Rebecca A Porritt1, Janet L Markman1, Daisuke Maruyama1, Begum Kocaturk1, Shuang Chen1,2,3,4, Thomas J A Lehman5, Youngho Lee1, Michael C Fishbein4, Magali Noval Rivas1,2,3,4, Moshe Arditi1,2,3,4. 1. From the Division of Infectious Diseases and Immunology, Department of Pediatrics (R.A.P., J.L.M., D.M., B.K., S.C., Y.L., M.N.R., M.A.), Cedars-Sinai Medical Center, Los Angeles, CA. 2. Department of Biomedical Sciences, Infectious and Immunologic Disease Research Center (S.C., M.N.R., M.A.), Cedars-Sinai Medical Center, Los Angeles, CA. 3. Department of Biomedical Science, Research Division of Immunology (S.C., M.N.R., M.A.), Cedars-Sinai Medical Center, Los Angeles, CA. 4. David Geffen School of Medicine, University of California, Los Angeles, CA (S.C., M.C.F., M.N.R., M.A.). 5. Division of Rheumatology, Department of Pediatrics, Weill Cornell Medical School, New York (T.J.A.L.).
Abstract
OBJECTIVE: Kawasaki disease (KD) is the leading cause of acute vasculitis and acquired heart disease in children in developed countries. Notably, KD is more prevalent in males than females. We previously established a key role for IL (interleukin)-1 signaling in KD pathogenesis, but whether this pathway underlies the sex-based difference in susceptibility is unknown. Approach and Results: The role of IL-1 signaling was investigated in the Lactobacillus casei cell wall extract-induced experimental mouse model of KD vasculitis. Five-week-old male and female mice were injected intraperitoneally with PBS, Lactobacillus caseicell wall extract, or a combination of Lactobacillus caseicell wall extract and the IL-1 receptor antagonist Anakinra. Aortitis, coronary arteritis inflammation score and abdominal aorta dilatation, and aneurysm development were assessed. mRNA-seq (messenger RNA sequencing) analysis was performed on abdominal aorta tissue. Publicly available human transcriptomics data from patients with KD was analyzed to identify sex differences and disease-associated genes. Male mice displayed enhanced aortitis and coronary arteritis as well as increased incidence and severity of abdominal aorta dilatation and aneurysm, recapitulating the increased incidence in males that is observed in human KD. Gene expression data from patients with KD and abdominal aorta tissue of Lactobacillus caseicell wall extract-injected mice showed enhanced Il1b expression and IL-1 signaling genes in males. Although the more severe IL-1β-mediated disease phenotype observed in male mice was ameliorated by Anakinra treatment, the milder disease phenotype in female mice failed to respond. CONCLUSIONS: IL-1β may play a central role in mediating sex-based differences in KD, with important implications for the use of anti-IL-1β therapies to treat male and female patients with KD.
OBJECTIVE:Kawasaki disease (KD) is the leading cause of acute vasculitis and acquired heart disease in children in developed countries. Notably, KD is more prevalent in males than females. We previously established a key role for IL (interleukin)-1 signaling in KD pathogenesis, but whether this pathway underlies the sex-based difference in susceptibility is unknown. Approach and Results: The role of IL-1 signaling was investigated in the Lactobacillus casei cell wall extract-induced experimental mouse model of KD vasculitis. Five-week-old male and female mice were injected intraperitoneally with PBS, Lactobacillus caseicell wall extract, or a combination of Lactobacillus caseicell wall extract and the IL-1 receptor antagonist Anakinra. Aortitis, coronary arteritis inflammation score and abdominal aorta dilatation, and aneurysm development were assessed. mRNA-seq (messenger RNA sequencing) analysis was performed on abdominal aorta tissue. Publicly available human transcriptomics data from patients with KD was analyzed to identify sex differences and disease-associated genes. Male mice displayed enhanced aortitis and coronary arteritis as well as increased incidence and severity of abdominal aorta dilatation and aneurysm, recapitulating the increased incidence in males that is observed in humanKD. Gene expression data from patients with KD and abdominal aorta tissue of Lactobacillus caseicell wall extract-injected mice showed enhanced Il1b expression and IL-1 signaling genes in males. Although the more severe IL-1β-mediated disease phenotype observed in male mice was ameliorated by Anakinra treatment, the milder disease phenotype in female mice failed to respond. CONCLUSIONS:IL-1β may play a central role in mediating sex-based differences in KD, with important implications for the use of anti-IL-1β therapies to treat male and female patients with KD.
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Authors: Stefanie Marek-Iannucci; Asli B Ozdemir; Debbie Moreira; Angela C Gomez; Malcolm Lane; Rebecca A Porritt; Youngho Lee; Kenichi Shimada; Masanori Abe; Aleksandr Stotland; David Zemmour; Sarah Parker; Elsa Sanchez-Lopez; Jennifer Van Eyk; Roberta A Gottlieb; Michael C Fishbein; Michael Karin; Timothy R Crother; Magali Noval Rivas; Moshe Arditi Journal: JCI Insight Date: 2021-09-22
Authors: Stefanie Marek-Iannucci; Asli D Yildirim; Syed M Hamid; Asli B Ozdemir; Angela C Gomez; Begüm Kocatürk; Rebecca A Porritt; Michael C Fishbein; Takao Iwawaki; Magali Noval Rivas; Ebru Erbay; Moshe Arditi Journal: JCI Insight Date: 2022-03-22