PCSK9 is a critical regulator of the innate immune response and septic shock outcome.

Walley KR, Thain KR, Russell JA, Reilly MP, Meyer NJ, Ferguson JF, Christie JD, Nakada TA, Fjell CD, Thair SA, Cirstea MS, Boyd JH
Sci Transl Med. 2014 6 (258): 258ra143

PMID: 25320235 · PMCID: PMC4342147 · DOI:10.1126/scitranslmed.3008782

A decrease in the activity of proprotein convertase subtilisin/kexin type 9 (PCSK9) increases the amount of low-density lipoprotein (LDL) receptors on liver cells and, therefore, LDL clearance. The clearance of lipids from pathogens is related to endogenous lipid clearance; thus, PCSK9 may also regulate removal of pathogen lipids such as lipopolysaccharide (LPS). Compared to controls, Pcsk9 knockout mice displayed decreases in inflammatory cytokine production and in other physiological responses to LPS. In human liver cells, PCSK9 inhibited LPS uptake, a necessary step in systemic clearance and detoxification. Pharmacological inhibition of PCSK9 improved survival and inflammation in murine polymicrobial peritonitis. Human PCSK9 loss-of-function genetic variants were associated with improved survival in septic shock patients and a decrease in inflammatory cytokine response both in septic shock patients and in healthy volunteers after LPS administration. The PCSK9 effect was abrogated in LDL receptor (LDLR) knockout mice and in humans who are homozygous for an LDLR variant that is resistant to PCSK9. Together, our results show that reduced PCSK9 function is associated with increased pathogen lipid clearance via the LDLR, a decreased inflammatory response, and improved septic shock outcome.

Copyright © 2014, American Association for the Advancement of Science.

MeSH Terms (14)

Animals Disease Models, Animal Genetic Variation Hep G2 Cells Humans Immunity, Innate Lipopolysaccharides Male Mice, Inbred C57BL Mice, Knockout Proprotein Convertase 9 Proprotein Convertases Serine Endopeptidases Shock, Septic

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