Public Release:  Deficient protein GM-CSF production found to impair gut's immune tolerance

Mount Sinai study suggests effective therapeutics for inflammatory bowel diseases may hinge on targeting GM-CSF axis

The Mount Sinai Hospital / Mount Sinai School of Medicine

New York, NY - The protein GM-CSF plays a critical role in maintaining immune tolerance in the gut, with defects in the protein increasing the susceptibility to inflammatory bowel diseases (IBD), according to a new mouse study by a team of researchers from the Icahn School of Medicine at Mount Sinai. IBD is a severe intestinal disease characterized by chronic intestinal inflammation that results from a dysregulated immune response to microbes and food antigens. Writing in the peer reviewed journal Science published online March 13, 2014, the research team writes that this advances our understanding of how commensal microbes can regulate intestinal immunity and should pave the wave for identifying new drug targets.

"These results are highly relevant to clinical inflammatory bowel diseases because GMSCF-impaired function is now emerging as one of the best predictors of IBD severity," said the study's senior author, Miriam Merad, MD, PhD, Professor in the Department of Oncological Sciences, the Tisch Cancer Institute and the Immunology Institute, at the Icahn School of Medicine at Mount Sinai.

GM-CSF is a cytokine that promotes the development and function of a group of gut resident macrophages and dendritic cells. Although GMCSF is mostly known for its role in inflammation, Dr. Merad's laboratory discovered that GM-CSF is produced in the normal gut by specialized cells called innate lymphocyte cells (ILCs) in response to microbiota signals. Strikingly, they found that microbiota-induced GM-CSF was required to imprint gut tissue resident macrophages and dendritic cells with regulatory function that was critical to protect against inflammation of the gut. Deletion of the GM-CSF gene in the mouse led to reduction and impaired regulatory function of gut tissue macrophages and dendritic cells which compromised induction of tolerance to food antigens and increased mice susceptibility to IBD.

"These results represent a significant advance in our understanding of how commensal microbes can regulate host intestinal immune responses and suggest that the identification of downstream targets in macrophages and dendritic cells along the GM-CSF axis can help the rationale design of novel strategies for the treatment of IBD patients with defective GM-CSF function," explained Dr. Merad.

Drs. Merad and Mortha are now developing a multiscale approach to identify GM-CSF downstream targets using macrophages and dendritic cells isolated from GM-CSF deficient mice and exposed to recombinant GMCSF. The regulatory function of novel targets will be validated in collaboration with Judy H. Cho, MD, Ward-Coleman Professor of Medicine and Genetics and Genomic Sciences, and Assistant Chief of Research in the Gastrointestinal Division, and Jean Federic Colombel, MD, Professor of Medicine and Director of the Leona M. and Harry B. Helmsley Charitable Trust Inflammatory Bowel Disease Center, at they Icahn School of Medicine at Mount Sinai. They will study human macrophages and dendritic cells isolated from IBD patients with defective GM-CSF function, "The approach represents a step forward in personalizing how we treat patients with IBD," said Dr. Colombel.

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Arthur Mortha, also from the Icahn School of Medicine at Mount Sinai was the lead author of this paper. Other contributors from Mount Sinai included Aleksey Chudnovskiy, Daigo Hashimoto, and Milena Bogunovic.

The study was supported with grants from the National Institutes of Health (NIH) grants R01 CA154947A, R01 CA173861 and U01 AI095611 A.M. is funded by the German Research Foundation (DFG) Grant MO2380/1-1. Dr. Mortha received funding from the German Research Foundation (DFG) Grant MO2380/1-1.

About the Mount Sinai Health System

The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven member hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services--from community-based facilities to tertiary and quaternary care.

The System includes approximately 6,600 primary and specialty care physicians, 12-minority-owned free-standing ambulatory surgery centers, over 45 ambulatory practices throughout the five boroughs of New York City, Westchester, and Long Island, as well as 31 affiliated community health centers. Physicians are affiliated with the Icahn School of Medicine at Mount Sinai, which is ranked among the top 20 medical schools both in National Institutes of Health funding and by U.S. News & World Report. For more information, visit http://www.mountsinai.org. Find Mount Sinai on: Facebook: http://www.facebook.com/mountsinainyc Twitter @mountsinainyc YouTube: http://www.youtube.com/mountsinainy

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