Increased T helper type 17 response to pathogen stimulation in patients with primary sclerosing cholangitis

TY - JOUR

T1 - Increased T helper type 17 response to pathogen stimulation in patients with primary sclerosing cholangitis

AU - Katt, Janosch

AU - Schwinge, Dorothee

AU - Schoknecht, Tanja

AU - Quaas, Alexander

AU - Sobottka, Ingo

AU - Burandt, Eike

AU - Becker, Christoph

AU - Neurath, Markus F

AU - Lohse, Ansgar W

AU - Herkel, Johannes

AU - Schramm, Christoph

N1 - © 2013 by the American Association for the Study of Liver Diseases.

PY - 2013/9/1

Y1 - 2013/9/1

N2 - T helper (Th)17 cells are important for host defense against bacteria and fungi, but are also involved in the pathogenesis of autoimmune diseases. In primary sclerosing cholangitis (PSC), bile fluid is frequently colonized with pathogens and its strong association with inflammatory bowel disease suggests the contribution of pathogen responses to disease pathogenesis. Interleukin (IL)-17A, the signature cytokine of Th17 cells, was recently described to promote inflammation and fibrosis within the liver. Therefore, we investigated Th17 immune response to pathogens in patients with PSC. Bile fluid was obtained by endoscopic retrograde cholangiography, and bacterial and fungal species grew in the majority of samples. In addition, bacterial RNA was stained in liver sections using 16sRNA fluorescence in situ hybridization and was detected in the portal tracts in 12 of 13 tested PSC patients. Bacteria grown from patients' bile fluid were then used to stimulate peripheral blood mononuclear cells (PBMCs) and to assess their Th17 response. Compared to healthy controls or primary biliary cirrhosis patients, PBMCs from PSC patients manifested significantly higher frequencies of Th17 and Th1/Th17 cells after pathogen stimulation. The highest frequencies of Th17 cells were detected after stimulation with Candida albicans, a pathogen that has been linked to disease progression. Immunohistochemically, IL-17A-expressing lymphocytes were detected within the periductal areas of PSC patients. Th17 induction was also noted after stimulation of Toll-like receptor 5 or 7, but not of other pattern recognition receptors tested, pointing to signaling pathways potentially involved in Th17 induction in PSC. Conclusion: We demonstrate an increased Th17 response to microbial stimulation in patients with PSC. These data should prompt further studies investigating the link between pathogen responses, inflammation, and fibrosis in patients with PSC.

AB - T helper (Th)17 cells are important for host defense against bacteria and fungi, but are also involved in the pathogenesis of autoimmune diseases. In primary sclerosing cholangitis (PSC), bile fluid is frequently colonized with pathogens and its strong association with inflammatory bowel disease suggests the contribution of pathogen responses to disease pathogenesis. Interleukin (IL)-17A, the signature cytokine of Th17 cells, was recently described to promote inflammation and fibrosis within the liver. Therefore, we investigated Th17 immune response to pathogens in patients with PSC. Bile fluid was obtained by endoscopic retrograde cholangiography, and bacterial and fungal species grew in the majority of samples. In addition, bacterial RNA was stained in liver sections using 16sRNA fluorescence in situ hybridization and was detected in the portal tracts in 12 of 13 tested PSC patients. Bacteria grown from patients' bile fluid were then used to stimulate peripheral blood mononuclear cells (PBMCs) and to assess their Th17 response. Compared to healthy controls or primary biliary cirrhosis patients, PBMCs from PSC patients manifested significantly higher frequencies of Th17 and Th1/Th17 cells after pathogen stimulation. The highest frequencies of Th17 cells were detected after stimulation with Candida albicans, a pathogen that has been linked to disease progression. Immunohistochemically, IL-17A-expressing lymphocytes were detected within the periductal areas of PSC patients. Th17 induction was also noted after stimulation of Toll-like receptor 5 or 7, but not of other pattern recognition receptors tested, pointing to signaling pathways potentially involved in Th17 induction in PSC. Conclusion: We demonstrate an increased Th17 response to microbial stimulation in patients with PSC. These data should prompt further studies investigating the link between pathogen responses, inflammation, and fibrosis in patients with PSC.

KW - Adult

KW - Aged

KW - Bile

KW - Candida albicans

KW - Case-Control Studies

KW - Cholangiopancreatography, Endoscopic Retrograde

KW - Cholangitis, Sclerosing

KW - Female

KW - Humans

KW - Immunity, Cellular

KW - Leukocytes, Mononuclear

KW - Male

KW - Middle Aged

KW - Signal Transduction

KW - T-Lymphocytes, Helper-Inducer

KW - Th17 Cells

KW - Toll-Like Receptor 5

KW - Toll-Like Receptor 7

U2 - 10.1002/hep.26447

DO - 10.1002/hep.26447

M3 - SCORING: Journal article

C2 - 23564624

VL - 58

SP - 1084

EP - 1093

JO - HEPATOLOGY

JF - HEPATOLOGY

SN - 0270-9139

IS - 3

ER -