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Silva BJDA, Bittencourt TL, Leal-Calvo T, Mendes MA, Prata RBDS, Barbosa MGDM, Andrade PR, Côrte-Real S, Sperandio da Silva GM, Moraes MO, Sarno EN, Pinheiro RO. Autophagy-Associated IL-15 Production Is Involved in the Pathogenesis of Leprosy Type 1 Reaction. Cells 2021; 10:2215. [PMID: 34571865 PMCID: PMC8468917 DOI: 10.3390/cells10092215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 01/18/2023] Open
Abstract
Leprosy reactional episodes are acute inflammatory events that may occur during the clinical course of the disease. Type 1 reaction (T1R) is associated with an increase in neural damage, and the understanding of the molecular pathways related to T1R onset is pivotal for the development of strategies that may effectively control the reaction. Interferon-gamma (IFN-γ) is a key cytokine associated with T1R onset and is also associated with autophagy induction. Here, we evaluated the modulation of the autophagy pathway in Mycobacterium leprae-stimulated cells in the presence or absence of IFN-γ. We observed that IFN-γ treatment promoted autophagy activation and increased the expression of genes related to the formation of phagosomes, autophagy regulation and function, or lysosomal pathways in M. leprae-stimulated cells. IFN-γ increased interleukin (IL)-15 secretion in M. leprae-stimulated THP-1 cells in a process associated with autophagy activation. We also observed higher IL15 gene expression in multibacillary (MB) patients who later developed T1R during clinical follow-up when compared to MB patients who did not develop the episode. By overlapping gene expression patterns, we observed 13 common elements shared between T1R skin lesion cells and THP-1 cells stimulated with both M. leprae and IFN-γ. Among these genes, the autophagy regulator Translocated Promoter Region, Nuclear Basket Protein (TPR) was significantly increased in T1R cells when compared with non-reactional MB cells. Overall, our results indicate that IFN-γ may induce a TPR-mediated autophagy transcriptional program in M. leprae-stimulated cells similar to that observed in skin cells during T1R by a pathway that involves IL-15 production, suggesting the involvement of this cytokine in the pathogenesis of T1R.
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Affiliation(s)
- Bruno Jorge de Andrade Silva
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Tamiris Lameira Bittencourt
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Thyago Leal-Calvo
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Mayara Abud Mendes
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Rhana Berto da Silva Prata
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Mayara Garcia de Mattos Barbosa
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Priscila Ribeiro Andrade
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Suzana Côrte-Real
- Structural Biology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil;
| | | | - Milton Ozório Moraes
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Euzenir Nunes Sarno
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
| | - Roberta Olmo Pinheiro
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (B.J.d.A.S.); (T.L.B.); (T.L.-C.); (M.A.M.); (R.B.d.S.P.); (M.G.d.M.B.); (P.R.A.); (M.O.M.); (E.N.S.)
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Abstract
Nonsteroidal medications, previously unfamiliar in the management of autoimmune hepatitis, can supplement or replace conventional corticosteroid regimens, especially in problematic patients. Mycophenolate mofetil is a next-generation purine antagonist that has been useful in treating patients with azathioprine intolerance. It has been less effective in salvaging patients with steroid-refractory disease. Azathioprine is the choice as a corticosteroid-sparing agent in treatment-naive patients and in individuals with corticosteroid intolerance, incomplete response and relapse after drug withdrawal. Tacrolimus is preferred over cyclosporine for recalcitrant disease because of its established preference in organ transplantation, but replacement with cyclosporine should be considered if the disease worsens on treatment. Rapamycin has antiproliferative and proapoptotic actions that warrant further study in autoimmune hepatitis. The nonstandard, nonsteroidal medications are mainly salvage therapies with off-label indications that must be used in highly individualized and well-monitored clinical situations.
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Affiliation(s)
- Albert J Czaja
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905 USA.
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