Decitabine Reactivation of FoxM1-Dependent Endothelial Regeneration and Vascular Repair for Potential Treatment of Elderly ARDS and COVID-19 Patients

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Abstract

Aging is a major risk factor of high incidence and increased mortality of acute respiratory distress syndrome (ARDS) and COVID-19. We repot that aging impairs the intrinsic FoxM1-dependent endothelial regeneration and vascular repair program and causes persistent lung injury and high mortality following sepsis. Therapeutic gene transduction of FOXM1 in vascular endothelium or treatment with FDA-approved drug Decitabine was sufficient to reactivate FoxM1-dependent lung endothelial regeneration in aged mice, reverse aging-impaired resolution of inflammatory injury, and promote survival. In COVID-19 lung autopsy samples, FOXM1 expression was not induced in vascular endothelial cells of elderly patients in contrast to mid-age patients. Thus, Decitabine reactivation of FoxM1-dependent vascular repair represents a potential effective therapy for elderly COVID-19 and non-COVID-19 ARDS patients.

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  1. SciScore for 10.1101/2021.04.29.442061: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIACUC: The animal care and study protocols were approved by the Institutional Animal Care and Use Committees of Northwestern University and The University of Illinois at Chicago.
    IRB: Human specimens: All experiments with human tissue samples were performed under protocols approved by the Institutional Review Boards at the University of Chicago and Ann & Robert H.
    Sex as a biological variableBoth male and female mice were used in the experiments.
    RandomizationFifteen 63X fields each section were randomly selected and examined.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Mouse lung cryosections were stained overnight with anti-BrdU (1:3, BD Biosciences, or 1:1000 Cell Signaling Technology, Danvers, MA) and incubated with Alexa Fluo 488-conjugated secondary antibody (1:200, Thermal Fisher Scientific, Waltham, MA)
    anti-BrdU
    suggested: None
    Lung vascular ECs were immunostained with anti-vWF (1:300, Sigma-Aldrich, St Louis, MO) and anti-CD31 (1:100, BD Bioscience) antibodies at 4°C.
    anti-vWF
    suggested: None
    Western blot analysis was performed using an anti-FoxM1 antibody (1:800, sc-376471, Santa Cruz Biotechnology, Santa Cruz, CA) and the same blot was incubated with anti-β-actin antibody (1:3000, BD Biosciences) as a loading control.
    anti-FoxM1
    suggested: (Santa Cruz Biotechnology Cat# sc-376471, RRID:AB_11150135)
    sc-376471 , Santa Cruz Biotechnology , Santa Cruz , CA
    suggested: None
    anti-β-actin
    suggested: None
    After RNAscope assay, the slides were incubated in blocking buffer (3% BSA, 1% FBS and 0.1% normal donkey serum) for 1 h followed by with a primary antibody against CD31 (Cat # Ab28364, Abcam, Cambridge, MA) at 4°C overnight.
    CD31
    suggested: (Abcam Cat# ab28364, RRID:AB_726362)
    The sections were washed and incubated with appropriate anti-rabbit secondary antibody labeled with Alexa Fluor 488 for 1 h.
    anti-rabbit
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    Foxm1 transgenic (Foxm1Tg) mice driven by the Rosa26 promoter were described previously (35).
    Foxm1Tg
    suggested: None
    C57BL/6 WT mice (2 mos.
    C57BL/6
    suggested: None
    At 3h following irradiation, the mice were transplanted with 10 million of bone marrow cells (200 μl of EBM2 medium) freshly isolated from EndoSCL-CreERT2 transgenic mice (2 mos. old) through tail vein injection.
    EndoSCL-CreERT2
    suggested: None
    Software and Algorithms
    SentencesResources
    The nuclei were counterstained with DAPI (Thermal Fisher Scientific).
    Thermal Fisher Scientific
    suggested: None
    Statistical significance was determined by one-way ANOVA with a Dunnett post hoc analysis that calculates P values corrected for multiple comparisons for equal variance or Kruskal-Wallis test for unequal variance using Prism 7 (Graphpad Software, Inc. La Jolla, CA)
    Prism
    suggested: (PRISM, RRID:SCR_005375)
    Graphpad
    suggested: (GraphPad, RRID:SCR_000306)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04482621RecruitingDecitabine for Coronavirus (COVID-19) Pneumonia- Acute Respi…


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap(s) used on pages 28 and 44. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.