TY - JOUR
T1 - Endothelial eNAMPT amplifies pre-clinical acute lung injury: efficacy of an eNAMPT-neutralising monoclonal antibody
AU - Quijada, Hector
AU - Bermudez, Tadeo
AU - Kempf, Carrie L.
AU - Valera, Daniel G.
AU - Garcia, Alexander N.
AU - Camp, Sara M.
AU - Song, Jin H.
AU - Franco, Evelyn
AU - Burt, Jessica K.
AU - Sun, Belinda
AU - Mascarenhas, Joseph B.
AU - Burns, Kimberlie
AU - Gaber, Amir
AU - Oita, Radu C.
AU - Reyes Hernon, Vivian
AU - Barber, Christy
AU - Moreno-Vinasco, Liliana
AU - Sun, Xiaoguang
AU - Cress, Anne E.
AU - Martin, Diego
AU - Liu, Zhonglin
AU - Desai, Ankit A.
AU - Natarajan, Viswanathan
AU - Jacobson, Jeffrey R.
AU - Dudek, Steven M.
AU - Bime, Christian
AU - Sammani, Saad
AU - Garcia, Joe G.N.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Rationale The severe acute respiratory syndrome coronavirus 2/coronavirus disease 2019 pandemic has highlighted the serious unmet need for effective therapies that reduce acute respiratory distress syndrome (ARDS) mortality. We explored whether extracellular nicotinamide phosphoribosyltransferase (eNAMPT), a ligand for Toll-like receptor (TLR)4 and a master regulator of innate immunity and inflammation, is a potential ARDS therapeutic target.Methods Wild-type C57BL/6J or endothelial cell (EC)-cNAMPT−/− knockout mice (targeted EC NAMPT deletion) were exposed to either a lipopolysaccharide (LPS)-induced (“one-hit”) or a combined LPS/ventilator (“two-hit”)-induced acute inflammatory lung injury model. A NAMPT-specific monoclonal antibody (mAb) imaging probe (99mTc-ProNamptor) was used to detect NAMPT expression in lung tissues. Either an eNAMPT-neutralising goat polyclonal antibody (pAb) or a humanised monoclonal antibody (ALT-100 mAb) were used in vitro and in vivo.Results Immunohistochemical, biochemical and imaging studies validated time-dependent increases in NAMPT lung tissue expression in both pre-clinical ARDS models. Intravenous delivery of either eNAMPT-neutralising pAb or mAb significantly attenuated inflammatory lung injury (haematoxylin and eosin staining, bronchoalveolar lavage (BAL) protein, BAL polymorphonuclear cells, plasma interleukin-6) in both pre-clinical models. In vitro human lung EC studies demonstrated eNAMPT-neutralising antibodies (pAb, mAb) to strongly abrogate eNAMPT-induced TLR4 pathway activation and EC barrier disruption. In vivo studies in wild-type and EC-cNAMPT−/− mice confirmed a highly significant contribution of EC-derived NAMPT to the severity of inflammatory lung injury in both pre-clinical ARDS models.Conclusions These findings highlight both the role of EC-derived eNAMPT and the potential for biologic targeting of the eNAMPT/TLR4 inflammatory pathway. In combination with predictive eNAMPT biomarker and NAMPT genotyping assays, this offers the opportunity to identify high-risk ARDS subjects for delivery of personalised medicine.Underscoring the therapeutic potential for targeting the eNAMPT/TLR4 pathway in ARDS/VILI, a humanised eNAMPT-neutralising monoclonal antibody (mAb) was highly effective in reducing the severity of ARDS in these dual complementary pre-clinical ARDS models https://bit.ly/3ljEhBD
AB - Rationale The severe acute respiratory syndrome coronavirus 2/coronavirus disease 2019 pandemic has highlighted the serious unmet need for effective therapies that reduce acute respiratory distress syndrome (ARDS) mortality. We explored whether extracellular nicotinamide phosphoribosyltransferase (eNAMPT), a ligand for Toll-like receptor (TLR)4 and a master regulator of innate immunity and inflammation, is a potential ARDS therapeutic target.Methods Wild-type C57BL/6J or endothelial cell (EC)-cNAMPT−/− knockout mice (targeted EC NAMPT deletion) were exposed to either a lipopolysaccharide (LPS)-induced (“one-hit”) or a combined LPS/ventilator (“two-hit”)-induced acute inflammatory lung injury model. A NAMPT-specific monoclonal antibody (mAb) imaging probe (99mTc-ProNamptor) was used to detect NAMPT expression in lung tissues. Either an eNAMPT-neutralising goat polyclonal antibody (pAb) or a humanised monoclonal antibody (ALT-100 mAb) were used in vitro and in vivo.Results Immunohistochemical, biochemical and imaging studies validated time-dependent increases in NAMPT lung tissue expression in both pre-clinical ARDS models. Intravenous delivery of either eNAMPT-neutralising pAb or mAb significantly attenuated inflammatory lung injury (haematoxylin and eosin staining, bronchoalveolar lavage (BAL) protein, BAL polymorphonuclear cells, plasma interleukin-6) in both pre-clinical models. In vitro human lung EC studies demonstrated eNAMPT-neutralising antibodies (pAb, mAb) to strongly abrogate eNAMPT-induced TLR4 pathway activation and EC barrier disruption. In vivo studies in wild-type and EC-cNAMPT−/− mice confirmed a highly significant contribution of EC-derived NAMPT to the severity of inflammatory lung injury in both pre-clinical ARDS models.Conclusions These findings highlight both the role of EC-derived eNAMPT and the potential for biologic targeting of the eNAMPT/TLR4 inflammatory pathway. In combination with predictive eNAMPT biomarker and NAMPT genotyping assays, this offers the opportunity to identify high-risk ARDS subjects for delivery of personalised medicine.Underscoring the therapeutic potential for targeting the eNAMPT/TLR4 pathway in ARDS/VILI, a humanised eNAMPT-neutralising monoclonal antibody (mAb) was highly effective in reducing the severity of ARDS in these dual complementary pre-clinical ARDS models https://bit.ly/3ljEhBD
U2 - 10.1183/13993003.02536-2020
DO - 10.1183/13993003.02536-2020
M3 - Article
VL - 57
JO - Eur Respir J
JF - Eur Respir J
IS - 5
ER -