Inhibiting NINJ1-dependent plasma membrane rupture protects against inflammasome-induced blood coagulation and inflammation

  1. Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY
  2. Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, College Station, TX
  3. Department of Molecular and Cellular Biochemistry, University of Kentucky, Lexington, KY
  4. Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY
  5. Department of Surgery, College of Medicine, University of Kentucky, Lexington, KY
  6. Department of Microbiology, Immunology, and Molecular Genetics, College of Medicine, University of Kentucky, Lexington, KY


  • Reviewing Editor
    Yousef Abu-Amer
    Washington University in St. Louis, St Louis, United States of America
  • Senior Editor
    Carla Rothlin
    Yale University, New Haven, United States of America

Reviewer #1 (Public Review):

Referring to previous research findings, the authors explain the connection between NINJ1 and MVs. Additional experiments and clarifications will strengthen the conclusions of this study.

Below are some comments I feel could strengthen the manuscript:

1. The authors mentioned their choice of using heterozygous NINJ1+/- mice on page 4, because of lethality and hydrocephalus. Nonetheless, there is a substantial number of references that use homozygous NINJ1-/- mice. Could there be any other specific reasons for using heterozygous mice in this study?

2. Figure S2 clearly shows the method of pyroptosis induction by flagellin. It is also necessary as a prerequisite for this paper to show the changes in flagellin-induced pyroptosis in heterozygous NINJ1+/- mice.

3. IL-1ß levels controlled by GSDMD were not affected by NINJ1 expression according to previous studies (Ref 37, 29, Nature volume 618, pages 1065-1071 (2023)). GSDMD also plays an important role in TF release in pyroptosis. Are GSDMD levels not altered in heterozygous NINJ1 +/- mice?

4. In Fig 1 F, the authors used a fibrin-specific monoclonal antibody for staining fibrin, but it's not clearly defined. There may be some problem with the quality of antibody or technical issues. Considering this, exploring alternative methods to visualize fibrin might be beneficial. Fibrin is an acidophil material, so attempting H&E staining or Movat's pentachrome staining might help for identify fibrin areas.

Reviewer #2 (Public Review):

The author's main goal is to understand the mechanism by which pyroptosis (through the formation of Gasdermin D (GSDMD) pores in the plasma membrane) contributes to increased release of procoagulant Tissue Factor-containing microvesicles (MV). Their previous data demonstrate that GSDMD is critical for the release of MV that contains Tissue Factor (TF), thus making a link between pyroptosis and hypercoagulation. Given the recent identification of NINJ1 being responsible for plasma membrane rupture (Kayagaki et al. Nature 2011), the authors wanted to determine if NINJ1 is responsible for TF-containing MV release. Given the constitutive ninj1 KO mouse leads to partial embryonic lethality, the authors decided to use a heterozygous ninj1 KO mouse (ninj1+/-). While the data are well controlled, there is limited understanding of the mechanism of action. Also, given that the GSDMD pores have an ~18 nm inner diameter enough to release IL-1β, while larger molecules like LDH (140 kDa) and other DAMPs require plasma membrane rupture (likely mediated by NINJ1), it s not unexpected that large MVs require NINJ1-mediated plasma cell rupture.

The authors convincingly demonstrate that ninj1 haploinsufficiency leads to decreased prothrombin time, plasma TAT and plasma cytokines 90 minutes post-treatment in mice, which leads to partial protection from lethality.

- In the abstract, the authors say "...cytokines and protected against blood coagulation and lethality triggered by bacterial flagellin". This conclusion is not substantiated by the data, as you still see 70% mortality at 24 hours in the ninj1+/- mice.

- The previous publication by the authors (Wu et al. Immunity 2019) clearly shows that GSDMD-dependent pyroptosis is required for inflammasome-induced coagulation and mouse lethality. However, as it is not possible for the authors to use the homozygous ninj1 KO mouse due to partial embryonic lethality, it becomes challenging to compare these two studies and the contributions of GSDMD vs. NINJ1. Comparing the contributions of GSDMD and NINJ1 in human blood-derived monocytes/macrophages where you can delete both genes and assess their relevant contributions to TF-containing MV release within the same background would be crucial in comparing how much contribution NINJ1 has versus what has been published for GSDMD? This would help support the in vivo findings and further corroborate the proposed conclusions made in this manuscript.

- What are the levels of plasma TAT, PT, and inflammatory cytokines if you collect plasma after 90 minutes? Given the majority (~70%) of the ninj+/- mice are dead by 24 hours, it is imperative to determine whether the 90-minute timeframe data (in Fig 1A-G) is also representative of later time points. The question is whether ninj1+/- just delays the increases in prothrombin time, plasma TAT, and plasma cytokines.

  1. Howard Hughes Medical Institute
  2. Wellcome Trust
  3. Max-Planck-Gesellschaft
  4. Knut and Alice Wallenberg Foundation