MS/MS analysis of plasma from AD patients and healthy volunteers (n=8 healthy volunteers

Transcription

1 Figure S. PGFα, - and -HETE are elevated in of patients with Acute Decompensation (AD) when compared with healthy volunteers. (a-g) Lipidomic LC/ESI- MS/MS analysis of from AD patients and healthy volunteers (n=8 healthy volunteers and AD patients). Data are represented as mean ± SEM. P<. t-test. Figure S. Aside from PGE other eicosanoids are not elevated in bile duct ligation (BDL) liver injury mice. (a-p) Lipidomic LC/ESI-MS/MS analysis of lipids from naïve, sham and BDL mice (n=6-8 mice/group). Data are represented as mean ± SEM. Figure S3. The immunosuppressive properties of BDL liver injury mice are mediated by PGE. (a) IL-6 and (b) IL- release from stimulated peritoneal macrophages from naive mice in the presence of healthy (naïve) or BDL mice with or without prior administration of indomethacin, SKFA or baicalein (n=6-8 mice/group). (c) TNFα and (d) IL- release from stimulated peritoneal macrophages from naive mice in the presence or absence of PGE at concentrations found in of BDL or CCL mice (n=8- mice per group). (e) TNFα and (f) IL- release from from stimulated peritoneal macrophages from naive mice in the presence of healthy (naïve) or BDL mice with or without AH689 (3μM) (n=6 mice/group). (g)tnfα, (h) IL6 and (i) IL- release from stimulated peritoneal macrophages from BDL mice in the presence of healthy (naïve) or BDL mice (n= mice/group). Data are represented as mean ± SEM. P<. P<. P<., ANOVA or t-test where appropriate. Figure S. Aside from PGD and PGE, no other eicosanoid was elevated in from CCL mice when compared to shams. (a-p) Lipidomic LC/ESI-MS/MS analysis of Nature Medicine: doi:.38/nm.36

2 from sham and CCL mice (n=6-8 mice/group). Data are represented as mean ± SEM. P<., t-test. Figure S. PGE antagonism with AH689 has a greater immune restorative effect on AD MIS (most immunosuppressive) compared with AD LIS (least immunosuppressed) samples. (a-d) TNFα and IL- release from human monocyte-derived macrophages stimulated with in the presence of from AD patients, patients awaiting liver transplant sampled weeks apart and healthy volunteers with and without AH689; with cirrhosis patients grouped into into AD MIS and AD LIS. (e) -stimulated human monocytederived macrophages TNFα synthesis in the presence of healthy volunteer or AD samples in patients administered.9% saline on days (-6ml) & 3 (-ml) of admission with samples obtained during admission and at - or 3-6 days post discharge (n=). Data are represented as mean ± SEM. P<. P<. P<., ANOVA. Nature Medicine: doi:.38/nm.36

3 Figure S a.3 b 7. c d. TxB (ng/ml).. 9-HODE (ng/ml).. -HETE (ng/ml) 3-HODE (ng/ml) e PGF (ng/ml) Standards Healthy AD f -HETE (ng/ml).. Standards Healthy AD. g.6 -HETE (ng/ml)...3. Standards Healthy AD. Nature Medicine: doi:.38/nm.36

4 Figure S a b c PGD (ng/ml) PGF (ng/ml) HETE (ng/ml) d 8-HETE (ng/ml) e -HETE (ng/ml) 3 f -HETE (ng/ml) 6 3 g -HETE (ng/ml) h TxB (ng/ml) i -HETrE (ng/ml) j 9-HODE (ng/ml) k -HEPE (ng/ml) 6 3 l 3-HODE (ng/ml) 7 7 m 3. n o p -HDOHA (ng/ml) HDOHA (ng/ml) 3 - HDOHA (ng/ml) 7-HDOHA (ng/ml) Nature Medicine: doi:.38/nm.36

5 Figure S3 a IL-6 (ng/ml) b IL- (ng/ml) BDL (+ ) BDL (+ ) c TNF (ng/ml).6.. IL- (pg/ml) d.. e TNF (ng/ml).. f f g h i 3..6 IL- (ng/ml) TNF (ng/ml).... IL- (ng/ml).. IL-6 (ng/ml) Nature Medicine: doi:.38/nm.36

6 Figure S PGD (ng/ml) a b c d PGF (ng/ml).. -HETE (ng/ml) 8-HETE (ng/ml). e 3 f g 6 h -HETE (ng/ml) -HETE (ng/ml) -HETE (ng/ml) TxB (ng/ml) i.6 j k. l 3 -HETrE (ng/ml).. 9-HODE (ng/ml) -HEPE (ng/ml). 3-HODE (ng/ml).. -HDOHA (ng/ml) m n 3-HDOHA (ng/ml) o - HDOHA (ng/ml) p 7-HDOHA (ng/ml).... Nature Medicine: doi:.38/nm.36

7 Figure S a TNF (ng/ml) 8 6 b IL- (ng/ml) 3... c 3. d 6 IL- (ng/ml). TNF α ng/ml 3. e 7 TNF α ng/ml 6 3 SALINE Day /3 Nature Medicine: doi:.38/nm.36

8 Supplementary Table. Patient Clinical Characteristics from DASIMAR study AD MIS n= AD LIS n =3 P Overall n=3 (median, IQR) (median, IQR) value (median, IQR) % 63 7 Age 9. (6.-6.) (8-7).6 (7-6) Sex (males) 6 (73%) 6 (6%) (63%) Albumin 8 (-3) 3 (8-3.). 9 (7-3) INR.7 (.-.).6 (.3-).93.7 (.-) Creatinine 6 (7-9) 6 (7.-). 6 (9-8) MELD score 9. (.6-.8) 8.39 (.-.).93 9 (.-3) Positive microbiology Died during 3 admission Died within 6 7 months Length of stay. (8-8) (.-9). (7-) (days) CRP 8 (-.) 3 (-3.). 6 (3-9) Bilirubin 78 (3-9) 3 (9-73) (-) Cause of Alcohol (68%) 6 Alcohol (6%) Alcohol (6%) cirrhosis 3 NASH 3 NASH 6 NASH (7%) PBC PBC PBC Sarcoid Cryptogenic HCV Congenital hepatic HBV HBV fibrosis HCV HCV Congenital hepatic fibrosis PGE. (.9-.6); n=7.6 (.3-.8);..9 (.6-.3); n=3 n=6 PGE /albumin. (.36-.8); n=7. (.-.8); n=6..37 (.-.9); n=3 NH3 8 (8-6.); n= ; n= (33-36); n=6 Ischemia modified albumin ratio (IMAR). (.-.6); n=. (.-.); n=.7.7(.-.); n= Nature Medicine: doi:.38/nm.36

9 Supplementary Table. Lipid levels in human Healthy Volunteers (n=8) (ng/ml) AD Patients (n=) (ng/ml) PGE.(.3).9(.) PGD PGFA.8(.8) PGE PGD TXB.3(.).77(.) 9-HODE.(.63).87(.) 3-HODE 8.7(.7) 6.9(.69) -HETE.(.).3(.) 8-HETE.(.) -HETE.6(.) -HETE.7(.) -HETE.66(.6).8(.8) -HETrE.39(.3) P<. P<. P<., t-test cirrhosis vs healthy volunteers Nature Medicine: doi:.38/nm.36

10 Supplementary Table 3. Mouse clinical and biochemical data Naïve Sham BDL CCL mouse mouse mouse mouse Albumin 9(3) 9() () 8.() ALT (9) 6(.) 3(33) 39(8) AST 68() 9(8) 96() Total Protein (3) 3() 3(.7) Glucose (.) () 6() Bilirubin () 7(.9) 38(3) Creatinine 9(.7) (.3) 7(.6) Urea 9(.7) 8(.) 9(.9) TNFα ρg.ml - (.6) 3(6) 6() Cardiac output 8.(.9) 6.7(.) 6() Mean arterial - () 99() pressure (mmhg) Core Temperature 37.8(.) 37.6 (.) 3.(.) 37.8(.) Age at surgery weeks weeks weeks Weight (g) 7.8(.6) 7(.) 9.(.3) 8(.) P<. P<. P<., t-test for BDL or CCL vs naïve or sham mice Nature Medicine: doi:.38/nm.36

11 Supplementary Table. Murine Sickness score following bacterial peritonitis. Mice culled if score of at any point or score of 3 for greater than h Clinical Feature Score Piloerection Slow movement Hunched posture Pus in eye(s) 3 Failure to move Weight loss >% Nature Medicine: doi:.38/nm.36