Regulation of Intestinal Mucosal Injury and Repair after Trauma/Hemorrhagic shock. PI: David J. Hackam, MD, PhD The long-term goal of the current proposal is to define the mechanisms that lead to the development of intestinal mucosal injury after trauma/hemorrhagic shock, and to develop novel therapeutic strategies to restore intestinal mucosal integrity after injury has occurred. Trauma/hemorrhagic shock is a leading cause of morbidity and mortality in children and adults, in part due to the development of systemic sepsis and multi-system organ injury (MSOF) several days after the initial injury has occurred. The mechanisms that lead to MSOF after trauma remain incompletely understood, yet a breakdown of the intestinal barrier with translocation of enteric bacteria has been shown to play a role in its development. We now hypothesize that activation of the innate immune system of the injured host damages the intestinal mucosal barrier, and that strategies that reduce innate immune system activation will maintain barrier integrity after trauma. To test this hypothesis, we propose the following aims:
Aim 1. To determine the role of enterocyte innate immune receptors Toll like receptor 4 (TLR4) and Toll like Receptor 9 (TLR9) in the pathogenesis of intestinal mucosal injury after trauma/hemorrhagic shock.
Aim 2. To assess the role of TLR9 activation with CpG-DNA in limiting TLR4 signaling in enterocytes via effects on IRAK-M signaling Aim 3. To determine the role of TLR9 activation with CpG-DNA in protecting against intestinal mucosal injury after trauma/hemorrhagic shock. We will seek to address these aims using a variety of cell biological and physiological techniques using cultured cells, primary enterocytes and in several strains of mice, including mice strains that we have engineered with mutations in innate immune receptor signaling or expression.

Public Health Relevance

The public health relevance of the current proposal lies in the fact that we are seeking to minimze the morbidity and mortality after trauma, which is currently the leading cause of death and disablity in children and young adults.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Specialized Center (P50)
Project #
5P50GM053789-14
Application #
8103247
Study Section
Special Emphasis Panel (ZGM1)
Project Start
Project End
Budget Start
2010-07-01
Budget End
2011-06-30
Support Year
14
Fiscal Year
2010
Total Cost
$262,386
Indirect Cost
Name
University of Pittsburgh
Department
Type
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
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Zettel, Kent; Korff, Sebastian; Zamora, Ruben et al. (2017) Toll-Like Receptor 4 on both Myeloid Cells and Dendritic Cells Is Required for Systemic Inflammation and Organ Damage after Hemorrhagic Shock with Tissue Trauma in Mice. Front Immunol 8:1672
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Li, Z; Scott, M J; Fan, E K et al. (2016) Tissue damage negatively regulates LPS-induced macrophage necroptosis. Cell Death Differ 23:1428-47
Namas, Rami A; Vodovotz, Yoram; Almahmoud, Khalid et al. (2016) Temporal Patterns of Circulating Inflammation Biomarker Networks Differentiate Susceptibility to Nosocomial Infection Following Blunt Trauma in Humans. Ann Surg 263:191-8

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