Genomics and Immunoregulation, LIMES-Institut, University of Bonn, Bonn, Germany.
Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.
Nat Immunol. 2017 Jun;18(6):622-632. doi: 10.1038/ni.3745. Epub 2017 May 1.
The high risk of neonatal death from sepsis is thought to result from impaired responses by innate immune cells; however, the clinical observation of hyperinflammatory courses of neonatal sepsis contradicts this concept. Using transcriptomic, epigenetic and immunological approaches, we demonstrated that high amounts of the perinatal alarmins S100A8 and S100A9 specifically altered MyD88-dependent proinflammatory gene programs. S100 programming prevented hyperinflammatory responses without impairing pathogen defense. TRIF-adaptor-dependent regulatory genes remained unaffected by perinatal S100 programming and responded strongly to lipopolysaccharide, but were barely expressed. Steady-state expression of TRIF-dependent genes increased only gradually during the first year of life in human neonates, shifting immune regulation toward the adult phenotype. Disruption of this critical sequence of transient alarmin programming and subsequent reprogramming of regulatory pathways increased the risk of hyperinflammation and sepsis. Collectively these data suggest that neonates are characterized by a selective, transient microbial unresponsiveness that prevents harmful hyperinflammation in the delicate neonate while allowing for sufficient immunological protection.
人们认为,败血症导致新生儿死亡的高风险是由于先天免疫细胞的反应受损所致;然而,新生儿败血症的炎症反应过度的临床观察与这一概念相矛盾。通过转录组学、表观遗传学和免疫学方法,我们证明大量围产期警报素 S100A8 和 S100A9 特异性改变了 MyD88 依赖性促炎基因程序。S100 编程可防止过度炎症反应而不损害病原体防御。TRIF 接头依赖性调节基因不受围产期 S100 编程的影响,对脂多糖反应强烈,但表达很少。人类新生儿在生命的第一年中,TRIF 依赖性基因的稳态表达仅逐渐增加,免疫调节向成人表型转变。这种关键的警报素编程的瞬时中断和随后的调节途径的重新编程会增加过度炎症和败血症的风险。总的来说,这些数据表明,新生儿的特点是一种选择性的、短暂的微生物无反应性,这种无反应性可防止脆弱的新生儿发生有害的过度炎症,同时提供足够的免疫保护。