Beneficial effects of citrulline enteral administration on sepsis-induced T cell mitochondrial dysfunction

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Reizine, Florian | Grégoire, Murielle | Lesouhaitier, Mathieu | Coirier, Valentin | Gauthier, Juliette | Delaloy, Céline | Dessauge, Elise | Creusat, Florent | Uhel, Fabrice | Gacouin, Arnaud | Dessauge, Frederic | Le Naoures, Cécile | Moreau, Caroline | Bendavid, Claude | Daniel, Yoann | Petitjean, Kilian | Bordeau, Valérie | Lamaison, Claire | Piau, Caroline | Cattoir, Vincent | Roussel, Mikaël | Fromenty, Bernard | Michelet, Christian | Le Tulzo, Yves | Zmijewski, Jaroslaw | Thibault, Ronan | Cogné, Michel | Tarte, Karin | Tadié, Jean-Marc

Edité par CCSD ; National Academy of Sciences -

International audience. Severe sepsis induces a sustained immune dysfunction associated with poor clinical behavior. In particular, lymphopenia along with increased lymphocyte apoptosis and decreased lymphocyte proliferation, enhanced circulating regulatory T cells (Treg), and the emergence of myeloid-derived suppressor cells (MDSCs) have all been associated with persistent organ dysfunction, secondary infections, and late mortality. The mechanisms involved in MDSC-mediated T cell dysfunction during sepsis share some features with those described in malignancies such as arginine deprivation. We hypothesized that increasing arginine availability would restore T cell function and decrease sepsis-induced immunosuppression. Using a mouse model of sepsis based on cecal ligation and puncture and secondary pneumonia triggered by methicillin-resistant Staphylococcus aureus inoculation, we demonstrated that citrulline administration was more efficient than arginine in increasing arginine plasma levels and restoring T cell mitochondrial function and proliferation while reducing sepsis-induced Treg and MDSC expansion. Because there is no specific therapeutic strategy to restore immune function after sepsis, we believe that our study provides evidence for developing citrulline-based clinical studies in sepsis.

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