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Dysbiosis in Mouse Models of Chronic Gut Inflammation: Cause or Consequence? Matthew B. Grisham, PhD. Department of Immunology and Molecular Microbiology TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER School of Medicine Worldwide Incidence and Prevalence of IBD have Increased Dramatically over the Past 50 Years 1960-79 1980-08 Moledecky et. al. Gastroenterology, 2012 CD and UC are Multifactorial Polygenic Diseases (~163 susceptibility loci) from Lees, C.W., Gut 2011 Jostins et. al. Nature, 2012 Environmental factors* are emerging as major contributors to disease pathogenesis in genetically-susceptible individuals ● Genetically-identical twins express a relatively low concordance rates for both CD (~30-35%) and UC (~10-15%). Spehlmann et. al. IBD, 2008. ● Increased incidence and prevalence of IBD in countries that have adapted a “Modernized” lifestyle. *antibiotics, hygiene, diet Antibiotics, Hygiene and Diet Alter Intestinal Microbiota Stomach 0-102 Lactobacillus Candida Streptococcus Helicobacter pylori Peptostreptococcus Duodenum 102 Lactobacillus Streptococcus Jejunum 102 Lactobacillus Streptococcus Proximal Ileum 103 Lactobacillus Streptococcus Colon 1011-1012 Distal Ileum 107-108 Streptococcus Clostridium Bacteroides Actinomycinae Corynebacteria Bacteroides Clostridium groups IV&XIV Bifidobacterium Enterobacteriaceae modified from Sartor, 2008 Clinical Evidence Implicating Intestinal Bacteria in the Pathogenesis of IBD ● Diversion of fecal stream prevents recurrence of Crohn’s Disease; Reinfusion of fecal contents rapidly induces disease. ● Antibiotic therapy attenuates intestinal inflammation in distal bowel disease. ● Increased numbers of bacteria are observed in intestinal tissue of patients with IBD. ● IBD-susceptibility genes are involved in bacterial killing. ● Composition of intestinal microbiota is altered in IBD (dysbiosis). Dysbiosis in IBD from Peterson and Gordon 2008 Alterations in the Microbiota Associated with Inflammatory Bowel Disease Decrease in alpha diversity Decrease in Bacteroides and Firmicutes Decreases in Clostridia, Ruminococcaceae, Lactobacillus, Faecalibacterium prausnitzii, Bifidobacterium Increase in Proteobacteria (e.g. Enterobacteriaceae) Increases in γ-proteobacteria; E. coli (AIEC) Increased Presence of Fusobacterium Kostic et. al. Gastroenterology, 2014 Alterations in Microbial Function in IBD Increased oxidative stress protection pathways ● increased cysteine and GSH transport; ● increased riboflavin and sulfur metabolism ● increased pentose phosphate shunt pathway Increased sulfate transport and metabolism Increase in amino acid transport Increase in auxotrophy Decrease in short chain fatty acids and metabolism Decreased in amino acid biosynthesis from Morgan et. al., 2012; Kostic et. al. 2014 Role of Intestinal Bacteria in Mouse Models of IBD Intestinal Bacteria are Required for the Induction of Chronic Gut Inflammation in Genetically-Susceptible Mice CD45RBhigh T-Cell →SCID or RAG-/IL-10-/IL-2-/TCR-α-/- or β-/C3H/HeJBir Samp1/Yit TLR-5-/Tbet-/- x RAG2-/- (Truc) IL-10r2-/- x TGFβr2-/- Mouse Models of Chronic Gut Inflammation exhibit Dysbiosis Healthy Colitic RAG-1-/- CD45RBhigh→RAG-1-/- Reinoso Webb, Koboziev et. al. 2014 Dysbiosis in Chronic Gut Inflammation: Cause or Consequence? Healthy Colitic RAG-1-/- CD45RBhigh→RAG-1-/- Reinoso Webb, Koboziev et. al. 2014 Intestinal Inflammation Promotes the Growth of Proteobacteria (Enterobacteriales) Control C. rodentium infection from Lupp et.al. 2007 Time-Dependent Dysbiosis in IL-10-/- Mice Wild Type IL-10-/- from Maharshak et. al. 2013 Intestinal Inflammation Induces Dysbiosis in Mice Intestinal inflammation enhances the growth of certain facultative anaerobes while decreasing the growth of obligate anaerobes Inflammation Provides a Selective Growth Advantage for Disease-Producing Pathobionts SO4-2 (Sulfate) NO3(nitrate) R3-N+-O- R2-SO (TMAO) (Sulfoxide) R2-S (Sulfide) R3-NH (Trimethyl Amine) ONOO- HOCl H 2 O2 CHO Mucolytic Bacteria Mucolytic Bacteria NO O 2- Intestinal Inflammation Modified from Winter et. al. EMBO, 2013 Modified from Winter et. al. EMBO, 201 Products of Intestinal Inflammation: Reactive Oxygen and Nitrogen Species diet, bacteria SO4-2 (Sulfate) NO3(nitrate) R3-N+-O- R2-SO (TMAO) (Sulfoxide) R2-S (Sulfide) R3-NH (Trimethylamine) ONOOHOCl H 2 O2 NO CHO O2- Mucolytic Bacteria Intestinal Inflammation Modified Modifiedfrom fromWinter Winteret. et.al. al.EMBO, EMBO,2013 2013 Alterations in Microbial Function in IBD Increased oxidative stress protection pathways ● increased cysteine and GSH transport ● increased riboflavin and sulfur metabolism ● increased pentose phosphate shunt pathway Increased sulfate transport and metabolism Increase in amino acid transport Increase in auxotrophy Decrease in short chain fatty acids and metabolism Decreased in amino acid biosynthesis from Morgan et. al., 2012; Kostic et. al. 2014 Proteobacteria are the only Major Group of Bacteria that can Produce GSH GSH cysteine, cystine sulfate Glut + Gly + Cys glucose LOOH H2O2 GR Riboflavin LOH H2O Pentose Phosphate Shunt Products of Intestinal Inflammation: Nitric Oxide-Derived Metabolites diet, bacteria SO4-2 (Sulfate) NO3(nitrate) R3-N+-O- R2-SO (TMAO) (Sulfoxide) R2-S (Sulfide) R3-NH (Trimethylamine) ONOOHOCl H 2 O2 NO CHO O2- Mucolytic Bacteria Intestinal Inflammation Modified Modifiedfrom fromWinter Winteret. et.al. al.EMBO, EMBO,2013 2013 Anaerobic Respiration by Enterobacteriaceae: Nitrate Reduction Generation of Proton-Motive Force via electron Transport H2O Pearson Education, Inc., 2015 GSH Protects the Fumarate and Nitrate Reductase Regulatory Protein from Oxidant-Induced Inactivation GSH Ox Active Ox Inactive Products of Intestinal Inflammation: Oxidant-Mediated formation of N- and S-Oxides diet, bacteria SO4-2 (Sulfate) NO3(nitrate) R3-N+-O- R2-SO (TMAO) (Sulfoxide) R2-S (Sulfide) R3-NH (Trimethylamine) ONOOHOCl H 2 O2 NO CHO O2- Mucolytic Bacteria Intestinal Inflammation Modified Modifiedfrom fromWinter Winteret. et.al. al.EMBO, EMBO,2013 2013 Anaerobic Respiration by Enterobacteriaceae: TMAO and DMSO Reductases TMAO Reductase + ATP Anaerobic Respiration TMAO DMSO Reductase Anaerobic Respiration DMSO + ATP Products of Intestinal Inflammation: Mucin-Derived Sulfate diet SO4-2 (Sulfate) NO3(nitrate) R3-N+-O- R2-SO (TMAO) (Sulfoxide) R2-S (Sulfide) R3-NH (Trimethyl Amine) ONOOHOCl H 2 O2 CHO Mucolytic Bacteria NO Mucolytic Bacteria O2- Intestinal Inflammation Modified Modifiedfrom fromWinter Winteret. et.al. al.EMBO, EMBO,2013 2013 Alterations in Microbial Function in IBD Increased oxidative stress protection pathways ● increased cysteine and GSH transport; ● increased riboflavin and sulfur metabolism ● increased pentose phosphate shunt pathway Increased sulfate transport and metabolism Increase in amino acid transport Increase in auxotrophy Decrease in short chain fatty acids and metabolism Decreased in amino acid biosynthesis from Morgan et. al., 2012; Kostic et. al. 2014 Anaerobic Respiration by δ Proteobacteria: Sulfate Reduction Desulfovibrio Bilophila wadsworthia Modified from Cypionka, Encyc. Geobiology, 2011 Products of Inflammation Feed the Expansion of Colitogenic Pathobionts Anaerobic Respiration CHO Clostridia Bacteriodia Enterobacteriaceae Modified from Winter et. al. EMBO, 2013 Sequential Generation of Inflammation, Dysbiosis and Disease in Susceptible Mice modified from Craven et. al. PLOS One, 2012 Healthy Inflammation Dybiosis Disease Inflammation Induces Dysbiosis Transplant of fecal microbiota from colitic mice into healthy recipients should accelerate the onset of disease in genetically-susceptible mice. RAG-1-/- feces 5-6 Days + CD45RBhigh T Cells ~ 2.0 mg/g body weight Colitic feces 5-6 Days Body Weight (% Original) Colitic Fecal Transplant Accelerates Weight Loss in the T Cell Transfer Model of Chronic Colitis ● T cell Transfer ● RAG Feces + T cells ● Colitic Feces + T cells Days Post T Cell Transfer Reinoso Webb, Koboziev et. al. 2014 Colitic Fecal Transplant Induces More Severe Colonic Inflammation * H is t o p a t h o lo g y s c o r e s 12 8 4 0 T cells RAG feces + T Cells Colitic feces + T Cells Koboziev, Reinoso Webb et. al. 2014 Colitic Fecal Transplant Increases Myeloid Cell Infiltration into the Inflamed Colon Cell Number per colon (105) 15 10 Monocytes/ Macrophages (CD11b+Ly6ChiLy6G-) 5 0 8 6 PMNs (CD11b+Ly6CintLy6G+) 4 2 0 Koboziev, Reinoso Webb et. al. 2014 T cells RAG feces + T cells Colitic feces + T cells Colitic Fecal Transplant Does Not Induce Colitis in Wild Type or RAG-/- Mice * Histopathology Scores 12 6 0 Reinoso Webb, Koboziev et. al. 2014 T cells + Colitic Feces WT + Colitic Feces RAG-/+ Colitic Feces Conclusions 1. Intestinal inflammation induces dysbiosis via the generation of metabolites that provide a selective growth advantage for disease-producing pathobionts (e.g. facultative anaerobes). 2. Failure to properly regulate this acute (and reversible) immune response allows for outgrowth and invasion of colitogenic microbes; This triggers the initiation and perpetuation of chronic gut inflammation. 3. Disease-producing pathobionts are not classic pathogens as they do not elicit acute or chronic inflammation in healthy wild type or lymphopenic recipients. Acknowledgements Cynthia Reinoso Webb Iurii Koboziev Dmitry Ostanin Katie Furr Rao Kottapalli Caleb Phillips Yava Jones-Hall Evidence Suggesting that Intestinal Inflammation is Associated with Enhanced Production of Reactive Oxygen and Nitrogen Species ● Detection of stable end products derived from reactive oxygen and nitrogen species within the bowel lumen (e.g. nitrate; oxidized/nitrated peptides and proteins). ● Attenuation of inflammation via transgenic overexpression or induction of oxidant defense genes (e.g. CuZn-SOD or Mn-SOD; HO-1). ● Pharmacologic or genetic depletion of essential oxidant defenses enhances intestinal inflammation (↓GSH) or induce spontaneous colitis (GPx-1 & -2-/- mice), respectively.