Abstract
BackgroundWe recently showed that an imbalance between the pro-inflammatory cytokine, interleukin (IL)-17, and the developmental endothelial locus-1 (Del-1) likely contributes to inflammation and salivary gland abnormalities in Sjögren’s syndrome (SS). The glucocorticoid-induced leucine zipper (GILZ) protein is a pivotal player in mediating the anti-inflammatory effects of glucocorticoids. However, its status and role in salivary gland inflammation and dysfunction in SS are not established. Thus, we tested the hypothesis that SS is associated with reduced GILZ expression, thereby contributing to Del-1/Il-17 imbalance and inflammation in salivary glands.MethodsWe utilized the nonobese diabetic (NOD) mice, a model of SS-like disease as well as lower-lip biopsy samples of subjects without or with a diagnosis of SS in association with immunostaining studies. These studies were complemented with in vitro and flow-cytometry studies whereby interleukin (IL)-23-treated salivary gland cells were co-cultured with GILZ-expressing cells or control cells; IL-23 is known to increase generation of IL-17.ResultsSalivary glands of NOD mice displayed marked leukocyte infiltration and reduced GILZ expression in association with increased IL-17 but decreased Del-1 expression. A similar pattern was observed for lower-lip biopsy samples of SS than non-SS subjects. Further, IL-23-treated salivary gland cells displayed marked increase in IL-17 but reduced Del-1 positive cells which were reversed with co-culturing with GILZ-expressing cells but not control cells. Collectively, the results are suggestive of dysregulation of GILZ playing a role in inflammation and associated Del-1/Il-17 imbalance in SS.ConclusionsComplementing our demonstration of Del-1/IL-17 imbalance in salivary glands in SS, the present study has established the relevance and significance of GILZ as a novel predictive and prognostic molecular fingerprint for SS. Thus, assessment of minor salivary gland GILZ expression, in conjunction with Del-1/IL-17 imbalance, could potentially offer a more sensitive approach to help with diagnosis of SS, at early stage of the disease, than that based on leukocyte infiltration. Future studies should establish whether treatment with GILZ ameliorates signs and symptoms of salivary malfunction of SS for which effective treatment options remain elusive.
Highlights
We recently showed that an imbalance between the pro-inflammatory cytokine, interleukin (IL)-17, and the developmental endothelial locus-1 (Del-1) likely contributes to inflammation and salivary gland abnormalities in Sjögren’s syndrome (SS)
As an initial approach and utilizing in vitro protocols, we explored the impact of glucocorticoid-induced leucine zipper (GILZ) delivery on salivary gland cells of mice which were treated with the pro-inflammatory cytokine, IL-23, on Del-1/IL-17 imbalance; Il-23 is an upstream of IL-17 and is known to upregulate its expression [26]
In order to explore the relevance of our observations using the nonobese diabetic (NOD) mouse model, we carried out immunostaining studies for GILZ, Del-1, and IL-17 on lower-lip biopsy samples of female patients with a diagnosis of Sjögren’s disease; lower-lip biopsy sample of patients for whom a diagnosis of SS was not made served as controls
Summary
We recently showed that an imbalance between the pro-inflammatory cytokine, interleukin (IL)-17, and the developmental endothelial locus-1 (Del-1) likely contributes to inflammation and salivary gland abnormalities in Sjögren’s syndrome (SS). Sjögren’s syndrome (SS) is a systemic autoimmune disease with a prevalence of 1–3 %, affecting more women than men (ratio of 9:1). It is characterized by chronic focal leukocyte infiltration and inflammation of exocrine glands, primarily involving salivary (and lacrimal) glands thereby resulting in persistent dryness of the mouth (and eyes) [1,2,3,4]. It is increasingly acknowledged that the salivary hypofunction of SS is not adequately explained based on immune cell infiltration alone This notion is supported by observations that dysregulation of salivary function and signal transduction pathways can occur prior to focal inflammation and reduction in saliva production. Important is the investigation of endogenous regulatory mechanisms which curtail immune and inflammatory responses
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