Abstract

BackgroundUlcerative colitis (UC) is a highly progressive inflammatory disease that requires the interaction of epithelial, immune, endothelial and muscle cells and fibroblasts. Previous studies suggested two inflammatory conditions in UC-patients: ‘acute’ and ‘remodeling’ and that the design of a disease network might improve the understanding of the inflammatory processes. The objective of the study was to design and validate a disease network in the NOD-SCID IL2rγnull (NSG)-UC mouse model to get a better understanding of the inflammatory processes.MethodsLeukocytes were isolated from the spleen of NSG-UC mice and subjected to flow cytometric analysis. RT-PCR and RNAseq analysis were performed from distal parts of the colon. Based on these analyses and the effects of interleukins, chemokines and growth factors described in the literature, a disease network was designed. To validate the disease network the effect of infliximab and pitrakinra was tested in the NSG-UC model. A clinical- and histological score, frequencies of human leukocytes isolated from spleen and mRNA expression levels from distal parts of the colon were determined.ResultsAnalysis of leukocytes isolated from the spleen of challenged NSG-UC mice corroborated CD64, CD163 and CD1a expressing CD14+ monocytes, CD1a expressing CD11b+ macrophages and HGF, TARC, IFNγ and TGFß1 mRNA as inflammatory markers. The disease network suggested that a proinflammatory condition elicited by IL-17c and lipids and relayed by cytotoxic T-cells, Th17 cells and CD1a expressing macrophages and monocytes. Conversely, the remodeling condition was evoked by IL-34 and TARC and promoted by Th2 cells and M2 monocytes. Mice benefitted from treatment with infliximab as indicated by the histological- and clinical score. As predicted by the disease network infliximab reduced the proinflammatory response by suppressing M1 monocytes and CD1a expressing monocytes and macrophages and decreased levels of IFNγ, TARC and HGF mRNA. As predicted by the disease network inflammation aggravated in the presence of pitrakinra as indicated by the clinical and histological score, elevated frequencies of CD1a expressing macrophages and TNFα and IFNγ mRNA levels.ConclusionsThe combination of the disease network and the NSG-UC animal model might be developed into a powerful tool to predict efficacy or in-efficacy and potential mechanistic side effects.

Highlights

  • Ulcerative colitis (UC) is a highly progressive inflammatory disease that requires the interaction of epithelial, immune, endothelial and muscle cells and fibroblasts

  • There seems to be a strong proinflammatory response which might be driven by IL-17 secreted by Th17 cells and by Th1 cells arising from Th17 cells in the presence of IL-6 [9, 10] or Th1 cells activated via CD1a providing an explanation for the responsiveness to TNFα blockers of a subgroup of UC patients

  • For the design and validation of the disease network, we took advantage of a mouse model of UC that is based on NODSCID IL2rγnull (NSG) mice reconstituted with Peripheral blood mononuclear cells (PBMC) from human patients with UC (NSG-UC) [11]

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Summary

Introduction

Ulcerative colitis (UC) is a highly progressive inflammatory disease that requires the interaction of epithelial, immune, endothelial and muscle cells and fibroblasts. Based on the assumption that epithelial cells play an active role in the inflammatory process by releasing cytokines to direct immune responses we designed a panel of immune cells, cytokines and growth factors to develop immune profiles of UC patients. There seems to be a strong proinflammatory response which might be driven by IL-17 secreted by Th17 cells and by Th1 cells arising from Th17 cells in the presence of IL-6 [9, 10] or Th1 cells activated via CD1a providing an explanation for the responsiveness to TNFα blockers of a subgroup of UC patients All these observations suggested that a map of the disease network illustrating the interaction and communication of immune-, epithelial cells and fibroblast may be a promising approach to understand inflammatory processes in UC and to predict efficacy and potential side effects of therapeutics. In the presence of IL-6 and other factors, Treg can adopt a Th17 phenotype skipping the inflammatory balance twofold: by diminishing the Treg and by increasing the Th17 pool [15]

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