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P2X7 receptor induces mitochondrial failure in monocytes and compromises NLRP3 inflammasome activation during sepsis
Open accessAbstract
Sepsis is characterized by a systemic inflammatory response followed by immunosuppression of the host. Metabolic defects and mitochondrial failure are common in immunocompromised patients with sepsis. The NLRP3 inflammasome is important for establishing an inflammatory response after activation by the purinergic P2X7 receptor. Here, we study a cohort of individuals with intra-abdominal origin sepsis and show that patient monocytes have impaired NLRP3 activation by the P2X7 receptor. Furthermore, most sepsis-related deaths are among patients whose NLRP3 activation is profoundly altered. In monocytes from sepsis patients, the P2X7 receptor is associated with mitochondrial dysfunction. Furthermore, activation of the P2X7 receptor results in mitochondrial damage, which in turn inhibits NLRP3 activation by HIF-1α. We show that mortality increases in a mouse model of sepsis when the P2X7 receptor is activated in vivo. These data reveal a molecular mechanism initiated by the P2X7 receptor that contributes to NLRP3 impairment during infection.
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“It was already reported its capacity to modulate acute and chronic infection [81, 82], inflammatory diseases [82], sepsis [83, 84], neuropathic pain [85], and T-cell activation [86].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [83]
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Self-citationMechanical ventilation preserves diaphragm mitochondrial function in a rat sepsis model
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“Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, is a biphasic disease whose progression has been shown to be closely related to systemic inflammatory responses and host immunosuppression (1,2).”
BackgroundMethodPurinergic P2X7 receptor expression increases in leukocytes from intra-abdominal septic patients
Martínez‐Banaclocha, H., García-Palenciano, C., Martínez-Alarcón, L., Amores-Iniesta, J., Martín‐Sánchez, F., Ercole, G. A., González-Lisorge, A., Fernández-Pacheco, J., Martínez-Gil, P., Padilla-Rodríguez, J., et al. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1297249 · Cited by 6
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BackgroundEVALUATION OF COMPONENTS OF THE EXTRACELLULAR PURINERGIC SIGNALING SYSTEM IN HUMAN SEPSIS
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Lozano‐Rodríguez, R., Ortiz, J. A., Montalbán-Hernández, K. M., Ruiz‐Rodríguez, J. C., Ferrer, R., Martín‐Quirós, A., Maroun‐Eid, C., González‐López, J. J., Fàbrega, A., Terrón, V., et al. (2020) · medRxiv · doi:10.1101/2020.05.30.20117473 · Cited by 6
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BackgroundInfluentialSelf-citationP2X7 receptor: A receptor closely linked with sepsis-associated encephalopathy
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“Immunosuppression is a compensatory response to avoid excessive production of inflammatory factors [4].”
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Sepsis-induced inflammasome impairment facilitates development of secondary A. baumannii pneumonia
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“This stays in line with a report on the altered inflammasome activity regulation in septic patients [27] .”
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Self-citationDifferential expression of plasma cytokines in sepsis patients and their clinical implications
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Biting the hand that feeds: Metabolic determinants of cell fate during infection
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“Calcium (Ca) flux is a known determinant of mitochondrial ROS production (55).”
BackgroundZalpoor, H., Akbari, A., Nabi‐Afjadi, M., Norouzi, A., Seif, F., & Pornour, M. (2023) · Journal of Cellular Signaling · doi:10.33696/signaling.4.087 · Cited by 3
“In severe inflammation, its increased activation may decrease lymphocyte function by impairing mitochondrial function, as has been seen in monocytes in sepsis [26].”
BackgroundSimões, J. L. B., Braga, G. D. C., Eichler, S. W., da Silva, G. B., & Bagatini, M. D. (2024) · Purinergic Signalling · doi:10.1007/s11302-024-09998-7 · Cited by 4
“Finally, as a result of all this mechanism that occurs simultaneously, it culminates in neurodegeneration and neuronal death [83, 104].”
Identification of prognostic biomarkers of sepsis and construction of ceRNA regulatory networks
Chen, G., Zhang, W., Wang, C., Chen, M., Hu, Y., & Wang, Z. (2025) · Scientific Reports · doi:10.1038/s41598-024-78502-3 · Cited by 4
Repositioning linifanib as a potent anti-necroptosis agent for sepsisPreprint
Kai, Y., Li, M., Yu, L., & He, X. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.03.24.485557 · Cited by 3
Lu, Y., Meng, J., Yun, M., Hacker, M., Li, X., & Zhang, X. (2023) · EJNMMI Research · doi:10.1186/s13550-023-01035-9 · Cited by 2
“The circulating innate immune cells are recruited to the injured myocardium to help myocardial repair after MI [20].”
BackgroundBiomimetic siRNA therapeutics attenuate mitochondrial DNA damage and cytokine storm in sepsis
Jiang, S., Zhou, Y., Ge, C., Zhou, R., Ren, M., Yin, L., & Zhu, J. (2025) · Journal of Controlled Release · doi:10.1016/j.jconrel.2025.114545 · Cited by 2
Johari, T., & Chicco, D. (2026) · Discover Computing · doi:10.1007/s10791-026-09974-2 · Cited by 2
P2X receptors in immune cells: key regulators of inflammation and immune function
Adinolfi, E., Falzoni, S., Fortuna, F., Ricci, L., Ruo, L., Grignolo, M., Giuliani, A. L., & Pegoraro, A. (2026) · Neuropharmacology · doi:10.1016/j.neuropharm.2026.110976 · Cited by 2
Altered Ex Vivo NLRP3 Inflammasome Activation Is Associated with 28-Day Mortality in Septic Patients
Coudereau, R., Monneret, G., Lukaszewicz, A., Py, B. F., Argaud, L., Cour, M., Bidar, F., Gossez, M., & Venet, F. (2023) · Viruses · doi:10.3390/v15122419 · Cited by 2
“This aligns with the “NLRP3 immunocompro-mised” proposed by Martinez-Garcia and colleagues who reported a decline in both IL-1 β production and the formation of ASC specks in septic patients [22].”
ResultExploring the role of pyroptosis and immune infiltration in sepsis based on bioinformatic analysis
Li, Z., Wang, Y., & Yu, X. (2024) · Immunobiology · doi:10.1016/j.imbio.2024.152826 · Cited by 2
Could P2X7 receptor be a potencial target in neonatal sepsis?
Fialho, S., Trieu‐Cuot, P., Ferreira, P., & Oliveira, L. (2024) · International Immunopharmacology · doi:10.1016/j.intimp.2024.112969 · Cited by 2
加奈子, 原., 堤, 理., 中西, 信., & Sakaue, H. (2020) · The Japanese Journal of SURGICAL METABOLISM and NUTRITION · doi:10.11638/jssmn.54.3_143 · Cited by 2
A rationale for targeting the P2X7 receptor in Coronavirus disease 19 (Covid-19)Preprint
Virgilio, F. D., Tang, Y., Sarti, A. C., & Rossato, M. (2020) · doi:10.22541/au.158757991.11121908 · Cited by 2
Quantitative assessment of mitochondrial membrane potential in macrophages in sepsis
Ahmad, A., Kanmani, P., & Hu, G. (2024) · Methods in cell biology · doi:10.1016/bs.mcb.2024.01.004 · Cited by 1
Kögel, A., Voßhage, N., Behzadi, A., Laufs, U., & Fikenzer, S. (2024) · Frontiers in Physiology · doi:10.3389/fphys.2024.1394340 · Cited by 1
Ulaş, N., Özkanlar, S., Yıldırım, S., Aydın, Ö., & Özkanlar, Y. (2025) · Current Issues in Molecular Biology · doi:10.3390/cimb47090770 · Cited by 1
“It has also been reported that LPS increases the expression of P2X7R, which is a strong activator of NLRP3 inflammasome, in lung tissue [16,40].”
Ma, X., Wang, J., Han, K. S., & Lu, J. (2025) · PLoS ONE · doi:10.1371/journal.pone.0336982 · Cited by 1
Targeting the purinergic P2X7 receptor in epilepsy: Cell types matter
Engel, T., Salari, V., Sun, M.-J., & Mitra, M. (2026) · Neuropharmacology · doi:10.1016/j.neuropharm.2026.110973 · Cited by 1
Zhang, N., Cai, C., Li, G., Zhang, X., Cui, M., Zhao, C., Zhu, H., Ren, S., & An, H. (2026) · Advanced Composites and Hybrid Materials · doi:10.1007/s42114-026-01844-1 · Cited by 1
Boldeanu, M. V., Boldeanu, L., & Siloşi, I. (2021) · Romanian Archives of Microbiology and Immunology · doi:10.54044/rami.2021.03.05 · Cited by 1
Hurtado‐Navarro, L., García-Palenciano, C., & Pelegrı́n, P. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-91802-2.00014-1 · Cited by 1
Self-citationLi, S., Chen, W., Zhang, Z., Yuan, L., Hu, Y., & Chen, M. (2024) · Open Life Sciences · doi:10.1515/biol-2022-0999 · Cited by 1
Cell-free fat extract protects septic lethality via restraining NLRP3 inflammasome activation.
Wu, D., Li, X., Wang, X., & Wang, D. (2022) · PubMed Central · Cited by 1
Integrated Bioinformatics Analysis Reveals APEX1 as a Potential Biomarker for Septic CardiomyopathyPreprint
Pu, J., Gao, F., & He, Y. (2023) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2023.01.03.522553 · Cited by 1
“Sepsis is a systemic inflammatory response syndrome caused by infection [22], and it is also one of the main causes of death in intensive care unit patients [23].”
BackgroundBai, Y., Liu, Y., & Jiang, S. (2021) · Journal of Biomaterials and Tissue Engineering · doi:10.1166/jbt.2021.2745
Guan, S., Ye, Z., Miao, H., Gong, X., Zhao, J., & Duan, S. (2023) · Research Square · doi:10.21203/rs.3.rs-2473958/v1
Systemic Oncosphere: Host Innate Immune System
Saw, P. E., & Song, E. (2023) · Springer eBooks · doi:10.1007/978-981-99-1183-7_19
Analysis of the Pathogenesis of Gram-Negative Bacterial Sepsis in Rats Under Nano-Body
Li, X., Wang, X., Liu, W., Li, W., & Li, M. (2023) · Journal of Biomedical Nanotechnology · doi:10.1166/jbn.2023.3653
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Parikh, M., Soni, A., & Gandhi, T. R. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-22300-6.00019-x
Metadata
- Authors
- Martínez-García, J. J., Martínez-Banaclocha, H., Angosto-Bazarra, D., de Torre-Minguela, C., Baroja-Mazo, A., Alarcón-Vila, C., Martínez-Alarcón, L., Amores-Iniesta, J., Martín-Sánchez, F., Ercole, G. A., Martínez, C. M., González-Lisorge, A., Fernández-Pacheco, J., Martínez-Gil, P., Adriouch, S., Koch-Nolte, F., Luján, J., Acosta-Villegas, F., Parrilla, P., García-Palenciano, C., & Pelegrin, P.
- Affiliations
- Instituto Murciano de Investigación Biosanitaria (ES)
- Hospital Universitario Virgen de la Arrixaca (ES)
- Inserm (FR)
- ORCID
- Venue
- Nature Communications
- Published
- 2019-06-20
- Volume
- 10
- Issue
- 1
- Pages
- 2711-2711
- ISSN
- 2041-1723 (ISSN-L)
- PMC
- PMC6586640
- OpenAlex
- W2952125019
- Cited by
- 233
- References
- 63
- Citations by year
- 2026: 16 · 2025: 16 · 2024: 44 · 2023: 48 · 2022: 39 · 2021: 34 · 2020: 33 · 2019: 3
- FWCI
- 9.01
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nature Communications (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Hispana (publishedVersion, cc-by)
- HAL (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Institute for Research in Biomedicine
- Ablynx
- European Cooperation in Science and Technology (BM-1406)
- Ministerio de Economía y Competitividad (FJCI-2014-22041, PI13/00174, CD13/00059)
- Ministerio de Asuntos Económicos y Transformación Digital, Gobierno de España (SAF2017‐88276‐R)
- European Regional Development Fund (PI13/00174)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Inflammasome and immune disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Physiology › Adenosine and Purinergic Signaling
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Keywords
- P2X7 receptor, NLRP3 inflammasome, mitochondrial dysfunction, monocytes, sepsis, HIF-1α, purinergic signaling, immunosuppression, sepsis mortality, abdominal sepsis, mouse sepsis model
- MeSH terms
- NLR Family, Pyrin Domain-Containing 3 Protein, Adult, Aged, Aged, 80 and over, Animals, Disease Models, Animal, Female, Follow-Up Studies, Humans, Macrophages, Male, Middle Aged, Mitochondria, Monocytes, Up-Regulation, Sepsis, Mice, Hypoxia-Inducible Factor 1, alpha Subunit, Receptors, Purinergic P2X7, Inflammasomes, Mitochondrial Dynamics
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