Role of Hippo/ACSL4 axis in ferroptosis-induced pericyte loss and vascular dysfunction in sepsis

Yiyan Liu; Daiqin Bao; Han She; Zisen Zhang; Shifeng Shao; Zhengbin Wu; Yue Wu; Qinghui Li; Li Wang; Tao Li; Liangming Liu

doi:10.1016/j.redox.2024.103353

Role of Hippo/ACSL4 axis in ferroptosis-induced pericyte loss and vascular dysfunction in sepsis

Redox Biol. 2024 Nov 12:78:103353. doi: 10.1016/j.redox.2024.103353. Online ahead of print.

Authors

Yiyan Liu¹, Daiqin Bao², Han She², Zisen Zhang¹, Shifeng Shao³, Zhengbin Wu³, Yue Wu¹, Qinghui Li¹, Li Wang⁴, Tao Li⁵, Liangming Liu⁶

Affiliations

¹ Shock and Transfusion Department, Daping Hospital, Army Medical University, Chongqing, 400042, China.
² Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, 400042, China.
³ Department of Critical Care Medicine, Daping Hospital, Army Medical University, Chongqing, 400042, China.
⁴ Shock and Transfusion Department, Daping Hospital, Army Medical University, Chongqing, 400042, China. Electronic address: wangli123@tmmu.edu.cn.
⁵ Shock and Transfusion Department, Daping Hospital, Army Medical University, Chongqing, 400042, China. Electronic address: lt200132@tmmu.edu.cn.
⁶ Shock and Transfusion Department, Daping Hospital, Army Medical University, Chongqing, 400042, China. Electronic address: lmliu62@tmmu.edu.cn.

PMID: 39566164
DOI: 10.1016/j.redox.2024.103353

Abstract

Sepsis is a critical condition characterized by a systemic inflammatory response to infection, often leading to severe vascular dysfunction and high mortality. One of the hallmarks of vascular dysfunction in sepsis is increased vascular permeability and the loss of pericytes, which are essential for maintaining vascular integrity. Despite the significance of pericyte loss in sepsis, the primary type of cell death responsible and the underlying molecular mechanisms remain incompletely understood. This study aims to elucidate these mechanisms by focusing on ferroptosis, a form of programmed cell death, and its regulation through the Hippo/ACSL4 axis. Our research confirmed significant pericyte loss in patients with sepsis. Through advanced single-cell analysis and proteomics, ferroptosis was identified as a key differentiating cell death type between sepsis and sham samples. Further metabolomics analysis revealed that Acyl-CoA Synthetase Long-Chain Family Member 4 (ACSL4) plays a pivotal role in the ferroptosis of pericytes during sepsis. In vitro experiments demonstrated that downregulation of ACSL4 effectively reduced lipopolysaccharide (LPS)-induced lipid peroxidation, restored pericyte viability, and improved endothelial permeability. In vivo studies with pericyte-specific ACSL4 knockout mice showed a marked decrease in pericyte loss and enhanced vascular barrier function following sepsis induction. To translate these findings into potential therapeutic strategies, we developed pericyte-targeting liposomes encapsulating ACSL4 shRNA adenovirus. These liposomes successfully restored pulmonary vascular barrier function and significantly reduced pericyte loss in septic conditions. The results of this study underscore the crucial role of ACSL4 in mediating ferroptosis in pericytes and highlight the therapeutic potential of targeting ACSL4 to mitigate vascular dysfunction in sepsis.

Keywords: ACSL4; Ferroptosis; Hippo pathway; Pericyte loss; Sepsis; Vascular permeability.