Throughout this application various publications are referred to as superscripts. Full citations for these references may be found at the end of the specification immediately preceding the claims. The disclosures of these publications are hereby incorporated by reference in their entireties into the subject application to more fully describe the art to which the subject application pertains.
Afferent vagus nerve signaling is a critical component of maintaining an organism's homeostasis. The afferent signaling of the vagus nerve helps maintain physiological states dealing with digestion, cardiac function, respiratory function and immunity1-3. The afferent vagus nerve carries the signal for interleukin 1β (IL-1β)-induced febrile response4, as well as the signaling for sickness behavior in rodents; including lethargy and anorexia when challenged with inflammatory stimuli5-7. Advancements in neuroscience and immunology along with recent technological advancements have begun to show that inflammatory molecules such as lipopolysaccharide (LPS) and pro-inflammatory cytokines such as tumor necrosis factor (TNF) and IL-1β can cause increases in vagus nerve signaling differentially8-11.
The efferent arm of the inflammatory reflex has been increasingly well studied. It has been shown that the afferent IL-1β signals continue to the efferent splenic nerve9. This has been identified through electrical recordings of the rat splenic nerve, in which IL-1β induced signaling is ablated by a subdiaphragmatic vagotomy9. Similarly, previous work has identified that not just the splenic nerve, but the spleen is essential to the inflammatory reflex12-14. The efferent reflex signaling has been shown to travel through the splenic nerve, with these fibers forming a synapse with ChAT+ T-cells, which can release acetylcholine that binds to the α7 subunit of the nicotinic acetylcholine receptor (nAChR) on cytokine-producing macrophages in the spleen inhibiting TNF production13-15.
IL-1β's link to the febrile response through the vagus nerve has been well documented4, as has the paradoxical thermoregulatory response that occurs within a mouse based on their environmental temperatures. When housed at thermoneutral temperature (˜30° C.), IL-1β induced a fever or hyperemia response; however, when housed below thermoneutral temperature, the opposite response occurs, and the mouse becomes hyperthermia16.
The present application addresses the need for improved methods for treating inflammation and sepsis, and promoting thermoregulation.
Method are provided for suppressing or ameliorating inflammation, promoting thermoregulation, and/or treating sepsis in a subject comprising activating neurons expressing the nociceptor ion channel designated “transient receptor potential cation channel, subfamily A, member 1” (a/k/a “transient receptor potential ankyrin 1” or “TRPA1”) in the subject's vagus nerve effective to suppress or ameliorate inflammation, promote thermoregulation, and/or treat sepsis in a subject.
Methods are also provided for suppressing or ameliorating fever in a subject and for activating an immune response in an immunosuppressed subject comprising administering to the subject an antagonist of TRPA1 in amount effective to suppress or ameliorate fever in a subject or activate an immune response in an immunosuppressed subject.
The invention provides a method of suppressing or ameliorating inflammation, promoting thermoregulation, and/or treating sepsis in a subject comprising activating neurons expressing the nociceptor ion channel designated “transient receptor potential cation channel, subfamily A, member 1” (a/k/a “transient receptor potential ankyrin 1” or “TRPA1”) in the subject's vagus nerve effective to suppress or ameliorate inflammation, promote thermoregulation, and/or treat sepsis in a subject.
In one embodiment, the method of suppressing inflammation, promoting thermoregulation, and/or treating sepsis is activated by selectively stimulating vagus nerve fibers expressing TRPA1 nociceptors in the subject. Preferably, the method comprises activating vagus nerve afferents.
In one embodiment, the TRPA1-positive neurons are activated by administering a TRPA1 nociceptor agonist to the subject. In one embodiment, a photochemical activator is administered to the subject and TRPA1+ nociceptors are activated using optogenetic stimulation. For example, optovin can be administered to the subject, or the vagus nerve of the subject, and TRPA1+ nociceptors activated using optogenetic stimulation.
In different embodiments, the subject can have one or more of sepsis, endotoxemia, septicemia or septic shock.
Preferably, activation of TRPA1+ neurons attenuates serum levels of one or more pro-inflammatory cytokines, such as for example, tumor necrosis factor (TNF), interleukin-6 (IL-6), interleukin-1β (IL-1β), and/or KC/GRO(CXCL1).
The invention also provides a method of suppressing or ameliorating fever in a subject comprising administering to the subject an antagonist of TRPA1 in amount effective to suppress or ameliorate fever in a subject.
The invention further provides a method of activating an immune response in an immunosuppressed subject comprising administering to the subject an antagonist of TRPA1 in amount effective to induce an immune response in a subject.
The subject can be any mammal and is preferably a human.
As used herein, to “treat” a disease or condition means to ameliorate a sign or symptom of the disease or condition.
Agonists of TRPA1 are known in the art and include, but are not limited to, optovin, polygodial, resveratrol, ASP 7663 (Tocris), JT010 (Tocris), 4-Oxo-2-nonenal, allicin, allyl isothiocyanate, cannabidiol, gingerol, icilin, hepoxilins A3 and B3, 12S-Hydroperoxy-5Z,8Z,10E,14Z-eicosatetraenoic acid, 4,5-Epoxyeicosatrienoic acid, and supercinnamaldehyde. Antagonists of TRPA1 are also known in the art and include, but are not limited to, AM0902 A967079, AP18, HC030031 and TCS5861528 (all from Tocris), ALGX-2513, ALGX-2541, ALGX-2563, ALGX-2561 and ALGX-2542.
“And/or” as used herein, for example, with option A and/or option B, encompasses the embodiments of (i) option A, (ii) option B, and (iii) option A plus option B.
All combinations of the various elements described herein are within the scope of the invention unless otherwise indicated herein or otherwise clearly contradicted by context.
This invention will be better understood from the Experimental Details, which follow. However, one skilled in the art will readily appreciate that the specific methods and results discussed are merely illustrative of the invention as described more fully in the claims that follow thereafter.
Animals:
All experimental protocols were approved by the Institutional Animal Care and Use Committee (IACUC) at the Feinstein Institute for Medical Research, Northwell Health, which follows the NIH guidelines for ethical treatment of animals. Male B6.129F and TRPA1 KO mice were purchased from Jackson Labs and used between 8 and 20 weeks of age. TRPV1-Cre and TRPV1-DTA mice were bred at the Feinstein Institute for Medical Research and used between the same age range. Mice were housed under reverse day/light cycle and had access to food and water ad libitum. Food was withheld for the 3-4 hours prior to nerve recording; animals continued to have access to water
Surgical Isolation of Cervical Vagus Nerve:
Mice were induced with general anesthesia using isoflurane at 2.5% in 100% oxygen at a flow rate of 1 L/min. Once anesthetized, the mouse was moved to a supine position with the isoflurane maintained at 2.0% during surgery. The nerve was then isolated as described in previous publications10,11,17. The core body temperature was monitored with a rectal probe and maintained around 37° C. with a heating pad and heat lamp. Prior to recording and nerve placement within the cuff, the electrode was submerged briefly in saline solution.
Recording Procedure:
The electrophysiological signals were digitized from the vagus nerve using a Plexon data acquisition system (Omniplex, Plexon Inc., Dallas, Tex.). Recordings were sampled at 40 kHz with a 120 Hz filter and 50 gain. All signals were recorded from a bipolar cuff electrode referenced to the animal ground placed between the right salivary gland and the skin. In experiments with IL-1β challenge, following acquisition of the baseline activity (10 min), 350 ng/kg recombinant human IL-1β (eBioscience, San Diego, Calif.) was administered intraperitoneally; recordings were then continued for 10 min post-injection.
Recording Analysis:
Analysis of raw recordings was done on Spike2 software (version 7, CED). Raw recordings were filtered (using a high pass filter) and smoothed. To identify neural signals, a user-specific adaptive threshold was employed. All signals were identified as neuronal or non-neuronal. Non-neuronal signals, which consisted mainly of cardiac and respiratory components, were manually removed. All recordings with no identifiable neuronal spikes were removed from analyses.
Optical Stimulation Procedure:
Optical stimulation was generated by Thor Labs LED driver DC4100, with a 405 nm LED model M405L3 (Newton, N.J.). Sham mice underwent surgical control up to the point of identifying the cervical vagus nerve, without isolating it from the bundle. In both conditions 2 μl of optovin was applied directly on the nerve for 2 minutes prior to stimulation. Sham animals received no light applied to the nerve. The stimulated group received 405 nm light 1000 mA, 10 hz, with a 10% duty cycle for 5 minutes with an approximate power of 80-85 μW. Animals then recovered for 2 hours and were administered LPS (8 mg/kg) via intraperitoneal (ip) injection. Mice were euthanized 1.5 hours after LPS administration, with serum collected.
Vagotomy Procedure:
All vagotomized animas had their vagus nerve isolated. Prior to the vagotomy a 6.0 suture was tied around the vagus nerve. The nerve was then cut proximally or above (blocking left vagus nerve signaling to the brain while signaling to the periphery remained intact) to where 2 μl of optovin was to be added. All mice were stimulated using the same parameters as previously indicated. Animals then recovered for 2 hours and were administered LPS (8 mg/kg) via intraperitoneal (ip) injection. Mice were euthanized 1.5 hours after LPS administration, with serum collected.
IL-1β Induced Inflammation:
Mice were injected with 3.2 μg/kg IL-1β ip or saline. Three hours later the mice were euthanized, and blood, spleen, and two brain regions collected. Blood was collected by cardiac puncture. To obtain serum from these samples, blood was allowed to clot for approximately 45 min to 1 h. The blood was then spun at 5,000 rpm for 10 min and 10,000 For 2 min. Supernatants (serum) were collected and stored at −20° C. prior to use. The spleen was homogenized using a bullet blender homogenizer (Next Advance, Averill Park, N.Y., USA) and the recommended bead homogenization kit and protocol in a 4° C. walk-in refrigerator. The homogenized sample was then spun down at 15,000 rpm for 10 min with the supernatants collected and stored at −20° C. Splenic protein level was measured using the Bradford assay. IL-6, IL-1β, KC/Gro (CXCL1), and IL-1β for both serum and spleen were measured on a custom mouse inflammatory electrochemiluminescent kit (Meso Scale Discovery, Gaithersburg, Md., USA) according to manufacturer's recommendations. The brain stem region was collected on ice, using a binocular dissection microscope and placed in the same tube. Brain regions were snap frozen on dry ice and transferred to storage at −80° C.
Thermoregulation:
Mice were anesthetized with 2.5% isoflurane with an oxygen flow of 1 L/min. Once anesthetized, the mouse was moved to a supine position with the isoflurane maintained at 2.0% during surgery. A midline incision was made above the peritoneal cavity, with a ETA-F10 temperature implant (DSI New Brighton, Minn.) placed in the peritoneal cavity and tacked to the peritoneal wall. The cavity was then closed, and the mouse monitored every day for 3 days. The mouse was allowed to recover for a minimum of five days prior to any manipulation. The mice were placed on the DIS with baseline ip body temperature recorded for 1 hour prior to IL-1β or saline injection. The ip body temperature recording then continued for 5 hours post injection.
Nodose Ganglion Patech Clamp Recordings:
Whole-cell patch clamp recordings were made with glass pipettes pulled on a P-97 electrode puller (Sutter Instruments, Novato, Calif.). The resistance of the pipettes was 2-4 MΩ when filled with an intracellular solution (in mM: CsCl 140, HEPES 10, EGTA 5, Mg-ATP 2, NaGTP 0.3, MgCl2 2, Phosphocreatine 10, pH 7.25 adjusted with CsOH). Cells were superfused at a rate of 2 ml/min with an external bath solution containing the following (in mM): 150 NaCl, 2.5 KCl, 10 HEPES, 10 D-glucose, 2 CaCl2, and 1 MgCl2, pH 7.3-7.4. Experiments were performed at room temperature (22-24° C.). Currents from neurons were monitored with an Multiclamp 700B amplifier (Molecular Devices, Union City, Calif.), acquired through Digidata 1550B (Molecular Devices) onto a computer using pClamp 11 software (Molecular Devices). Data were analyzed using Clampfit 11 (Molecular Devices). All chemicals used for electrophysiological recordings were purchased from Sigma. All drugs and solutions were made fresh from drug stock solutions.
Statistical Analysis.
Data are presented as individual samples, mean±SEM. Two-way ANOVA, paired t-test, and Mann-Whitney U tests were used to examine statistical significance using PRISM 6 (Graphpad, La Jolla, Calif.).
Treating Inflammation:
Vagus nerve stimulation has been used as a treatment for peripheral inflammation in both rodents and humans18-21. TRPA1 is an ion channel that has been indicated in neural sensing of inflammation within the skin and lungs 22-24. To determine TRPA1's role in the inflammatory reflex, photochemical stimulation of TRPA1+ fibers of the vagus nerve was carried out using a molecule called optovin. Optovin selectively binds to TRPA1 making it photoactive to 405 nm light25. To directly stimulate the TRPA1+ vagus nerve fibers, optovin was applied directly to nerve, with one group unstimulated and one group stimulated with the 405 nm light for 5 minutes with LPS (8 mg/kg) administer 2 hours later. Stimulation of TRPA1+ fibers significantly reduced TNF levels in response to LPS (
Pharmacological stimulation of TRPA1+ neurons using polygodial also attenuates TNF levels in serum and spleen in endotoxemic mice (
To recognize how knocking out TRPA1 further effects inflammatory signaling, TRPA1 KO and WT mice were injected with either saline or IL-1β (3.2 ng/kg). IL1β induces activation of the vagus nerve in wild type mice; however, IL-1β fails to induce activation of the vagus nerve in TRPA1 KO mice indicating that TRPA1 is necessary for IL-1β induced vagus nerve signaling (
To further determine fiber specificity, a TRPV1 cell depletion model was employed by breeding TRPV1-Cre mice with ROSA-DTA mice. No significant enhancement of vagus nerve activity was observed due to IL-1β administration, indicating that TRPV1+ fibers of the vagus nerve carried the IL-1β induced signal. To identify if TRPV1 itself is necessary for propagation of the signal, recordings were done in a genetic TRPV1 knockout (TRPV1 KO) mouse. Unlike the cell depleted mice, the TRPV1 KO IL-1β induced a significant increase (Mann-Whitney, p>0.05, U=4) in vagus nerve activity, indicating that genetically ablating the TRPV1 ion channel is not necessary to significantly reduce IL-1β vagus nerve signaling. To determine a molecular target on TRPV1+ neurons mediating afferent IL-1β signaling, the cation channel TRPA1 was identified. TRPA1 is found on a subset of TRPV1+ neurons; approximately 30%. However, TRPA1 co-localized with TRPV1 on 97% of TRPA1+ neurons26.
Using patch clamp recordings, IL-1β responses were recorded in nodose ganglion neurons. Application of IL-1β (20 μg/ml) induced calcium influx as indicated by increase of fluorescence in 6 out of 332 (1.8%) sensory nodose ganglion neurons from VGlut2-GCaMP3 mice. Next, whole-cell patch clamp recordings were carried out on the same neurons that responded to IL-1β in calcium influx analysis. When the membrane potential was held at −65 mV, bath application of IL-1β (20 μg/ml) produced slow inward currents in 4 out of 332 (1.2%) nodose neurons. The amplitude of IL-1β induced currents are 108±23 pA (n=4). Inward currents after IL-1β application were completely blocked by a specific TRPA1 antagonist AM0902, indicating that IL-1β induced currents could be mediated by the TRPA1 channel. In current-clamp mode, IL-1β reduced action potential threshold from −25±2 mV to −31±3 mV (n=4). Together, these data show that IL-1β increases membrane excitability via TRPA1 activation in a subset of nodose sensory neurons. Using Ca-influx assay, it was found that the nodose ganglia consist of neurons that selectively respond to capsaicin (TRPV1-positive), polygodial (TRPA1-positive), and IL-1β. The vast majority of IL-1β-responsive neurons also contained TRPA1, suggesting a potential overlap in their neuronal expression. To further determine the potential interaction of TRPA1 with IL-1β, nodose ganglion neurons from TRPA1 KO mice were examined in a culture system. Neurons responding to IL-1β also responded to TRPA1 activation, and in the absence of TRPA1, IL-1β failed to induce activation of nodose sensory neurons. IL1R1 co-localizes with TRPA1 on nodose ganglion neurons, as was determined using immunohistochemical staining.
The serum and splenic tissue of these mice were then analyzed for known downstream signaling molecules of IL-1β, IL-6, IL-1β and KC/GRO (CXCL1). Significant increases in both the serum (
Promoting Thermoregulation:
Thermoregulation, specifically in cold sensing, is another major function of the TRPA1 ion channel. When housed at approximately 23° C., WT mice injected with murine IL-1β (5 μg/kg) have significant decrease in body temperature (t-test, p<0.0001) peaking at a temperature change of −2.3±0.15° C., while TRPA1 KO mice have no significant change in body temperature after IL-1β (5 μg/kg) peaking at 0.18±0.40° C. (
Treating Sepsis:
To assess TRPA1's role in disease, cecal ligation and puncture (CLP) was performed to induce sepsis causing a dysregulation in systemic inflammation. In a mild model of CLP, WT mice had 100% survival seven days post-surgery while TRPA1 KO mice had significantly reduced survival rate of 75% (Gehan-Breslow-Wilcoxon test, p<0.05) (
The neural-immune interaction described here identifies a newly discovered mechanism of afferent signaling of the inflammatory reflex. The observation that both activation of TRPA1+ fibers of the vagus nerve decreases TNF response in a model of endotoxemia, and that knocking out TRPA1 causes heightened levels of circulating IL-6, IL-1β, and KC/GRO as well as increased sepsis mortality identifies TRPA1 as necessary for proper regulation of inflammatory homeostasis. IL-1β induced inflammation is through the same pathway as indicated by the lack of thermoregulatory response when TRPA1 KO mice are treated with IL-O. The identification of these mechanisms provides new molecular targets that have not been identified for treating systemic inflammatory conditions, as well as IL-1β induced fever and disease.
This application claims the benefit of U.S. Provisional Patent Application No. 62/631,585 filed on Feb. 16, 2018, the contents of which are incorporated herein in their entirety.
This invention was made with government support under grant number GM118182 awarded by the National Institutes of Health. The government has certain rights in the invention.
Number | Date | Country | |
---|---|---|---|
62631585 | Feb 2018 | US |