Exogenous and Endogenous Danger Signals in Inflammatory Bowel Disease

The human chronic inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) are ostensibly disorders of innate immunity with an exaggerated inflammatory response and loss of tolerance to the normal enteric microbial flora. In this project, we have extensively characterized innate immune responses driven by Pathogen Associated Molecular Pattern Molecules (PAMPs) and the more recently recognized Damage Associated Molecular Pattern molecules (DAMPs). The prototype DAMP, a chromatin-associated protein, high mobility group box 1 (HMGB1), is released during cellular necrosis and is secreted from activated macrophages. Extracellularly, it binds the receptor for advanced glycation end products (RAGE), as well as toll-like receptor (TLR) 2 and TLR4, important in the recognition of PAMPs. PAMPs and DAMPs trigger inflammatory signaling pathways in neighboring cells through activation of the transcription factor family, NF-kappaB.Much attention has been given to the central role played by PAMPs in the form of the enteric bacterial flora in IBD pathogenesis. We hypothesize that DAMPs also play a pivotal role in this process. Accordingly, we have determined the significance of DAMPs and PAMPs in the mucosal inflammatory response in macrophages and in vivo in mouse models of IBD.We first investigated expression of TLRs in the gut to determine cell types in the intestinal epithelium that may respond to danger signals. TLR expression was most prominent on intestinal epithelial enteroendocrine cells (EEC). Using a murine EEC line, multiple functional consequences of TLR activation were demonstrated. Second, in IL-10 deficient (-/-) mice with chronic Th1-mediated enterocolitis, we demonstrate a role for HMGB1 in macrophage activation and IBD. Lastly, we examined an in vivo therapy targeted at inhibiting the prominent downstream effector of DAMP and PAMP signaling, NF-kappaB, in murine IBD. Inhibition of activated NF-kappaB with a short cell permeable peptide inhibited chronic enterocolitis in IL-10-/- mice.In summary, this dissertation provides new insight into our understanding of intestinal innate mucosal inflammatory responses. We demonstrate the relevance of TLRs on EECs and the contribution of DAMP and PAMP signaling in disease. These results also provide proof of concept for new therapeutic approaches in IBD

Enteroendocrine cells express functional Toll-like receptors

Intestinal epithelial cells (IECs) provide a physical and immunological barrier against enteric microbial flora. Toll-like receptors (TLRs), through interactions with conserved microbial patterns, activate inflammatory gene expression in cells of the innate immune system. Previous studies of the expression and function of TLRs in IECs have reported varying results. Therefore, TLR expression was characterized in human and murine intestinal sections, and TLR function was tested in an IEC line. TLR1, TLR2, and TLR4 are coexpressed on a subpopulation of human and murine IECs that reside predominantly in the intestinal crypt and belong to the enteroendocrine lineage. An enteroendocrine cell (EEC) line demonstrated a similar expression pattern of TLRs as primary cells. The murine EEC line STC-1 was activated with specific TLR ligands: LPS or synthetic bacterial lipoprotein. In STC-1 cells stimulated with bacterial ligands, NF-κB and MAPK activation was demonstrated. Furthermore, the expression of TNF and macrophage inhibitory protein-2 were induced. Additionally, bacterial ligands induced the expression of the anti-inflammatory gene transforming growth factor-β. LPS triggered a calcium flux in STC-1 cells, resulting in a rapid increase in CCK secretion. Finally, conditioned media from STC-1 cells inhibited the production of nitric oxide and IL-12 p40 by activated macrophages. In conclusion, human and murine IECs that express TLRs belong to the enteroendocrine lineage. Using a murine EEC model, a broad range of functional effects of TLR activation was demonstrated. This study suggests a potential role for EECs in innate immune responses

Ethyl pyruvate decreases HMGB1 release and ameliorates murine colitis

Signals from stressed cells and the enteric microbiota activate macrophages and dendritic cells and mediate intestinal inflammation. HMGB1 serves as an immunogenic stimuli causing release of inflammatory cytokines by myeloid cells. Ethyl pyruvate inhibits secretion of HMGB1 and improves survival in models of endotoxemia and hemorrhagic shock. We reasoned that ethyl pyruvate may be protective in colitis, which involves similar inflammatory pathways. In IL-10-/- mice with established chronic colitis, ethyl pyruvate administration ameliorated colitis and reduced intestinal cytokine production. IL-10-/- mice demonstrated increased intestinal HMGB1 expression and decreased expression of RAGE compared with wild-type mice. Fecal HMGB1 levels were decreased in ethyl pyruvate-treated mice. Furthermore, ethyl pyruvate induced HO-1 expression in intestinal tissue. In TNBS-induced colitis, intrarectal administration of ethyl pyruvate resulted in amelioration of colitis and reduced intestinal cytokine production. In LPS-activated murine macrophages, ethyl pyruvate decreased expression of IL-12 p40 and NO production but did not affect IL-10 levels. Ethyl pyruvate did not inhibit nuclear translocation of NF-κB family members but attenuated NF-κB DNA binding. Additionally, ethyl pyruvate induced HO-1 mRNA and protein expression and HO-1 promoter activation. Moreover, ethyl pyruvate prevented nuclear-to-cytoplasmic translocation of HMGB1. In conclusion, the HMGB1/RAGE pathway has pathophysiologic and diagnostic significance in experimental colitis. Ethyl pyruvate and other strategies to inhibit HMGB1 release and function represent promising interventions in chronic inflammatory diseases. © Society for Leukocyte Biology

Amelioration of chronic murine colitis by peptide-mediated transduction of the IκB kinase inhibitor NEMO binding domain peptide

The NF-κB family of transcription factors is a central regulator of chronic inflammation. The phosphorylation of IκB proteins by the IκB kinase (IKK) complex (IKKα, IKKβ, and NF-κB essential modulator or NEMO) is a key step in NF-κB activation. Peptides corresponding to the NEMO binding domain (NBD) of IKK blocks NF-κB activation without inhibiting basal NF-κB activity. In this report, we determined the effects of the IKK inhibitor peptide (NBD) in a model of spontaneously occurring chronic murine colitis, the IL-10-deficient (IL-10 -/-) mouse. Using a novel cationic peptide transduction domain (PTD) consisting of eight lysine residues (8K), we were able to transduce the NBD peptide into cells and tissues. In a NF-κB reporter system, 8K-NBD dose-dependently inhibits TNF-induced NF-κB activation. Furthermore, 8K-NBD inhibited nuclear translocation of NF-κB family members. In NF-κBEGFP knock-in mice, 8K-NBD inhibited LPS-activated NF-κB (EGFP activity) in the ileum but did not inhibit basal NF-κB in Peyer\u27s patches. IL-10-/- mice treated systemically with 8K-NBD demonstrate amelioration of established colitis, decreased NF-κB activation in the lamina propria, and a reduction in spontaneous intestinal IL-12 p40, TNF, IFN-γ, and IL-17 production. These results demonstrate that inhibitors of IKK, in particular a PTD-NBD peptide, may be therapeutic in the treatment of inflammatory bowel disease. Copyright © 2007 by The American Association of Immunologists, Inc