New York University School of Medicine, New York, New York.
Radboud University Medical Center, Nijmegen, The Netherlands.
Arthritis Rheumatol. 2018 Dec;70(12):1971-1983. doi: 10.1002/art.40657.
Intestinal microbiota are associated with the development of inflammatory arthritis. The aim of this study was to dissect intestinal mucosal immune responses in the preclinical phase of arthritis and determine whether the presence of Th17 cells, beyond involvement of the cytokine interleukin-17 (IL-17), is required for arthritis development, and whether the involvement of Th17 cells in arthritis depends on the composition of the host microbiota.
Mucosal T cell production of IL-17, interferon-γ, tumor necrosis factor α (TNFα), IL-22, and granulocyte-macrophage colony-stimulating factor (GM-CSF) was analyzed by flow cytometry and Luminex assay before arthritis onset in mice immunized to develop collagen-induced arthritis (CIA). Pathogenic features of arthritis in mice with CIA and mice with antigen-induced arthritis were compared between Th17 cell-deficient (CD4-Cre Rorc ) and Th17 cell-sufficient (CD4-Cre Rorc ) mice. In addition, the impact of intestinal microbiota on the Th17 cell dependence of CIA was assessed.
Lamina propria CD4 T cells were activated before the onset of arthritis in mice with CIA, with marked up-regulation of several cytokines, including IL-17A, TNFα, and GM-CSF. CD4-Cre Rorc mice showed a specific reduction in intestinal mucosal levels of Th17 cells and partially reduced levels of IL-17-producing CD8 T cells. However, total levels of IL-17A, mostly produced by γδ T cells and neutrophils, were unaffected. The severity of arthritis was significantly reduced in Th17 cell-deficient mice, suggesting that Th17 cells have additional, IL-17A-independent roles in inflammatory arthritis. Accordingly, antigen-stimulated T cells from Th17 cell-deficient mice produced less IL-17A, IL-17F, and GM-CSF. Importantly, the dependence of CIA on the involvement of Th17 cells was mitigated in the presence of an alternative microbiome.
These data from murine models suggest that activation of mucosal immunity precedes the development of arthritis, and also that Th17 cells have a microbiota-dependent role in arthritis. Therefore, a microbiome-guided stratification of patients might improve the efficacy of Th17-targeted therapies.
肠道微生物群与炎症性关节炎的发展有关。本研究旨在剖析关节炎临床前期的肠道黏膜免疫反应,并确定 Th17 细胞的存在(除了细胞因子白细胞介素-17(IL-17)的参与)是否是关节炎发展所必需的,以及 Th17 细胞在关节炎中的参与是否取决于宿主微生物群的组成。
通过流式细胞术和 Luminex 分析,在胶原诱导关节炎(CIA)免疫小鼠发病前分析肠道黏膜 T 细胞产生的白细胞介素-17(IL-17)、干扰素-γ、肿瘤坏死因子-α(TNFα)、IL-22 和粒细胞-巨噬细胞集落刺激因子(GM-CSF)。比较 CIA 小鼠和抗原诱导关节炎小鼠的关节炎发病特征,比较 Th17 细胞缺陷(CD4-Cre Rorc )和 Th17 细胞充足(CD4-Cre Rorc )小鼠之间。此外,还评估了肠道微生物群对 CIA 中 Th17 细胞依赖性的影响。
CIA 小鼠关节炎发病前,固有层 CD4 T 细胞被激活,多种细胞因子包括白细胞介素-17A、TNFα 和 GM-CSF 表达上调。CD4-Cre Rorc 小鼠肠道黏膜 Th17 细胞水平特异性降低,IL-17 产生 CD8 T 细胞水平部分降低。然而,γδ T 细胞和中性粒细胞产生的 IL-17A 总水平不受影响。Th17 细胞缺陷小鼠关节炎严重程度显著降低,表明 Th17 细胞在炎症性关节炎中具有额外的、不依赖于 IL-17A 的作用。相应地,Th17 细胞缺陷小鼠的抗原刺激 T 细胞产生的 IL-17A、IL-17F 和 GM-CSF 减少。重要的是,在存在替代微生物组的情况下,CIA 对 Th17 细胞参与的依赖性降低。
这些来自小鼠模型的研究结果表明,黏膜免疫的激活先于关节炎的发展,并且 Th17 细胞在关节炎中具有依赖于微生物群的作用。因此,基于微生物组的患者分层可能会提高 Th17 靶向治疗的疗效。