Haptoglobin inhibits the pro-inflammatory activity of HMGB1. (172.19)

Abstract

Severe sepsis accounts for over 200,000 deaths in US annually (Angus et al, CCM, 2001). The mechanism involves endogenous molecules that impair organ function. Extracellular hemoglobin is one such factor enhancing tissue damage during sepsis. We designed haptoglobin-coated beads for a perfusion system to remove hemoglobin in an experimental sepsis model. Surprisingly, we observed that in addition to removing hemoglobin, haptoglobin beads also captured large amounts of HMGB1. HMGB1 is a major mediator on the final common pathway to lethality in sepsis (Yang et al, BBA 2009). Addition of haptoglobin suppressed HMGB1-stimulated TNF and IL-8 release in cultured macrophages. Haptoglobin knockout mice subjected to cecal perforation-induced sepsis had significantly higher serum HMGB1 levels and higher mortality compared to wild type animals (75% survival in wild type vs. 34% in haptoglobin knockout mice; n=15/group, P<0.05). Treatment with anti-HMGB1 antibodies significantly reduced the mortality in haptoglobin knockout mice (12% survival in control vs. 56% in animals receiving HMGB1 antibodies; n=16/group, P<0.05). Structure-function analysis revealed that haptoglobin beta subunit alone is sufficient to recapitulate the protective effects observed with haptoglobin. These findings indicate that haptoglobin is an endogenous modulator of HMGB1 that is capable of reducing the toxicity of HMGB1 in sepsis. Supported in part by grants from NIH (RO1GM62508, to KJT and RO1GM098446, to HY).