One million newborn children die each year from sepsis. Mortality rates among these children range from 10-40% depending on birth weight and age at onset of sepsis, but are especially high in very low birth weight infants (VLBW). Very little is known about how neonates differ from young adults, and thus, therapeutic opportunities are limited and often based on therapies meant for adults. Based on our published and preliminary observations, our central belief is that the neonate has greater risk to sepsis- induced organ injury and mortality because of differences in adaptor signaling in the early innate immune response. More specifically, we propose that TRIF signaling leading to downstream CXCL10 production is defective in neonates, and that neonate survival to sepsis is adversely affected by these defective signaling pathways.
Our specific aims are to (1) characterize the importance of TRIF-dependent signaling in neonatal versus adult murine sepsis, (2) determine the role of TRIF-dependent CXCL10 production in murine neonatal sepsis, and, (3) identify the role of TRIF and CXCL10 signaling pathways as a 'target'for therapeutic modality for murine neonatal sepsis. We will use a neonatal mouse model of polymicrobial peritonitis (sepsis) that we have developed and validated, and evaluate the importance of TRIF signaling and CXCL10 through both genetic (TRIF-/-, MyD88-/- knockouts) and pharmacologic approaches. Post-partum day 4-7 mice (neonate) and 5-7 week old mice (young adult) will have sepsis induced. In some cases, TRIF and MyD88 signaling pathways will be eliminated by using knockout mice and the dependence of these pathways on CXCL10 production and antimicrobial responses will be evaluated. Similarly, we will block CXCL10 activity pharmacologically. The alternative approach will be to use TLR agonists and CXCL10 as an adjuvant for neonatal mice subjected to polymicrobial sepsis, and evaluate outcomes and antimicrobial responses. These studies will lead to a better fundamental understanding of the neonatal response to sepsis and elucidate possible pathways that may be used to augment neonatal responses. Importantly, this application addresses multiple """"""""Healthy People 2010"""""""" objectives to reduce infant morbidity and mortality related to sepsis, and may lead to the discovery of novel therapeutics that will enhance the survival of these particularly susceptible children.

Public Health Relevance

Newborn infants, especially very low birthweight infants are at increased risk of developing sepsis and dying from it. We propose that this increased susceptibility is due to defects in innate immunity and production of chemokines, particularly CXCL10. Studies are proposed to examine differential adaptor signaling in murine neonatal sepsis, and explore the use of adjuvants that will enhance survival.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Research Project (R01)
Project #
1R01GM097531-01
Application #
8093830
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Program Officer
Dunsmore, Sarah
Project Start
2011-04-01
Project End
2015-01-31
Budget Start
2011-04-01
Budget End
2012-01-31
Support Year
1
Fiscal Year
2011
Total Cost
$278,350
Indirect Cost
Name
University of Florida
Department
Surgery
Type
Schools of Medicine
DUNS #
969663814
City
Gainesville
State
FL
Country
United States
Zip Code
32611
Raymond, Steven L; Rincon, Jaimar C; Wynn, James L et al. (2017) Impact of Early-Life Exposures to Infections, Antibiotics, and Vaccines on Perinatal and Long-term Health and Disease. Front Immunol 8:729
Raymond, Steven L; Holden, David C; Mira, Juan C et al. (2017) Microbial recognition and danger signals in sepsis and trauma. Biochim Biophys Acta 1863:2564-2573
Mathias, Brittany; Mira, Juan C; Rehfuss, Jonathan P et al. (2017) LPS Stimulation of Cord Blood Reveals a Newborn-Specific Neutrophil Transcriptomic Response and Cytokine Production. Shock 47:606-614
Rincon, J C; Cuenca, A L; Raymond, S L et al. (2017) Adjuvant pretreatment with alum protects neonatal mice in sepsis through myeloid cell activation. Clin Exp Immunol :
Raymond, Steven L; López, María Cecilia; Baker, Henry V et al. (2017) Unique transcriptomic response to sepsis is observed among patients of different age groups. PLoS One 12:e0184159
Raymond, Steven L; Mathias, Brittany J; Murphy, Tyler J et al. (2017) Neutrophil chemotaxis and transcriptomics in term and preterm neonates. Transl Res 190:4-15
Stortz, Julie A; Raymond, Steven L; Mira, Juan C et al. (2017) Murine Models of Sepsis and Trauma: Can We Bridge the Gap? ILAR J 58:90-105
Mathias, Brittany; Mira, Juan C; Larson, Shawn D (2016) Pediatric sepsis. Curr Opin Pediatr 28:380-7
Wynn, James Lawrence; Wilson, Chris S; Hawiger, Jacek et al. (2016) Targeting IL-17A attenuates neonatal sepsis mortality induced by IL-18. Proc Natl Acad Sci U S A 113:E2627-35
Cuenca, Alex G; Joiner, Dallas N; Gentile, Lori F et al. (2015) TRIF-dependent innate immune activation is critical for survival to neonatal gram-negative sepsis. J Immunol 194:1169-77

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