Marsico Lung Institute and Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Research Center of Regeneration Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
J Clin Invest. 2019 Oct 1;129(10):4433-4450. doi: 10.1172/JCI125669.
Cystic fibrosis (CF) lung disease is characterized by early and persistent mucus accumulation and neutrophilic inflammation in the distal airways. Identification of the factors in CF mucopurulent secretions that perpetuate CF mucoinflammation may provide strategies for novel CF pharmacotherapies. We show that IL-1β, with IL-1α, dominated the mucin prosecretory activities of supernatants of airway mucopurulent secretions (SAMS). Like SAMS, IL-1β alone induced MUC5B and MUC5AC protein secretion and mucus hyperconcentration in CF human bronchial epithelial (HBE) cells. Mechanistically, IL-1β induced the sterile α motif-pointed domain containing ETS transcription factor (SPDEF) and downstream endoplasmic reticulum to nucleus signaling 2 (ERN2) to upregulate mucin gene expression. Increased mRNA levels of IL1B, SPDEF, and ERN2 were associated with increased MUC5B and MUC5AC expression in the distal airways of excised CF lungs. Administration of an IL-1 receptor antagonist (IL-1Ra) blocked SAMS-induced expression of mucins and proinflammatory mediators in CF HBE cells. In conclusion, IL-1α and IL-1β are upstream components of a signaling pathway, including IL-1R1 and downstream SPDEF and ERN2, that generate a positive feedback cycle capable of producing persistent mucus hyperconcentration and IL-1α and/or IL-1β-mediated neutrophilic inflammation in the absence of infection in CF airways. Targeting this pathway therapeutically may ameliorate mucus obstruction and inflammation-induced structural damage in young CF children.
囊性纤维化(CF)肺病的特征是早期和持续的粘液积累和中性粒细胞炎症在远端气道。确定 CF 脓性分泌物中持续 CF 粘液炎症的因素可能为新型 CF 药物治疗提供策略。我们表明,IL-1β与 IL-1α一起,主导气道脓性分泌物上清液(SAMS)的粘蛋白分泌活性。与 SAMS 一样,IL-1β 单独诱导 CF 人支气管上皮(HBE)细胞的 MUC5B 和 MUC5AC 蛋白分泌和粘液高浓度。在机制上,IL-1β 诱导无活性α基序指向域包含 ETS 转录因子(SPDEF)和内质网到核信号 2(ERN2)上调粘蛋白基因表达。在切除的 CF 肺的远端气道中,IL1B、SPDEF 和 ERN2 的 mRNA 水平增加与 MUC5B 和 MUC5AC 表达增加相关。IL-1 受体拮抗剂(IL-1Ra)的给药阻断了 SAMS 在 CF HBE 细胞中诱导的粘蛋白和促炎介质的表达。总之,IL-1α 和 IL-1β 是包括 IL-1R1 在内的信号通路的上游成分,以及下游的 SPDEF 和 ERN2,产生一个正反馈循环,能够在 CF 气道中产生持续的粘液高浓度和 IL-1α 和/或 IL-1β 介导的中性粒细胞炎症,而不存在感染。针对该途径的治疗可能改善年轻 CF 儿童的粘液阻塞和炎症引起的结构损伤。