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Daubeuf B, Mathison J, Spiller S, Hugues S, Herren S, Ferlin W, Kosco-Vilbois M, Wagner H, Kirschning CJ, Ulevitch R, Elson G. TLR4/MD-2 Monoclonal Antibody Therapy Affords Protection in Experimental Models of Septic Shock. THE JOURNAL OF IMMUNOLOGY 2007; 179:6107-14. [DOI: 10.4049/jimmunol.179.9.6107] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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152
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Liu H, Redline RW, Han YW. Fusobacterium nucleatum induces fetal death in mice via stimulation of TLR4-mediated placental inflammatory response. THE JOURNAL OF IMMUNOLOGY 2007; 179:2501-8. [PMID: 17675512 DOI: 10.4049/jimmunol.179.4.2501] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Intrauterine infection plays a pivotal role in preterm birth (PTB) and is characterized by inflammation. Currently, there is no effective therapy available to treat or prevent bacterial-induced PTB. Using Fusobacterium nucleatum, a Gram-negative anaerobe frequently associated with PTB, as a model organism, the mechanism of intrauterine infection was investigated. Previously, it was shown that F. nucleatum induced preterm and term stillbirth in mice. Fusobacterial-induced placental infection was characterized by localized bacterial colonization, inflammation, and necrosis. In this study, F. nucleatum was shown to activate both TLR2 and TLR4 in vitro. In vivo, the fetal death rate was significantly reduced in TLR4-deficient mice (C57BL/6 TLR4(-/-) and C3H/HeJ (TLR4(d/d))), but not in TLR2-deficient mice (C57BL/6 TLR2(-/-)), following F. nucleatum infection. The reduced fetal death in TLR4-deficient mice was accompanied by decreased placental necroinflammatory responses in both C57BL/6 TLR4(-/-) and C3H/HeJ. Decreased bacterial colonization in the placenta was observed in C3H/HeJ, but not in C57BL/6 TLR4(-/-). These results suggest that inflammation, rather than the bacteria per se, was the likely cause of fetal loss. TLR2 did not appear to be critically involved, as no difference in bacterial colonization, inflammation, or necrosis was observed between C57BL/6 and C57BL/6 TLR2(-/-) mice. A synthetic TLR4 antagonist, TLR4A, significantly reduced fusobacterial-induced fetal death and decidual necrosis without affecting the bacterial colonization in the placentas. TLR4A had no bactericidal activity nor did it affect the birth outcome in sham-infected mice. TLR4A could have promise as an anti-inflammatory agent for the treatment or prevention of bacterial-induced preterm birth.
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Affiliation(s)
- Hongqi Liu
- Department of Periodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
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153
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Abstract
The innate immune system is the primary line of defence against invading pathogenic microbes. Toll-like receptors (TLRs) are a family of membrane receptors which play a pivotal role in sensing a wide range of invading pathogens including bacteria, fungi and viruses. TLR-deficient mice have provided us with immense knowledge on the functioning of individual TLRs. Dysregulation of TLR signalling is linked with a number of disease conditions. Disease models have helped show that targeting components of TLR signalling cascades could lead to novel therapies in the treatment of infectious diseases. In this review we focus on the evidence provided to date to explain just how important TLRs are in host defence against microbial pathogens.
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Affiliation(s)
- Susan Carpenter
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland.
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154
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Heimesaat MM, Fischer A, Siegmund B, Kupz A, Niebergall J, Fuchs D, Jahn HK, Freudenberg M, Loddenkemper C, Batra A, Lehr HA, Liesenfeld O, Blaut M, Göbel UB, Schumann RR, Bereswill S. Shift towards pro-inflammatory intestinal bacteria aggravates acute murine colitis via Toll-like receptors 2 and 4. PLoS One 2007; 2:e662. [PMID: 17653282 PMCID: PMC1914380 DOI: 10.1371/journal.pone.0000662] [Citation(s) in RCA: 164] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2007] [Accepted: 06/22/2007] [Indexed: 12/31/2022] Open
Abstract
Background Gut bacteria trigger colitis in animal models and are suspected to aggravate inflammatory bowel diseases. We have recently reported that Escherichia coli accumulates in murine ileitis and exacerbates small intestinal inflammation via Toll-like receptor (TLR) signaling. Methodology and Principal Findings Because knowledge on shifts in the intestinal microflora during colitis is limited, we performed a global survey of the colon flora of C57BL/10 wild-type (wt), TLR2-/-, TLR4-/-, and TLR2/4-/- mice treated for seven days with 3.5% dextrane-sulfate-sodium (DSS). As compared to wt animals, TLR2-/-, TLR4-/-, and TLR2/4-/- mice displayed reduced macroscopic signs of acute colitis and the amelioration of inflammation was associated with reduced IFN-gamma levels in mesenteric lymph nodes, lower amounts of neutrophils, and less FOXP3-positive T-cells in the colon in situ. During acute colitis E. coli increased in wt and TLR-deficient mice (P<0.05), but the final numbers reached were significantly lower in TLR2-/-, TLR4-/- and TLR2/4-/- animals, as compared to wt controls (P<0.01). Concentrations of Bacteroides/ Prevotella spp., and enterococci did not increase during colitis, but their numbers were significantly reduced in the colon of DSS-treated TLR2/4-/- animals (P<0.01). Numbers of lactobacilli and clostridia remained unaffected by colitis, irrespective of the TLR-genotype of mice. Culture-independent molecular analyses confirmed the microflora shifts towards enterobacteria during colitis and showed that the gut flora composition was similar in both, healthy wt and TLR-deficient animals. Conclusions and Significance DSS-induced colitis is characterized by a shift in the intestinal microflora towards pro-inflammatory Gram-negative bacteria. Bacterial products exacerbate acute inflammation via TLR2- and TLR4-signaling and direct the recruitment of neutrophils and regulatory T-cells to intestinal sites. E. coli may serve as a biomarker for colitis severity and DSS-induced barrier damage seems to be a valuable model to further identify bacterial factors involved in maintaining intestinal homeostasis and to test therapeutic interventions based upon anti-TLR strategies.
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Affiliation(s)
- Markus M. Heimesaat
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - André Fischer
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - Britta Siegmund
- Medizinische Klinik I, Charité - Universitätsmedizin Berlin, Campus-Benjamin-Franklin, Berlin, Germany
| | - Andreas Kupz
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - Julia Niebergall
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - David Fuchs
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - Hannah-Katharina Jahn
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | | | - Christoph Loddenkemper
- Institut für Pathologie, Charité-Universitätsmedizin Berlin, Campus-Benjamin-Franklin, Berlin, Germany
| | - Arvind Batra
- Medizinische Klinik I, Charité - Universitätsmedizin Berlin, Campus-Benjamin-Franklin, Berlin, Germany
| | - Hans-Anton Lehr
- Institut Universitaire de Pathologie, Centre Universitaire Hospitalier Vaudois, Lausanne, Switzerland
| | - Oliver Liesenfeld
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - Michael Blaut
- Abteilung Gastrointestinale Mikrobiologie, Deutsches Institut für Ernährungsforschung, Potsdam-Rehbrücke, Nuthetal, Germany
| | - Ulf B. Göbel
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - Ralf R. Schumann
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - Stefan Bereswill
- Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
- * To whom correspondence should be addressed. E-mail:
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155
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Gioannini TL, Weiss JP. Regulation of interactions of Gram-negative bacterial endotoxins with mammalian cells. Immunol Res 2007; 39:249-60. [DOI: 10.1007/s12026-007-0069-0] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 12/22/2022]
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156
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Hua J, Qiu DK, Li JQ, Li EL, Chen XY, Peng YS. Expression of Toll-like receptor 4 in rat liver during the course of carbon tetrachloride-induced liver injury. J Gastroenterol Hepatol 2007; 22:862-9. [PMID: 17504260 DOI: 10.1111/j.1440-1746.2007.04896.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIM It has recently been reported that Toll-like receptor 4 (TLR4) is involved in cellular responses to lipopolysaccharides (LPS) and early liver injury induced by LPS. The aim of the present study was to investigate the alterations of TLR4 gene expression in liver tissues and Kupffer cells during the course of carbon tetrachloride (CCl(4))-induced chronic liver injury and fibrosis and its role in liver injury. METHODS Rats were induced with liver injury and fibrosis by CCl(4) administered subcutaneously twice weekly for up to 8 weeks. The Kupffer cells were isolated by the combined collagenase-pronase perfusion method and incubated with varying doses of LPS. The mRNA expression of TLR4 in liver tissues and Kupffer cells was measured by reverse transcriptase polymerase chain reaction. The levels of tumor necrosis factor (TNF)-alpha in Kupffer cell culture supernatants were determined by enzyme-linked immunosorbent assay. The plasma levels of the endotoxin were determined by chromogenic substrate limulus amebocyte lysate assay. The association of the endotoxin receptor expression with plasma endotoxin levels was assessed. RESULTS CCl(4) administration elicited extensive changes in liver morphology, including steatosis, inflammation, necrosis, and fibrosis. Low levels of TLR4 mRNA were detected in normal rat liver tissues, but no expression was detected in the Kupffer cells. The expression of TLR4 mRNA in liver tissues and Kupffer cells was increased 2 weeks after CCl(4) administration, peaked at 4 and 6 weeks, and declined at 8 weeks. Basic TNF-alpha production of Kupffer cells isolated from CCl(4)-treated rats at 4 and 6 weeks was significantly higher than that of normal rats (P < 0.05). Upon LPS stimulation, production of TNF-alpha was markedly increased in Kupffer cells isolated from normal and 2-,4-, and 6-week CCl(4)-treated rats. Moreover, LPS-induced TNF-alpha production was dose-dependent. The plasma levels of the endotoxin were increased during the time of liver injury. There was a correlation between plasma endotoxin levels and TLR4 gene expression in the early and middle stage of liver injury. CONCLUSION The gene expression of TLR4 was upregulated during the course of CCl(4)-induced liver injury, which is associated with the degree of liver injury and Kupffer cell activation. The gut-derived endotoxin may be involved in the upregulation of TLR4 expression.
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Affiliation(s)
- Jing Hua
- Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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157
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Van Limbergen J, Russell RK, Nimmo ER, Ho GT, Arnott ID, Wilson DC, Satsangi J. Genetics of the innate immune response in inflammatory bowel disease. Inflamm Bowel Dis 2007; 13:338-55. [PMID: 17206667 DOI: 10.1002/ibd.20096] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The discovery of nucleotide-binding oligomerization domain 2/caspase recruitment domain-containing protein 15 (NOD2/CARD15) as the first susceptibility gene in Crohn's disease (CD) has shifted the focus of research into the pathogenesis of inflammatory bowel disease (IBD) firmly to the innate immune response and the integrity of the epithelial barrier. The subsequent implication in IBD of variant alleles of OCTN, DLG5, MDR1, and TLRs has provided further support for a new, more complex model of innate immunity function in the gastrointestinal tract. In this review, we examine the recent advances in our understanding of the influence of genetics of the innate immune response on IBD. We will focus on germline variation of genes encoding pathogen-recognition receptors, proteins involved in epithelial homeostasis and secreted antimicrobial proteins.
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Affiliation(s)
- Johan Van Limbergen
- Gastrointestinal Unit, Molecular Medicine Centre, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.
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158
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Michelsen KS, Arditi M. Toll-like receptors and innate immunity in gut homeostasis and pathology. Curr Opin Hematol 2007; 14:48-54. [PMID: 17133100 DOI: 10.1097/00062752-200701000-00010] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW Immune responses to commensal bacteria and resulting chronic inflammation are hallmarks of inflammatory bowel disease. Considerable evidence has accumulated to suggest that innate immune defense mechanisms interact with pro-inflammatory pathways and exacerbate or perhaps even initiate development of inflammatory bowel disease. RECENT FINDINGS Recent cellular and mouse studies now show Toll-like receptor responses in intestinal epithelial cells are polarized and their activation by commensal bacteria plays an essential role in maintaining colonic homeostasis and controlling tolerance in the gut. Recent data also implicate signaling by Toll-like receptors and the common adaptor molecule MyD88 in intestinal epithelial homeostasis as well as the pathogenesis of inflammatory bowel disease, establishing a key link between the innate and adaptive immune defenses. SUMMARY We review recent progresses in the understanding of the role of Toll-like receptors and other pattern recognition receptors in the host defense against gastrointestinal pathogens and maintenance of immune tolerance to commensal bacteria, highlighting areas that should provide fertile ground for future studies aimed at a more comprehensive understanding of the interplay between innate and adaptive immune defense mechanisms and inflammatory bowel disease.
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Affiliation(s)
- Kathrin S Michelsen
- Division of Gastroenterology, Inflammatory Bowel Disease Center, University of California, Los Angeles, California, USA
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159
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Goyette P, Labbé C, Trinh TT, Xavier RJ, Rioux JD. Molecular pathogenesis of inflammatory bowel disease: genotypes, phenotypes and personalized medicine. Ann Med 2007; 39:177-99. [PMID: 17457716 DOI: 10.1080/07853890701197615] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Crohn's disease (CD) and ulcerative colitis (UC), also known as inflammatory bowel diseases (IBD), are characterized by chronic inflammation of the gastrointestinal tract. IBD is among the few complex diseases for which several genomic regions and specific genes have been identified and confirmed in multiple replication studies. We will review the different loci implicated in disease risk in the context of three proposed mechanisms leading to chronic inflammation of the gut mucosa: 1) deregulation of the innate immune response to enteric microflora or pathogens; 2) increased permeability across the epithelial barrier; and 3) defective regulation of the adaptive immune system. As our knowledge of genetic variation, analytical approaches and technology improves, additional genetic risk factors are expected to be identified. With the identification of novel risk variants, additional pathophysiological mechanisms are likely to emerge. The resulting discoveries will further our molecular understanding of IBD, potentially leading to improved disease classification and rational drug design. Moreover, these approaches and tools can be applied in the context of variable drug response with the goal of providing more personalized clinical management of patients with IBD.
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Affiliation(s)
- Philippe Goyette
- Université de Montréal, Department of Medicine, Montréal, Québec, Canada
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160
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Brenchley JM, Price DA, Schacker TW, Asher TE, Silvestri G, Rao S, Kazzaz Z, Bornstein E, Lambotte O, Altmann D, Blazar BR, Rodriguez B, Teixeira-Johnson L, Landay A, Martin JN, Hecht FM, Picker LJ, Lederman MM, Deeks SG, Douek DC. Microbial translocation is a cause of systemic immune activation in chronic HIV infection. Nat Med 2006; 12:1365-71. [PMID: 17115046 DOI: 10.1038/nm1511] [Citation(s) in RCA: 2654] [Impact Index Per Article: 147.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2006] [Accepted: 10/26/2006] [Indexed: 02/06/2023]
Abstract
Chronic activation of the immune system is a hallmark of progressive HIV infection and better predicts disease outcome than plasma viral load, yet its etiology remains obscure. Here we show that circulating microbial products, probably derived from the gastrointestinal tract, are a cause of HIV-related systemic immune activation. Circulating lipopolysaccharide, which we used as an indicator of microbial translocation, was significantly increased in chronically HIV-infected individuals and in simian immunodeficiency virus (SIV)-infected rhesus macaques (P <or= 0.002). We show that increased lipopolysaccharide is bioactive in vivo and correlates with measures of innate and adaptive immune activation. Effective antiretroviral therapy seemed to reduce microbial translocation partially. Furthermore, in nonpathogenic SIV infection of sooty mangabeys, microbial translocation did not seem to occur. These data establish a mechanism for chronic immune activation in the context of a compromised gastrointestinal mucosal surface and provide new directions for therapeutic interventions that modify the consequences of acute HIV infection.
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Affiliation(s)
- Jason M Brenchley
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA
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161
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Weng M, Walker WA. Bacterial colonization, probiotics, and clinical disease. The journal The Journal of Pediatrics 2006. [DOI: 10.1016/j.jpeds.2006.06.061] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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162
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Jilling T, Simon D, Lu J, Meng FJ, Li D, Schy R, Thomson RB, Soliman A, Arditi M, Caplan MS. The roles of bacteria and TLR4 in rat and murine models of necrotizing enterocolitis. THE JOURNAL OF IMMUNOLOGY 2006; 177:3273-82. [PMID: 16920968 PMCID: PMC2697969 DOI: 10.4049/jimmunol.177.5.3273] [Citation(s) in RCA: 300] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Bacteria are thought to contribute to the pathogenesis of necrotizing enterocolitis (NEC), but it is unknown whether their interaction with the epithelium can participate in the initiation of mucosal injury or they can act only following translocation across a damaged intestinal barrier. Our aims were to determine whether bacteria and intestinal epithelial TLR4 play roles in a well-established neonatal rat model and a novel neonatal murine model of NEC. Neonatal rats, C57BL/6J, C3HeB/FeJ (TLR4 wild type), and C3H/HeJ (TLR4 mutant) mice were delivered by Cesarean section and were subjected to formula feeding and cold asphyxia stress or were delivered naturally and were mother-fed. NEC incidence was evaluated by histological scoring, and gene expression was quantified using quantitative real-time PCR from cDNA generated from intestinal total RNA or from RNA obtained by laser capture microdissection. Spontaneous feeding catheter colonization or supplementation of cultured bacterial isolates to formula increased the incidence of experimental NEC. During the first 72 h of life, i.e., the time frame of NEC development in this model, intestinal TLR4 mRNA gradually decreases in mother-fed but increases in formula feeding and cold asphyxia stress, correlating with induced inducible NO synthase. TLR4, inducible NO synthase, and inflammatory cytokine induction occurred in the intestinal epithelium but not in the submucosa. NEC incidence was diminished in C3H/HeJ mice, compared with C3HeB/FeJ mice. In summary, bacteria and TLR4 play significant roles in experimental NEC, likely via an interaction of intraluminal bacteria and aberrantly overexpressed TLR4 in enterocytes.
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Affiliation(s)
- Tamas Jilling
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60614
- Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201
| | - Dyan Simon
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60614
| | - Jing Lu
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60614
- Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201
| | - Fan Jing Meng
- Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201
| | - Dan Li
- Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201
| | - Robert Schy
- Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201
| | - Richard B. Thomson
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60614
- Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201
| | - Antoine Soliman
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Moshe Arditi
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Michael S. Caplan
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60614
- Evanston Northwestern Healthcare Research Institute, Evanston, IL 60201
- Address correspondence and reprint requests to Dr. Michael S. Caplan, Professor of Pediatrics, The Evanston Hospital, 2650 Ridge Avenue, Evanston, IL 60201. E-mail address:
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163
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Mikocka-Walus AA, Turnbull DA, Moulding NT, Wilson IG, Andrews JM, Holtmann GJ. Antidepressants and inflammatory bowel disease: a systematic review. Clin Pract Epidemiol Ment Health 2006; 2:24. [PMID: 16984660 PMCID: PMC1599716 DOI: 10.1186/1745-0179-2-24] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2006] [Accepted: 09/20/2006] [Indexed: 12/29/2022]
Abstract
Background A number of studies have suggested a link between the patient's psyche and the course of inflammatory bowel disease (IBD). Although pharmacotherapy with antidepressants has not been widely explored, some investigators have proposed that treating psychological co-morbidities with antidepressants may help to control disease activity. To date a systematic analysis of the available studies assessing the efficacy of antidepressants for the control of somatic symptoms in IBD patients has not been performed. Methods We searched electronic databases, without any language restriction. All relevant papers issued after 1990 were examined. Results 12 relevant publications were identified. All of them referred to non-randomised studies. Antidepressants reported in these publications included paroxetine, bupropion, amitriptyline, phenelzine, and mirtazapine. In 10 articles, paroxetine, bupropion, and phenelzine were suggested to be effective for treating both psychological and somatic symptoms in patients suffering from IBD. Amitriptyline was found ineffective for treating somatic symptoms of IBD. Mirtazapine was not recommended for IBD patients. Conclusion Although most of reviewed papers suggest a beneficial effect of treatment with antidepressants in patients with IBD, due to the lack of reliable data, it is impossible to judge the efficacy of antidepressants in IBD. Properly designed trials are justified and needed based upon the available uncontrolled data.
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Affiliation(s)
- Antonina A Mikocka-Walus
- School of Psychology and Discipline of General Practice, University of Adelaide, and Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, level 3, Eleanor Harrald Building, 5005 Adelaide, South Australia, Australia
| | - Deborah A Turnbull
- School of Psychology, the University of Adelaide, level 4, Hughes Building, Adelaide 5005, South Australia, Australia
| | - Nicole T Moulding
- Nicole T. Moulding, Discipline of General Practice, the University of Adelaide, Level 3, Eleanor Harrald Building, Adelaide 5005, South Australia, Australia
| | - Ian G Wilson
- School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith SouthDC 1797, New South Wales, Australia
| | - Jane M Andrews
- Department of Gastroenterology, Hepatology and General Medicine, the Royal Adelaide Hospital, North Wing Q7, Adelaide 5005, South Australia, Australia
| | - Gerald J Holtmann
- Department of Gastroenterology, Hepatology and General Medicine, the Royal Adelaide Hospital, North Wing Q7, Adelaide 5005, South Australia, Australia
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164
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Tomai MA, Miller RL, Lipson KE, Vasilakos JP, Woulfe SL. Immune response modifiers: Imiquimod and future drugs for modulating the immune response. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ddstr.2006.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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165
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Cario E, Podolsky DK. Toll-Like Receptor Signaling and its Relevance to Intestinal Inflammation. Ann N Y Acad Sci 2006; 1072:332-8. [PMID: 17057213 DOI: 10.1196/annals.1326.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This review discusses the current progress in the understanding of how commensal-mediated activation of toll-like receptors (TLRs) may be involved in the regulation of physiological and pathophysiological processes of the intestinal mucosa including tissue regeneration and inflammation. While regulation of TLRs and their downstream signaling mediators might be used to prevent and treat inflammatory bowel diseases, paradoxically, at this time, it remains uncertain whether this would be more effectively accomplished by enhancing or inhibiting these pathways.
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Affiliation(s)
- Elke Cario
- Division of Gastroenterology & Hepatology, University Hospital of Essen, Institutsgruppe I, Virchowstrasse 171, D-45147 Essen, Germany.
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166
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Wakelin SJ, Sabroe I, Gregory CD, Poxton IR, Forsythe JLR, Garden OJ, Howie SEM. "Dirty little secrets"--endotoxin contamination of recombinant proteins. Immunol Lett 2006; 106:1-7. [PMID: 16765451 DOI: 10.1016/j.imlet.2006.04.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2005] [Revised: 04/19/2006] [Accepted: 04/21/2006] [Indexed: 01/22/2023]
Abstract
The identification of Toll-like receptors has revolutionised our understanding of innate immunity. TLR4 transduces the LPS signal and that of a number of structurally and functionally unrelated agonists. However, recent evidence adds to longstanding concerns that endotoxin contamination of bacterially derived recombinant TLR4 agonists is responsible for effects attributed to these molecules. We highlight key factors in differentiating specific agonist effects from those of endotoxin and emphasize why conventional methods of detecting and eliminating LPS may lead to erroneous results. We propose that considerable caution is needed in the investigation of TLR4 agonists, particularly when using proteins produced in a bacterium that also houses the most ideal TLR4 agonist, LPS.
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Affiliation(s)
- Sonia J Wakelin
- MRC Centre for Inflammation Research, University of Edinburgh, UK.
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167
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Abstract
The chronic inflammatory bowel diseases Crohn's disease and ulcerative colitis are common causes of gastrointestinal disease in northern Europe, affecting as many as one in 250 people. Although mortality is low, morbidity associated with these diseases is substantial. We review the recent advances in the genetics of inflammatory bowel disease, with particular emphasis on the data that have been generated since the discovery of the CARD15 (NOD2) gene in 2001.
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Affiliation(s)
- Daniel R Gaya
- Gastrointestinal Unit, Molecular Medicine Centre, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK
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168
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Abstract
The inflammatory bowel disease, Crohn’s disease and ulcerative colitis, are polygenic disorders with important environmental interactions. To date, the most widely adopted approach to identifying susceptibility genes in complex diseases has involved genome wide linkage studies followed by studies of positional candidate genes in loci of interest. This review encompasses data from studies into novel candidate genes implicated in the pathogenesis of inflammatory bowel disease. Novel techniques to identify candidate genes-genome wide association studies, yeast-two hybrid screening, microarray gene expression studies and proteomic profiling, are also reviewed and their potential role in unravelling the pathogenesis of inflammatory bowel disease are discussed.
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Affiliation(s)
- Colin Noble
- Gastrointestinal Unit, Molecular Medicine Centre, Western General Hospital, Edinburgh, EH4 2XU, United Kindgom.
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169
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Abstract
PURPOSE OF REVIEW Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain (NOD)-containing proteins are innate immune sensors for microbial signature molecules. This review highlights new insights into the functions of these sensors in intestinal physiology. RECENT FINDINGS TLRs are membrane bound and survey the extracellular space for microbe-derived molecules, while NOD-containing proteins are cytoplasmic and detect microbial molecules in the cytoplasm. Most microbial sensors recognize components of the bacterial cell wall and its appendages. For example, TLR4 detects lipopolysaccharide in the Gram-negative bacterial cell wall. TLR5 recognizes flagellin, a component of bacterial flagella required for motility. NOD1 recognizes diaminopimelic acid-containing dipeptide or tripeptide motifs in the Gram-positive bacterial cell wall, while NOD2 detects muramyl dipeptide, a ubiquitous cell wall peptidoglycan motif. These sensors are important for host defense against gastrointestinal pathogens. Thus, TLR4 is required for Salmonella eradication, NOD1 contributes to controlling Helicobacter pylori infection, and NOD2 is involved in mucosal defense against Listeria monocytogenes. These sensors also regulate mucosal inflammation independent of pathogen infections. SUMMARY Toll-like receptors and nucleotide-binding oligomerization domain-containing proteins not only play critical roles in host defense against known gastrointestinal bacterial pathogens, but also contribute to mucosal homeostasis in the apparent absence of such pathogens.
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Affiliation(s)
- Lars Eckmann
- Department of Medicine, University of California, San Diego, La Jolla, California, USA.
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170
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Ii M, Matsunaga N, Hazeki K, Nakamura K, Takashima K, Seya T, Hazeki O, Kitazaki T, Iizawa Y. A novel cyclohexene derivative, ethyl (6R)-6-[N-(2-Chloro-4-fluorophenyl)sulfamoyl]cyclohex-1-ene-1-carboxylate (TAK-242), selectively inhibits toll-like receptor 4-mediated cytokine production through suppression of intracellular signaling. Mol Pharmacol 2005; 69:1288-95. [PMID: 16373689 DOI: 10.1124/mol.105.019695] [Citation(s) in RCA: 297] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Proinflammatory mediators such as cytokines and NO play pivotal roles in various inflammatory diseases. To combat inflammatory diseases successfully, regulation of proinflammatory mediator production would be a critical process. In the present study, we investigated the in vitro effects of ethyl (6R)-6-[N-(2-chloro-4-fluorophenyl)sulfamoyl]cyclohex-1-ene-1-carboxylate (TAK-242), a novel small molecule cytokine production inhibitor, and its mechanism of action. In RAW264.7 cells and mouse peritoneal macrophages, TAK-242 suppressed lipopolysaccharide (LPS)-induced production of NO, tumor necrosis factor-alpha (TNF-alpha), and interleukin (IL)-6, with 50% inhibitory concentration (IC50) of 1.1 to 11 nM. TAK-242 also suppressed the production of these cytokines from LPS-stimulated human peripheral blood mononuclear cells (PBMCs) at IC50 values from 11 to 33 nM. In addition, the inhibitory effects on the LPS-induced IL-6 and IL-12 production were similar in human PBMCs, monocytes, and macrophages. TAK-242 inhibited mRNA expression of IL-6 and TNF-alpha induced by LPS and interferon-gamma in RAW264.7 cells. The phosphorylation of mitogen-activated protein kinases induced by LPS was also inhibited in a concentration-dependent manner. However, TAK-242 did not antagonize the binding of LPS to the cells. It is noteworthy that TAK-242 suppressed the cytokine production induced by Toll-like receptor (TLR) 4 ligands, but not by ligands for TLR2, -3, and -9. In addition, IL-1beta-induced IL-8 production from human PBMCs was not markedly affected by TAK-242. These data suggest that TAK-242 suppresses the production of multiple cytokines by selectively inhibiting TLR4 intracellular signaling. Finally, TAK-242 is a novel small molecule TLR4 signaling inhibitor and could be a promising therapeutic agent for inflammatory diseases, whose pathogenesis involves TLR4.
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Affiliation(s)
- Masayuki Ii
- Pharmacology Research Laboratories I, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 17-85, Jusohonmachi 2-chome, Yodogawa-ku, Osaka 532-8686, Japan.
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