Intratracheal instillation of bacterial LPS is a well-established model of acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS). Because the myristoylated alanine-rich C kinase substrate (MARCKS) protein is involved in neutrophil migration and proinflammatory cytokine production, we examined whether an aerosolized peptide that inhibits MARCKS function could attenuate LPS-induced lung injury in mice. The peptide, BIO-11006, was delivered at 50 mM via inhalation either just before intratracheal instillation of 5 mg of LPS into Balb/C mice, or 4, 12, 24, or 36 hours after LPS instillation. Effects of BIO-11006 were evaluated via analysis of mouse disease-related behavior, lung histology, bronchoalveolar lavage fluid total protein, neutrophil counts and percentages, cytokine (KC [CXCl1, mouse IL-8 equivalent] and TNF-a) expression, and activation of NF-kB in lung tissue. Treatment with aerosolized BIO-11006 at 0, 4, 12, 24, and even 36 hours after LPS instillation reversed the disease process: mouse behavior returned to normal after two treatments 12 hours apart with the inhaled peptide after LPS injury, whereas control LPS-instilled animals treated with PBS only remained moribund. Histological appearance of inflammation, bronchoalveolar lavage fluid protein levels, leukocyte and neutrophil numbers, KC and TNF-a gene and protein expression, and NF-kB activation were all significantly attenuated by inhaled BIO-11006 at all time points. These results implicate MARCKS protein in the pathogenesis of ALI/ARDS and suggest that MARCKS-inhibitory peptide(s), delivered by inhalation, could represent a new and potent therapeutic treatment for ALI/ARDS, even if administered well after the disease process has begun.Keywords: myristoylated alanine-rich C kinase substrate; acute lung injury; LPS; neutrophils
Clinical RelevanceThese studies show that treatment of mice with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) with an inhaled inhibitor of myristoylated alanine-rich C kinase substrate (MARCKS) protein reverses disease progression, even when treatment is initiated well into the disease process, a time when the animals are moribund. These results implicate MARCKS protein in the pathogenesis of ALI/ARDS and suggest that MARCKS-inhibitory peptide(s), delivered by inhalation, could represent a new and potent therapeutic treatment for ALI/ARDS, even if administered well after the disease process has begun. Acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS), are major causes of respiratory failure; worldwide, over 1 million cases occur annually, with over 200,000 adult and 20,000 pediatric cases per year in the United States. This disorder is characterized by a large influx of leukocytes, especially neutrophils, to the lung as part of an acute inflammatory response, with injury to epithelial and endothelial cell barriers and pulmonary edema, all of which lead to respiratory failure. Treatment options remain limited to mechanical ventilation...