Abstract
We studied the role of NF-κB in acute inflammation caused by gut ischemia-reperfusion through selective ablation of IκB kinase (IKK)-β, the catalytic subunit of IKK that is essential for NF-κB activation. Ablation of IKK-β in enterocytes prevented the systemic inflammatory response, which culminates in multiple organ dysfunction syndrome (MODS) that is normally triggered by gut ischemia-reperfusion. IKK-β removal from enterocytes, however, also resulted in severe apoptotic damage to the reperfused intestinal mucosa. These results show the dual function of the NF-κB system, which is responsible for both tissue protection and systemic inflammation, and underscore the caution that should be exerted in using NF-κB and IKK inhibitors.
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References
Ghosh, S., May, M.J. & Kopp, E.B. NF-κB and Rel proteins: evolutionarily conserved mediators of immune responses. Ann. Rev. Immunol. 16, 225–260 (1998).
Ghosh, S. & Karin, M. Missing pieces in the NF-κB puzzle. Cell 109, S81–S96 (2002).
Barnes, P.J. & Karin, M. NF-κB—a pivotal transcription factor in chronic inflammatory diseases. N. Engl. J. Med. 336, 1066–1071 (1997).
Bohrer, H. et al. Role of NF-κB in the mortality of sepsis. J. Clin. Invest. 100, 972–985 (1997).
Arnalich, F. et al. Predictive value of NF-κB activity and plasma cytokine levels in patients with sepsis. Infect. Immun. 68, 1942–1945 (2000).
Pennington, C., Dunn, J., Li, C., Ha, T. & Browder, W. NF-κB activation in acute appendicitis: a molecular marker for extent of disease? Am. J. Surg. 66, 914–918 (2000).
Lawrence, T., Gilroy, D.W., Colville-Nash, P.R. & Willoughby, D.A. Possible new role for NF-κB in the resolution of inflammation. Nat. Med. 7, 1291–1297 (2001).
Gerondakis, S., Grossmann, M., Nakamura, Y., Pohl, T. & Grumont, R. Genetic approaches in mice to understand Rel/NF-κB and IκB function: transgenics and knockouts. Oncogene 18, 6888–6895 (1999).
Rothwarf, D.M. & Karin, M. The NF-κB activation pathway: a paradigm in information transfer from membrane to nucleus. Sci. STKE 1999 (5), RE1 (1999).
Li, Q., Van Antwerp, D., Mercurio, F., Lee, K.-F. & Verma, I.M. Severe liver degeneration in mice lacking the IκB kinase 2 gene. Science 284, 321–325 (1999a).
Park, J.M., Greten, F.R., Li, Z.-W. & Karin, M. Macrophage apoptosis by anthrax lethal factor and p38 MAP kinase inhibition. Science 297, 2048–2051 (2002).
Balk, R.A. Pathogenesis and management of multiple organ dysfunction or failure in severe sepsis and septic shock. Crit. Care Clin. 16, 337–352 (2000).
Schmeling, D.J., Caty, M.G., Oldham, K.T., Guice, K.S. & Hinshaw, D.B. Evidence for neutrophil-related acute lung injury after intestinal ischemia-reperfusion. Surgery 106, 201–202 (1989).
Carden, D.L. & Granger, D.N. Pathophysiology of ischaemia-reperfusion injury. J. Pathol. 190, 255–266 (2000).
Fukatsu, K. et al. Enteral nutrition prevents remote organ injury and death after a gut ischemic insult. Ann. Surg. 233, 660–668 (2001).
Caty, M.G., Guice, K.S., Oldham, K.T., Remick, D.G. & Kunkel, S.I. Evidence for tumor necrosis factor-induced pulmonary microvascular injury after intestinal ischemia-reperfusion injury. Ann. Surg. 212, 694–700 (1990).
Pfeffer, K. et al. Mice deficient for the 55 kD tumor necrosis factor receptor are resistant to endotoxic shock, yet succumb to L. monocytogenes infection. Cell 73, 457–467 (1993).
DiDonato, J.A., Hayakawa, M., Rothwarf, D.M., Zandi, E. & Karin, M. A cytokine-responsive IκB kinase that activates the transcription factor NF-κB. Nature 388, 548–554 (1997).
McCord, J.M. Oxygen-derived free radicals in postischemic tissue injury. N. Engl. J. Med. 312, 159–163 (1985).
Li, Z.-W. et al. The IKKβ subunit of IκB kinase (IKK) is essential for NF-κB activation and prevention of apoptosis. J. Exp. Med. 189, 1839–1845 (1999).
Imbert, V. et al. Tyrosine phosphorylation of IκBα activates NF-κB without proteolytic degradation of IκBα. Cell 86, 787–798 (1996).
Li, Z.-W., Omori, S.A., Labuda, T., Karin, M. & Rickert, R.C. IKKβ is required for peripheral B cell proliferation and survival. J. Immunol. (in the press).
Pinto, D., Robine, S., Jaisser, F., El Marjou, F.E. & Louvard, D. Regulatory sequences of the mouse villin gene that efficiently drive transgenic expression in immature and differentiated epithelial cells of small and large intestines. J. Biol. Chem. 274, 6476–6482 (1999).
Nakajima, A. et al. Endogenous PPARγ mediates anti-inflammatory activity in murine ischemia-reperfusion injury. Gastroenterology 120, 460–469 (2001).
Song, Y. et al. A low level of TNFα mediates hemorrhage-induced acute lung injury via p55 TNF receptor. Am. J. Physiol. Lung Cell. Mol. Physiol. 281, L677–L684 (2001).
Makris, C. et al. Female mice heterozygote for IKKγ/NEMO deficiencies develop a genodermatosis similar to the human X-linked disorder incontinentia pigmenti. Mol. Cell 15, 969–979 (2000).
Lewis, S.E. & Konradi, C. Analysis of DNA-protein interactions in the nervous system using the electrophoretic mobility shift assay. Methods 10, 301–311 (1996).
Hu, Y. et al. Abnormal morphogenesis but intact IKK activation in mice lacking the IKKα subunit of the IκB kinase. Science 284, 316–320 (1999).
Senftleben, U. et al. Activation by IKKα of a second, evolutionary conserved, NF-κB signaling pathway. Science 293, 1495–1499 (2001).
Acknowledgements
We thank S. Robine and D. Louvard (Institut Curie) for providing the Vil gene promoter. Z.W.L. and F.R.G. were supported by postdoctoral fellowships from the Cancer Research Institute and the German Research Foundation (D.F.G.). Grant support came from the National Science Council of Taiwan (L.W.C.), Kaohsiung Veterans General Hospital (L.W.C.), National Institutes of Health (M.K. and M.F.K.), Superfund Basic Research Program (M.K.), Cystic Fibrosis Foundation (M.F.K.), State of California Cancer Research Program (M.K.) and an award to M.K. from the Sandler Family Supporting Foundation. M.K. is a Frank and Else Schilling American Cancer Society Research Professor.
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Chen, LW., Egan, L., Li, ZW. et al. The two faces of IKK and NF-κB inhibition: prevention of systemic inflammation but increased local injury following intestinal ischemia-reperfusion. Nat Med 9, 575–581 (2003). https://doi.org/10.1038/nm849
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DOI: https://doi.org/10.1038/nm849