[HTML][HTML] TNF overproduction impairs epithelial staphylococcal response in hyper IgE syndrome

IA Myles, ED Anderson, NJ Earland… - The Journal of …, 2018 - Am Soc Clin Investig
IA Myles, ED Anderson, NJ Earland, KA Zarember, I Sastalla, KW Williams, P Gough…
The Journal of Clinical Investigation, 2018Am Soc Clin Investig
Autosomal dominant hyper IgE syndrome (AD-HIES), or Job's syndrome, is a primary
immune deficiency caused by dominant-negative mutations in STAT3. Recurrent
Staphylococcus aureus skin abscesses are a defining feature of this syndrome. A widely
held hypothesis that defects in peripheral Th17 differentiation confer this susceptibility has
never been directly evaluated. To assess the cutaneous immune response in AD-HIES, we
induced suction blisters in healthy volunteers (HVs) and patients with AD-HIES and then …
Autosomal dominant hyper IgE syndrome (AD-HIES), or Job’s syndrome, is a primary immune deficiency caused by dominant-negative mutations in STAT3. Recurrent Staphylococcus aureus skin abscesses are a defining feature of this syndrome. A widely held hypothesis that defects in peripheral Th17 differentiation confer this susceptibility has never been directly evaluated. To assess the cutaneous immune response in AD-HIES, we induced suction blisters in healthy volunteers (HVs) and patients with AD-HIES and then challenged the wound with lethally irradiated bacteria. We show that cutaneous production of IL-17A and IL-17F was normal in patients with AD-HIES. Overproduction of TNF-α differentiated the responses in AD-HIES from HVs. This was associated with reduced IL-10 family signaling in blister-infiltrating cells and defective epithelial cell function. Mouse models of AD-HIES recapitulated these aberrant epithelial responses to S. aureus and involved defective epithelial-to-mesenchymal transition (EMT) rather than a failure of bacterial killing. Defective responses in mouse models of AD-HIES and primary keratinocyte cultures from patients with AD-HIES could be reversed by TNF-α blockade and by drugs with reported modulatory effects on EMT. Our results identify these as potential therapeutic approaches in patients with AD-HIES suffering S. aureus infections.
The Journal of Clinical Investigation