Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut.
Am J Physiol Lung Cell Mol Physiol. 2021 Jun 1;320(6):L1137-L1146. doi: 10.1152/ajplung.00575.2020. Epub 2021 Apr 14.
Sarcoidosis is a systemic granulomatous disease predominantly affecting the lungs. The mechanisms promoting disease pathogenesis and progression are unknown, although interleukin-15 (IL-15) has been associated with the immune-mediated inflammation of sarcoidosis. Because the identification of a mechanistically based, clinically relevant biomarker for sarcoidosis remains elusive, we hypothesized this role for IL-15. Pulmonary sarcoidosis granuloma formation was modeled using trehalose 6,6'-dimicolate (TDM), which was administered into wild-type and three lineages of mice: those overexpressing IL-15, deficient in IL-15, and deficient in IL-15 receptor α. The number of granulomas per lung was counted and normalized to the wild type. IL-15 concentrations were measured in the bronchoalveolar lavage (BAL) from healthy controls and subjects with sarcoidosis in our cohort, where associations between IL-15 levels and clinical manifestations were sought. Findings were validated in another independent sarcoidosis cohort. TDM administration resulted in similar granuloma numbers across all lineages of mice. IL-15 concentrations were elevated in the BAL of both human cohorts, irrespective of disease phenotypes. In exploratory analysis, an association with obesity was observed, and various other soluble mediators were identified in the BAL of both cohorts. Although IL-15 is enriched in the sarcoidosis lung, it was independent of disease pathogenesis or clinical manifestations in our mouse model and human cohorts of sarcoidosis. An association with obesity perhaps reflects the ongoing inflammatory processes of these comorbid conditions. Our findings showed that IL-15 is redundant for disease pathogenesis and clinical progression of sarcoidosis.
结节病是一种主要影响肺部的系统性肉芽肿性疾病。虽然白细胞介素-15(IL-15)与结节病的免疫介导炎症有关,但促进疾病发病机制和进展的机制尚不清楚。由于尚未确定一种基于机制的、与临床相关的结节病生物标志物,我们假设 IL-15 具有这种作用。使用海藻糖 6,6'-二酯(TDM)模拟肺结节病肉芽肿形成,将 TDM 注入野生型和三种小鼠谱系:过表达 IL-15、缺乏 IL-15 和缺乏 IL-15 受体 α 的小鼠。对每个肺中的肉芽肿数量进行计数,并与野生型进行归一化。测量了来自我们队列中健康对照者和结节病患者的支气管肺泡灌洗液(BAL)中的 IL-15 浓度,并寻找 IL-15 水平与临床表现之间的关联。在另一个独立的结节病队列中验证了这些发现。TDM 给药导致所有小鼠谱系的肉芽肿数量相似。无论疾病表型如何,BAL 中的 IL-15 浓度在两个人类队列中均升高。在探索性分析中,观察到与肥胖的相关性,并在两个队列的 BAL 中鉴定出各种其他可溶性介质。尽管 IL-15 在结节病肺中丰富,但在我们的小鼠模型和结节病患者的人类队列中,它与疾病发病机制或临床表现无关。与肥胖的关联可能反映了这些合并症的持续炎症过程。我们的研究结果表明,IL-15 对于结节病的发病机制和临床进展是冗余的。