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Bhattacharya B, Xiao S, Chatterjee S, Urbanowski M, Ordonez A, Ihms EA, Agrahari G, Lun S, Berland R, Pichugin A, Gao Y, Connor J, Ivanov AR, Yan BS, Kobzik L, Koo BB, Jain S, Bishai W, Kramnik I. The integrated stress response mediates necrosis in murine Mycobacterium tuberculosis granulomas. J Clin Invest 2021; 131:130319. [PMID: 33301427 PMCID: PMC7843230 DOI: 10.1172/jci130319] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 12/04/2020] [Indexed: 12/27/2022] Open
Abstract
The mechanism by which only some individuals infected with Mycobacterium tuberculosis develop necrotic granulomas with progressive disease while others form controlled granulomas that contain the infection remains poorly defined. Mice carrying the sst1-suscepible (sst1S) genotype develop necrotic inflammatory lung lesions, similar to human tuberculosis (TB) granulomas, which are linked to macrophage dysfunction, while their congenic counterpart (B6) mice do not. In this study we report that (a) sst1S macrophages developed aberrant, biphasic responses to TNF characterized by superinduction of stress and type I interferon pathways after prolonged TNF stimulation; (b) the late-stage TNF response was driven via a JNK/IFN-β/protein kinase R (PKR) circuit; and (c) induced the integrated stress response (ISR) via PKR-mediated eIF2α phosphorylation and the subsequent hyperinduction of ATF3 and ISR-target genes Chac1, Trib3, and Ddit4. The administration of ISRIB, a small-molecule inhibitor of the ISR, blocked the development of necrosis in lung granulomas of M. tuberculosis-infected sst1S mice and concomitantly reduced the bacterial burden. Hence, induction of the ISR and the locked-in state of escalating stress driven by the type I IFN pathway in sst1S macrophages play a causal role in the development of necrosis in TB granulomas. Interruption of the aberrant stress response with inhibitors such as ISRIB may offer novel host-directed therapy strategies.
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Affiliation(s)
- Bidisha Bhattacharya
- The National Emerging Infectious Diseases Laboratory, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Shiqi Xiao
- Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sujoy Chatterjee
- The National Emerging Infectious Diseases Laboratory, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michael Urbanowski
- Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alvaro Ordonez
- Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth A. Ihms
- Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Garima Agrahari
- The National Emerging Infectious Diseases Laboratory, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Shichun Lun
- Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert Berland
- The National Emerging Infectious Diseases Laboratory, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Alexander Pichugin
- Department of Cellular Immunology, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Yuanwei Gao
- Department of Pharmacokinetics, Pharmacodynamics & Drug Metabolism (PPDM), Merck, West Point, Pennsylvania, USA
| | - John Connor
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Alexander R. Ivanov
- Department of Chemistry & Chemical Biology, Northeastern University, Boston, Massachusetts, USA
| | - Bo-Shiun Yan
- Institute of Biochemistry and Molecular Biology, National Taiwan University Medical College, Zhongzheng District, Taipei City, Taiwan
| | - Lester Kobzik
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Bang-Bon Koo
- The National Emerging Infectious Diseases Laboratory, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sanjay Jain
- Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - William Bishai
- Center for TB Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Igor Kramnik
- The National Emerging Infectious Diseases Laboratory, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Medicine, Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, USA
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