Angiopoietin 2 mediates microvascular and hemodynamic alterations in sepsis

作者：Ziegler Tilman; Horstkotte Jan; Schwab Claudia; Pfetsch Vanessa; Weinmann Karolina; Dietzel Steffen; Rohwedder Ina; Hinkel Rabea; Gross Lisa; Lee Seungmin; Hu Junhao; Soehnlein Oliver; Franz Wolfgang M; Sperandio Markus; Pohl Ulrich; Thomas Markus; Weber Christian; Augustin Hellmut G; Faessler Reinhard; Deutsch Urban; Kupatt Christian^*

来源：Journal of Clinical Investigation, 2013, 123(8): 3436-3445.

DOI：10.1172/JCI66549

Septic shock is characterized by increased vascular permeability and hypotension despite increased cardiac output. Numerous vasoactive cytokines are upregulated during sepsis, including angiopoietin 2 (ANG2), which increases vascular permeability. Here we report that mice engineered to inducibly overexpress ANG2 in the endothelium developed sepsis-like hemodynamic alterations, including systemic hypotension, increased cardiac output, and dilatory cardiomyopathy. Conversely, mice with carcliomyocyte-restricted ANG2 overexpression failed to develop hemodynamic alterations. Interestingly, the hemodynamic alterations associated with endothelial-specific overexpression of ANG2 and the loss of capillary-associated pericytes were reversed by intravenous injections of adeno-associated viruses (AAVs) transducing cDNA for angiopoietin 1, a TIE2 ligand that antagonizes ANG2, or AAVs encoding PDGFB, a chemoattractant for pericytes. To confirm the role of ANG2 in sepsis, we i.p. injected LPS into C57BL/6J mice, which rapidly developed hypotension, acute pericyte loss, and increased vascular permeability. Importantly, ANG2 antibody treatment attenuated LPS-induced hemodynamic alterations and reduced the mortality rate at 36 hours from 95% to 61%. These data indicate that ANG2-mediated microvascular disintegration contributes to septic shock and that inhibition of the ANG2/TIE2 interaction during sepsis is a potential therapeutic target.

• 出版日期2013-8