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Single-cell RNA sequencing deciphers the mechanism of sepsis-induced liver injury and the therapeutic effects of artesunate

Xue-ling He1,2, Jia-yun Chen1,2, Yu-lin Feng3, Ping Song4, Yin Kwan Wong5, Lu-lin Xie2, Chen Wang1, Qian Zhang1, Yun-meng Bai2, Peng Gao1, Piao Luo1, Qiang Liu6, Fu-long Liao1, Zhi-jie Li2, Yong Jiang7, Ji-gang Wang1,2,3
1 Artemisinin Research Center, and Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
2 Department of Nephrology, Shenzhen Key Laboratory of Kidney Diseases, and Shenzhen Clinical Research Centre for Geriatrics, Shenzhen People’s Hospital, the First Affiliated Hospital, Southern University of Science and Technology, Shenzhen 518020, China
3 National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Chinese Medicine, Nanchang 330004, China
4 China Academy of Chinese Medical Sciences, Beijing 100700, China
5 Department of Biological Sciences, National University of Singapore, Singapore 117543, Singapore
6 Advanced Drug Delivery and Regenerative Biomaterials Laboratory, and Cardiovascular Pharmacology Division of Cardiovascular Institute, School of Medicine, Stanford University, Stanford, CA 94304, USA
7 Guangdong Provincial Key Laboratory of Proteomics, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
Correspondence to: Zhi-jie Li: li.zhijie@szhospital.com, Yong Jiang: jiang48231@163.com, Ji-gang Wang: jgwang@icmm.ac.cn,
DOI: 10.1038/s41401-023-01065-y
Received: 16 November 2022
Accepted: 16 February 2023
Advance online: 11 April 2023

Abstract

Liver, as an immune and detoxification organ, represents an important line of defense against bacteria and infection and a vulnerable organ that is easily injured during sepsis. Artesunate (ART) is an anti-malaria agent, that also exhibits broad pharmacological activities including anti-inflammatory, immune-regulation and liver protection. In this study, we investigated the cellular responses in liver to sepsis infection and ART hepatic-protective mechanisms against sepsis. Cecal ligation and puncture (CLP)-induced sepsis model was established in mice. The mice were administered ART (10 mg/kg, i.p.) at 4 h, and sacrificed at 12 h after the surgery. Liver samples were collected for preparing single-cell RNA transcriptome sequencing (scRNA-seq). The scRNA-seq analysis revealed that sepsis-induced a dramatic reduction of hepatic endothelial cells, especially the subtypes characterized with proliferation and differentiation. Macrophages were recruited during sepsis and released inflammatory cytokines (Tnf, Il1b, Il6), chemokines (Ccl6, Cd14), and transcription factor (Nfkb1), resulting in liver inflammatory responses. Massive apoptosis of lymphocytes and abnormal recruitment of neutrophils caused immune dysfunction. ART treatment significantly improved the survival of CLP mice within 96 h, and partially relieved or reversed the above-mentioned pathological features, mitigating the impact of sepsis on liver injury, inflammation, and dysfunction. This study provides comprehensive fundamental proof for the liver protective efficacy of ART against sepsis infection, which would potentially contribute to its clinical translation for sepsis therapy.

Keywords: sepsis; scRNA-seq; artesunate; liver; hepatic endothelial cells; macrophages; lymphocytes; neutrophils

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