[HTML][HTML] Coordinated epithelial NHE3 inhibition and barrier dysfunction are required for TNF-mediated diarrhea in vivo

DR Clayburgh, MW Musch, M Leitges… - The Journal of …, 2006 - Am Soc Clin Investig
DR Clayburgh, MW Musch, M Leitges, YX Fu, JR Turner
The Journal of clinical investigation, 2006Am Soc Clin Investig
Acute T cell–mediated diarrhea is associated with increased mucosal expression of
proinflammatory cytokines, including the TNF superfamily members TNF and LIGHT. While
we have previously shown that epithelial barrier dysfunction induced by myosin light chain
kinase (MLCK) is required for the development of diarrhea, MLCK inhibition does not
completely restore water absorption. In contrast, although TNF-neutralizing antibodies
completely restore water absorption after systemic T cell activation, barrier function is only …
Acute T cell–mediated diarrhea is associated with increased mucosal expression of proinflammatory cytokines, including the TNF superfamily members TNF and LIGHT. While we have previously shown that epithelial barrier dysfunction induced by myosin light chain kinase (MLCK) is required for the development of diarrhea, MLCK inhibition does not completely restore water absorption. In contrast, although TNF-neutralizing antibodies completely restore water absorption after systemic T cell activation, barrier function is only partially corrected. This suggests that, while barrier dysfunction is critical, other processes must be involved in T cell–mediated diarrhea. To define these processes in vivo, we asked whether individual cytokines might regulate different events in T cell–mediated diarrhea. Both TNF and LIGHT caused MLCK-dependent barrier dysfunction. However, while TNF caused diarrhea, LIGHT enhanced intestinal water absorption. Moreover, TNF, but not LIGHT, inhibited Na+ absorption due to TNF-induced internalization of the brush border Na+/H+ exchanger NHE3. LIGHT did not cause NHE3 internalization. PKCα activation by TNF was responsible for NHE3 internalization, and pharmacological or genetic PKCα inhibition prevented NHE3 internalization, Na+ malabsorption, and diarrhea despite continued barrier dysfunction. These data demonstrate the necessity of coordinated Na+ malabsorption and barrier dysfunction in TNF-induced diarrhea and provide insight into mechanisms of intestinal water transport.
The Journal of Clinical Investigation