TY - JOUR AB - Hemolysis drives susceptibility to bacterial infections and predicts poor outcome from sepsis. These detrimental effects are commonly considered to be a consequence of heme-iron serving as a nutrient for bacteria. We employed a Gram-negative sepsis model and found that elevated heme levels impaired the control of bacterial proliferation independently of heme-iron acquisition by pathogens. Heme strongly inhibited phagocytosis and the migration of human and mouse phagocytes by disrupting actin cytoskeletal dynamics via activation of the GTP-binding Rho family protein Cdc42 by the guanine nucleotide exchange factor DOCK8. A chemical screening approach revealed that quinine effectively prevented heme effects on the cytoskeleton, restored phagocytosis and improved survival in sepsis. These mechanistic insights provide potential therapeutic targets for patients with sepsis or hemolytic disorders. AU - Martins, Rui AU - Maier, Julia AU - Gorki, Anna AU - Huber, Kilian AU - Sharif, Omar AU - Starkl, Philipp AU - Saluzzo, Simona AU - Quattrone, Federica AU - Gawish, Riem AU - Lakovits, Karin AU - Aichinger, Michael AU - Radic Sarikas, Branka AU - Lardeau, Charles AU - Hladik, Anastasiya AU - Korosec, Ana AU - Brown, Markus AU - Vaahtomeri, Kari AU - Duggan, Michelle AU - Kerjaschki, Dontscho AU - Esterbauer, Harald AU - Colinge, Jacques AU - Eisenbarth, Stephanie AU - Decker, Thomas AU - Bennett, Keiryn AU - Kubicek, Stefan AU - Sixt, Michael K AU - Superti Furga, Giulio AU - Knapp, Sylvia ID - 1142 IS - 12 JF - Nature Immunology TI - Heme drives hemolysis-induced susceptibility to infection via disruption of phagocyte functions VL - 17 ER -