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Hypoxia determines survival outcomes of bacterial infection through HIF-1alpha dependent re-programming of leukocyte metabolism.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Thompson, AAR 
Dickinson, RS 
Murphy, F 
Thomson, JP 
Marriott, HM 

Abstract

Hypoxia and bacterial infection frequently co-exist, in both acute and chronic clinical settings, and typically result in adverse clinical outcomes. To ameliorate this morbidity, we investigated the interaction between hypoxia and the host response. In the context of acute hypoxia, both S. aureus and S. pneumoniae infections rapidly induced progressive neutrophil mediated morbidity and mortality, with associated hypothermia and cardiovascular compromise. Preconditioning animals through longer exposures to hypoxia, prior to infection, prevented these pathophysiological responses and profoundly dampened the transcriptome of circulating leukocytes. Specifically, perturbation of HIF pathway and glycolysis genes by hypoxic preconditioning was associated with reduced leukocyte glucose utilisation, resulting in systemic rescue from a global negative energy state and myocardial protection. Thus we demonstrate that hypoxia preconditions the innate immune response and determines survival outcomes following bacterial infection through suppression of HIF-1α and neutrophil metabolism. The therapeutic implications of this work are that in the context of systemic or tissue hypoxia therapies that target the host response could improve infection associated morbidity and mortality.

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Keywords

1108 Medical Microbiology, Basic Science, Infection, 2.1 Biological and endogenous factors

Journal Title

Science Immunology

Conference Name

Journal ISSN

2470-9468
2470-9468

Volume Title

2

Publisher

American Association for the Advancement of Science
Sponsorship
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Wellcome Trust (092738/Z/10/Z)
Medical Research Council (MR/P502091/1)
This work was supported by the Medical Research Council (MRC) Clinical Training Fellowship (awards G0802255 and MR/K023845/1 to A.A.R.T. and R.S.D., respectively), a National Institute for Health Research (NIHR) Clinical Lectureship and an Academy of Medical Sciences starter grant (to A.A.R.T.), a Wellcome Trust postdoctoral clinical fellowship (110086 to A.M.), a Wellcome Trust Senior Clinical Fellowship award (098516 to S.R.W.), a Wellcome Trust Senior Clinical Fellowship award (076945 to D.H.D.), a British Lung Foundation Fellowship (F05/7 to H.M.M.), a Wellcome Trust New Investigator Award (WT100981MA to N.M.M.), and a British Heart Foundation Senior Basic Science Research Fellowship (FS/13/48/30453 to A.L.). E.R.C. and A.S.C. are supported by the NIHR Cambridge Biomedical Research Centre. R.H.S. is supported by the MRC. R.R.M. is supported by MRC (MC_PC_U127574433), Biotechnology and Biological Sciences Research Council, and European Chemical Industry Council grants. M.M. is supported by the European Research Council (OxyMO). The MRC/University of Edinburgh Centre for Inflammation Research is supported by an MRC Centre Grant.