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Liposome-encapsulated dexamethasone attenuates ventilator-induced lung inflammation
Authors:Hegeman M A  Cobelens P M  Kamps Jaam  Hennus M P  Jansen N J G  Schultz M J  van Vught A J  Molema G  Heijnen C J
Institution:Laboratory of Neuroimmunology and Developmental Origins of Disease, Utrecht, the Netherlands.
Abstract:

BACKGROUND AND PURPOSE

Systemic glucocorticoid therapy may effectively attenuate lung inflammation but also induce severe side-effects. Delivery of glucocorticoids by liposomes could therefore be beneficial. We investigated if liposome-encapsulated dexamethasone inhibited ventilator-induced lung inflammation. Furthermore, we evaluated whether targeting of cellular Fcγ-receptors (FcγRs) by conjugating immunoglobulin G (IgG) to liposomes, would improve the efficacy of dexamethasone-liposomes in attenuating granulocyte infiltration, one of the hallmarks of lung inflammation.

EXPERIMENTAL APPROACH

Mice were anaesthetized, tracheotomized and mechanically ventilated for 5 h with either ‘low’ tidal volumes ~7.5 mL·kg?1 (LVT) or ‘high’ tidal volumes ~15 mL·kg?1 (HVT). At initiation of ventilation, we intravenously administered dexamethasone encapsulated in liposomes (Dex-liposomes), dexamethasone encapsulated in IgG-modified liposomes (IgG-Dex-liposomes) or free dexamethasone. Non-ventilated mice served as controls.

KEY RESULTS

Dex-liposomes attenuated granulocyte infiltration and IL-6 mRNA expression after LVT-ventilation, but not after HVT-ventilation. Dex-liposomes also down-regulated mRNA expression of IL-1β and KC, but not of CCL2 (MCP-1) in lungs of LVT and HVT-ventilated mice. Importantly, IgG-Dex-liposomes inhibited granulocyte influx caused by either LVT or HVT-ventilation. IgG-Dex-liposomes diminished IL-1β and KC mRNA expression in both ventilation groups, and IL-6 and CCL2 mRNA expression in the LVT-ventilated group. Free dexamethasone prevented granulocyte influx and inflammatory mediator expression induced by LVT or HVT-ventilation.

CONCLUSIONS AND IMPLICATIONS

FcγR-targeted IgG-Dex-liposomes are pharmacologically more effective than Dex-liposomes particularly in inhibiting pulmonary granulocyte infiltration. IgG-Dex-liposomes inhibited most parameters of ventilator-induced lung inflammation as effectively as free dexamethasone, with the advantage that liposome-encapsulated dexamethasone will be released locally in the lung thereby preventing systemic side-effects.
Keywords:mechanical ventilation  ventilator-induced lung injury  lung inflammation  Fcγ-receptor targeting  dexamethasone-liposomes  mouse
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