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Dual alarmin-receptor-specific targeting peptide systems for treatment of sepsis.

Acta pharmaceutica Sinica. B2025-01-14PubMed
Total: 79.0Innovation: 9Impact: 8Rigor: 7Citation: 8

Summary

A dual-receptor blocking peptide (TMR) derived from HMGB1/PTX3 interaction motifs inhibited TLR4/MD2 and RAGE signaling, reducing HMGB1/PTX3- and LPS-driven cytokine release. Liposomal TMR improved pharmacokinetics, and antibiotic-loaded TMR-liposomes conferred significant therapeutic benefit in cecal ligation and puncture (CLP) sepsis. This establishes a late-mediator–targeted adjunctive strategy.

Key Findings

  • TMR peptide disrupted HMGB1/PTX3 interactions with TLR4 and RAGE, attenuating cytokine production induced by HMGB1/PTX3 and LPS.
  • Liposomal formulation (TMR-Lipo) improved peptide pharmacokinetics.
  • Antibiotic-loaded TMR-Lipo produced significant therapeutic benefit in CLP-induced murine sepsis.

Clinical Implications

If translated safely to humans, TMR-based adjuncts could complement antibiotics by dampening late-phase inflammation (HMGB1/PTX3–TLR4/RAGE axis), potentially improving outcomes in severe sepsis.

Why It Matters

Introduces a mechanistically rational, dual-target strategy against late alarmins with in vivo efficacy, addressing prior failures of early cytokine blockade in sepsis.

Limitations

  • Preclinical study without human safety or efficacy data
  • Generalizability from CLP model and peptide-liposome PK/toxicity profiles remain to be established

Future Directions

Advance to GLP toxicology, pharmacokinetics, and dose-finding; test in larger animals; evaluate combinations with standard care; explore biomarker-guided selection (HMGB1/PTX3 levels).

Study Information

Study Type
Preclinical experimental study
Research Domain
Treatment
Evidence Level
V - Preclinical in vitro and animal model evidence without human clinical outcomes
Study Design
OTHER