Molecular Medicine 2015

HMGB1 Mediates Anemia Of Inflammation In Murine Sepsis Survivors

Sergio I Valdés-Ferrer, Julien Papoin, Meghan E Dancho, Peder S Olofsson, Jianhua Li, Jeffrey M Lipton,
Patricia Avancena, Huan Yang, Yong-Rui Zou, Sangeeta S Chavan, Bruce T Volpe, Sara Gardenghi, Stefano Rivella, Betty Diamond, Ulf Andersson, Bettie M Steinberg, Lionel Blanc, and Kevin J Tracey


Patients surviving sepsis develop anemia, but the molecular mechanism is unknown. Here we observed that mice surviving polymicrobial gram-negative sepsis develop hypochromic, microcytic anemia with reticulocytosis. The bone marrow of sepsis survivors accumulates polychromatophilic and orthochromatic erythroblasts. Compensatory extramedullary erythropoiesis in the spleen is defective during terminal differentiation. Circulating tumor necrosis factor (TNF) and interleukin (IL)-6 are elevated for 5 d after the onset of sepsis, and serum high-mobility group box 1 (HMGB1) levels are increased from d 7 until at least d 28. Administration of recombinant HMGB1 to healthy mice mediates anemia with extramedullary erythropoiesis and significantly elevated reticulocyte counts. Moreover, administration of anti-HMGB1 monoclonal antibodies after sepsis significantly ameliorates the development of anemia (hematocrit 48.5 ± 9.0% versus 37.4 ± 6.1%, p < 0.01; hemoglobin 14.0 ± 1.7 versus 11.7 ± 1.2 g/dL, p < 0.01). Together, these results indicate that HMGB1 mediates anemia by interfering with erythropoiesis, suggesting a potential therapeutic strategy for anemia in sepsis.

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Posted by Sheila Platt on Mar 17, 2016 10:06 AM CDT