Cellular Pathophysiology of Leptospirosis: Role of Na/K-ATPase

Abstract

Inada and Ido identified Leptospira sp. as the pathogen responsible for Weil’s Disease in 1915. Later, it was confirmed that Leptospira causes leptospirosis. The host microorganism’s interaction at the cellular level remained misunderstood for many years. Although different bacterial components have been isolated and purified, the complexity of the molecular interactions between these components and the host and the molecular mechanisms responsible for the systemic dysfunctions still needs to be fully unveiled. Leptospirosis affects virtually all animal species. Its cellular pathophysiology must involve a ubiquitous cellular mechanism in all eukaryotes. Na/K-ATPase is the molecular target of the leptospiral endotoxin (glycolipoprotein—GLP). Na/K-ATPase dysfunctions on different types of cells give rise to the organ disorders manifested in leptospirosis. Concomitantly, the development of a peculiar metabolic disorder characterized by dyslipidemia, with increased levels of circulating free fatty acids and an imbalance in the fatty acid/albumin molar ratio, triggers events of cellular lipotoxicity. Synergistically, multiple molecular stimuli are prompted during the infection, activating inflammasomes and Na/K-ATPase signalosome, leading to pro-inflammatory and metabolic alterations during leptospirosis. Leptospirosis involves diverse molecular mechanisms and alteration in patient inflammatory and metabolic status. Nonetheless, Na/K-ATPase is critical in the disease, and it is targeted by GLP, its components, and other molecules, such as fatty acids, that inhibit or trigger intracellular signaling through this enzyme. Herein, we overview the role of Na/K-ATPase during leptospirosis infection as a potential therapeutic target or an indicator of disease severity.

The Na/K-ATPase role as a signal transducer in lung inflammation

“…During the infection, inflammasomes are formed, and NKA once again leads to pro-inflammatory and metabolic alterations and involves inflammasome activation. NKA is related to the severity and considered a therapeutic target ( 100 ).…”

Acute Kidney Injury Associated with Severe Leptospirosis: Fatal Re-Emerging Disease in Latin America

“…[39,40]. Its main characteristic is its specificity for the Na/K-ATPase pump [41] on the cytosolic surface of cell membranes through the action of its lipid component on the cell membrane (oleic acid), and the poor adsorption of the albumin toward these fatty acids [42][43][44]. Synergistic inhibition reduces the co-transport activity of the Na/K-ATPase pump, increasing affinity for sodium and potassium loss [45,46].…”