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Carbon monoxide alleviates endotoxin-induced acute lung injury via NADPH oxidase inhibition in macrophages and neutrophils.

Biochemical pharmacology2025-01-30PubMed
Total: 73.0Innovation: 8Impact: 6Rigor: 7Citation: 8

Summary

In endotoxin ALI models, CO—delivered via hemoglobin vesicles—attenuated lung injury by inhibiting NOX in neutrophils and macrophages, suppressing ROS, TLR4/NF-κB signaling, and M1-like polarization. These data position NOX and redox signaling as actionable targets in sepsis-related ALI/ARDS.

Key Findings

  • CO inhibited NOX activity in neutrophils and macrophages, reducing ROS and TLR4/NF-κB signaling.
  • CO-HbV therapy mitigated LPS-induced ALI, decreasing oxidative/inflammatory responses and neutrophil/M1-like macrophage infiltration in BALF.
  • Macrophage polarization toward an M1-like phenotype was suppressed by CO across cellular systems.

Clinical Implications

Suggests exploring NOX inhibition and CO-donor strategies as adjunctive therapies in early sepsis-related ALI/ARDS, with careful safety evaluation and dosing.

Why It Matters

Provides a mechanistic, targetable pathway (NOX–TLR4–NF-κB) and a drug delivery modality (CO-HbV) with translational potential for sepsis-related ALI/ARDS.

Limitations

  • Preclinical models; clinical translatability and safety of CO delivery remain unproven
  • Sample sizes and long-term outcomes were not detailed in the abstract

Future Directions

Define dose–exposure–response and safety windows for CO-HbV, validate in large-animal sepsis/ALI, and develop biomarkers of NOX/TLR pathway engagement for early-phase trials.

Study Information

Study Type
Case-control
Research Domain
Treatment
Evidence Level
V - Preclinical experimental work in animal and cell models comparing treatment vs control
Study Design
OTHER