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Publication : Dysregulation of TLR9 in neonates leads to fatal inflammatory disease driven by IFN-γ.

First Author  Stanbery AG Year  2020
Journal  Proc Natl Acad Sci U S A Volume  117
Issue  6 Pages  3074-3082
PubMed ID  31980536 Mgi Jnum  J:287989
Mgi Id  MGI:6391153 Doi  10.1073/pnas.1911579117
Citation  Stanbery AG, et al. (2020) Dysregulation of TLR9 in neonates leads to fatal inflammatory disease driven by IFN-gamma. Proc Natl Acad Sci U S A 117(6):3074-3082
abstractText  Recognition of self-nucleic acids by innate immune receptors can lead to the development of autoimmune and/or autoinflammatory diseases. Elucidating mechanisms associated with dysregulated activation of specific receptors may identify new disease correlates and enable more effective therapies. Here we describe an aggressive in vivo model of Toll-like receptor (TLR) 9 dysregulation, based on bypassing the compartmentalized activation of TLR9 in endosomes, and use it to uncover unique aspects of TLR9-driven disease. By inducing TLR9 dysregulation at different stages of life, we show that while dysregulation in adult mice causes a mild systemic autoinflammatory disease, dysregulation of TLR9 early in life drives a severe inflammatory disease resulting in neonatal fatality. The neonatal disease includes some hallmarks of macrophage activation syndrome but is much more severe than previously described models. Unlike TLR7-mediated disease, which requires type I interferon (IFN) receptor signaling, TLR9-driven fatality is dependent on IFN-gamma receptor signaling. NK cells are likely key sources of IFN-gamma in this model. We identify populations of macrophages and Ly6C(hi) monocytes in neonates that express high levels of TLR9 and low levels of TLR7, which may explain why TLR9 dysregulation is particularly consequential early in life, while symptoms of TLR7 dysregulation take longer to manifest. Overall, this study demonstrates that inappropriate TLR9 responses can drive a severe autoinflammatory disease under homeostatic conditions and highlights differences in the diseases resulting from inappropriate activation of TLR9 and TLR7.
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