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Metformin stimulated AMPK{alpha}1 promotes microvascular repair in acute lung injury

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AJP Lung Cellular and Molecular Physiology

Published online on

Abstract

Acute lung injury secondary to sepsis is a leading cause of mortality in sepsis related death. Current therapies are not effective in reversing endothelial cell dysfunction; which plays a key role in increased vascular permeability and compromised lung function. AMP-activated protein kinase (AMPK) is a molecular sensor important for detection and mediation of cellular adaptations to vascular disruptive stimuli. In this study, we sought to determine the role of AMPK in resolving increased endothelial permeability in the sepsis-injured lung. AMPK function was determined in vivo using a rat model of endotoxin-induced lung injury, ex vivo using the isolated lung, and in vitro using cultured rat pulmonary microvascular endothelial cells (PMVECs). AMPK stimulation using N1-(α-d-ribofuranosyl)-5-aminoimidizole-4-carboxamide (AICAR) or metformin decreased the LPS-induced increase in permeability, as determined by filtration co-efficient (Kf) measurements, and resolved edema as indicated by decreased wet-to-dry ratios. The role of AMPK in the endothelial response to LPS was determined by shRNA designed to decrease expression of the AMPKα1 isoform in capillary endothelial cells. Permeability, wounding, and barrier resistance assays using PMVECs identified AMPKα1 as the molecule responsible for the beneficial effects of AMPK in the lung. Our findings provide novel evidence for AMPKα1 as a vascular repair mechanism important in the pulmonary response to sepsis and identify a role for metformin treatment in the management of capillary injury.