Acute lung injury (ALI) models are characterized by neutrophil accumulation, tissue damage, alteration of the alveolar capillary membrane, and physiological dysfunction. Lipoxin A 4 (LXA 4 ) is an anti-inflammatory eicosanoid that was demonstrated to attenuate lipopolysaccharide-induced ALI. Experimental models of severe malaria can be associated with lung injury. However, to date, a putative effect of LXA 4 on malaria (M)-induced ALI has not been addressed. In this study, we evaluated whether LXA 4 exerts an effect on M-ALI. Male C57BL/6 mice were randomly assigned to the following five groups: noninfected; saline-treated Plasmodium berghei-infected; LXA 4 -pretreated P. berghei-infected (LXA 4 administered 1 h before infection and daily, from days 0 to 5 postinfection), LXA 4 -and LXA 4 receptor antagonist BOC-2-pretreated P. berghei-infected; and LXA 4posttreated P. berghei-infected (LXA 4 administered from days 3 to 5 postinfection). By day 6, pretreatment or posttreatment with LXA 4 ameliorate lung mechanic dysfunction reduced alveolar collapse, thickening and interstitial edema; impaired neutrophil accumulation in the pulmonary tissue and blood; and reduced the systemic production of CXCL1. Additionally, in vitro treatment with LXA 4 prevented neutrophils from migrating toward plasma collected from P. berghei-infected mice. LXA 4 also impaired neutrophil cytoskeleton remodeling by inhibiting F-actin polarization.Ex vivo analysis showed that neutrophils from pretreated and posttreated mice were unable to migrate. In conclusion, we demonstrated that LXA 4 exerted therapeutic effects in malariainduced ALI by inhibiting lung dysfunction, tissue injury, and neutrophil accumulation in lung as well as in peripheral blood. Furthermore, LXA 4 impaired the migratory ability of P. berghei-infected mice neutrophils.
K E Y W O R D Scytoskeleton remodeling, lung, LXA 4 receptor, Plasmodium berghei, specialized proresolving mediators
INTRODUCTIONMalaria is present in more than 100 countries and accounts for 438,000 deaths each year. 1,2 The most severe form of malaria is Abbreviations: ALI, acute lung injury; ALX/FPR, LXA 4 receptor/formyl peptide receptor; ARDS, acute respiratory distress syndrome; BOC-2, N-Boc-Phe-Leu-Phe-Leu-Phe; CC, C-C motif chemokine; DAD, diffuse alveolar damage; HPFs, high-power fields; LTB 4 , leukotriene B 4 ; LXA 4 , lipoxin A 4 ; MA-ARDS, malaria associated ARDS; M-ALI, malaria induced ALI; Nip, noninfected plasma; Pbp, Plasmodium berghei-infected mouse plasma; PbRBC, Plasmodium berghei parasitized red blood cell; PI, propidium iodide characterized by cerebral dysfunction, which can result in convulsions, long-term neurological deficits, coma, and death. 3,4 Additionally, malaria-associated acute respiratory distress syndrome (MA-ARDS) is a common complication of malaria in adults, and the prevalence of MA-ARDS ranges from 2% to more than 20% of adults with severe malaria, depending on the study area and parasite species. 5,6 Autopsies performed in fatal cases of severe cerebral malaria show l...