MAPK p38 antagonism as a novel method of inhibiting lymphoid immune suppression in polymicrobial sepsis

Although studies indicatethat a shift from a Th1 to a Th2 response contributes to a markedsuppression of cell-mediated immunity during sepsis, the mechanism bywhich this occurs remains unknown. Given that the mitogen-activatedprotein kinase (MAPK) p38 plays a critical role in the activation andfunction of immune cells, the aim of this study was to determine thecontribution of MAPK p38 activation to the immune dysfunction seen inpolymicrobial sepsis. To study this, polymicrobial sepsis was inducedin C3H/HeN male mice by cecal ligation and puncture (CLP). Spleniclymphocytes and purified T cells were harvested 24 h post-CLP,pretreated with the specific MAPK p38 inhibitor SB-203580, and thenstimulated with a monoclonal antibody against the T cell marker CD3.The results indicate that interleukin (IL)-2 release is markedlydepressed while the release of the immunosuppressive mediator, IL-10,as well as mRNA levels of IL-10 and IL-4, are augmented after CLP. Inhibition of MAPK p38 suppressed in vitro IL-10 levels as well asIL-10 and IL-4 gene expression while restoring the release of IL-2. Todetermine whether these in vitro findings could be translated to an invivo setting, mice were given 100 mg of SB-203580/kg body wt or salinevehicle (intraperitoneal) at 12 h post-CLP. Examination of ex vivolymphocyte responsiveness indicated that, as with the in vitro finding,septic mouse Th1 responsiveness was restored. In light of our recentfinding that delayed in vivo SB-203580 treatment also improved survivalafter CLP, we believe that these results not only illustrate the roleof MAPK p38 in the induction of immunosuppressive agents in sepsis butdemonstrate that SB-203580 administration after the initialproinflammatory state of sepsis significantly prevents the morbidityfrom sepsis.