Ruxolitinib: A new hope for ventilator-induced diaphragm dysfunction

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  • Addinsall, Alex Bernard
  • Nicola Cacciani
  • Noah Moruzzi
  • Hazem Akkad
  • Alice Maestri
  • Per Olof Berggren
  • Anna Widegren
  • Jonas Bergquist
  • Tamara Tchkonia
  • James L. Kirkland
  • Lars Larsson

Aim: Mechanical ventilation (MV) results in diminished diaphragm size and strength, termed ventilator-induced diaphragm dysfunction (VIDD). VID increases dependence, prolongs weaning, and increases discharge mortality rates. The Janus kinase (JAK)/Signal Transducer and Activator of Transcription (STAT) pathway is implicated in VIDD, upregulated following MV. JAK/STAT inhibition alleviates chronic muscle wasting conditions. This study aimed to explore the therapeutic potential of Ruxolitinib, an FDA approved JAK1/2 inhibitor (JI) for the treatment of VIDD. Methods: Rats were subjected to 5 days controlled MV (CMV) with and without daily Ruxolitinib gavage. Muscle fiber size and function were assessed. RNAseq, mitochondrial morphology, respirometry, and mass spectrometry were determined. Results: CMV significantly reduced diaphragm size and specific force by 45% (p < 0.01), associated with a two-fold P-STAT3 upregulation (p < 0.001). CMV disrupted mitochondrial content and reduced the oxygen consumption rate (p < 0.01). Expression of the motor protein myosin was unaffected, however CMV alters myosin function via post-translational modifications (PTMs). Daily administration of JI increased animal survival (40% vs. 87%; p < 0.05), restricted P-STAT3 (p < 0.001), and preserved diaphragm size and specific force. JI was associated with preserved mitochondrial content and respiratory function (p < 0.01), and the reversal or augmentation of myosin deamidation PTMs of the rod and head region. Conclusion: JI preserved diaphragm function, leading to increased survival in an experimental model of VIDD. Functional enhancement was associated with maintenance of mitochondrial content and respiration and the reversal of ventilator-induced PTMs of myosin. These results demonstrate the potential of repurposing Ruxolitinib for treatment of VIDD.

OriginalsprogEngelsk
Artikelnummere14128
TidsskriftActa Physiologica
Vol/bind240
Udgave nummer5
Antal sider14
ISSN1748-1708
DOI
StatusUdgivet - 2024
Eksternt udgivetJa

Bibliografisk note

Funding Information:
This study was supported by Swedish Research Council (8651, 7154, 1001), Swedish Heart and Lung Foundation, Erling\u2010Persson Foundation, Stockholm City Council (Alf; 20150423, 20170133), Centrum f\u00F6r Idrottsforskning (CIF; 2020\u20100014; 118\u20102021), and Karolinska Institute to LL. CIF Postdoctoral Fellowship (D2020\u20100018) and Loo and Hans Osterman Foundation to ABA. JLK and TT are supported by the Noaber Foundation, Connor Fund, and Robert J. and Theresa W. Ryan. The authors acknowledge support from the National Genomics Infrastructure in Stockholm.

Publisher Copyright:
© 2024 The Authors. Acta Physiologica published by John Wiley & Sons Ltd on behalf of Scandinavian Physiological Society.

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