Microvesicle release drives cycles of mitophagy flux disruption and inflammatory amplification in sepsis-induced myocardial dysfunction

Apr 6, 2026Proceedings of the National Academy of Sciences of the United States of America

Microvesicle release may cause repeated breakdown of damaged heart cell parts and increased inflammation in sepsis-related heart problems

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Abstract

Elevated reactive oxygen species (ROS) levels may disrupt mitophagy flux and trigger inflammatory responses in sepsis-induced myocardial dysfunction.

DRP1-mediated mitochondrial fission is linked to excessive ROS accumulation.
Impaired mitophagy flux may activate the RIP1/RIP3 pathway.
The activation of this pathway promotes the release of microvesicles containing mitochondrial components and DNA.
These microvesicles could amplify inflammatory responses via the cGAS-STING and RIP1/RIP3 pathways.
Two interlinked cycles of mitophagy disruption and inflammatory amplification may drive myocardial injury in sepsis.

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Sepsis-induced myocardial dysfunction strongly contributes to high mortality in patients with sepsis by exacerbating systemic organ failure; however, the onset and molecular mechanisms driving this vicious cycle remain unclear. Here, we revealed that DRP1-mediated mitochondrial fission and excessive reactive oxygen species (ROS) accumulation are central to the disruption of mitophagy flux and triggering of inflammatory cascades. Using cecal ligation and puncture mice and lipopolysaccharide-treated HL-1 cell models, combined with advanced imaging and molecular analyses, we demonstrated that elevated ROS activates the RIP1/RIP3 pathway, impairing mitophagy flux and promoting the release of microvesicles containing mitochondrial inner membrane components and mitochondrial DNA. These microvesicles amplify inflammatory responses through the cGAS-STING and RIP1/RIP3 pathways, driving the production of damage- and pathogen-associated molecular patterns. This study highlights two interlinked vicious cycles, mitophagy flux disruption and damage- and pathogen-associated molecular pattern amplification, as critical drivers of sepsis-induced myocardial injury, providing therapeutic targets for mitigating inflammatory damage and improving clinical outcomes in patients with sepsis.

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Microvesicle release drives cycles of mitophagy flux disruption and inflammatory amplification in sepsis-induced myocardial dysfunction

Abstract

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