Overview of cytokines and nitric oxide involvement in immuno-pathogenesis of inflammatory bowel diseases

Inflammatory bowel diseases (IBDs), including Crohn’s disease and ulcerative colitis are complex disorders with undetermined etiology. Several hypotheses suggest that IBDs result from an abnormal immune response against endogenous flora and luminal antigens in genetically susceptible individuals. The dysfunction of the mucosal immune response is implicated in the pathogenesis of IBD. The balance between pro-inflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-8, and IL-17A], anti-inflammatory cytokines (IL-4 and IL-13), and immunoregulatory cytokines (IL-10 and transforming growth factors β) is disturbed. Moreover, evidence from animal and clinical studies demonstrate a positive correlation between an increased concentration of nitric oxide (NO) and the severity of the disease. Interestingly, proinflammatory cytokines are involved in the up-regulation of inducible oxide synthase (iNOS) expression in IBD. However, anti-inflammatory and immunoregulatory cytokines are responsible for the negative regulation of iNOS. A positive correlation between NO production and increased pro-inflammatory cytokine levels (TNF-α, IL-6, IL-17, IL-12, and interferon-γ) were reported in patients with IBD. This review focuses on the role of cytokines in intestinal inflammation and their relationship with NO in IBD.

The "Ozone Deficit" Problem: O2(X, v ge 26) + O(3P) from 226-nm Ozone Photodissociation

Highly vibrationally excited O(2)(X(3)sigmag(-), v >/= 26) has been observed from the photodissociation of ozone (O(3)), and the quantum yield for this reaction has been determined for excitation at 226 nanometers. This observation may help to address the "ozone deficit" problem, or why the previously predicted stratospheric O(3) concentration is less than that observed. Recent kinetic studies have suggested that O(2)(X(3)sigmag(-), v >/= 26) can react rapidly with O(2) to form O(3) + O and have led to speculation that, if produced in the photodissociation of O(3), this species might be involved in resolving the discrepancy. The sequence O(3) + hv --> O(2)(X(3)sigmag(-), v >/= 26) + O; O(2)(X(3)sigmag(-), v >/= 26) + O(2) --> O(3) + O (where hv is a photon) would be an autocatalytic mechanism for production of odd oxygen. A two-dimensional atmospheric model has been used to evaluate the importance of this new mechanism. The new mechanism can completely account for the tropical O(3) deficit at an altitude of 43 kilometers, but it does not completely account for the deficit at higher altitudes. The mechanism also provides for isotopic fractionation and may contribute to an explanation for the anomalously high concentration of heavy O(3) in the stratosphere.

Probiotic bacteria lactobacillus and bifidobacterium attenuate inflammation in dextran sulfate sodium-induced experimental colitis in mice

It is widely accepted that inflammatory Bowel disease (IBD) arises from a dysregulated mucosal immune response to the enteric microbiota in the gut of a genetically susceptible individual. No definitive therapies are available for this inflammatory disorder. Therefore it became imperative to develop new strategies for treating this disease. Probiotics have emerged as a potential new therapeutic strategy for IBD, however their exact mechanisms of action is still poorly defined. In this study, we address the potential effect of a probiotic cocktail (Ultrabiotique®) composed of four live bacterial strains (L. acidophilus, L. plantarum, B. lactis and B.breve) to promote recovery from acute colitis. Probiotic was given to mice by oral gavage after the onset of colitis and the establishment of dextran sulfate sodium (DSS)-induced intestinal injury. Clinical parameters were monitored daily, histological scores of colitis and the production of nitric oxide (NO) and interferon-γ (IFN-γ) were determined. In addition, TLR4, NF-κB and iNOS colonic expression were examined. Probiotic treatment ameliorated clinical symptoms and histological scores. NO and IFN-γ production in plasma were decreased by probiotic. These results were associated with reduced TLR4, iNOS and NF-кB expression in colonic tissue. In conclusion, probiotic exerted anti-inflammatory effects and contributed to a rapid recovery of DSS-induced acute colitis.

IL-23/IL-17A axis correlates with the nitric oxide pathway in inflammatory bowel disease: immunomodulatory effect of retinoic acid

Inflammatory bowel diseases (IBDs) are chronic inflammatory diseases of the gastrointestinal tract, which are clinically present as 1 of the 2 disorders, Crohn's disease (CD) or ulcerative colitis (UC) (Rogler 2004). The immune dysregulation in the intestine plays a critical role in the pathogenesis of IBD, involving a wide range of molecules, including cytokines. The aim of this work was to study the involvement of T-helper 17 (Th17) subset in the bowel disease pathogenesis by the nitric oxide (NO) pathway in Algerian patients with IBD. We investigated the correlation between the proinflammatory cytokines [(interleukin (IL)-17, IL-23, and IL-6] and NO production in 2 groups of patients. We analyzed the expression of messenger RNAs (mRNAs) encoding Th17 cytokines, cytokine receptors, and NO synthase 2 (NOS2) in plasma of the patients. In the same way, the expression of p-signal transducer and activator of transcription 3 (STAT3) and NOS2 was measured by immunofluorescence and immunohistochemistry. We also studied NO modulation by proinflammatory cytokines (IL-17A, IL-6, tumor necrosis factor α, or IL-1β) in the presence or absence of all-trans retinoic acid (At RA) in peripheral blood mononuclear cells (PBMCs), monocytes, and in colonic mucosa cultures. Analysis of cytokines, cytokine receptors, and NOS2 transcripts revealed that the levels of mRNA transcripts of the indicated genes are elevated in all IBD groups. Our study shows a significant positive correlation between the NO and IL-17A, IL-23, and IL-6 levels in plasma of the patients with IBD. Interestingly, the correlation is significantly higher in patients with active CD. Our study shows that both p-STAT3 and inducible NOS expression was upregulated in PBMCs and colonic mucosa, especially in patients with active CD. At RA downregulates NO production in the presence of proinflammatory cytokines for the 2 groups of patients. Collectively, our study indicates that the IL-23/IL-17A axis plays a pivotal role in IBD pathogenesis through the NO pathway.

Beneficial role of the probiotic mixture Ultrabiotique on maintaining the integrity of intestinal mucosal barrier in DSS-induced experimental colitis

The etiology of inflammatory bowel diseases which include ulcerative colitis (UC) and Crohn disease has not yet been clarified. Several hypotheses suggest a change in composition of gut microflora along with an impaired mucosal barrier that lead to excessive mucosal immunologic responses. Increased production of nitric oxide (NO) contributes greatly to the tissue injury caused by chronic inflammation. Evidence indicates that the mucus layer covering the epithelium is altered during UC and experimental colitis. Our aim in this study was to investigate the potential therapeutic effect of probiotic during DSS-induced colitis by modulating the immune system and colonic mucus production. For that purpose, the probiotic formulation Ultrabiotique(®) (Lactobacillus acidophilus, Bifidobacterium lactis, Lactobacillus plantarum and Bifidobacterium breve) was administered daily for 7 d to mice with colitis. Probiotic supplementation improved clinical symptoms and histological alterations observed during DSS induced colitis. Ultrabiotique(®) treatment down regulated the NO production by peritoneal macrophages of DSS-treated mice and enhanced mucus production in both DSS-treated and healthy mice. In conclusion, the modification of microflora by the Ultrabiotique(®) played a beneficial role in maintaining the integrity of the intestinal mucosal barrier and promoted tissue repair.

Mucosal intestinal alteration in experimental colitis correlates with nitric oxide production by peritoneal macrophages: effect of probiotics and prebiotics

Inflammatory bowel disease (IBD) consists mainly of Ulcerative colitis (UC) and Crohn disease (CD). Although its aetiology is still not clearly established, it is thought to be due to overly aggressive immune response to enteric bacteria in genetically predisposed individuals. Manipulating the microbiota using probiotics or prebiotics is considered as a promising field of new therapeutic strategies used to attenuate immune disorders observed during IBD. The production of nitric oxide (NO) seems to be implicated in IBD pathogenesis. In our study, an acute UC was induced in Swiss mice using 3% Dextran Sulfate Sodium (DSS). The preventive effects of "Ultrabiotique®" (a probiotic) and inulin (a prebiotic) on the colitis were investigated. The production of NO was evaluated in the supernatants of peritoneal macrophages (pMφ) cultures. Colonic mucosa histology was subsequently examined. Results showed severe acute UC after administration of DSS. High levels of NO in pMφ cultures were also observed compared to control samples. These findings correlated with a significant destruction of the colonic mucosa. Oral administration of Ultrabiotique® or inulin decreased the severity of DSS-induced colitis. These treatments lead to a decrease in NO levels in pMφ cultures. A considerable reduction of colonic lesions was also noticed. Our findings suggest the involvement of NO in experimental UC pathogenesis. Pre- and pro-biotics, as discussed herein, seem to have an anti-inflammatory effect.

Crude extract of hydatid laminated layer from Echinococcus granulosus cyst attenuates mucosal intestinal damage and inflammatory responses in Dextran Sulfate Sodium induced colitis in mice

Background

Inflammatory bowel disease is an immunologically mediated disease. Notably, it is less common in countries where there is a greater risk of exposure to helminths. In our study, we examined the modulatory effect of the laminated layer extracted from the cyst wall of a helminth parasite, Echinococcus granulosus, on dextran sulfate sodium (DSS)-induced colitis in mice.

Methods

An acute colitis was induced in BALB/c mice using 2.5% w/v DSS in drinking water. The crude extract of E. granulosus laminated layer was injected intraperitoneally daily, starting 3 days before colitis induction. The Disease Activity Index was monitored daily, colon length and weight were measured and histological scores were evaluated. Nitric oxide (NO) and cytokine levels (interferon γ (IFN-γ), tumor necrosis factor α (TNF-α) and interleukin 10 (IL-10)) were assessed by enzyme-linked immunosorbent assay. In addition, the colonic expression of inducible nitric oxide synthase (iNOS) and nuclear factor-κB (NF-κB) was examined. Statistical analyses were performed by one-way analysis of variance and the survival rate was analyzed by the long rank test.

Results

Hydatid laminated layer pretreatment significantly improved the clinical symptoms and histological scores (*** p < 0.01) observed during DSS-induced colitis and maintained mucus production by goblet cells. Furthermore, treatment with hydatid laminated layer caused a significant decrease in NO, IFN-γ (** p < 0.01) and TNF-α production (* p < 0.05) and an increase in IL-10 production. These results were associated with localized downregulation of iNOS and NF-κB expression.

Conclusions

Our results demonstrate the potent anti-inflammatory effects of hydatid laminated layer. Furthermore, preventive treatment with the laminated layer played a beneficial role in maintaining the integrity of the intestinal mucosal barrier against DSS-induced injury.

Autocrine and paracrine IL-2 signals collaborate to regulate distinct phases of CD8 T cell memory

Differential interleukin-2 (IL-2) signaling and production are associated with disparate effector and memory fates. Whether the IL-2 signals perceived by CD8 T cells come from autocrine or paracrine sources, the timing of IL-2 signaling and their differential impact on CD8 T cell responses remain unclear. Using distinct models of germline and conditional IL-2 ablation in post-thymic CD8 T cells, this study shows that paracrine IL-2 is sufficient to drive optimal primary expansion, effector and memory differentiation, and metabolic function. In contrast, autocrine IL-2 is uniquely required during primary expansion to program robust secondary expansion potential in memory-fated cells. This study further shows that IL-2 production by antigen-specific CD8 T cells is largely independent of CD4 licensing of dendritic cells (DCs) in inflammatory infections with robust DC activation. These findings bear implications for immunizations and adoptive T cell immunotherapies, where effector and memory functions may be commandeered through IL-2 programming.

A case for IL-6, IL-17A, and nitric oxide in the pathophysiology of Sjögren's syndrome

Sjögren's syndrome (SS) is an autoimmune epithelitis characterized by mononuclear cell (MNC) infiltration of the lacrimal and salivary glands (SG), as well as the presence of serum autoantibodies. This condition is a growing public health concern in Algeria. Herein, we sought to determine if the levels of interleukin (IL)-6, IL-17A, and nitric oxide (NO), were correlated with the extent of MNC infiltration. The expression of inducible NO synthase (NOS2) and CD68 was measured in the SG of all patients, but not in those of the normal controls (NCs). We included 44 primary Sjögren's syndrome (pSS) patients and 15 NCs in this study; we found that the expression of NOS2 and CD68 was elevated in all of the SG of SS patients. Additionally, the serum and saliva levels of IL-6, IL-17A, and NO were higher in the pSS patients, compared with the NCs. Furthermore, the NOS2-induced excess NO was associated with the extent of the MNC infiltration, and thereby with tissue injury. It is also important to note that there were correlations between the levels of IL-6, IL-17A, and NO. Such findings indicate that through the effects of NO, IL-17A participates in the pathophysiology of the disease. With the purpose of improving both the diagnosis and prognosis, IL-6, IL-17A, and NO should be assayed in the serum and saliva of patients suspected of SS.

Open Air Laboratories (OPAL): a community-driven research programme

OPAL is an English national programme that takes scientists into the community to investigate environmental issues. Biological monitoring plays a pivotal role covering topics of: i) soil and earthworms; ii) air, lichens and tar spot on sycamore; iii) water and aquatic invertebrates; iv) biodiversity and hedgerows; v) climate, clouds and thermal comfort. Each survey has been developed by an inter-disciplinary team and tested by voluntary, statutory and community sectors. Data are submitted via the web and instantly mapped. Preliminary results are presented, together with a discussion on data quality and uncertainty. Communities also investigate local pollution issues, ranging from nitrogen deposition on heathlands to traffic emissions on roadside vegetation. Over 200,000 people have participated so far, including over 1000 schools and 1000 voluntary groups. Benefits include a substantial, growing database on biodiversity and habitat condition, much from previously unsampled sites particularly in urban areas, and a more engaged public.

Long-memory analysis of time series with missing values

The estimation of long memory is often restricted by missing data. We examine the effects on the estimation of long memory of three simple gap-filling techniques: interpolation, random, and mean filling. Numerical simulations show that the gap-filling techniques introduce significant deviations from the expected scaling behavior for both persistent and antipersistent time series. For persistent time series the interpolation method provides a reliable estimation of long memory for scales longer than the largest likely gap.

Early heterogeneity of IL2R□ expression influences the programming of exhausted CD8T cells during chronic infection

IL-2 signaling at the time of CD8 T cell activation is a critical factor dictating effector and memory CD8 T cell differentiation. However, how IL-2 signaling impacts exhausted CD8 T cell fate outcomes remains poorly defined. Here, we address the role of IL-2 signaling in regulating the differentiation of the stem-like and terminally exhausted CD8 T cells. Prolonged expression of the high affinity IL-2 receptor (IL-2Ra, CD25), and resultant increase in IL-2 signaling drives terminal differentiation of effector cells during acute infection. We hypothesized that curtailing this signal would prevent terminal differentiation and promote the formation of less exhausted stem-cell like TCF-1+CD8T cells in chronic antigenic setting. Our studies show that blocking IL-2 signals at the early phase of chronic infection significantly increased the proportions of TCF-1+CD8T cells. Similarly, knocking down Il2ra augmented the development of TCF-1+CD8T cells. The therapeutic success of PD-1/PD-L1 checkpoint blockade immunotherapy (CBI) relies primarily on stem-cell like cells for vigorous expansion and effector responses. Thus, we next investigated how FACS-purified CD25Hi and CD25Lo cells adoptively transferred into infection-matched chronically infected recipients respond to PD-1 CBI. In contrast to CD25Hi cells, CD25Lo cells underwent vigorous proliferation after PD-1 CBI and produced high amount of effector molecules (GzmB, TNF-α and IFN-γ). Collectively, these data highlight the role of IL-2 signaling in the regulation of CD8 T cell exhaustion, which may be therapeutically exploited to optimize treatments of chronic infections and cancers with immune checkpoint inhibitors.

Supported by NIH R21AI154363 NIH R01AI32819 

Characteristics and potential hemodynamic benefits of proning on the right ventricle in intensive care patients with SARS-CoV-2 ARDS

Funding Acknowledgements

Type of funding sources: None.

Introduction

One of the key challenges in treating COVID-19 ARDS patients is hemodynamic monitoring. Therapies proven to be effective in ARDS, such as protective ventilation, fluid restriction or high PEEP tend to alter right ventricular (RV) function and indicate a closer in-bed management, which is particularly difficult in prone position (PP) patients. Transthoracic echocardiography(TTE) enables a direct window for hemodynamic monitoring of RV performance.

Objective

To assess characteristics and potential hemodynamic benefits of proning on the RV in ICU patients with SARS-CoV-2 ARDS, using echocardiography.

Methods

This is an observational, cross-sectional study of SARS-CoV-2 ARDS in 11 patients hospitalized in a 12 bed ICU in Farhat Hached University hospital in December 2020. All patients were deeply sedated and curarized during the study.

After a stabilization period (MAP ≥ 65mmHg), TTE was performed first in the supine position before putting the patient on PP. Same measures were repeated during a second scan 4 to 8 hours after PP setting.

Norepinephrine infusion levels were not changed between the two scans. The average duration of a scan was 20 ± 10 minutes depending mostly on echogenicity. Several frequencies and harmonics were tested and we selected the ones that provided the best image quality.

PP ventilation (PPV) was performed continuously for 12 hours using the "swimmer position" that enabled affordable TTE views.

A quantitative study of the RV was performed using RV focused 4C view. A special view dedicated to the IVC was studied.

 Parameters measured were RV basal end diastolic diameter, S’ peak wave in TDI, tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and maximal trans tricuspid velocity (MTTV).

 Post hoc analysis was performed by two readers (one intensivist and one cardiologist). All parameters are expressed as a mean of two measurements.

Results

Twenty-four TTEs were performed in 11 patients respectively 40 ± 15mn before and 5.8 ± 1.1hrs after the PP setting. Patients were 71.0 ± 9.4yrs aged, 5(45%) obese, 7(63%) had diabetes mellitus, 4(36%) hypertension, 1(9%) coronary artery disease. All (100%) were on sinus rhythm. 7(63.6%) presented moderate ARDS and 3(27.3%) severe ARDS. None of the patients developed RV failure prior to the examination.

The PPV achieved a non-statistically significant improvement in RV function as assessed by the increase of S′, TAPSE, a decrease in RV basal diameter and an increase in FAC.

 A statistically significant decrease in MTTV (mean 3.20 ± 0.49 m/s before PP vs mean 2.47 ± 0.77m/s (p = 0.01)) was objectified.

Conclusions

PPV improves hemodynamic parameters of the RV.

TEE 4C view is sufficient in the assessment of RV function in PP.

SPAP monitoring could be the key parameter to quickly and reliably assess RV response to PPV.

Incorporation of Id3 enhances CAR T cell therapeutic efficacy against solid tumors in an immunocompetent murine model

T cell exhaustion in the tumor microenvironment (TME) has hindered the success of T cell-based immunotherapy against multiple types of solid tumors. To combat this exhaustion, we have engineered a CD19-targeted fourth generation CAR construct to express the pro-memory transcription factor Inhibitor of DNA Binding 3 (Id3). Id3 critical for the formation of long-lived memory T cells in viral infection models, and retrovirally-induced expression of Id3 in T cells has been shown to enhance the survival of effector T cells in both acute infection and tumor models.Using an immunocompetent murine model of syngeneic solid tumors expressing truncated human-CD19 (hCD19t), we demonstrate that ectopic expression of Id3 via 4th generation CARs containing Id3 (Id3-CAR) augments CAR T cell therapeutic efficacy against solid tumors. Amongst cells recovered from established solid tumors, Id3-CAR T cells retained a memory-precursor effector cell (MPEC) like phenotype including elevated expression of TCF-1, while the 3rd generation CAR T cells largely displayed a terminally exhausted (TEx) phenotype. Importantly, the inclusion of Id3 did not compromise CAR T cell proliferation or expression of the effector cytokines IFN-γ and TNFα following restimulation. In addition to superior control of primary tumors, the Id3-CAR T cells instilled greater long-term protection from tumor relapse in mice, which cleared primary tumors (6/7) compared to 3rd generation CAR T cells (3/7). Highlighting Id3 as a candidate, these data present incorporation of pro-memory transcription factors as an attractive engineering strategy to intrinsically combat CAR T cell exhaustion in the TME and promote long-term CAR T cell memory and protection from tumor relapse.

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number F32CA265056, and Pediatric Cancer Research Foundation.