Department of Microbiology, Immunology and Cancer Biology, University of Virginia Health System, Charlottesville, VA, 22908, USA.
Department of Medicine, University of Virginia Health System, Charlottesville, VA, 22908, USA.
Nat Commun. 2019 Jun 20;10(1):2712. doi: 10.1038/s41467-019-10733-9.
Clostridium difficile (C. difficile) incidence has tripled over the past 15 years and is attributed to the emergence of hypervirulent strains. While it is clear that C. difficile toxins cause damaging colonic inflammation, the immune mechanisms protecting from tissue damage require further investigation. Through a transcriptome analysis, we identify IL-33 as an immune target upregulated in response to hypervirulent C. difficile. We demonstrate that IL-33 prevents C. difficile-associated mortality and epithelial disruption independently of bacterial burden or toxin expression. IL-33 drives colonic group 2 innate lymphoid cell (ILC2) activation during infection and IL-33 activated ILC2s are sufficient to prevent disease. Furthermore, intestinal IL-33 expression is regulated by the microbiota as fecal microbiota transplantation (FMT) rescues antibiotic-associated depletion of IL-33. Lastly, dysregulated IL-33 signaling via the decoy receptor, sST2, predicts C. difficile-associated mortality in human patients. Thus, IL-33 signaling to ILC2s is an important mechanism of defense from C. difficile colitis.
艰难梭菌(C. difficile)的发病率在过去 15 年中增加了两倍,这归因于高毒力菌株的出现。虽然很明显,艰难梭菌毒素会导致结肠炎症,但保护组织免受损伤的免疫机制仍需要进一步研究。通过转录组分析,我们确定 IL-33 是一种对高毒力艰难梭菌有反应而上调的免疫靶标。我们证明,IL-33 可独立于细菌负荷或毒素表达预防与艰难梭菌相关的死亡和上皮破坏。IL-33 在感染期间驱动结肠 2 型固有淋巴细胞(ILC2)的激活,而激活的 ILC2 足以预防疾病。此外,肠道中 IL-33 的表达受微生物群调节,因为粪便微生物群移植(FMT)可挽救抗生素相关的 IL-33 耗竭。最后,通过诱饵受体 sST2 失调的 IL-33 信号转导,可预测人类患者中与艰难梭菌相关的死亡率。因此,IL-33 信号转导至 ILC2 是防御艰难梭菌结肠炎的重要机制。