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Type I interferonopathies cover a phenotypically heterogeneous group of rare genetic diseases including the recently described proteasome-associated autoinflammatory syndromes (PRAAS). By definition, PRAAS are caused by inherited and/or de novo loss-of-function mutations in genes encoding proteasome subunits such as PSMB8, PSMB9, PSMB7, PSMA3, or proteasome assembly factors including POMP and PSMG2, respectively. Disruption of any of these subunits results in perturbed intracellular protein homeostasis including accumulation of ubiquitinated proteins which is accompanied by a type I interferon (IFN) signature. The observation that, similarly to pathogens, proteasome dysfunctions are potent type I IFN inducers is quite unexpected and, up to now, the underlying molecular mechanisms of this process remain largely unknown. One promising candidate for triggering type I IFN under sterile conditions is the unfolded protein response (UPR) which is typically initiated in response to an accumulation of unfolded and/or misfolded proteins in the endoplasmic reticulum (ER) (also referred to as ER stress). The recent observation that the UPR is engaged in subjects carrying POMP mutations strongly suggests its possible implication in the cause-and- effect relationship between proteasome impairment and interferonopathy onset. The purpose of this present review is therefore to discuss the possible role of the UPR in the pathogenesis of PRAAS. We will particularly focus on pathways initiated by the four ER-membrane proteins ATF6, PERK, IRE1-a, and TCF11/Nrf1 which undergo activation under proteasome inhibition. An overview of the current understanding of the mechanisms and potential cross-talk between the UPR and inflammatory signaling casacades is provided to convey a more integrated picture of the pathophysiology of PRAAS and shed light on potential biomarkers and therapeutic targets.
Numerous signalling pathways orchestrate the development, the functions, and the survival of cells, mostly in response to external stimuli. An overwhelming amount of data supports the concept of specific, spatio-temporal redox signalling pathways that affect the redox state of protein cysteinyl side chains and thus the biological function of these proteins. Glutaredoxins (Grxs) and thioredoxins (Trxs) catalyse reversible thiol-disulphide exchange reactions. The cytosolic Grx2 isoform Grx2c is essential for brain development and axonal outgrowth. A reversible dithiol-disulphide switch of CRMP2 has been identified as one of the major targets regulated by Grx2c. This CRMP2 redox switch is toggled in neuronal differentiation. Reduction of CRMP2 thiols induces profound conformational changes, modifying interactions and downstream elements of this redox switch. In [article I] and [manuscript V], we identified the Cys504 of CRMP2 to be the redox regulated residue. We used various in vitro assays with recombinant protein and molecular dynamics simulations to characterise the conformational change. The changes involve the solvent accessible surface area of at least one known phosphorylation site at the C-terminus of the protein. In [article III], we analysed the function of Grx2 and Trx1 in a model for perinatal asphyxia. Trx family proteins exhibit a very complex, cell-type and tissue specific expression pattern following hypoxia/ischemia and reoxygenation, especially Trx1 and Grx2. The results imply the clinical relevance for both proteins in perinatal asphyxia as well as many other neurological disorders. In agreement with the results presented in [articleI], Grx2 may be required for the re-establishment of neuronal integrity and connectivity. Cell shape, all forms of intracellular transport, and cell movement depend on the cytoskeleton, particularly on the fine tuned complex regulation of the dynamic re-arrangement of actin filaments and microtubules. In [article IV], we discuss the redox regulation of this dynamic cytoskeletal remodelling. Taking recent discoveries into account, we focus on redox signalling mechanisms, e.g. reversible thiol and methionyl switches. These switches are specifically controlled by enzymes such as Trx1 and Grx2c, for instance, and not the result of random modification by unspecific oxidants. Methionyl sulphoxidation of actin can be reversed by methionyl sulphoxide reductase (MsrA), promoting actin polymerisation. Human cells express two different Msr enzymes (MsrA and MsrB), that can reduce S- and R-methionyl sulphoxide, respectively. In the gram-positive Streptococcus pneumoniae, on the other hand, both Msr genes and thus enzymes were fused during evolution. In [article II], we characterised the surface-exposed thioredoxin family lipoproteins Etrx1 and 2 and regulators of this Msr (SpMsrAB). A loss of function of both Etrx proteins or SpMsrAB dramatically reduced pneumococcal virulence, enhanced the bacterial uptake by macrophages, and accelerated pneumococcal killing by H2O2 or free methionine sulphoxide. Identification and characterisation of components of this redox regulated system may contribute to the design of new antimicrobials. In [manuscript VI], we investigated the effects of Grx2c expression on cell morphology, migration, and invasion behaviour of cancer cells. Grx2c expressing cancer cells developed dramatic changes in phenotype, including alterations in cytoskeletal dynamics and significantly increased motility and invasiveness. We used quantitative proteomics and phopshoproteomic approaches to characterise the underlying mechanisms. Proteins and pathways regulating cytoskeletal dynamics, cell adhesion, and receptor-mediated signal transduction were detected to be specifically altered. We started a clinical pilot study with patients suffering from clear cell renal cell carcinoma (ccRCC). Grx2c was expressed with significantly higher frequency in ccRCC compared to healthy kidney tissue, associated with a strong trend for locally more advanced tumour stages and a clear tendency for a decreased cancer-specific survival, compared to patients without detectable Grx2c. These results were supported by data from "The Cancer Genome Atlas". In synopsis, the results presented and discussed in these articles and manuscripts, support the concept of specific redox signalling in different models and model organisms. They also demonstrate the importance of the specific redox control of signalling pathways that, in the case of errors or misinterpretations, contribute to pathophysiological alterations. The regulation of the CRMP2 redox switch by Grx2c, for instance, is physiologically essential for brain development, but might lead to cancer progression, if "switched on" in adult tissue. Identification of further interaction partners as well as the development of compounds modulating this redox switch and CRMP2s conformations, will be part of our future research.
Despite their very close structural similarity, CxxC/S-type (class I) glutaredoxins (Grxs) actas oxidoreductases, while CGFS-type (class II) Grxs act as FeS cluster transferases. Here weshow that the key determinant of Grx function is a distinct loop structure adjacent to theactive site. Engineering of a CxxC/S-type Grx with a CGFS-type loop switched its functionfrom oxidoreductase to FeS transferase. Engineering of a CGFS-type Grx with a CxxC/S-typeloop abolished FeS transferase activity and activated the oxidative half reaction of the oxi-doreductase. The reductive half-reaction, requiring the interaction with a second GSHmolecule, was enabled by switching additional residues in the active site. We explain howsubtle structural differences, mostly depending on the structure of one particular loop, act inconcert to determine Grx function.
Patients with atrial fibrillation (AF) often present with typical angina pectoris and mildly elevated levels of cardiac troponin (non-ST-segment elevation myocardial infarction) during an acute episode of AF. However, in a large proportion of these patients, significant coronary artery disease is excluded by coronary angiography, which suggests that AF itself influences myocardial blood flow. The present review summarizes the effect of AF on the occurrence of ventricular oxidative stress, redox-sensitive signaling pathways and gene expression, and microcirculatory flow abnormalities in the left ventricle.
Despite the extensive ongoing research, there still exist plenty of diseases whose mechanisms have not yet been fully understood, one such example being proteasome-related disorders. Over the last few years, an increasing number of studies have been initiated
to elucidate their driving pathophysiological mechanisms. Determining the systematic effects of genomic alterations occurring in genes encoding 19S proteasome subunits is a key to comprehend the molecular basis of syndromic intellectual disability (ID) pathogenesis and
the subsequent design of new targeted therapies. Therefore, the main objective of my research was to contribute to the identification of potential drivers of syndromic ID, and thereby pave the way for the development of new targeted therapy approaches. In this regard, my aim was to characterize tissue, proteomic and metabolomic changes in cells from patients with PSMC5 mutations and uncover a potential dysregulation of various biochemical and/or inflammatory pathways.
To this end, I undertook a comparative examination of control and patient T cells expanded from peripheral blood mononuclear cells (PBMCs). First, I assessed the proteasome composition in these samples (both in its denaturized and native form), by means of
SDS-PAGE, native PAGE and western-blotting. Moreover, I determined proteasome chymotrypsin-like activity by measure of Suc-LLVY-AMC peptidase activity assay. In addition, I analysed the activation status of the ER stress and mTOR pathway by RT-PCR and SDS-PAGE /western-blotting prior to a subsequent analysis of T-cell markers.
The data show that the investigated p.(Pro320Arg) and p.(Arg201Trp) de novo heterozygous missense mutations in the PSMC5 gene do not cause haploinsufficiency as the steady-state expression level of the PSMC5/Rpt6 full-length protein does not vary between control and patient cells. Further analysis of control and patient T cells under non-reducing conditions revealed that PSMC5/Rpt6 mutants were less efficiently incorporated into 26S proteasome complexes than their wild-type counterparts. The failure to assemble PSMC5/Rpt6 into fully mature proteasomes was associated with a reduced proteasome chymotrypsin-like activity in patient T cells, as determined by in-plate assays. These data unambiguously demonstrate that both of the p.(Pro320Arg) and p.(Arg201Trp) PSMC5 mutations identified in patients suffering from syndromic ID are loss-of-function mutations. Interestingly, my data further show that proteasome dysfunction in these patients was accompanied by abnormalities in mTOR signalling and T-cell differentiation, as determined by western-blotting and flow cytometry, respectively.
Altogether, our data identified for the first time PSMC5 as a disease-causing gene for
a syndromic form of ID. How proteasome dysfunction caused by PSMC5 variants contributes to disease pathogenesis, remains to be fully determined.
Endogenous redox systems not only counteract oxidative damage induced by high levels of hydroxyl radicals (OH·) under pathological conditions, but also shape redox signaling as a key player in the regulation of physiological processes. Second messengers like hydrogen peroxide and nitric oxide, as well as redox enzymes of the Thioredoxin (Trx) family, including Trxs, glutaredoxins (Grxs), and peroxiredoxins (Prxs) modulate reversible, oxidative modifications of proteins. Thereby redox regulation is part of various cellular processes such as the immune response and Trx proteins have been linked in different disorders including inflammatory diseases. Here, we have analyzed the protein distribution of representative oxidoreductases of the Trx fold protein family—Trx1, Grx1, Grx2, and Prx2—in a murine model of allergic asthma bronchiale, as well as their potential therapeutic impact on type-2 driven airway inflammation. Ovalbumin (OVA) sensitization and challenge using the type-2 prone Balb/c mouse strain resulted in increased levels of all investigated proteins in distinct cellular patterns. While concomitant treatment with Grx1 and Prx2 did not show any therapeutic impact on the outcome of the disease, Grx2 or Trx1 treatment before and during the OVA challenge phase displayed pronounced protective effects on the manifestation of allergic airway inflammation. Eosinophil numbers and the type-2 cytokine IL-5 were significantly reduced while lung function parameters profoundly improved. The number of macrophages in the bronchoalveolar lavage (BAL) did not change significantly, however, the release of nitric oxide that was linked to airway inflammation was successfully prevented by enzymatically active Grx2 ex vivo. The Grx2 Cys-X-X-Ser mutant that facilitates de-/glutathionylation, but does not catalyze dithiol/disulfide exchange lost the ability to protect from airway hyper reactivity and to decrease NO release by macrophages, however, it reduced the number of infiltrating immune cells and IL-5 release. Altogether, this study demonstrates that specific redox proteins and particular enzyme activities protect against inflammatory damage. During OVA-induced allergic airway inflammation, administration of Grx2 exerts beneficial and thus potentially therapeutic effects.
The failure of insulin-producingβ-cells is the underlying cause of hyperglycemia in diabetes mellitus.β-cell decay has been linked to hypoxia, chronic inflammation,and oxidative stress. Thioredoxin (Trx) proteins are major actors in redox signaling and essential for signal transduction and the cellular stress response. We haveanalyzed the cytosolic, mitochondrial, and extracellular Trx system proteins in hypoxic and cytokine-induced stress usingβ-cell culture, isolated pancreatic islets, andpancreatic islet transplantation modelling low oxygen supply.Protein levels of cytosolic Trx1 and Trx reductase (TrxR) 1 significantly decreased, while mitochondrial Trx2 and TrxR2 increased upon hypoxia and reox-ygenation. Interestingly, Trx1 was secreted byβ-cells during hypoxia. Moreover, murine and human pancreatic islet grafts released Trx1 upon glucose stimulation.Survival of transplanted islets was substantially impaired by the TrxR inhibitor auranofin.Since a release was prominent upon hypoxia, putative paracrine effects of Trx1 onβ-cells were examined. In fact, exogenously added recombinant hTrx1 mitigatedapoptosis and preserved glucose sensitivity in pancreatic islets subjected to hypoxia and inflammatory stimuli, dependent on its redox activity. Human subjects werestudied, demonstrating a transient increase in extracellular Trx1 in serum after glucose challenge. This increase correlated with better pancreatic islet function.Moreover, hTrx1 inhibited the migration of primary murine macrophages.In conclusion, our study offers evidence for paracrine functions of extracellular Trx1 that improve the survival and function of pancreaticβ-cells.
Reduction and oxidation reactions are essential for biochemical processes. They are part of metabolic pathways and signal transduction. Reactive oxygen species (ROS) as second messengers and oxidative modifications of cysteinyl (Cys) residues are key to transduce and translate intracellular and intercellular signals. Dysregulation of cellular redox signaling is known as oxidative distress, which has been linked to various pathologies, including neurodegeneration. Alzheimer's disease (AD) is a neurodegenerative pathology linked to both, abnormal amyloid precursor protein (APP) processing, generating Aβ peptide, and Tau hyperphosphorylation and aggregation. Signs of oxidative distress in AD include: increase of ROS (H2O2, O2•−), decrease of the levels or activities of antioxidant enzymes, abnormal oxidation of macromolecules related to elevated Aβ production, and changes in mitochondrial homeostasis linked to Tau phosphorylation. Interestingly, Cys residues present in APP form disulfide bonds that are important for intermolecular interactions and might be involved in the aggregation of Aβ. Moreover, two Cys residues in some Tau isoforms have been shown to be essential for Tau stabilization and its interaction with microtubules. Future research will show the complexities of Tau, its interactome, and the role that Cys residues play in the progression of AD. The specific modification of cysteinyl residues in redox signaling is also tightly connected to the regulation of various metabolic pathways. Many of these pathways have been found to be altered in AD, even at very early stages. In order to analyze the complex changes and underlying mechanisms, several AD models have been developed, including animal models, 2D and 3D cell culture, and ex-vivo studies of patient samples. The use of these models along with innovative, new redox analysis techniques are key to further understand the importance of the redox component in Alzheimer's disease and the identification of new therapeutic targets in the future.
The systemic renin-angiotensin system (RAS) is an endocrine system that is mainly known to regulate blood pressure, fluid and electrolyte balance as well as volume homeostasis in the body through different active metabolites, the angiotensin (Ang) peptides. In addition, local renin-angiotensin systems have been discovered in various tissues, including the islet of Langerhans. Starting with angiotensinogen, the precursor of all angiotensin peptides which is cleaved into the decapeptide Ang I by renin, the RAS is divided into three axes. The main classical RAS axis is composed of angiotensin converting enzyme (ACE), angiotensin (Ang) II, and the Ang II type 1 receptor (AT1R), whereas the two alternative RAS axes comprise either ACE2, Ang-(1-7) and the receptor Mas or the aminopeptidase N (APN), Ang IV and the insulin-regulated aminopeptidase (IRAP). The activation of the main ACE/Ang II/AT1R RAS axis has been associated with metabolic syndrome, type 2 diabetes mellitus, and islet dysfunction. The detrimental effects resulting from the pathological activation of this axis have been shown to be attenuated or even abolished by the pharmacological inhibition of components of the main RAS axis. However, the impact of the two alternative ACE2/Ang-(1-7)/Mas and APN/Ang IV/IRAP RAS axes on islet function is less well understood. Previous studies mainly focused on the possible protective actions of Ang-(1-7) via the receptor Mas in insulin-sensitive tissues and on well known risk factors of metabolic syndrome (insulin resistance, hyperglycemia, obesity, hypertension and dyslipidemia). Thus, the impact of this axis on β-cell function and, in particular, insulin production and release was examined in the present study. Glucose and fatty acids have been subjects of diabetic research because they are established pathophysiologically relevant features of the metabolic syndrome and are known to harm β cells, phenomena which are referred to as gluco- or lipotoxicity, respectively. The pathophysiologically relevant factors glucose, saturated fatty acid (FA) palmitic acid (PA), and the methyl ester of the omega-3 fatty acid docosahexaenoic acid (DHA-ME) were used in the present study to characterize the local β-cell RAS as well as β-cell function under pathophysiological conditions. Results of the present work demonstrate the expression of selected components of the RAS in isolated murine islets of Langerhans and the rat insulinoma cell line BRIN-BD11 under basal conditions. The alternative ACE2/Ang-(1-7)/Mas and APN/Ang IV/IRAP RAS axes were activated by high glucose in BRIN-BD11 cells after 24 h. Coincidently with these findings insulin production was found to be increased. In contrast, the expression of components of the main ACE/Ang II/AT1R RAS axis and the Ang II type 2 receptor (AT2R) were not affected under the same conditions (Härdtner et al., 2013). Both FAs, PA and DHA-ME were shown to alter the expression of components of the renin-angiotensin system in BRIN-BD11 cells. PA increased the expression of AT1R, the receptor of the main RAS axis, and of AT2R, whereas that of the receptor of the alternative ACE2/Ang-(1-7)/Mas RAS axis, Mas, appeared to be down-regulated at basal low glucose concentrations (5.5 mM). These effects were accompanied by a dose-dependent reduction of the insulin production and secretion. In contrast, DHA-ME augmented the expression of components of the ACE2/Ang-(1-7)/Mas axis and IRAP at low glucose concentrations, an effect which could be partially enhanced under high glucose conditions (25 mM). At basal glucose concentrations DHA-ME reduced the insulin secretion, whereas it was increased under high glucose conditions. However, the insulin mRNA amount remained unaffected by DHA-ME. Additionally, in contrast to glucose and palmitic acid, DHA-ME significantly increased the production of reactive oxygen species, at least hydrogen peroxide after 30 min. Expression alterations of components of the alternative ACE2/Ang-(1-7)/Mas RAS axis by glucose and PA correlated strongly with the corresponding insulin secretion and production. Therefore, an involvement of the ACE2/Ang-(1-7)/Mas RAS axis in the regulation of insulin secretion and production was hypothesized and validated in primary islets of Langerhans of both Mas-deficient and wild-type mice. Islets were exposed to the preferred natural ligand for Mas, Ang-(1-7), or to its pharmacological agonists or antagonists, respectively....
Abstract
G‐quadruplexes have attracted growing interest in recent years due to their occurrence in vivo and their possible biological functions. In addition to being promising targets for drug design, these four‐stranded nucleic acid structures have also been recognized as versatile tools for various technological applications. Whereas a large number of studies have yielded insight into their remarkable structural diversity, our current knowledge on G‐quadruplex stabilities as a function of sequence and environmental factors only gradually emerges with an expanding collection of thermodynamic data. This minireview provides an overview of general rules that may be used to better evaluate quadruplex thermodynamic stabilities but also discusses present challenges in predicting most stable folds for a given sequence and environment.
Abstract
Aims
Treating patients with acute decompensated heart failure (ADHF) presenting with volume overload is a common task. However, optimal guidance of decongesting therapy and treatment targets are not well defined. The inferior vena cava (IVC) diameter and its collapsibility can be used to estimate right atrial pressure, which is a measure of right‐sided haemodynamic congestion. The CAVA‐ADHF‐DZHK10 trial is designed to test the hypothesis that ultrasound assessment of the IVC in addition to clinical assessment improves decongestion as compared with clinical assessment alone.
Methods and results
CAVA‐ADHF‐DZHK10 is a randomized, controlled, patient‐blinded, multicentre, parallel‐group trial randomly assigning 388 patients with ADHF to either decongesting therapy guided by ultrasound assessment of the IVC in addition to clinical assessment or clinical assessment alone. IVC ultrasound will be performed daily between baseline and hospital discharge in all patients. However, ultrasound results will only be reported to treating physicians in the intervention group. Treatment target is relief of congestion‐related signs and symptoms in both groups with the additional goal to reduce the IVC diameter ≤21 mm and increase IVC collapsibility >50% in the intervention group. The primary endpoint is change in N‐terminal pro‐brain natriuretic peptide from baseline to hospital discharge. Secondary endpoints evaluate feasibility, efficacy of decongestion on other scales, and the impact of the intervention on clinical endpoints.
Conclusions
CAVA‐ADHF‐DZHK10 will investigate whether IVC ultrasound supplementing clinical assessment improves decongestion in patients admitted for ADHF.
Macrophages are cells of the innate immune system and represent an important component of the first-line defense against pathogens and tumor cells. Here, their diverse functions in inflammation and tumor defense are described, and the mechanisms, tools, and activation pathways and states applied are presented. The main focus is on the role and origin of reactive oxygen species (ROS), the important signal pathways TLR/NF-κB, and the M1/M2 polarization of macrophages.
Cancer stem cells (CSCs) represent a small subset of slowly dividing cells with tumor-initiating ability. They can self-renew and differentiate into all the distinct cell populations within a tumor. CSCs are naturally resistant to chemotherapy or radiotherapy. CSCs, thus, can repopulate a tumor after therapy and are responsible for recurrence of disease. Stemness manifests itself through, among other things, the expression of stem cell markers, the ability to induce sphere formation and tumor growth in vivo, and resistance to chemotherapeutics and irradiation. Stemness is maintained by keeping levels of reactive oxygen species (ROS) low, which is achieved by enhanced activity of antioxidant pathways. Here, cellular sources of ROS, antioxidant pathways employed by CSCs, and underlying mechanisms to overcome resistance are discussed.
Survival, development, and function of cells depend on numerous signaling pathways or-
chestrating the response to external and internal stimuli. Besides the well-established signaling through reversible phosphorylation, the concept of specific, spatio-temporal redox modifi-
cations of protein cysteinyl and methionyl side chains that regulate the biological function of these proteins is supported by an overwhelming amount of data. Although the specific reduction of protein redox modifications has been studied intensively, the oxidation of protein side chains was thought to be a result of so-called ‘oxidative stress’. However, this term has been increasingly challenged, since signaling pathways depend on specific, spatio-temporal oxidation of target proteins, most likely catalyzed by specific enzymes. The discovery of MICAL (molecule interacting with CasL) proteins evinced
the first examples of specific oxidases in signal transduction in the redox regulation of cellular functions.As part of the semaphorin signaling pathway, MICAL proteins were characterized to stereospecifically oxidize methionyl residues in actin, thereby regulating actin deolymerization, a process important in neurogenesis and cell migration. This oxidation can be reversed by the specific methionine-R-sulfoxide eductase B1. Besides the regulation of actin dynamics, MICALs are involved in the regulation of cell proliferation and
apoptosis, and the production of hydrogen peroxide may qualify them as specific oxidases also for cysteinyl residues.
Mutations in genes coding for proteasome subunits and/or proteasome assembly helpers typically cause recurring autoinflammation referred to as chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperatures (CANDLE) or proteasome-associated autoinflammatory syndrome (PRAAS). Patients with CANDLE/PRAAS present with mostly chronically elevated type I interferon scores that emerge as a consequence of increased proteotoxic stress by mechanisms that are not fully understood. Here, we report on five unrelated patients with CANDLE/PRAAS carrying novel inherited proteasome missense and/or nonsense variants. Four patients were compound heterozygous for novel pathogenic variants in the known CANDLE/PRAAS associated genes, PSMB8 and PSMB10, whereas one patient showed additive loss-of-function mutations in PSMB8. Variants in two previously not associated proteasome genes, PSMA5 and PSMC5, were found in a patient who also carried the PSMB8 founder mutation, p.T75M. All newly identified mutations substantially impact the steady-state expression of the affected proteasome subunits and/or their incorporation into mature 26S proteasomes. Our observations expand the spectrum of PRAAS-associated genetic variants and improve a molecular diagnosis and genetic counseling of patients with sterile autoinflammation.
Proteostasis, a portmanteau of the words protein and homeostasis, refers to the ability of
eukaryotic cells to maintain a stable proteome by acting on protein synthesis, quality control and/or
degradation. Over the last two decades, an increasing number of disorders caused by proteostasis
perturbations have been identified. Depending on their molecular etiology, such diseases may be
classified into ribosomopathies, proteinopathies and proteasomopathies. Strikingly, most—if not
all—of these syndromes exhibit an autoinflammatory component, implying a direct cause-and-effect
relationship between proteostasis disruption and the initiation of innate immune responses. In this
review, we provide a comprehensive overview of the molecular pathogenesis of these disorders and
summarize current knowledge of the various mechanisms by which impaired proteostasis promotes
autoinflammation. We particularly focus our discussion on the notion of how cells sense and integrate
proteostasis perturbations as danger signals in the context of autoinflammatory diseases to provide
insights into the complex and multiple facets of sterile inflammation.
Streptococcus pneumoniae infections can lead to severe complications with excessive immune activation and tissue damage. Interleukin-37 (IL-37) has gained importance as a suppressor of innate and acquired immunity, and its effects have been therapeutic as they prevent tissue damage in autoimmune and inflammatory diseases. By using RAW macrophages, stably transfected with human IL-37, we showed a 70% decrease in the cytokine levels of IL-6, TNF-α, and IL-1β, and a 2.2-fold reduction of the intracellular killing capacity of internalized pneumococci in response to pneumococcal infection. In a murine model of infection with S. pneumoniae, using mice transgenic for human IL-37b (IL-37tg), we observed an initial decrease in cytokine expression of IL-6, TNF-α, and IL-1β in the lungs, followed by a late-phase enhancement of pneumococcal burden and subsequent increase of proinflammatory cytokine levels. Additionally, a marked increase in recruitment of alveolar macrophages and neutrophils was noted, while TRAIL mRNA was reduced 3-fold in lungs of IL-37tg mice, resulting in necrotizing pneumonia with augmented death of infiltrating neutrophils, enhanced bacteremic spread, and increased mortality. In conclusion, we have identified that IL-37 modulates several core components of a successful inflammatory response to pneumococcal pneumonia, which lead to increased inflammation, tissue damage, and mortality.