Modulation of the sigma-1 receptor–IRE1 pathway is beneficial in preclinical models of inflammation and sepsis

DA Rosen, SM Seki, A Fernández-Castañeda… - Science translational …, 2019 - science.org
DA Rosen, SM Seki, A Fernández-Castañeda, RM Beiter, JD Eccles, JA Woodfolk
Science translational medicine, 2019science.org
Sepsis is an often deadly complication of infection in which systemic inflammation damages
the vasculature, leading to tissue hypoperfusion and multiple organ failure. Currently, the
standard of care for sepsis is predominantly supportive, with few therapeutic options
available. Because of increased sepsis incidence worldwide, there is an urgent need for
discovery of novel therapeutic targets and development of new treatments. The recently
discovered function of the endoplasmic reticulum (ER) in regulation of inflammation offers a …
Sepsis is an often deadly complication of infection in which systemic inflammation damages the vasculature, leading to tissue hypoperfusion and multiple organ failure. Currently, the standard of care for sepsis is predominantly supportive, with few therapeutic options available. Because of increased sepsis incidence worldwide, there is an urgent need for discovery of novel therapeutic targets and development of new treatments. The recently discovered function of the endoplasmic reticulum (ER) in regulation of inflammation offers a potential avenue for sepsis control. Here, we identify the ER-resident protein sigma-1 receptor (S1R) as an essential inhibitor of cytokine production in a preclinical model of septic shock. Mice lacking S1R succumb quickly to hypercytokinemia induced by a sublethal challenge in two models of acute inflammation. Mechanistically, we find that S1R restricts the endonuclease activity of the ER stress sensor IRE1 and cytokine expression but does not inhibit the classical inflammatory signaling pathways. These findings could have substantial clinical implications, as we further find that fluvoxamine, an antidepressant therapeutic with high affinity for S1R, protects mice from lethal septic shock and dampens the inflammatory response in human blood leukocytes. Our data reveal the contribution of S1R to the restraint of the inflammatory response and place S1R as a possible therapeutic target to treat bacterial-derived inflammatory pathology.
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