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ResearchIn-Press PreviewInfectious diseaseInflammation Open Access | 10.1172/JCI184721

IGFBP6 orchestrates anti-infective immune collapse in murine sepsis via prohibitin-2-mediated immunosuppression

Kai Chen,1 Ying Hu,1 Xiaoyan Yu,1 Hong Tang,2 Yanting Ruan,1 Yue Li,3 Xun Gao,4 Qing Zhao,5 Hong Wang,6 Xuemei Zhang,6 David Paul Molloy,7 Yibing Yin,6 Dapeng Chen,8 and Zhixin Song1

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Chen, K. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Hu, Y. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Yu, X. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Tang, H. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Ruan, Y. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Li, Y. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Gao, X. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Zhao, Q. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Wang, H. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Zhang, X. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Molloy, D. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Yin, Y. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Chen, D. in: PubMed | Google Scholar

1Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, China

2Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China

4Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, China

5Department of Laboratory Medicine, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China

6Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Chongqing Medical University, Chongqing, China

7Department of Biochemistry and Molecular Biology, Chongqing Medical University, Chongqing, China

8Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University, Chongqing, China

Find articles by Song, Z. in: PubMed | Google Scholar

Published September 2, 2025 - More info

J Clin Invest. https://doi.org/10.1172/JCI184721.
Copyright © 2025, Chen et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published September 2, 2025 - Version history
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Abstract

The persistent challenge of sepsis-related mortality underscores the necessity for deeper insights, with our multi-center cross-age cohort study identifying insulin-like growth factor binding protein 6 (IGFBP6) as a critical regulator in sepsis diagnosis, prognosis, and mortality risk evaluation. Mechanistically, IGFBP6 engages in IGF-independent binding to prohibitin2 (PHB2) on epithelial cells, driving PHB2 tyrosine phosphorylation during sepsis. This process disrupts STAT1 phosphorylation, nuclear translocation, and its recruitment to the CCL2 promoter, ultimately impairing CCL2 transcription and macrophage chemotaxis. Crucially, PHB2 silencing via siPHB2 and STAT1 activation using 2-NP restored CCL2 expression in vitro and in vivo, improving bacterial clearance and survival in septic mice. Concurrently, IGFBP6 compromises macrophage bactericidal activity by inhibiting Akt phosphorylation, reducing ROS/IL-1β production and phagocytic capacity – defects reversible by Akt agonist SC79. Collectively, IGFBP6 emerges as an endogenous driver of sepsis pathogenesis, positioning it as a dual diagnostic biomarker and therapeutic target. Intervention strategies targeting IGFBP6-mediated signaling may offer transformative approaches for sepsis management.

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graphical abstract
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  • Version 1 (September 2, 2025): In-Press Preview

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