Activating Multiorgan Antioxidative Gene Network for Treating Sepsis
ABSTRACT
Despite more than three decades of extensive research, sepsis remains the chief cause of death in intensive
care units. Currently, there is no specific treatment for sepsis. Thus, it is imperative to develop effective
therapies for managing this dread disorder. The exact pathophysiology of sepsis remains to be elucidated. It is
thought that sepsis is the culmination of complex interactions between the infecting microorganisms and the
host inflammatory cells, leading to dysregulated inflammation, multiple organ failure, and death. In this context,
substantial studies support a causal role for reactive oxygen and nitrogen species (ROS/RNS) and the
consequent oxidative/inflammatory stress in the development and progression of multiple organ injury in sepsis
in both animals and humans. However, exogenous antioxidant-based therapies have been unsuccessful
possibly due to their limited ability to scavenge ROS/RNS and counteract oxidative/inflammatory stress. As
coordinated actions of a series of endogenous Nrf2-regulated antioxidative/anti-inflammatory (AO/AI) enzymes
are essential for efficient detoxification of ROS/RNS in target organs, we propose a novel strategy to treat
sepsis via activating the endogenous Nrf2-regulated AO/AI gene network in multiple vital organs. Our long-
term objective is to develop an innovative mechanistically-based effective modality targeting multiple vital
organs to treat sepsis. The central hypothesis of this R15 application is that the simultaneous coordinated
activation of the Nrf2-regulated AO/AI gene network in multiple organs by the novel Nrf2-activating agent, 3H-
1,2-dithiole-3-thione (D3T) is an innovative and highly effective therapeutic strategy to protect against
oxidative/inflammatory stress and multiorgan dysfunction and failure in experimental sepsis. This hypothesis is
supported by our preliminary studies showing a nearly complete protection by D3T against endotoxemia-
induced mortality in mice. Accordingly, the specific aims of this R15 proposal are designed to systematically
(1) investigate the upregulation of endogenous AO/AI defenses by D3T in multiple organs, including the heart,
lung, liver, kidney, and intestine, and the underlying signaling mechanisms in mice; (2) determine the
therapeutic effects of D3T-induced multiorgan AO/AI defenses in the pathophysiological process of LPS-
induced endotoxemia and the signaling mechanisms in mice; and (3) investigate the therapeutic effects of
D3T-induced multiorgan AO/AI defenses in the pathophysiological process of polymicrobial sepsis induced by
cecal ligation and puncture (CLP) and the signaling mechanisms in mice. The proposed studies will provide
novel insights into the molecular basis of pharmacological activation of multiorgan AO/AI genes to protect
against multiple organ dysfunction and failure in sepsis and will contribute to the development of an effective
D3T-based therapeutic modality targeting Nrf2-regulated multiorgan AO/AI genes to treat human sepsis. This
project is well within the PI’s extensive research and student training expertises, and will provide a unique
opportunity for training additional undergraduate students doing innovative research at the PI’s institution.