학술논문

Targeting IL-17A attenuates neonatal sepsis mortality induced by IL-18
Document Type
article
Source
Proceedings of the National Academy of Sciences of the United States of America. 113(19)
Subject
Pediatric
Hematology
Infectious Diseases
Sepsis
Clinical Research
2.1 Biological and endogenous factors
Aetiology
Infection
Inflammatory and immune system
Good Health and Well Being
Animals
Animals
Newborn
Antibodies
Monoclonal
Female
Interleukin-17
Interleukin-18
Male
Mice
Mice
Inbred C57BL
Molecular Targeted Therapy
Neonatal Sepsis
Survival Rate
Treatment Outcome
IL-18
IL-17
sepsis
neonate
pathogenesis
Language
Abstract
Interleukin (IL)-18 is an important effector of innate and adaptive immunity, but its expression must also be tightly regulated because it can potentiate lethal systemic inflammation and death. Healthy and septic human neonates demonstrate elevated serum concentrations of IL-18 compared with adults. Thus, we determined the contribution of IL-18 to lethality and its mechanism in a murine model of neonatal sepsis. We find that IL-18-null neonatal mice are highly protected from polymicrobial sepsis, whereas replenishing IL-18 increased lethality to sepsis or endotoxemia. Increased lethality depended on IL-1 receptor 1 (IL-1R1) signaling but not adaptive immunity. In genome-wide analyses of blood mRNA from septic human neonates, expression of the IL-17 receptor emerged as a critical regulatory node. Indeed, IL-18 administration in sepsis increased IL-17A production by murine intestinal γδT cells as well as Ly6G(+) myeloid cells, and blocking IL-17A reduced IL-18-potentiated mortality to both neonatal sepsis and endotoxemia. We conclude that IL-17A is a previously unrecognized effector of IL-18-mediated injury in neonatal sepsis and that disruption of the deleterious and tissue-destructive IL-18/IL-1/IL-17A axis represents a novel therapeutic approach to improve outcomes for human neonates with sepsis.