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1 Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Surgical Research, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
2 Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
* To whom correspondence should be addressed. E-mail: jif7{at}pitt.edu.
Hemorrhagic shock renders patients susceptible to the development of acute lung injury in response to a second inflammatory stimulus, by as yet unclear mechanisms. We investigated the role of neutrophils (PMN) in alveolar macrophages (AM
) priming, specifically, the role in mediating Toll-like receptor (TLR)4 and TLR2 cross-talk in AM
. Using a mouse model of hemorrhagic shock followed by intratracheal administration of LPS, we explored a novel function of shock-activated PMN in the mechanism of TLR2 upregulation induced by LPS-TLR4 signaling in AM
. We showed that antecedent hemorrhagic shock enhanced LPS-induced TLR2 upregulation in AM
. In neutropenic mice subjected to shock, the LPS-induced TLR2 expression was significantly reduced, and the response was restored upon repletion with PMN obtained from shock-resuscitated mice but not by PMN from sham-operated mice. These findings were recapitulated in mouse AM
co-cultured with PMN. The enhanced TLR2 upregulation in AM
augmented the expression of macrophage inflammatory protein-2 (MIP-2), TNF
, and macrophage migration inhibitory factor (MIF) in the AM
in response to sequential challenges of LPS and peptidoglycan, a prototypical TLR2 ligand, and which physiologically associated with amplified AM
-induced PMN migration into air pouch and lung alveoli. Thus TLR2 expression in AM
, signaled by TLR4 and regulated by shock-activated PMN, is an important positive-feedback mechanism responsible for shock-primed PMN infiltration into the lung following primary PMN sequestration.
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