RIPK3 collaborates with GSDMD to drive tissue injury in lethal polymicrobial sepsis

Cell Death Differ. 2020 Sep;27(9):2568-2585. doi: 10.1038/s41418-020-0524-1. Epub 2020 Mar 9.

Abstract

Sepsis is a systemic inflammatory disease causing life-threatening multi-organ dysfunction. Accumulating evidences suggest that two forms of programmed necrosis, necroptosis and pyroptosis triggered by the pathogen component lipopolysaccharide (LPS) and inflammatory cytokines, play important roles in the development of bacterial sepsis-induced shock and tissue injury. Sepsis-induced shock and tissue injury required receptor-interacting protein kinase-3 (RIPK3) and mixed lineage kinase domain-like protein (MLKL) phosphorylation, caspase11 activation and gasdermin D (GSDMD) cleavage. However, the synergistic effect of necroptosis and pyroptosis in the pathological progress of sepsis remains elusive. In this study, we found that blockage of both necroptosis and pyroptosis (double deletion of Ripk3/Gsdmd or Mlkl/Gsdmd) resulted in accumulative protection against septic shock, systemic blood clotting and multi-organ injury in mice. Bone marrow transplantation confirmed that necroptosis and pyroptosis in both myeloid and nonmyeloid cells are indispensable in the progression of sepsis-induced multi-organ injury. Both RIPK3 and GSDMD signaling collaborated to amplify necroinflammation and tissue factor release in macrophages and endothelial cells, which led to tissue injury. Furthermore, cell death induced by inflammatory cytokines and high-mobility group box 1 could be prevented by double ablation of Ripk3/Gsdmd or Mlkl/Gsdmd, suggesting that a positive feedback loop interconnecting RIPK3/MLKL and GSDMD machinery and inflammation facilitated sepsis progression. Collectively, our findings demonstrated that RIPK3-mediated necroptosis and GSDMD-mediated pyroptosis collaborated to amply inflammatory signaling and enhance tissue injury in the process of sepsis, which may shed new light on two potential targets of combined therapeutic interventions for this highly lethal disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Lung Injury / blood
  • Acute Lung Injury / etiology
  • Animals
  • Blood Coagulation
  • Cecum / pathology
  • Cell Movement
  • Endothelial Cells / metabolism
  • Endothelial Cells / pathology
  • Gene Deletion
  • Inflammation / pathology
  • Interleukin-1beta / metabolism
  • Intestines / pathology
  • Intracellular Signaling Peptides and Proteins / deficiency
  • Intracellular Signaling Peptides and Proteins / metabolism*
  • Ligation
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Monocytes / pathology
  • Myeloid Cells / pathology
  • Necroptosis
  • Neutrophils / pathology
  • Organ Specificity*
  • Phosphate-Binding Proteins / deficiency
  • Phosphate-Binding Proteins / metabolism*
  • Punctures
  • Pyroptosis
  • Receptor-Interacting Protein Serine-Threonine Kinases / deficiency
  • Receptor-Interacting Protein Serine-Threonine Kinases / metabolism*
  • Sepsis / metabolism*
  • Sepsis / microbiology*
  • Sepsis / pathology
  • Sepsis / prevention & control
  • Signal Transduction
  • Thromboplastin / metabolism

Substances

  • Gsdmd protein, mouse
  • Interleukin-1beta
  • Intracellular Signaling Peptides and Proteins
  • Phosphate-Binding Proteins
  • Thromboplastin
  • Receptor-Interacting Protein Serine-Threonine Kinases
  • Ripk3 protein, mouse