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

R Rui Song (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University) Y Yinrui Ma (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University) J Junfang Wan (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University) S Shuai Hao (State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry) B Bing Chen Y Yichen Liao (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University) Y Yingjiao Liao (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University) Y Yuzhou Xiao (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University) X Xi Zhang Z Zhaocai Zhang (Department of Critical Care Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine) S Shuang Ren (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University) X Xuxin Tan (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University) J Jiahe Tan (Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University) H He Huang M Milad Ashrafizadeh (Department of Radiation Oncology, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences) G Gautam Sethi (Department of Pharmacology and National University of Singapore Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore) J João Conde L Liangming Liu (State Key Laboratory of Trauma and Chemical Poisoning, Department of Shock and Transfusion, Army Medical Center, Army Medical University) C Chenyang Duan (Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University)

Abstract

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.

Article Details

Volume / Issue Vol. 123, Issue 15
Published April 14, 2026
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (19)

R

Rui Song

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University

Y

Yinrui Ma

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University

J

Junfang Wan

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University

S

Shuai Hao

State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry

B

Bing Chen

Y

Yichen Liao

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University

Y

Yingjiao Liao

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University

Y

Yuzhou Xiao

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University

X

Xi Zhang

Z

Zhaocai Zhang

Department of Critical Care Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine

S

Shuang Ren

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University

X

Xuxin Tan

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University

J

Jiahe Tan

Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University

H

He Huang

M

Milad Ashrafizadeh

Department of Radiation Oncology, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences

G

Gautam Sethi

Department of Pharmacology and National University of Singapore Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore

J

João Conde

L

Liangming Liu

State Key Laboratory of Trauma and Chemical Poisoning, Department of Shock and Transfusion, Army Medical Center, Army Medical University

C

Chenyang Duan

Department of Critical Care Medicine and Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University