Aspergillosis TRIF-Dependent Immune Protection in PTX3 Binds MD-2 and Promotes
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PTX3 Binds MD-2 and Promotes TRIF-Dependent Immune Protection in Aspergillosis This information is current as Silvia Bozza, Silvia Campo, Brunilde Arseni, Antonio of September 25, 2021. Inforzato, Lindstedt Ragnar, Barbara Bottazzi, Alberto Mantovani, Silvia Moretti, Vasileios Oikonomous, Rita De Santis, Agostinho Carvalho, Giovanni Salvatori and Luigina Romani J Immunol 2014; 193:2340-2348; Prepublished online 21 Downloaded from July 2014; doi: 10.4049/jimmunol.1400814 http://www.jimmunol.org/content/193/5/2340 http://www.jimmunol.org/ Supplementary http://www.jimmunol.org/content/suppl/2014/07/18/jimmunol.140081 Material 4.DCSupplemental References This article cites 41 articles, 15 of which you can access for free at: http://www.jimmunol.org/content/193/5/2340.full#ref-list-1 Why The JI? Submit online. by guest on September 25, 2021 • Rapid Reviews! 30 days* from submission to initial decision • No Triage! 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The Journal of Immunology PTX3 Binds MD-2 and Promotes TRIF-Dependent Immune Protection in Aspergillosis Silvia Bozza,* Silvia Campo,† Brunilde Arseni,† Antonio Inforzato,† Lindstedt Ragnar,† Barbara Bottazzi,‡ Alberto Mantovani,‡ Silvia Moretti,* Vasileios Oikonomous,* Rita De Santis,† Agostinho Carvalho,* Giovanni Salvatori,† and Luigina Romani* The long pentraxin 3 (PTX3) modulates different effector pathways involved in innate resistance to Aspergillus fumigatus, including complement activation or promotion of phagocytosis by interacting with FcgRs. However, whether and how TLRs modulate PTX3 mediates antifungal resistance is not known. In this study, we demonstrate that PTX3 binds myeloid differentiation protein 2 (MD-2) in vitro and exerts its protective antifungal activity in vivo through TLR4/MD-2–mediated signaling. Similar to Tlr42/2 mice, Md22/2 mice displayed high susceptibility to pulmonary aspergillosis, a phenotype associated with a proinflammatory cytokine profile and impaired antifungal activity of polymorphonuclear neutrophils. Treating Md22/2 mice with PTX3 failed to Downloaded from confer immune protection against the fungus, whereas adoptive transfer of MD-2–competent polymorphonuclear neutrophils restored it. Mechanistically, engagement of MD-2 by PTX3-opsonized Aspergillus conidia activated the TLR4/Toll/IL-1R domain-containing adapter inducing IFN-b–dependent signaling pathway converging on IL-10. Thus, we have identified a novel receptor mechanism, involving the TLR4/MD-2/Toll/IL-1R domain-containing adapter inducing IFN-b–mediated signaling, whereby PTX3 elicits antifun- gal resistance with limited immunopathology in A. fumigatus infection. The Journal of Immunology, 2014, 193: 2340–2348. http://www.jimmunol.org/ nvasive aspergillosis is an infection caused by fungi of the pulmonary aspergillosis in immunocompetent individuals (8). genus Aspergillus that typically affects severely immuno- TLR4 signaling in response to its prototype ligand LPS relies on I compromised hematologic patients undergoing intensive che- the action of two accessory molecules, myeloid differentiation motherapy and bone marrow or solid organ transplantation (1–3). protein 2 (MD-2) (9) and CD14 (10), which are essential for the Despite the availability of new azole and echinochandin drugs that stabilization of TLR4 expression on the cell surface following have significantly improved the management of this severe infection, activation by LPS (11, 12). As a matter of fact, TLR4 is unable to the prevention, diagnosis, and therapy of aspergillosis remain ex- induce a complete response to LPS in the absence of MD-2 (9), tremely difficult, rendering it a leading cause of death among im- a glycoprotein that belongs to the MD-2–related lipid recognition by guest on September 25, 2021 munocompromised patients, with a 1-y mortality reaching 75% (1). family (13), that is a critical compound in host response to Gram- The immune response to Aspergillus fumigatus is critically de- negative bacteria and plays a central role in physiologic adaptation pendent on the recognition of fungal motifs, mostly cell wall com- to various insults (14). ponents, by pattern recognition receptors (4). TLR4 has been Of interest, naturally occurring alternatively spliced isoforms of demonstrated as one major pattern recognition receptor required for human MD-2 acted as a negative regulator of LPS-mediated TLR4 resistance to A. fumigatus infection (5). Consistently, a missense activation (15), a finding indicating that targeting MD-2 could mutation affecting the extracellular domain of human TLR4 was inhibit TLR4 inflammatory signaling, as recently suggested (16). found to be associated with increased susceptibility to Aspergillus Due to the conserved nature of the TLR4/MD-2/CD14 complex, pneumonia (6) and colonization (7) in recipients of allogeneic he- several reports have suggested that it is biologically relevant and matopoietic stem cell transplants, as well as to chronic cavitary responsive to several microorganisms, including bacteria (17, 18) and viruses (19). However, little is known about whether and how the TLR4/MD-2/CD14 complex mediates immune responses to *Department of Experimental Medicine, University of Perugia, Perugia 06132, Italy; †Department of Immunology, Sigma-Tau S.p.A., Pomezia 00040, Italy; and A. fumigatus. ‡Istituto Clinico Humanitas, Rozzano, Milan 20089, Italy Fungal sensing is assisted by the action of several molecules, Received for publication March 31, 2014. Accepted for publication June 19, 2014. including collectins, ficolins, pentraxins, and complement compo- This work was supported by Italian Projects PRIN 2009HL28E8_002 (to S.B.), nents that act as opsonins and facilitate the interaction of phagocytes Research Grant RS_R_280100 from Sigma-Tau (to L.R.), and European Commu- with fungi (20). Among these, the long pentraxin 3 (PTX3) has been nity Grant ERC-2011-AdG-293714 (to L.R.). found to have a nonredundant protective role in the immune re- Address correspondence and reprint requests to Prof. Luigina Romani, Department of Experimental Medicine, University of Perugia, Piazzale Gambuli, Polo Unico sponse to A. fumigatus (21). PTX3 modulates different effector Sant’Andrea delle Fratte, Perugia 06132, Italy. E-mail address: luigina. pathways involved in innate resistance to A. fumigatus, including [email protected] complement activation, promotion of phagocytosis, and regulation The online version of this article contains supplemental material. of inflammation (22–26). The molecular mechanisms underlying Abbreviations used in this article: BAL, bronchoalveolar lavage; DC, dendritic cell; the opsonic activity of PTX3 and increased phagocytosis of conidia HSCT, hematopoietic stem cell transplantation; IKK, IkB kinase; i.n., intranasal; IRF3, IFN regulatory factor 3; MD-2, myeloid differentiation protein 2; PAS, peri- by neutrophils involved FcgRII-, CD11b-, and complement- odic acid-Schiff; PMN, polymorphonuclear neutrophil; PTX3, pentraxin 3; sMD-2, dependent mechanisms (26). However, the PTX3 protective ac- soluble MD-2; TLN, thoracic lymph node; Treg, regulatory T; TRIF, Toll/IL-1R tivity against CMV was impaired in TLR4-deficient mice (27), domain-containing adapter inducing IFN-b; WT, wild-type. a finding suggesting some level of cooperation between TLR4 and Copyright Ó 2014 by The American Association of Immunologists, Inc. 0022-1767/14/$16.00 PTX3 in host antimicrobial immunity. www.jimmunol.org/cgi/doi/10.4049/jimmunol.1400814 The Journal of Immunology 2341 In the current study, we sought to investigate the contribution of Collection of bronchoalveolar lavage fluid the TLR4/MD-2/CD14 complex to the PTX3-dependent activity Lungs were filled thoroughly with 1-ml aliquots of pyrogen-free saline through against A. fumigatus. Our findings demonstrate that PTX3 activates a 22-gauge bead-tipped feeding needle introduced into the trachea. Bron- the TLR4/Toll/IL-1R domain-containing adapter inducing IFN-b choalveolar lavage (BAL) fluid was collected in a plastic tube on ice and (TRIF)–dependent signaling pathway converging on IDO and IL-10 centrifuged at 400 3 g at 4˚C for 5 min. For differential BAL fluid cell counts, € upon binding MD-2. cytospin preparations were made and stained with May-Grunwald Giemsa reagents (Sigma-Aldrich). At least 200 cells/field/10 fields were counted, and the absolute number of each cell type was calculated (25). Photographs were taken using a using a BX51 microscope (Olympus, Milan, Italy), and images Materials and Methods were captured using a high-resolution DP71 camera (Olympus). Binding assays Treatment HEK293TCM, HEK293CM, and HEK293T cells expressing human TLR4A/ MD-2/CD14 or TLR4A and CD14/MD-2 (Invivogen), respectively, were Human PTX3 was obtained under endotoxin-free conditions by immu- used. The control line was HEK293Null. Binding of PTX3 to HEK293 noaffinity