Mitochondrial transplant after ischemia reperfusion promotes cellular salvage and improves lung function during ex-vivo lung perfusion

In lung transplantation, ischemia-reperfusion injury associated with mitochondrial damage can lead to graft rejection. Intact, exogenous mitochondria provide a unique treatment option to salvage damaged cells within lung tissue. We developed a novel method to freeze and store allogeneic mitochondria...

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Bibliographic Details
Published in:	The Journal of heart and lung transplantation Vol. 42; no. 5; pp. 575 - 584
Main Authors:	Cloer, Caryn M., Givens, Christopher S., Buie, Lakisha K., Rochelle, Lauren K., Lin, Yi-Tzu, Popa, Sam, Shelton, Randolph V.M., Zhan, James, Zimmerman, Tyler R., Jones, Bria G., Lesesne, Zion, Hogan, Sarah S., Petersen, Thomas H.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-05-2023
Subjects:	Animals Antioxidants - metabolism Antioxidants - pharmacology Autophagy Endothelial Cells - metabolism Ex-vivo lung perfusion Humans Ischemia Ischemia reperfusion Lung Lung Transplantation - methods Mitochondria - metabolism Mitochondrial transplant Perfusion - methods Primary graft dysfunction Reperfusion Reperfusion Injury - metabolism Swine IRI Primary graft dysfunction EVLP Ischemia reperfusion ROS Ex-vivo lung perfusion PGD Autophagy Mitochondrial transplant
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Summary:	In lung transplantation, ischemia-reperfusion injury associated with mitochondrial damage can lead to graft rejection. Intact, exogenous mitochondria provide a unique treatment option to salvage damaged cells within lung tissue. We developed a novel method to freeze and store allogeneic mitochondria isolated from porcine heart tissue. Stored mitochondria were injected into a model of induced ischemia-reperfusion injury using porcine ex-vivo lung perfusion. Treatment benefits to immune modulation, antioxidant defense, and cellular salvage were evaluated. These findings were corroborated in human lungs undergoing ex-vivo lung perfusion. Lung tissue homogenate and primary lung endothelial cells were then used to address underlying mechanisms. Following cold ischemia, mitochondrial transplant reduced lung pulmonary vascular resistance and tissue pro-inflammatory signaling and cytokine secretion. Further, exogenous mitochondria reduced reactive oxygen species by-products and promoted glutathione synthesis, thereby salvaging cell viability. These results were confirmed in a human model of ex-vivo lung perfusion wherein transplanted mitochondria decreased tissue oxidative and inflammatory signaling, improving lung function. We demonstrate that transplanted mitochondria induce autophagy and suggest that bolstered autophagy may act upstream of the anti-inflammatory and antioxidant benefits. Importantly, chemical inhibitors of the MEK autophagy pathway blunted the favorable effects of mitochondrial transplant. These data provide direct evidence that mitochondrial transplant improves cellular health and lung function when administered during ex-vivo lung perfusion and suggest the mechanism of action may be through promotion of cellular autophagy. Data herein contribute new insights into the therapeutic potential of mitochondrial transplant to abate ischemia-reperfusion injury during lung transplant, and thus reduce graft rejection.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1053-2498 1557-3117
DOI:	10.1016/j.healun.2023.01.002