[PDF][PDF] α-Toxin induces platelet aggregation and liver injury during Staphylococcus aureus sepsis

BGJ Surewaard, A Thanabalasuriar, Z Zeng… - Cell host & …, 2018 - cell.com
BGJ Surewaard, A Thanabalasuriar, Z Zeng, C Tkaczyk, TS Cohen, BW Bardoel, SK Jorch
Cell host & microbe, 2018cell.com
During sepsis, small blood vessels can become occluded by large platelet aggregates of
poorly understood etiology. During Staphylococcal aureus infection, sepsis severity is linked
to the bacterial α-toxin (α-hemolysin, AT) through unclear mechanisms. In this study, we
visualized intravascular events in the microcirculation and found that intravenous AT
injection induces rapid platelet aggregation, forming dynamic micro-thrombi in the
microcirculation. These aggregates are retained in the liver sinusoids and kidney glomeruli …
Summary
During sepsis, small blood vessels can become occluded by large platelet aggregates of poorly understood etiology. During Staphylococcal aureus infection, sepsis severity is linked to the bacterial α-toxin (α-hemolysin, AT) through unclear mechanisms. In this study, we visualized intravascular events in the microcirculation and found that intravenous AT injection induces rapid platelet aggregation, forming dynamic micro-thrombi in the microcirculation. These aggregates are retained in the liver sinusoids and kidney glomeruli, causing multi-organ dysfunction. Acute staphylococcal infection results in sequestration of most bacteria by liver macrophages. Platelets are initially recruited to these macrophages and help eradicate S. aureus. However, at later time points, AT causes aberrant and damaging thrombosis throughout the liver. Treatment with an AT neutralizing antibody (MEDI4893) prevents platelet aggregation and subsequent liver damage, without affecting the initial and beneficial platelet recruitment. Thus, AT neutralization may represent a promising approach to combat staphylococcal-induced intravascular coagulation and organ dysfunction.
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