Physician-Scientist Award (to A Tsung), R01-GM95566 (to A Tsung) and R01-GM50441 (to T Billiar). The authors would like to thank Eisai for the generous gift of eritroran and Xinghua Liao for technical assistance in preparing the manuscript.

Supplementary material

10020_2014_2001639_MOESM1_ESM.pdf (1 mb)
Supplementary material, approximately 1.04 MB.

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Authors and Affiliations

  • Kerry-Ann McDonald
    • 1
  • Hai Huang
    • 1
  • Samer Tohme
    • 1
  • Patricia Loughran
    • 2
  • Kimberly Ferrero
    • 1
  • Timothy Billiar
    • 1
  • Allan Tsung
    • 1
    • 3
  1. 1.Department of SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Center for Biologic Imaging, Department of Cell BiologyUniversity of Pittsburgh Medical CenterPittsburghUSA
  3. 3.South PittsburghUSA

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