The mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.

Necrotizing enterocolitis (NEC) is a devastating neonatal intestinal inflammatory disease, occurring primarily in premature infants, causing significant morbidity and mortality. The pathogenesis of NEC is associated with an excessive inflammatory IL-8 response. In this study, we hypothesized that th...

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Autores principales: Nanda Nanthakumar, Di Meng, Allan M Goldstein, Weishu Zhu, Lei Lu, Ricardo Uauy, Adolfo Llanos, Erika C Claud, W Allan Walker
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spelling oai:doaj.org-article:e967c28133dc45888393c533eae44fa82021-11-18T06:57:03ZThe mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.1932-620310.1371/journal.pone.0017776https://doaj.org/article/e967c28133dc45888393c533eae44fa82011-03-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21445298/?tool=EBIhttps://doaj.org/toc/1932-6203Necrotizing enterocolitis (NEC) is a devastating neonatal intestinal inflammatory disease, occurring primarily in premature infants, causing significant morbidity and mortality. The pathogenesis of NEC is associated with an excessive inflammatory IL-8 response. In this study, we hypothesized that this excessive inflammatory response is related to an immature expression of innate immune response genes. To address this hypothesis, intestinal RNA expression analysis of innate immune response genes was performed after laser capture microdissection of resected ileal epithelium from fetuses, NEC patients and children and confirmed in ex vivo human intestinal xenografts. Changes in mRNA levels of toll-like receptors (TLR)-2 and -4, their signaling molecules and transcription factors (MyD88, TRAF-6 and NFκB1) and negative regulators (SIGIRR, IRAK-M, A-20 and TOLLIP) and the effector IL-8 were characterized by qRT-PCR. The expression of TLR2, TLR4, MyD88, TRAF-6, NFκB1 and IL-8 mRNA was increased while SIGIRR, IRAK-M, A-20 and TOLLIP mRNA were decreased in fetal vs. mature human enterocytes and further altered in NEC enterocytes. Similar changes in mRNA expression were observed in immature, but not mature, human intestinal xenografts. Confirmation of gene expression was also validated with selective protein measurements and with suggested evidence that immature TRL4 enterocyte surface expression was internalized in mature enterocytes. Cortisone, an intestinal maturation factor, treatment corrected the mRNA differences only in the immature intestinal xenograft. Using specific siRNA to attenuate expression of primary fetal enterocyte cultures, both TOLLIP and A-20 were confirmed to be important when knocked down by exhibiting the same excessive inflammatory response seen in the NEC intestine. We conclude that the excessive inflammatory response of the immature intestine, a hallmark of NEC, is due to a developmental immaturity in innate immune response genes.Nanda NanthakumarDi MengAllan M GoldsteinWeishu ZhuLei LuRicardo UauyAdolfo LlanosErika C ClaudW Allan WalkerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 3, p e17776 (2011)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Nanda Nanthakumar
Di Meng
Allan M Goldstein
Weishu Zhu
Lei Lu
Ricardo Uauy
Adolfo Llanos
Erika C Claud
W Allan Walker
The mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.
description Necrotizing enterocolitis (NEC) is a devastating neonatal intestinal inflammatory disease, occurring primarily in premature infants, causing significant morbidity and mortality. The pathogenesis of NEC is associated with an excessive inflammatory IL-8 response. In this study, we hypothesized that this excessive inflammatory response is related to an immature expression of innate immune response genes. To address this hypothesis, intestinal RNA expression analysis of innate immune response genes was performed after laser capture microdissection of resected ileal epithelium from fetuses, NEC patients and children and confirmed in ex vivo human intestinal xenografts. Changes in mRNA levels of toll-like receptors (TLR)-2 and -4, their signaling molecules and transcription factors (MyD88, TRAF-6 and NFκB1) and negative regulators (SIGIRR, IRAK-M, A-20 and TOLLIP) and the effector IL-8 were characterized by qRT-PCR. The expression of TLR2, TLR4, MyD88, TRAF-6, NFκB1 and IL-8 mRNA was increased while SIGIRR, IRAK-M, A-20 and TOLLIP mRNA were decreased in fetal vs. mature human enterocytes and further altered in NEC enterocytes. Similar changes in mRNA expression were observed in immature, but not mature, human intestinal xenografts. Confirmation of gene expression was also validated with selective protein measurements and with suggested evidence that immature TRL4 enterocyte surface expression was internalized in mature enterocytes. Cortisone, an intestinal maturation factor, treatment corrected the mRNA differences only in the immature intestinal xenograft. Using specific siRNA to attenuate expression of primary fetal enterocyte cultures, both TOLLIP and A-20 were confirmed to be important when knocked down by exhibiting the same excessive inflammatory response seen in the NEC intestine. We conclude that the excessive inflammatory response of the immature intestine, a hallmark of NEC, is due to a developmental immaturity in innate immune response genes.
format article
author Nanda Nanthakumar
Di Meng
Allan M Goldstein
Weishu Zhu
Lei Lu
Ricardo Uauy
Adolfo Llanos
Erika C Claud
W Allan Walker
author_facet Nanda Nanthakumar
Di Meng
Allan M Goldstein
Weishu Zhu
Lei Lu
Ricardo Uauy
Adolfo Llanos
Erika C Claud
W Allan Walker
author_sort Nanda Nanthakumar
title The mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.
title_short The mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.
title_full The mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.
title_fullStr The mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.
title_full_unstemmed The mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.
title_sort mechanism of excessive intestinal inflammation in necrotizing enterocolitis: an immature innate immune response.
publisher Public Library of Science (PLoS)
publishDate 2011
url https://doaj.org/article/e967c28133dc45888393c533eae44fa8
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