Combined zinc supplementation with proinsulin C-peptide treatment decreases the inflammatory response and mortality in murine polymicrobial sepsis

Shock. 2014 Apr;41(4):292-300. doi: 10.1097/SHK.0000000000000127.

Abstract

Zinc is a trace element vital for immune function during host response to infection. The proinsulin C-peptide has been shown to exert beneficial effects through activation of the anti-inflammatory peroxisome proliferator-activated receptor γ (PPARγ) in experimental endotoxemia. Some in vitro activities of C-peptide appear dependent on the presence of zinc. We investigated the effect of zinc supplementation before onset of sepsis on the anti-inflammatory properties of C-peptide. Male C57BL/6 mice were subjected to polymicrobial sepsis by cecal ligation and puncture (CLP). Mice received zinc gluconate (1.3 mg/kg) intraperitoneally (i.p.) for 3 days before CLP. One hour after CLP, animals received C-peptide (280 nmol/kg i.p.) or the antimicrobial agent imipenem (25 mg/kg i.p.). Cecal ligation and puncture was associated with an 11% survival rate, pulmonary leukosequestration, and liver injury. Molecular analysis in lungs of septic mice showed increased nuclear activation of the proinflammatory extracellular signal-regulated kinases 1 and 2 and nuclear factor κB, but decreased PPARγ expression, when compared with sham animals. Combination of zinc supplementation with C-peptide posttreatment significantly improved survival rate (61%) similarly to antibiotic treatment (60%), ameliorated lung architecture and liver function, reduced tissue neutrophil infiltration, and increased bacterial clearance when compared with vehicle, C-peptide, or zinc treatment alone. These beneficial effects were associated with restored lung nuclear expression of PPARγ and reduction of phosphorylated extracellular signal-regulated kinases 1 and 2 and nuclear factor κB activities in comparison to vehicle or single treatment protocols. Our data demonstrate that short-term zinc prophylaxis before the infectious insult is a requisite for the anti-inflammatory properties of C-peptide by facilitating modulation of inflammatory pathways.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Lung Injury / prevention & control
  • Animals
  • Bacterial Load / drug effects
  • Bronchoalveolar Lavage Fluid / cytology
  • C-Peptide / therapeutic use*
  • Cytokines / blood
  • Dietary Supplements*
  • Drug Evaluation, Preclinical / methods
  • Drug Therapy, Combination
  • Extracellular Signal-Regulated MAP Kinases / metabolism
  • Liver Diseases / microbiology
  • Liver Diseases / prevention & control
  • Male
  • Mice
  • Mice, Inbred C57BL
  • NF-kappa B / metabolism
  • Neutrophil Infiltration / drug effects
  • Sepsis / complications
  • Sepsis / drug therapy*
  • Sepsis / metabolism
  • Sepsis / microbiology
  • Survival Analysis
  • Systemic Inflammatory Response Syndrome / metabolism
  • Systemic Inflammatory Response Syndrome / microbiology
  • Systemic Inflammatory Response Syndrome / prevention & control*
  • Zinc / therapeutic use*

Substances

  • C-Peptide
  • Cytokines
  • NF-kappa B
  • Extracellular Signal-Regulated MAP Kinases
  • Zinc