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TNF-?–induced protein 3 (TNFAIP3)/A20 acts as a master switch in TNF-? blockade–driven IL-17A expression - 04/08/18

Doi : 10.1016/j.jaci.2017.11.024 
Paulo C.M. Urbano, MSc a, Raúl Aguirre-Gamboa, MSc b, Angel Ashikov, PhD c, Bennie van Heeswijk, BSc a, Anja Krippner-Heidenreich, PhD d, Henk Tijssen, BSc a, Yang Li, PhD b, Valderilio F. Azevedo, MD, PhD e, Lisa J.T. Smits, MSc f, Frank Hoentjen, MD, PhD f, Irma Joosten, DVM, PhD a, Hans J.P.M. Koenen, PhD a,
a Department of Laboratory Medicine, Laboratory of Medical Immunology (LMI), Radboud University Medical Center, Nijmegen, The Netherlands 
c Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands 
f Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands 
b Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands 
d Newcastle University, Northern Institute for Cancer Research, Wolfson Childhood Cancer Research Centre, Newcastle upon Tyne, United Kingdom 
e Departamento de Medicina Interna, Universidade Federal do Parana, Hospital de Clinicas de Curitiba, Curitiba, Brazil 

Corresponding author: Hans J.P.M. Koenen, PhD, Department of Laboratory Medicine, Laboratory Medical Immunology (LMI), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6500 HB, Route 469, Nijmegen, The Netherlands.Department of Laboratory MedicineLaboratory Medical Immunology (LMI)Radboud University Medical CenterGeert Grooteplein Zuid 10, 6500 HB, Route 469NijmegenThe Netherlands

Abstract

Background

Anti-TNF inhibitors successfully improve the quality of life of patients with inflammatory disease. Unfortunately, not all patients respond to anti-TNF therapy, and some patients show paradoxical immune side effects, which are poorly understood. Surprisingly, anti-TNF agents were shown to promote IL-17A production with as yet unknown clinical implications.

Objective

We sought to investigate the molecular mechanism underlying anti-TNF–driven IL-17A expression and the clinical implications of this phenomenon.

Methods

Fluorescence-activated cell sorting, RNA sequencing, quantitative real-time PCR, Western blotting, small interfering RNA interference, and kinase inhibitors were used to study the molecular mechanisms in isolated human CD4+ T cells from healthy donors. The clinical implication was studied in blood samples of patients with inflammatory bowel disease (IBD) receiving anti-TNF therapy.

Results

Here we show that anti-TNF treatment results in inhibition of the anti-inflammatory molecule TNF-α–induced protein 3 (TNFAIP3)/A20 in memory CD4+ T cells. We found an inverse relationship between TNFAIP3/A20 expression levels and IL-17A production. Inhibition of TNFAIP3/A20 promotes kinase activity of p38 mitogen-activated protein kinase and protein kinase C, which drives IL-17A expression. Regulation of TNFAIP3/A20 expression and cognate IL-17A production in T cells are specifically mediated through TNF receptor 2 signaling. Ex vivo, in patients with IBD treated with anti-TNF, we found further evidence for an inverse relationship between TNFAIP3/A20 expression levels and IL-17A–producing T cells.

Conclusion

Anti-TNF treatment interferes in the TNFAIP3/A20-mediated anti-inflammatory feedback loop in CD4+ T cells and promotes kinase activity. This puts TNFAIP3/A20, combined with IL-17A expression, on the map as a potential tool for predicting therapy responsiveness or side effects of anti-TNF therapy. Moreover, it provides novel targets related to TNFAIP3/A20 activity for superior therapeutic regimens in patients with IBD.

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Key words : TNF-α, A20, TNF-α–induced protein 3, anti-TNF, IL-17A, inflammatory bowel disease

Abbreviations used : APC, DC, DEG, FACS, IBD, MAPK, mTNF, NF-κB, PKC, RA, rhIL-2, rhTNF-α, RNA-seq, RT-qPCR, siRNA, SNP, TCR, Tmem, Tnaive, TNFAIP3, TNFR


Plan


 The study and P.C.M.U. were supported by grant no. 11920/13-0 provided by the Brazilian mobility program Science Without Borders.
 Disclosure of potential conflict of interest: V. F. Azevedo received board membership from Americas Health Foundation; consultancy fees from Pfizer, AbbVie, and Janssen-Cylag; payment for lectures from Pfizer, Janssen, AbbVie, and Roche; payment for development of educational materials; and travel expenses from Janssen-Cylag and AbbVie. The rest of the authors declare that they have no relevant conflicts of interest.


© 2017  American Academy of Allergy, Asthma & Immunology. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 142 - N° 2

P. 517-529 - août 2018 Retour au numéro
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