Targeting of cell-free DNA by DNase I diminishes endothelial dysfunction and inflammation in a rat model of cardiopulmonary bypass

Sci Rep. 2019 Dec 17;9(1):19249. doi: 10.1038/s41598-019-55863-8.

Abstract

The use of cardiopulmonary bypass (CPB) results in the activation of leukocytes, release of neutrophil extracellular traps (NETs) and severe inflammation. We hypothesize that targeting of circulating cell-free DNA (cfDNA) by DNases might represent a feasible therapeutic strategy to limit CPB-associated side effects. Male Wistar rats (n = 24) underwent CPB with deep hypothermic circulatory arrest (DHCA) and were divided into 3 groups: control (group 1), one i.v. bolus DNase I before CPB start (group 2) and a second DNase I dose before reperfusion (group 3). We found a positive correlation between plasma cfDNA/NETs levels and compromised endothelial vasorelaxation after CPB. DNase I administration significantly diminished plasma cfDNA/NETs levels. Further, a dose-dependent improvement in endothelial function accompanied by significant reduction of circulating intercellular adhesion molecule (ICAM)-1 was observed. Rats of group 3 had significantly reduced plasma IL-6 levels and downregulated expression of adhesion molecules resulting in impaired leukocyte extravasation and reduced MPO activity in lungs. Mechanistically, digestion of NETs by DNase I significantly diminished NETs-dependent upregulation of adhesion molecules in human endothelial cells. Altogether, systemic DNase I administration during CPB efficiently reduced cfDNA/NETs-mediated endothelial dysfunction and inflammation and might represents a promising therapeutic strategy for clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cardiopulmonary Bypass*
  • Cell-Free Nucleic Acids / blood*
  • Deoxyribonuclease I / pharmacology*
  • Extracellular Traps / metabolism*
  • Intercellular Adhesion Molecule-1 / blood
  • Interleukin-6 / blood
  • Lung / metabolism
  • Lung / pathology
  • Male
  • Peroxidase / metabolism
  • Rats
  • Rats, Wistar

Substances

  • Cell-Free Nucleic Acids
  • ICAM1 protein, rat
  • Il6 protein, rat
  • Interleukin-6
  • Intercellular Adhesion Molecule-1
  • Peroxidase
  • Deoxyribonuclease I