Rapid and rigorous IL-17A production by a distinct subpopulation of effector memory T lymphocytes constitutes a novel mechanism of toxic shock syndrome immunopathology

Authors

Peter A. Szabo, The University of Western Ontario
Ankur Goswami, The University of Western Ontario
Delfina M. Mazzuca, The University of Western Ontario
Kyoungok Kim, The University of Western Ontario
David B. O'Gorman, Hand and Upper Limb Centre
David A. Hess, The University of Western Ontario
Ian D. Welch, The University of British Columbia
Howard A. Young, National Cancer Institute at FrederickFollow
Bhagirath Singh, The University of Western Ontario
John K. McCormick, The University of Western Ontario
S. M.Mansour Haeryfar, The University of Western OntarioFollow

ORCID IDs

0000-0001-6195-2644 (D.B.O.);

0000-0002-3118-5111 (H.A.Y.);

0000-0002- 9792-8694 (B.S.);

0000-0003-3742-7289 (J.K.M.);

0000-0002-1125-8176 (S.M.M.H.).

Date of this Version

4-1-2017

Citation

The Journal of Immunology, 2017, 198: 2805–2818.

Comments

U.S. government work

Abstract

Toxic shock syndrome (TSS) is caused by staphylococcal and streptococcal superantigens (SAgs) that provoke a swift hyperinflammatory response typified by a cytokine storm. The precipitous decline in the host's clinical status and the lack of targeted therapies for TSS emphasize the need to identify key players of the storm's initial wave. Using a humanized mouse model of TSS and human cells, we herein demonstrate that SAgs elicit in vitro and in vivo IL-17A responses within hours. SAg-triggered human IL-17A production was characterized by remarkably high mRNA stability for this cytokine. A distinct subpopulation of CD4+ effector memory T (TEM) cells that secrete IL-17A, but not IFN-γ, was responsible for early IL-17A production. We found mouse "TEM-17" cells to be enriched within the intestinal epithelium and among lamina propria lymphocytes. Furthermore, interfering with IL-17A receptor signaling in human PBMCs attenuated the expression of numerous inflammatory mediators implicated in the TSS-associated cytokine storm. IL-17A receptor blockade also abrogated the secondary effect of SAg-stimulated PBMCs on human dermal fibroblasts as judged by C/EBP d expression. Finally, the early IL-17A response to SAgs was pathogenic because in vivo neutralization of IL-17A in humanized mice ameliorated hepatic and intestinal damage and reduced mortality. Together, our findings identify CD4+ TEM cells as a key effector of TSS and reveal a novel role for IL-17A in TSS immunopathogenesis. Our work thus elucidates a pathogenic, as opposed to protective, role for IL-17A during Gram-positive bacterial infections. Accordingly, the IL-17-IL-17R axis may provide an attractive target for the management of SAg-mediated illnesses.