Project Summary
How can we promote health and survival during infection? Clinically, most patients are treated with drugs that
work to eliminate the pathogen: antibiotics, antivirals, antifungals, etc., but this approach is often insufficient.
The primary determinant of survival during infection is the host’s ability to prevent, withstand, or repair damage.
Thus, eliminating the pathogen is not necessarily sufficient for survival. This is particularly relevant during
sepsis, an infection in which the host response causes much more damage than the microbe itself. To address
this disconnect, over the past decade the Ayres lab has pioneered cooperative defenses, a new infection
defense framework focused on promoting health independent of pathogen burden. Cooperative defenses
include anti-virulence strategies which neutralize pathogen- or host-derived virulence signals before they cause
damage in the host (e.g. preventing maladaptive cytokine production) and disease tolerance strategies which
prevent physiological damage in the presence of virulence signals (e.g. metabolic shifts that prevent damage
from excess cytokine production). The Ayres lab has established a novel approach to identifying cooperative
defense mechanisms by leveraging the decades-old phenomenon of the lethal dose 50 (LD50). LD50 is the
dose of a pathogen that kills 50% of a genetically identical host population while the other 50% survives.
Strikingly, for many infections, surviving and dying LD50-infected mice exhibit the same pathogen burden
throughout the course of the infection, indicating that LD50-infected surviving mice survive due to differences in
their ability to engage cooperative defenses. An LD50 polymicrobial bacterial sepsis model has identified
serotonin neutralization as a candidate cooperative defense mechanism during sepsis. Preliminary data
demonstrates inhibiting peripheral serotonin during polymicrobial sepsis promotes health and survival through
cooperative defense mechanisms. While serotonin is most commonly studied in its role as a neurotransmitter,
95% of the body’s serotonin is found in the periphery, largely carried by platelets in circulation. Recent
research has begun to elucidate the role of this peripheral serotonin in regulating a wide variety of processes:
chief among these are inflammation and metabolism. Widespread platelet activation occurs during sepsis,
inducing platelet serotonin release, yet the effects of this serotonin and the means by which it is handled are
not well understood. Three specific aims will be addressed: 1) Determine the impact of serotonin on
cooperative defenses during sepsis, 2) Determine how inhibition of serotonin signaling promotes health and
survival during polymicrobial sepsis, and 3) Determine the mechanisms by which serotonin is neutralized
during a cooperative defense response to sepsis. This research will take place at the Salk Institute for
Biological Studies. In addition to these research objectives, the proposed training goals include improving
scientific mentoring and communication skills.