Computational Modeling Predicts IL-10 Control of Lesion Sterilization by Balancing Early Host Immunity–Mediated Antimicrobial Responses with Caseation during Mycobacterium tuberculosis Infection

Although almost a third of the world’s population is infected with the bacterial pathogen Mycobacterium tuberculosis, our understanding of the functions of many immune factors involved in fighting infection is limited. Determining the role of the immunosuppressive cytokine IL-10 at the level of the granuloma has proven difficult because of lesional heterogeneity and the limitations of animal models. In this study, we take an in silico approach and, through a series of virtual experiments, we predict several novel roles for IL-10 in tuberculosis granulomas: 1) decreased levels of IL-10 lead to increased numbers of sterile lesions, but at the cost of early increased caseation; 2) small increases in early antimicrobial activity cause this increased lesion sterility; 3) IL-10 produced by activated macrophages is a major mediator of early antimicrobial activity and early host-induced caseation; and 4) increasing levels of infected macrophage derived IL-10 promotes bacterial persistence by limiting the early antimicrobial response and preventing lesion sterilization. Our findings, currently only accessible using an in silico approach, suggest that IL-10 at the individual granuloma scale is a critical regulator of lesion outcome. These predictions suggest IL-10–related mechanisms that could be used as adjunctive therapies during tuberculosis.

[1]  J. Flynn,et al.  An essential role for interferon gamma in resistance to Mycobacterium tuberculosis infection , 1993, The Journal of experimental medicine.

[2]  I. Orme,et al.  In Vivo IL-10 Production Reactivates Chronic Pulmonary Tuberculosis in C57BL/6 Mice1 , 2002, The Journal of Immunology.

[3]  R. Gamelli,et al.  Genomic responses in mouse models poorly mimic human inflammatory diseases , 2013, Proceedings of the National Academy of Sciences.

[4]  N. Winter,et al.  Mycobacteria-Infected Dendritic Cells Attract Neutrophils That Produce IL-10 and Specifically Shut Down Th17 CD4 T Cells through Their IL-10 Receptor , 2013, The Journal of Immunology.

[5]  G. Bancroft,et al.  Blockade of IL-10 Signaling during Bacillus Calmette-Guérin Vaccination Enhances and Sustains Th1, Th17, and Innate Lymphoid IFN-γ and IL-17 Responses and Increases Protection to Mycobacterium tuberculosis Infection , 2012, The Journal of Immunology.

[6]  W. Britton,et al.  Life and death in the granuloma: immunopathology of tuberculosis , 2007, Immunology and cell biology.

[7]  A. Myers,et al.  Early Events in Mycobacterium tuberculosis Infection in Cynomolgus Macaques , 2006, Infection and Immunity.

[8]  G. Trinchieri,et al.  CD4+ T Cell Clones Producing both Interferon-γ and Interleukin-10 Predominate in Bronchoalveolar Lavages of Active Pulmonary Tuberculosis Patients , 1999 .

[9]  D. Liggitt,et al.  Lung-specific delivery of cytokines induces sustained pulmonary and systemic immunomodulation in rats. , 1988, Journal of immunology.

[10]  O. Stendahl,et al.  Mycobacterium tuberculosis-Induced Neutrophil Extracellular Traps Activate Human Macrophages , 2013, Journal of Innate Immunity.

[11]  A. Casadevall,et al.  The damage-response framework of microbial pathogenesis , 2003, Nature Reviews Microbiology.

[12]  T. Miyakawa,et al.  Genomic responses in mouse models poorly mimic human inflammatory diseases , 2013 .

[13]  G. Trinchieri,et al.  CD4(+) T cell clones producing both interferon-gamma and interleukin-10 predominate in bronchoalveolar lavages of active pulmonary tuberculosis patients. , 1999, Clinical immunology.

[14]  Fluctuations in HIV‐1 Viral Load Are Correlated to CD4+ T‐Lymphocyte Count During the Natural Course of Infection , 2000, Journal of acquired immune deficiency syndromes.

[15]  P. Ghazal,et al.  Hijacking and exploitation of IL-10 by intracellular pathogens. , 2001, Trends in microbiology.

[16]  A. Fayyazi,et al.  Apoptosis of macrophages and T cells in tuberculosis associated caseous necrosis , 2000, The Journal of pathology.

[17]  Na Zhang,et al.  RIP3, an Energy Metabolism Regulator That Switches TNF-Induced Cell Death from Apoptosis to Necrosis , 2009, Science.

[18]  G. Trinchieri Regulatory Role of T Cells Producing both Interferon γ and Interleukin 10 in Persistent Infection , 2001, The Journal of experimental medicine.

[19]  D. Greaves,et al.  Autocrine Deactivation of Macrophages in Transgenic Mice Constitutively Overexpressing IL-10 Under Control of the Human CD68 Promoter1 , 2002, The Journal of Immunology.

[20]  G. Majno,et al.  Apoptosis, oncosis, and necrosis. An overview of cell death. , 1995, The American journal of pathology.

[21]  J. Flynn,et al.  Differential Virulence and Disease Progression following Mycobacterium tuberculosis Complex Infection of the Common Marmoset (Callithrix jacchus) , 2013, Infection and Immunity.

[22]  J. Christian J. Ray,et al.  Synergy between Individual TNF-Dependent Functions Determines Granuloma Performance for Controlling Mycobacterium tuberculosis Infection1 , 2009, The Journal of Immunology.

[23]  A. O’Garra,et al.  The role of IL-10 in immune regulation during M. tuberculosis infection , 2011, Mucosal Immunology.

[24]  Z. Hasan,et al.  Interferonγ/IL10 ratio defines the disease severity in pulmonary and extra pulmonary tuberculosis , 2007 .

[25]  JoAnne L. Flynn,et al.  Radiologic Responses in Cynomolgus Macaques for Assessing Tuberculosis Chemotherapy Regimens , 2013, Antimicrobial Agents and Chemotherapy.

[26]  B. Cookson,et al.  Apoptosis, Pyroptosis, and Necrosis: Mechanistic Description of Dead and Dying Eukaryotic Cells , 2005, Infection and Immunity.

[27]  A. O’Garra,et al.  IL-10-producing and naturally occurring CD4+ Tregs: limiting collateral damage. , 2004, The Journal of clinical investigation.

[28]  R. de Waal Malefyt,et al.  IL-10 is produced by subsets of human CD4+ T cell clones and peripheral blood T cells. , 1992, Journal of immunology.

[29]  N. Boéchat,et al.  Down-Modulation of Lung Immune Responses by Interleukin-10 and Transforming Growth Factor β (TGF-β) and Analysis of TGF-β Receptors I and II in Active Tuberculosis , 2004, Infection and Immunity.

[30]  L. Ramakrishnan,et al.  TNF Dually Mediates Resistance and Susceptibility to Mycobacteria via Mitochondrial Reactive Oxygen Species , 2013, Cell.

[31]  S. Gordon Alternative activation of macrophages , 2003, Nature Reviews Immunology.

[32]  P. Cardona,et al.  Damaging role of neutrophilic infiltration in a mouse model of progressive tuberculosis. , 2014, Tuberculosis.

[33]  H. Gan,et al.  Interleukin 10 produced by macrophages inoculated with Mycobacterium avium attenuates mycobacteria-induced apoptosis by reduction of TNF-alpha activity. , 1999, The Journal of infectious diseases.

[34]  M. Yazdanbakhsh,et al.  BCG stimulated dendritic cells induce an interleukin‐10 producing T‐cell population with no T helper 1 or T helper 2 bias in vitro , 2007, Immunology.

[35]  R. Coffman,et al.  Interleukin-10 and the interleukin-10 receptor. , 2001, Annual review of immunology.

[36]  Tao Wang,et al.  Receptor Interacting Protein Kinase-3 Determines Cellular Necrotic Response to TNF-α , 2009, Cell.

[37]  B. Bloom,et al.  TB or Not TB: That Is No Longer the Question , 2013, Science Translational Medicine.

[38]  Andrea De Maria,et al.  Immunology of Tuberculosis , 2014, Mediterranean journal of hematology and infectious diseases.

[39]  A. Rudensky,et al.  Expansion and function of Foxp3-expressing T regulatory cells during tuberculosis , 2007, The Journal of experimental medicine.

[40]  S. Hasnain,et al.  The PPE18 of Mycobacterium tuberculosis Interacts with TLR2 and Activates IL-10 Induction in Macrophage1 , 2009, The Journal of Immunology.

[41]  Simeone Marino,et al.  Multiscale Computational Modeling Reveals a Critical Role for TNF-α Receptor 1 Dynamics in Tuberculosis Granuloma Formation , 2011, The Journal of Immunology.

[42]  Robert J Wilkinson,et al.  The immune response in tuberculosis. , 2013, Annual review of immunology.

[43]  E. Radwanski,et al.  Pharmacokinetics and immunomodulatory properties of intravenously administered recombinant human interleukin-10 in healthy volunteers. , 1996, Blood.

[44]  P. Haslett,et al.  Mycobacterium tuberculosis CDC1551 induces a more vigorous host response in vivo and in vitro, but is not more virulent than other clinical isolates. , 1999, Journal of immunology.

[45]  Z. Toossi,et al.  A role for CD4+CD25+ T cells in regulation of the immune response during human tuberculosis , 2006, Clinical and experimental immunology.

[46]  G. Beamer,et al.  IL-10 Inhibits Mature Fibrotic Granuloma Formation during Mycobacterium tuberculosis Infection , 2013, The Journal of Immunology.

[47]  Katharina Fleischhauer,et al.  Interleukin‐10‐secreting type 1 regulatory T cells in rodents and humans , 2006, Immunological reviews.

[48]  D. McMurray,et al.  The in vivo immunomodulatory effect of recombinant tumour necrosis factor‐alpha in guinea pigs vaccinated with Mycobacterium bovis bacille Calmette–Guérin , 2011, Clinical and experimental immunology.

[49]  J. Goedert,et al.  Fluctuations in HIV-1 viral load are correlated to CD4+ T-lymphocyte count during the natural course of infection. , 2000 .

[50]  J. Flynn,et al.  Metronidazole prevents reactivation of latent Mycobacterium tuberculosis infection in macaques , 2012, Proceedings of the National Academy of Sciences.

[51]  A. Myers,et al.  Tumor necrosis factor neutralization results in disseminated disease in acute and latent Mycobacterium tuberculosis infection with normal granuloma structure in a cynomolgus macaque model. , 2010, Arthritis and rheumatism.

[52]  S. Almo,et al.  Programmed death-1 (PD-1)–deficient mice are extraordinarily sensitive to tuberculosis , 2010, Proceedings of the National Academy of Sciences.

[53]  Xiaodong Wang,et al.  TNF-α Induces Two Distinct Caspase-8 Activation Pathways , 2008, Cell.

[54]  E. Hoffman,et al.  Multiscale image‐based modeling and simulation of gas flow and particle transport in the human lungs , 2013, Wiley interdisciplinary reviews. Systems biology and medicine.

[55]  J. Wain,et al.  A deletion defining a common Asian lineage of Mycobacterium tuberculosis associates with immune subversion , 2006, Proceedings of the National Academy of Sciences.

[56]  A. Sher,et al.  CD4 T Cells Promote Rather than Control Tuberculosis in the Absence of PD-1–Mediated Inhibition , 2011, The Journal of Immunology.

[57]  I. Orme,et al.  The Hypervirulent Mycobacterium tuberculosis Strain HN878 Induces a Potent TH1 Response followed by Rapid Down-Regulation1 , 2007, The Journal of Immunology.

[58]  Hannah P. Gideon,et al.  Latent tuberculosis: what the host “sees”? , 2011, Immunologic research.

[59]  Antonio Bru,et al.  Mathematical Modeling of Tuberculosis Bacillary Counts and Cellular Populations in the Organs of Infected Mice , 2010, PloS one.

[60]  S. Kaufmann,et al.  Inflammation in tuberculosis: interactions, imbalances and interventions. , 2013, Current opinion in immunology.

[61]  M. Olivier,et al.  TNF-alpha and IL-10 modulate the induction of apoptosis by virulent Mycobacterium tuberculosis in murine macrophages. , 1999, Journal of immunology.

[62]  Denise Kirschner,et al.  A Model to Predict Cell-Mediated Immune Regulatory Mechanisms During Human Infection with Mycobacterium tuberculosis1 , 2001, The Journal of Immunology.

[63]  M. Jeyanathan,et al.  Within the Enemy’s Camp: contribution of the granuloma to the dissemination, persistence and transmission of Mycobacterium tuberculosis , 2013, Front. Immun..

[64]  JoAnne L. Flynn,et al.  Understanding Latent Tuberculosis: A Moving Target , 2010, The Journal of Immunology.

[65]  Hardy Kornfeld,et al.  Virulent Mycobacterium tuberculosis Strains Evade Apoptosis of Infected Alveolar Macrophages1 , 2000, The Journal of Immunology.

[66]  I. Comas,et al.  Human Macrophage Responses to Clinical Isolates from the Mycobacterium tuberculosis Complex Discriminate between Ancient and Modern Lineages , 2011, PLoS pathogens.

[67]  A. Cooper,et al.  Protection versus pathology in tuberculosis: recent insights. , 2012, Current opinion in immunology.

[68]  Sang-Nae Cho,et al.  Neutrophils are the predominant infected phagocytic cells in the airways of patients with active pulmonary TB. , 2010, Chest.

[69]  R. Wilkinson,et al.  Neutrophils in tuberculosis: friend or foe? , 2012, Trends in immunology.

[70]  JoAnne L. Flynn,et al.  Quantitative Comparison of Active and Latent Tuberculosis in the Cynomolgus Macaque Model , 2009, Infection and Immunity.

[71]  D. Laskin,et al.  Macrophages and inflammatory mediators in tissue injury. , 1995, Annual review of pharmacology and toxicology.

[72]  M. Arcila,et al.  Activation of apoptosis, but not necrosis, during Mycobacterium tuberculosis infection correlated with decreased bacterial growth: role of TNF-alpha, IL-10, caspases and phospholipase A2. , 2007, Cellular immunology.

[73]  Denise E. Kirschner,et al.  Multi-Scale Modeling Predicts a Balance of Tumor Necrosis Factor-α and Interleukin-10 Controls the Granuloma Environment during Mycobacterium tuberculosis Infection , 2013, PloS one.

[74]  J. Flynn,et al.  Macrophages and control of granulomatous inflammation in tuberculosis , 2011, Mucosal Immunology.

[75]  N. Juffermans,et al.  Serum concentrations of cytokines in patients with active tuberculosis (TB) and after treatment , 1999, Clinical and experimental immunology.

[76]  D. Kirschner,et al.  A methodology for performing global uncertainty and sensitivity analysis in systems biology. , 2008, Journal of theoretical biology.

[77]  S. Rutz,et al.  Regulation and functions of the IL-10 family of cytokines in inflammation and disease. , 2011, Annual review of immunology.

[78]  I. Orme,et al.  Lack of IL-10 alters inflammatory and immune responses during pulmonary Mycobacterium tuberculosis infection. , 2009, Tuberculosis.

[79]  J. Sedgwick,et al.  Structural deficiencies in granuloma formation in TNF gene-targeted mice underlie the heightened susceptibility to aerosol Mycobacterium tuberculosis infection, which is not compensated for by lymphotoxin. , 1999, Journal of immunology.

[80]  A. Perelson,et al.  Rapid turnover of plasma virions and CD4 lymphocytes in HIV-1 infection , 1995, Nature.

[81]  J. Ernst,et al.  Mycobacterium tuberculosis inhibits neutrophil apoptosis, leading to delayed activation of naive CD4 T cells. , 2012, Cell host & microbe.

[82]  James A. Raleigh,et al.  Tuberculous Granulomas Are Hypoxic in Guinea Pigs, Rabbits, and Nonhuman Primates , 2008, Infection and Immunity.

[83]  M. Geletu,et al.  Circulating TNF‐α, TGF‐β, and IL‐10 in Tuberculosis Patients and Healthy Contacts , 2001, Scandinavian journal of immunology.

[84]  J. Turner,et al.  Interleukin-10 and Immunity against Prokaryotic and Eukaryotic Intracellular Pathogens , 2011, Infection and Immunity.