Abstract:
One of the fundamental steps in a successful therapy of Th1/Th17-mediated autoimmune diseases is the induction of type II dendritic cells (DCs), which subsequently cause an immune deviation towards an anti-inflammatory Th2 response. In the first part of the work, the characterization of new substances, which release carbon monoxide as well as fumaric acid esters, was carried out. The treatment with these FumET-CORMs proved to be highly effective, as a robust induction of type II DCs was achieved. The characteristic reduction of STAT1 phosphorylation, induction of HO-1 and the resulting inhibition of the cytokines IL-12p70 and IL-23 occurred even more pronounced and at significantly lower concentrations than in the control treatment with dimethyl fumarate (DMF).
For a detailed mechanistic analysis of the DMF therapy, a cystine/glutamate antiporter knockout mouse model was employed in the second part of the study. In DCs of these mice, the loss of the scavenger of reactive oxygen species, glutathione (GSH), and an associated induction of said chemical entities was achieved on the genetic level without additional effects of pharmacological treatment. In contrast to the previously proposed hypothesis, these changes in redox homeostasis did not result in the differentiation of the DCs into a type II phenotype. Instead, the additional treatment of these already GSH-depleted cells still resulted in the HO-1 and STAT1 signaling pathway's modulation and the inhibition of downstream cytokines IL-12p70 and IL-23, indicating that additional targets of the fumarate are responsible for the mediation of these effects. In further experiments, an overcompensation of the antiporter loss via the thioredoxin signaling pathway could be excluded by using the inhibitor auranofin. Accordingly, the modulation of redox homeostasis alone is not sufficient to transform DCs into an anti-inflammatory type II phenotype. Instead, further intracellular targets of DMF treatment probably also play a decisive role in this process.