Batroxobin accelerated tissue repair via neutrophil extracellular trap regulation and defibrinogenation in a murine ischemic hindlimb model

PLoS One. 2019 Aug 16;14(8):e0220898. doi: 10.1371/journal.pone.0220898. eCollection 2019.

Abstract

Batroxobin, isolated from Bothrops moojeni, is a defibrinogenating agent used as a thrombin-like serine protease against fibrinogen for improving microcirculation. Here, we investigated whether, and if so, how batroxobin restores ischemic tissue injury in terms of anti-inflammatory effects. In an in vitro flow cytometry assay for human neutrophil extracellular traps (NETs), batroxobin (DF-521; Defibrase) inhibited human NETs induced by tumor necrosis factor-α (TNF-α) in the presence of human fibrinogen. Next, the effect of batroxobin was investigated by immunohistochemistry of the anterior tibial muscle (ATM) in an ischemic hindlimb model using C57BL/6J mice intraperitoneally injected with DF-521 versus the saline control. NETs and fibrinogen deposition in the ischemic ATM decreased in DF-521-treated mice on day 2 after ischemia. Meanwhile, reverse transcription-quantitative PCR assay of the ischemic ATM unveiled continuous downregulation in the expression of the genes; Tnf-α and nitric oxide synthase2 (Nos2) with hypoxia-inducible factor-1α (Hif-1α) and vascular endothelial growth factor-a (Vegf-a) from day 3 to day 7, but the upregulation of arginase-1 (Arg-1) and placental growth factor (Plgf) with myogenin (Myog) on day 7. Daily intraperitoneal DF-521 injection for the initial 7 days into mice with ischemic hindlimbs promoted angiogenesis and arteriogenesis on day 14. Moreover, DF-521 injection accelerated myofiber maturation after day 14. Laser doppler imaging analysis revealed that blood perfusion in DF-521-injected mice significantly improved on day 14 versus the saline control. Thus, DF-521 improves microcirculation by protecting NETs with tissue defibrinogenation, thereby protecting against severe ischemic tissue injury and accelerating vascular and skeletal muscular regeneration. To our knowledge, batroxobin might be the first clinically applicable NET inhibitor against ischemic diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Batroxobin / therapeutic use*
  • Cells, Cultured
  • Disease Models, Animal
  • Extracellular Traps / drug effects*
  • Extracellular Traps / immunology
  • Fibrinolytic Agents / therapeutic use*
  • Hindlimb / blood supply
  • Humans
  • Inflammation / drug therapy
  • Inflammation / immunology
  • Ischemia / drug therapy*
  • Ischemia / immunology
  • Male
  • Mice, Inbred C57BL
  • Middle Aged
  • Wound Healing / drug effects
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Fibrinolytic Agents
  • Batroxobin

Grants and funding

Batroxobin (DF-521; Defibrase®) was supplied by Tobishi Pharmaceutical Co., Ltd. This study was financially supported by AMED under Grant Number JP19lm0203004 (HM), Tokai University School of Medicine Research Aid (HM), the Ministry of Education, Culture, Sports, Science and Technology (Academic Frontier Promotion Program and Basic Research Grant 25461091), and Tobishi Pharmaceutical Co., Ltd., under Grant Number 17A006000 (HM). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.