Acta Pharmaceutica Sinica B
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2026, 16(6): 3655-3679
• Original articles •
Steroid hormone ouabain cooperates with Na⁺,K⁺-ATPase to improve innate immunity against bacterial infections through a non-classic training mechanism regulated by mRNA reprogramming
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Lili Chen1, Kuida Chen1,2, RunRun Shan1, Jinjun Bian3, PeiPei Jin3, Hao Lin1, Jian Liu1, Yan Chen1, Siyao Zhu4, Fangzhou Yin5, Wu Yin1
Affiliations
1 State Key Lab of Pharmaceutical Biotechnology, College of Life Sciences, Nanjing University, Nanjing 210023, China;
2 Department of Intensive Care Unit, Northern Jiangsu People's Hospital, Yangzhou 225001, China;
3 Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China;
4 Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA;
5 School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China
doi: 10.1016/j.apsb.2025.12.041
Outline
Epigenetic reprogramming underpins trained immunity (TRIM). However, the importance of mRNA reprogramming in TRIM remains unknown. Here, we discovered, for the first time, that the steroid hormone ouabain creates a significant training effect on peripheral innate immune cells (IICs), leading to functional enhancement of IICs against bacterial infections. However, unlike conventional training mechanisms, ouabain primarily relies on an integrated posttranscriptional RNA regulon complex (IPRRC) to establish immune memory and reprogram cytokine expression, with lncRNA-CYTOR playing a critical role in this process. Moreover, to enhance training effects while reducing lactate production, ouabain promotes a rapid degradation of the Na⁺,K⁺-ATPase receptor. Pathologically, endogenous ouabain is downregulated in sepsis-induced immunoparalysis in vivo, correlating with impaired innate immunity. Exogenous ouabain rescue significantly reverses this impairment, and its effect is superior to β-glucan, even when used at one percent of β-glucan dosage. Notably, posttranscriptional RNA regulons are also critically involved in β-glucan’s training effects. Overall, mRNA reprogramming emerges as a new mechanism for TRIM; steroid hormone ouabain is a novel innate immunity regulator.
Innate immune cells
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Immune training
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mRNA reprogramming
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Endotoxin tolerance
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Posttranscriptional RNA regulons
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Steroid hormone ouabain
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Na+,K+-ATPase
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CYTOR
Lili Chen, Kuida Chen, RunRun Shan, Jinjun Bian, PeiPei Jin, Hao Lin, Jian Liu, Yan Chen, Siyao Zhu, Fangzhou Yin, Wu Yin.
Steroid hormone ouabain cooperates with Na⁺,K⁺-ATPase to improve innate immunity against bacterial infections through a non-classic training mechanism regulated by mRNA reprogramming[J].
Acta Pharmaceutica Sinica B,
2026
, 16
(6)
: 3655
-3679
.
DOI: 10.1016/j.apsb.2025.12.041
Year 2026 volume 16 Issue 6
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Article Info
doi: 10.1016/j.apsb.2025.12.041
- Receive Date:2025-07-29
- Online Date:2026-09-17