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Secreted phospholipase PLA2G5 acts as a hemolytic factor in sepsis
Michihiro Takahama, Krysta S. Wolfe, Gabriella Richey, Madison Plaster, Anna Czapar, Fabian Hernandez, Denis Cipurko, Tatsuki Ueda, Yoshimi Miki, Yuki Nagasaki, Yoshitaka Taketomi, Tatsuya Saitoh, Tadafumi Kawamoto, Steven M. Dudek, Makoto Murakami, Nicolas Chevrier
Michihiro Takahama, Krysta S. Wolfe, Gabriella Richey, Madison Plaster, Anna Czapar, Fabian Hernandez, Denis Cipurko, Tatsuki Ueda, Yoshimi Miki, Yuki Nagasaki, Yoshitaka Taketomi, Tatsuya Saitoh, Tadafumi Kawamoto, Steven M. Dudek, Makoto Murakami, Nicolas Chevrier
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Research Article Infectious disease Inflammation

Secreted phospholipase PLA2G5 acts as a hemolytic factor in sepsis

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Abstract

Sepsis is a systemic response to infection with life-threatening consequences such as hemolysis, a predictor of mortality risks for the disease. Here, by measuring organism-wide changes in gene expression, we discovered that the secreted phospholipase PLA2G5 is induced in colon cell types during sepsis. The genetic deletion of Pla2g5 and treatment with a PLA2G5 antibody were both associated with protection from lethal sepsis. Treatment with a PLA2G5 antibody during sepsis was associated with increased splenic red pulp macrophages and improved iron homeostasis, linking PLA2G5 to red blood cell homeostasis during sepsis. Mechanistically, bloodborne PLA2G5 led to intravascular hemolysis through its lipolytic activity on red blood cell membranes. In humans with sepsis due to bacterial, fungal, or viral infections, the serum level of PLA2G5 was elevated and predictive of disease severity and mortality. We conclude that sepsis corrupts PLA2G5 into becoming an intravascular hemolytic factor which is toxic for host red blood cells.

Authors

Michihiro Takahama, Krysta S. Wolfe, Gabriella Richey, Madison Plaster, Anna Czapar, Fabian Hernandez, Denis Cipurko, Tatsuki Ueda, Yoshimi Miki, Yuki Nagasaki, Yoshitaka Taketomi, Tatsuya Saitoh, Tadafumi Kawamoto, Steven M. Dudek, Makoto Murakami, Nicolas Chevrier

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Figure 7

The serum level of PLA2G5 is elevated in humans with sepsis.

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The serum level of PLA2G5 is elevated in humans with sepsis.
(A) Schemat...
(A) Schematic of study cohort. Serum samples were collected from patients from the University of Chicago hospital’s Medical Intensive Care Unit who matched the clinical definition of sepsis. Control samples were obtained from age-matched, healthy control individuals. (B) Box plot depicting the serum levels of PLA2G5 in septic patients with the sequential organ failure assessment (SOFA) scores of ≤ 7 versus ≥ 8. Box edges, interquartile range; middle line, median. **P < 0.01 by 2-tailed Student’s t test. (C) Correlation between the serum levels of PLA2G5 in patients with bacterial, fungal, or viral sepsis as indicated (colors) and SOFA score (data from B). Dots outlined in black indicate samples from patients who died from sepsis. (D) Schematic of study cohort in public blood proteomic data from patients with COVID-19. A1 is the most severe group and A5 is the least severe group. ED, Emergency Department. (E) Box plots depicting log2 relative fluorescence units of PLA2G5 level in plasma of patients with COVID-19 by severity over time (see Methods). Patients were classified by acuity levels based on the WHO Ordinal Outcomes Scale. Acuity levels were determined by their severity condition within 28 days after enrollment as follows: A1, death within 28 days; A2, intubation, mechanical ventilation; A3, hospitalized and requiring supplemental oxygen; A4, hospitalized without requiring supplemental oxygen; and A5, discharged directly from the Emergency Department without subsequently returning and requiring admission within 28 days. A1–A2 were classified as sepsis (dark grey) and A3–A5 as nonsepsis (white). Box edges, interquartile range; middle line, median. (F) Distribution of accuracy values from a decision tree classifier analysis using PLA2G5 plasma levels at day 0 from sepsis and nonsepsis patient groups (data from E).

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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