Skip to main content

Advertisement

Log in

Recombinant human milk fat globule-EGF factor 8 produces dose-dependent benefits in sepsis

  • Experimental
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Purpose

Animal milk fat globule-EGF factor 8 (MFG-E8) has been shown to be beneficial in attenuating the inflammatory response in sepsis. In this study, we examined the effect of recombinant human MFG-E8 (rhMFG-E8) in an animal model of sepsis in an effort to develop it as a potential therapy against sepsis in humans.

Methods

Rats were subjected to sepsis by cecal ligation and puncture (CLP), and at 5 h post-CLP, they were given different doses of rhMFG-E8 (20, 40, 80, 160 μg/kg BW) in normal saline. At 20 h post-CLP, samples were collected for further analysis. A 10-day survival study was also performed.

Results

At 20 h after CLP, organ injury indicators, serum IL-6 and TNF-α, and plasma HMGB-1 levels were significantly increased as compared to sham-operated animals. Treatment with 20 μg/kg rhMFG-E8 significantly reduced these levels. With higher doses, further reductions in AST and ALT (59–62%), creatinine (65–68%), and lactate (46–57%), and serum IL-6 and TNF-α were obtained. The 160 μg/kg dose produced the greatest reduction in serum TNF-α. With treatment with 20 μg/kg rhMFG-E8, HMGB-1 levels decreased by 80%, returning back to sham values. In a 10-day survival study, vehicle-treated animals produced a 36% survival rate, while rhMFG-E8 significantly improved the survival rate to 68–72%. Treatment with increasing doses of rhMFG-E8 significantly reduced the number of apoptotic cells detected and markedly attenuated the tissue damages observed in the lungs.

Conclusions

These data suggest that recombinant human MFG-E8 is beneficial in ameliorating sepsis in an animal model of sepsis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Levy MM, Dellinger RP, Townsend SR, Linde-Zwirble WT, Marshall JC, Bion J, Schorr C, Artigas A, Ramsay G, Beale R, Parker MM, Gerlach H, Reinhart K, Silva E, Harvey M, Regan S, Angus DC (2010) The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med 38:367–374

    Article  PubMed  Google Scholar 

  2. Dombrovskiy VY, Martin AA, Sunderram J, Paz HL (2007) Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003. Crit Care Med 35:1244–1250

    Article  PubMed  Google Scholar 

  3. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR (2001) Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29:1303–1310

    Article  PubMed  CAS  Google Scholar 

  4. Sprung CL, Zimmerman JL, Christian MD, Joynt GM, Hick JL, Taylor B, Richards GA, Sandrock C, Cohen R, Adini B (2010) Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster: summary report of the European Society of Intensive Care Medicine’s Task Force for intensive care unit triage during an influenza epidemic or mass disaster. Intensive Care Med 36:428–443

    Google Scholar 

  5. Briegel J, Sprung CL, Annane D, Singer M, Keh D, Moreno R, Mohnle P, Weiss Y, Avidan A, Brunkhorst FM, Fiedler F, Vogeser M (2009) Multicenter comparison of cortisol as measured by different methods in samples of patients with septic shock. Intensive Care Med 35:2151–2156

    Article  PubMed  CAS  Google Scholar 

  6. Bernard GR, Macias WL, Joyce DE, Williams MD, Bailey J, Vincent JL (2003) Safety assessment of drotrecogin alfa (activated) in the treatment of adult patients with severe sepsis. Crit Care 7:155–163

    Article  PubMed  Google Scholar 

  7. Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, Ely EW, Fisher CJ Jr (2001) Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 344:699–709

    Article  PubMed  CAS  Google Scholar 

  8. Stubbs JD, Lekutis C, Singer KL, Bui A, Yuzuki D, Srinivasan U, Parry G (1990) cDNA cloning of a mouse mammary epithelial cell surface protein reveals the existence of epidermal growth factor-like domains linked to factor VIII-like sequences. Proc Natl Acad Sci USA 87:8417–8421

    Article  PubMed  CAS  Google Scholar 

  9. Miyasaka K, Hanayama R, Tanaka M, Nagata S (2004) Expression of milk fat globule epidermal growth factor 8 in immature dendritic cells for engulfment of apoptotic cells. Eur J Immunol 34:1414–1422

    Article  PubMed  CAS  Google Scholar 

  10. Hanayama R, Tanaka M, Miwa K, Shinohara A, Iwamatsu A, Nagata S (2002) Identification of a factor that links apoptotic cells to phagocytes. Nature 417:182–187

    Article  PubMed  CAS  Google Scholar 

  11. Lotze MT, Tracey KJ (2005) High-mobility group box 1 protein (HMGB1): nuclear weapon in the immune arsenal. Nat Rev Immunol 5:331–342

    Article  PubMed  CAS  Google Scholar 

  12. Huber-Lang MS, Younkin EM, Sarma JV, McGuire SR, Lu KT, Guo RF, Padgaonkar VA, Curnutte JT, Erickson R, Ward PA (2002) Complement-induced impairment of innate immunity during sepsis. J Immunol 169:3223–3231

    PubMed  CAS  Google Scholar 

  13. Kaufmann I, Hoelzl A, Schliephake F, Hummel T, Chouker A, Peter K, Thiel M (2006) Polymorphonuclear leukocyte dysfunction syndrome in patients with increasing sepsis severity. Shock 26:254–261

    Article  PubMed  CAS  Google Scholar 

  14. Fink SL, Cookson BT (2005) Apoptosis, pyroptosis, and necrosis: mechanistic description of dead and dying eukaryotic cells. Infect Immun 73:1907–1916

    Article  PubMed  CAS  Google Scholar 

  15. Komura H, Miksa M, Wu R, Goyert SM, Wang P (2009) Milk fat globule epidermal growth factor–factor VIII is down-regulated in sepsis via the lipopolysaccharide-CD14 pathway. J Immunol 182:581–587

    PubMed  CAS  Google Scholar 

  16. Miksa M, Wu R, Dong W, Das P, Yang D, Wang P (2006) Dendritic cell-derived exosomes containing milk fat globule epidermal growth factor–factor VIII attenuate proinflammatory responses in sepsis. Shock 25:586–593

    Article  PubMed  CAS  Google Scholar 

  17. Miksa M, Wu R, Dong W, Komura H, Amin D, Ji Y, Wang Z, Wang H, Ravikumar TS, Tracey KJ, Wang P (2009) Immature dendritic cell-derived exosomes rescue septic animals via milk fat globule epidermal growth factor VIII. J Immunol 183:5983–5990

    Article  PubMed  CAS  Google Scholar 

  18. Andersson U, Tracey KJ (2003) HMGB1 in sepsis. Scand J Infect Dis 35:577–584

    Article  PubMed  CAS  Google Scholar 

  19. Moretta A (2002) Natural killer cells and dendritic cells: rendezvous in abused tissues. Nat Rev Immunol 2:957–964

    Article  PubMed  CAS  Google Scholar 

  20. Martin GS, Mannino DM, Eaton S, Moss M (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554

    Article  PubMed  Google Scholar 

  21. Weber P, Wang P, Maddens S, Wang P, Wu R, Miksa M, Dong W, Mortimore M, Golec JM, Charlton P (2009) VX-166: a novel potent small molecule caspase inhibitor as a potential therapy for sepsis. Crit Care 13:R146

    Article  PubMed  Google Scholar 

  22. Lauber K, Blumenthal SG, Waibel M, Wesselborg S (2004) Clearance of apoptotic cells: getting rid of the corpses. Mol Cell 14:277–287

    Article  PubMed  CAS  Google Scholar 

  23. Hanayama R, Tanaka M, Miyasaka K, Aozasa K, Koike M, Uchiyama Y, Nagata S (2004) Autoimmune disease and impaired uptake of apoptotic cells in MFG-E8-deficient mice. Science 304:1147–1150

    Article  PubMed  CAS  Google Scholar 

  24. Larocca D, Peterson JA, Urrea R, Kuniyoshi J, Bistrain AM, Ceriani RL (1991) A Mr 46, 000 human milk fat globule protein that is highly expressed in human breast tumors contains factor VIII-like domains. Cancer Res 51:4994–4998

    PubMed  CAS  Google Scholar 

  25. Oshima K, Aoki N, Negi M, Kishi M, Kitajima K, Matsuda T (1999) Lactation-dependent expression of an mRNA splice variant with an exon for a multiply O-glycosylated domain of mouse milk fat globule glycoprotein MFG-E8. Biochem Biophys Res Commun 254:522–528

    Article  PubMed  CAS  Google Scholar 

  26. Yamaguchi H, Takagi J, Miyamae T, Yokota S, Fujimoto T, Nakamura S, Ohshima S, Naka T, Nagata S (2008) Milk fat globule EGF factor 8 in the serum of human patients of systemic lupus erythematosus. J Leukoc Biol 83:1300–1307

    Article  PubMed  CAS  Google Scholar 

  27. Hu CY, Wu CS, Tsai HF, Chang SK, Tsai WI, Hsu PN (2009) Genetic polymorphism in milk fat globule-EGF factor 8 (MFG-E8) is associated with systemic lupus erythematosus in human. Lupus 18:676–681

    Article  PubMed  CAS  Google Scholar 

  28. Miksa M, Amin D, Wu R, Jacob A, Zhou M, Dong W, Yang WL, Ravikumar TS, Wang P (2008) Maturation-induced down-regulation of MFG-E8 impairs apoptotic cell clearance and enhances endotoxin response. Int J Mol Med 22:743–748

    PubMed  CAS  Google Scholar 

  29. Miksa M, Amin D, Wu R, Ravikumar TS, Wang P (2007) Fractalkine-induced MFG-E8 leads to enhanced apoptotic cell clearance by macrophages. Mol Med 13:553–560

    Article  PubMed  CAS  Google Scholar 

  30. Song G, Ouyang G, Bao S (2005) The activation of Akt/PKB signaling pathway and cell survival. J Cell Mol Med 9:59–71

    Article  PubMed  CAS  Google Scholar 

  31. Wu CH, Liu JY, Wu JP, Hsieh YH, Liu CJ, Hwang JM, Lee SD, Chen LM, Chang MH, Kuo WW, Shyu JC, Tsai JH, Huang CY (2005) 17beta-estradiol reduces cardiac hypertrophy mediated through the up-regulation of PI3 K/Akt and the suppression of calcineurin/NF-AT3 signaling pathways in rats. Life Sci 78:347–356

    Article  PubMed  CAS  Google Scholar 

  32. Jinushi M, Nakazaki Y, Carrasco DR, Draganov D, Souders N, Johnson M, Mihm MC, Dranoff G (2008) Milk fat globule EGF-8 promotes melanoma progression through coordinated Akt and twist signaling in the tumor microenvironment. Cancer Res 68:8889–8898

    Article  PubMed  CAS  Google Scholar 

  33. Aziz MM, Ishihara S, Mishima Y, Oshima N, Moriyama I, Yuki T, Kadowaki Y, Rumi MA, Amano Y, Kinoshita Y (2009) MFG-E8 attenuates intestinal inflammation in murine experimental colitis by modulating osteopontin-dependent alphavbeta3 integrin signaling. J Immunol 182:7222–7232

    Article  PubMed  CAS  Google Scholar 

  34. Cui T, Miksa M, Wu R, Komura H, Zhou M, Dong W, Wang Z, Higuchi S, Chaung W, Blau SA, Marini CP, Ravikumar TS, Wang P (2010) Milk fat globule epidermal growth factor 8 attenuates acute lung injury in mice after intestinal ischemia and reperfusion. Am J Respir Crit Care Med 181:238–246

    Article  PubMed  CAS  Google Scholar 

  35. Wu R, Chaung WW, Zhou M, Ji Y, Dong W, Wang Z, Qiang X, Wang P (2010) Milk fat globule EGF factor 8 attenuates sepsis-induced apoptosis and organ injury in alcohol-intoxicated rats. Alcohol Clin Exp Res 34:1625–1633

    Article  PubMed  CAS  Google Scholar 

  36. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent JL, Levy MM (2004) Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Intensive Care Med 30:536–555

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the National Institutes of Health (NIH) grants, R01GM057468 and R01GM053008 (P.W.).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ping Wang.

Additional information

One of the authors (P. Wang) is an inventor of the pending PCT application no. WO/2006/122327: “Milk fat globule epidermal growth factor-factor VIII and sepsis” and PCT application no. WO/2009/064448: “Prevention and treatment of inflammation and organ injury after ischemia/reperfusion using MFG-E8.” These patent applications cover the fundamental concept of using MFG-E8 for the treatment of sepsis and ischemia/reperfusion injury. The other authors report no financial conflicts of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 68 kb)

Supplementary material 2 (DOC 38 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shah, K.G., Wu, R., Jacob, A. et al. Recombinant human milk fat globule-EGF factor 8 produces dose-dependent benefits in sepsis. Intensive Care Med 38, 128–136 (2012). https://doi.org/10.1007/s00134-011-2353-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-011-2353-7

Keywords

Navigation