Abstract

Tuberculosis (TB) is characterized by extensive pulmonary matrix breakdown. Interleukin‐17 (IL‐17) is key in host defence in TB but its role in TB‐driven tissue damage is unknown. We investigated the hypothesis that respiratory stromal cell matrix metalloproteinase (MMP) production in TB is regulated by T‐helper 17 (TH‐17) cytokines. Biopsies of patients with pulmonary TB were analysed by immunohistochemistry (IHC), and patient bronchoalveolar lavage fluid (BALF) MMP and cytokine concentrations were measured by Luminex assays. Primary human airway epithelial cells were stimulated with conditioned medium from human monocytes infected with Mycobacterium tuberculosis (Mtb) and TH‐17 cytokines. MMP secretion, activity, and gene expression were determined by ELISA, Luminex assay, zymography, RT‐qPCR, and dual luciferase reporter assays. Signalling pathways were examined using phospho‐western analysis and siRNA. IL‐17 is expressed in TB patient granulomas and MMP‐3 is expressed in adjacent pulmonary epithelial cells. IL‐17 had a divergent, concentration‐dependent effect on MMP secretion, increasing epithelial secretion of MMP‐3 (p < 0.001) over 72 h, whilst decreasing that of MMP‐9 (p < 0.0001); mRNA levels were similarly affected. Both IL‐17 and IL‐22 increased fibroblast Mtb‐dependent MMP‐3 secretion but IL‐22 did not modulate epithelial MMP‐3 expression. Both IL‐17 and IL‐22, but not IL‐23, were significantly up‐regulated in BALF from TB patients. IL‐17‐driven MMP‐3 was dependent on p38 MAP kinase and the PI3K p110α subunit. In summary, IL‐17 drives airway stromal cell‐derived MMP‐3, a mediator of tissue destruction in TB, alone and with monocyte‐dependent networks in TB. This is regulated by p38 MAP kinase and PI3K pathways. © 2017 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

Highlights

  • Mycobacterium tuberculosis (Mtb) has evolved adaptive mechanisms to evade host immunity with such success that today it is the number 1 infectious killer in the world and caused 1.3 million deaths in 2016

  • IL-17 decreased respiratory epithelial cell matrix metalloproteinase (MMP)-9 production. Both IL-17 and IL-22 increased fibroblast MMP-3 secretion and we demonstrated for the first time that both of these cytokines are elevated in bronchoalveolar lavage fluid (BALF) from TB patients

  • We have demonstrated for the first time that IL-17 is expressed within human TB granulomas and that adjacent epithelial cells express MMP-3

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Summary

Introduction

Mycobacterium tuberculosis (Mtb) has evolved adaptive mechanisms to evade host immunity with such success that today it is the number 1 infectious killer in the world and caused 1.3 million deaths in 2016 (http://www.who .int/tb/publications/global_report/en/). Diverse studies indicate that host matrix metalloproteinases (MMPs) are key [2,3] and we recently showed that collagen destruction may be a key initial event triggering caseous necrosis [4]. A matrix-degrading phenotype in human TB where MMP activity was relatively unopposed by specific tissue inhibitors of matrix metalloproteinases (TIMPs) was first described by our group [7]. MMP-1 expression was greater in TB cavities and an MMP-1/TIMP imbalance was associated with the development of cavities containing very high bacterial burdens [9]. A study in the zebrafish model showed that MMP-9 from epithelial cells, induced by the mycobacterial virulence factor ESAT-6, enhanced macrophage recruitment [10], thereby implicating MMPs in immunoregulatory as well as tissue destructive roles in TB

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