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The Journal of Immunology, 1999, 162: 1049-1055.
Copyright © 1999 by The American Association of Immunologists

Alleviation of Lipopolysaccharide-Induced Acute Liver Injury in Propionibacterium acnes-Primed IFN-{gamma}-Deficient Mice by a Concomitant Reduction of TNF-{alpha}, IL-12, and IL-18 Production1

Hirokazu Tsuji2,*, Naofumi Mukaida§,{dagger}{dagger}, Akihisa Harada{dagger},**,{dagger}{dagger}, Shuichi Kaneko*, Eiki Matsushita*, Yasuni Nakanuma{ddagger}, Hiroko Tsutsui, Haruki Okamura||, Kenji Nakanishi,||, Yoh-ichi Tagawa#, Yoichiro Iwakura#, Ken-ichi Kobayashi* and Kouji Matsushima**,{dagger}{dagger}

* First Department of Internal Medicine, {dagger} Department of Hygiene, {ddagger} Second Department of Pathology, School of Medicine, and § Department of Molecular Pharmacology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan; Department of Immunology and Medical Zoology, || Laboratory of Host Defenses, Institute for Advanced Medical Sciences, Hyogo College of Medicine, Hyogo, Japan; # Laboratory Animal Research Center, Institute of Medical Science, ** Molecular Preventive Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan; and {dagger}{dagger} Core Research for Evolutional Science and Technology, Japan Science and Technology Corporation, Tokyo, Japan


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The present study was designed to investigate the role of IFN-{gamma} in LPS-induced liver injury following priming with Propionibacterium acnes. At 1 week after priming BALB/c mice with P. acnes, a large number of macrophages (M{phi}) and lymphocytes predominantly infiltrated the portal area, resulting in the intrahepatic formation of granulomas consisting of epithelioid and lymphoid cells. In comparison, in IFN-{gamma} gene-disrupted BALB/c mice (IFN-{gamma} knockout mice), the number of infiltrated M{phi} was decreased, with a significant reduction in the number and size of granulomas. Subsequent elicitation with a low dose of LPS induced massive hepatic necrosis in wild-type BALB/c mice, with a marked increase in the serum levels of TNF-{alpha}, IL-12, and IL-18 and subsequently of alanine transferase. In contrast, IFN-{gamma} knockout mice developed scattered focal necrosis of the liver with significantly lower levels of serum alanine transferase as well as drastic decreases in TNF-{alpha}, IL-12, and IL-18 production. The administration of an anti-IFN-{gamma} neutralizing mAb at the eliciting phase significantly alleviated liver injury and reduced serum IL-12 and IL-18 levels. Thus, endogenously produced IFN-{gamma} is involved in the pathogenesis of this liver injury model by regulating M{phi} infiltration and granuloma formation in the priming phase as well as cytokine production in the eliciting phase.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Accumulating evidence indicates that inflammatory stimuli and microbial products induce the production of various cytokines, which interact in a complex manner (1). IFN-{gamma}, which is produced mainly by Th1 lymphocytes and NK cells, is involved in macrophage (M{phi})3 activation and plays an important role in M{phi}-mediated host reactions. Several lines of evidence implicate the potential involvement of IFN-{gamma} in clinical hepatitis (2, 3, 4). Moreover, enhanced local IFN-{gamma} production has been documented to have a role in a number of experimental liver injury models, including Con A-induced hepatitis, D-galactosamine-LPS-induced hepatitis, and mouse viral hepatitis (5, 6, 7).

Liver injury can be also induced by a low dose of LPS in animals primed with heat-killed bacteria such as Propionibacterium acnes. This injury occurs in two phases: the early priming and the late elicitation phases (8). During the priming phase induced by P. acnes injection, activated mononuclear cells infiltrate the liver lobules, resulting in granuloma formation consisting mainly of M{phi} and lymphoid cells, whereas massive hepatocellular damage ensues during the elicitation phase induced by LPS injection (9). Moreover, the participation of proinflammatory cytokines in liver pathology, particularly TNF-{alpha}, has been suggested based on the inhibitory effect of the administration of neutralizing Ab or antiinflammatory cytokines (10, 11, 12). In support of this notion, we demonstrated previously that TNF receptor p55-deficient mice exhibited tremendous reduction in intrahepatic inflammatory cell infiltration and granuloma formation during the priming phase and diminished hepatocellular apoptotic and necrotic changes during the later eliciting phase (13).

The role of IFN-{gamma} in this model has been investigated using neutralizing anti-IFN-{gamma} Abs (14, 15). Because the Abs were administered in the middle of the priming phase or 24 h before LPS injection in these studies, the precise role of IFN-{gamma} in either the priming or the eliciting phase remains elusive. Moreover, a lack of pathologic analyses in these studies precluded any definitive conclusions concerning the effects of IFN-{gamma} deficiency on granuloma formation during the priming phase or in the subsequent hepatocyte apoptotic/necrotic changes after LPS administration. Hence, to clarify the role of IFN-{gamma} more definitively, this study explored the pathologic changes in LPS-challenged, IFN-{gamma}-deficient mice after priming with P. acnes and their relationship to changes in the serum levels of IFN-{gamma}-related cytokines.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Reagents

LPS (Escherichia coli serotype 055.B5) was obtained from Difco Laboratories (Detroit, MI). P. acnes (ATCC 11828, American Type Culture Collection, Manassas, VA) was heat-killed and lyophilized as described previously (12).

Mice

Specific pathogen-free BALB/c mice were obtained from Sankyo Laboratories (Tokyo, Japan) and thereafter designated as wild-type (wt) mice. IFN-{gamma} knockout (gko) mice were generated as described previously (7) and backcrossed to BALB/c mice for six generations. All animal procedures in this study complied with the standards set out in the Guidelines for the Care and Use of Laboratory Animals on the Takara-machi Campus of Kanazawa University.

Experimental procedures

wt or gko mice that were 8–12 wk of age received an i.v. injection of 1 mg of P. acnes suspended in 100 µl of PBS. After 7 days, the animals were given an i.v. injection of 1 µg of LPS in 100 µl of PBS.

The combined administration of 1 mg of P. acnes and 1 µg of LPS did not induce any lethality until 36 h after LPS challenge in this study. Animals were randomly sacrificed at the indicated timepoints to collect sera and to obtain livers for histologic analyses. Five mice were examined at each timepoint.

In the subsequent experiment, wt mice were i.v. injected with 1 mg of P. acnes. After 7 days, the animals were injected i.p. with 250 µg of neutralizing anti-mouse IFN-{gamma} Ab (XMG1.2) (16) or control rat IgG (ICN Pharmaceuticals, Costa Mesa, CA) at 1 h before LPS injection. Four mice from each group were sacrificed at 6 h after LPS administration to collect sera and to obtain livers for pathologic analyses.

Histologic and immunohistochemical examination

Liver specimens were fixed with 10% neutral buffered formalin and embedded in paraffin. Deparaffinized thin sections from each paraffin block were stained with hematoxylin and eosin for histologic examinations.

For immunohistochemical analyses, paraffin-embedded liver sections were dewaxed with Histo-Clear (National Diagnostics, Atlanta, GA) and dehydrated through graded concentrations of ethanol. After being treated with microwave Ag retrieval and blocked with avidin, biotin, and 1% skim milk in PBS, tissue sections were incubated overnight at 4°C with rat anti-mouse M{phi} Ab against the M{phi}-specific cell surface protein F4/80 (Serotec, Oxford, U.K.); F4/80 had been diluted 1/2 with 1% skim milk-PBS. The sections were rinsed and subsequently incubated for 30 min with biotinylated rabbit anti-rat Ig (Dako, Carpenteria, CA) diluted 1/300 with 1% skim milk-PBS. Tissue sections were then rinsed and further incubated for 30 min with alkaline phosphatase (AP)-labeled streptavidin (diluted 1/100 with 1% skim milk-PBS). The slides were rinsed again in PBS and reacted with AP substrate solution (Vector Laboratories, Burlingame, CA) containing 1 mM of levamisole for 30 min at room temperature. Finally, sections were rinsed and counterstained with methyl green.

All slides were evaluated by one of us without prior knowledge of the experimental procedures.

Measurement of granuloma number and size

The numbers and the size of granulomas in the liver from P. acnes-treated mice were histologically determined on 10 randomly chosen microscopic fields at x100 magnification. The area of each granuloma was determined with the help of National Institutes of Health Image Analysis software (version 1.55).

Determination of serum alanine transferase (ALT) and TNF-{alpha}

Serum ALT levels were determined with a Fuji Dri-Chem 5500V (Fuji Medical System, Tokyo, Japan) according to the manufacturer’s instructions.

Serum murine TNF-{alpha} levels were measured with an ELISA kit (Quantikine M, R&D systems, Minneapolis, MN). The detection limit of the assay was consistently ~20 pg/ml.

ELISA against IL-12

Monoclonal rat anti-mouse IL-12 p70 IgG (clone C15.6) and another rat anti-mouse IL-12 p70 IgG (clone C17.8) were obtained from Genzyme (Cambridge, MA); the Ab clone C17.8 was biotinylated. rIL-12 was also obtained from Genzyme and was used as a standard. Serum murine IL-12 levels were determined with by ELISA using C15.6, biotinylated C17.8, and AP-conjugated streptavidin. Enzyme activities were determined using p-nitrophenylphosphate as a substrate. The detection limit of the assay was consistently ~40 pg/ml.

ELISA against IL-18

IL-18 levels were measured by ELISA using purified rabbit polyclonal Ab against IL-18 (17) and rabbit polyclonal anti-IL-18 conjugated with horseradish peroxidase. 4-amino-antipyrine in potassium phosphate buffer was used as a substrate, and the color intensity was measured at 492 nm. This ELISA detected 0.1–10 ng/ml of IL-18.

Statistical analysis

Data are expressed as mean ± 1 SE. Statistical significance on the serum ALT level and IL-12 were analyzed by two-way ANOVA followed by the Scheffe’s multiple comparison procedure. The numbers and the size of granulomas were analyzed by the Mann-Whitney U test. The serum ALT, IL-12, and IL-18 levels of neutralizing IFN-{gamma} Ab-treated mice were analyzed by the Student t test.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Reduced elevation in serum ALT levels in gko mice

In wt mice, serum ALT levels were elevated <=391 ± 92 international units (IU)/L at 7 days after priming with P. acnes. LPS treatment further increased serum ALT levels nearly 10-fold, reaching a maximum at 12 h and returning to pretreatment levels by 36 h after LPS challenge (Fig. 1Go). In gko mice, priming with P. acnes induced a slight increase in serum ALT levels (112 ± 28 IU/L). Subsequent LPS challenge further increased serum ALT levels, which reached one-third of maximal levels of wt mice at 12 h and returned to almost normal levels by 24 h after LPS challenge in gko mice (Fig. 1Go). Although neither wt nor gko mice succumbed until 36 h under these conditions, these results suggest the involvement of IFN-{gamma} in the development of this liver injury model.



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FIGURE 1. Comparison of changes in serum ALT levels with time (mean ± SE) in P. acnes-primed wt and gko mice after LPS injection. Serum ALT levels of wt (•; n = 5 at each timepoint) and gko ({circ}; n = 5) mice were measured as described in Materials and Methods. *, p < 0.05 and **, p < 0.01, compared with untreated animals.

 
Histopathologic changes of liver in P. acnes-primed wt and gko mice

To elucidate the basis for the reduced elevation in serum ALT levels in gko mice, liver tissue was examined histopathologically. No apparent histologic difference was observed in the livers of untreated wt and gko mice (Fig. 2Go, a and b). At 7 days after P. acnes administration, a large number of M{phi} and lymphocytes infiltrated portal areas, with additional focal hepatocellular necrosis in wt mice (Fig. 2Goc). Moreover, in wt mice, granulomas consisted mainly of epithelioid and lymphoid cells that were diffusely distributed in hepatic lobules (Fig. 2Goc), which is consistent with previous reports (8, 10, 13). At a higher magnification, immunohistochemical analysis using an anti-M{phi} Ab demonstrated the presence of a large number of M{phi} in granulomas (Fig. 2Go, e and g).



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FIGURE 2. Comparison of histopathologic analyses of livers from P. acnes-primed wt (BALB/c) (A, C, E, and G) and gko (B, D, F, and H) mice. Livers were obtained from nontreated mice (A and B, x50 magnification) and from P. acnes-primed mice at 7 days after injection (C and D, x50 magnification; E and F, x200 magnification). Intrahepatic granuloma formation is present in C and to a lesser degree in D (arrowheads). Lymphocytes and M{phi} are seen in E and lymphocytes and neutrophils are observed in F. An immunohistochemical demonstration of M{phi} in P. acnes-treated mice is shown in G and H. Immunochemistry was performed using Ab F4/80 against M{phi}, as described in Materials and Methods. A granuloma consisting mainly of M{phi} is seen in G. Intrasinusoidal Kupffer cells, but not granuloma cells, are stained in H. Tissue sections were observed at x160 magnification.

 
An infiltration of mononuclear cells, particularly M{phi}, was less evident in livers from P. acnes-primed gko mice (Fig. 2God) compared with wt mice. Moreover, the number of granulomas was reduced by nearly 80% in gko mice compared with wt mice (p < 0.01, Fig. 3GoA). Furthermore, the area of each granuloma was decreased by nearly 60% in gko mice in comparison with wt mice (p < 0.01, Fig. 3GoB). Examination at a higher magnification revealed that the main cellular components of granulomas in gko mice were lymphocytes and neutrophils, whereas M{phi} and epithelioid cells were sparse (Fig. 2Gof). This analysis was supported by an immunohistochemical examination, which detected few M{phi} in the granulomas of P. acnes-primed gko mice (Fig. 2Goh). Collectively, these results suggest that IFN-{gamma} is involved in M{phi} infiltration and granuloma formation during the priming phase.



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FIGURE 3. Comparison of the number and size of P. acnes-induced granulomas. A, The number per microscopic field (x100 magnification) in wt and gko mice (n = 5). B, Area per granuloma in both types of mice (n = 5). The number and size were counted and measured as described in Materials and Methods.

 
Comparison of histopathologic changes of liver in gko and wt mice after LPS challenge

At 6 h after LPS challenge, massive cytolytic and coagulative necrosis and hepatocyte apoptosis were observed in livers from wt mice, accompanied by a massive infiltration of mononuclear cells, most of which were lymphocytes (Fig. 4Goa). Moreover, at the same time, thrombi were formed in the portal vein, whereas neutrophils and lymphocytes adhered to hepatic vein endothelium and extravasated transendothelially as reported previously (12) (Fig. 4Goa). In contrast, mononuclear cell infiltration and hepatocyte apoptosis were less evident in gko mice than wt mice. Moreover, in gko mice, only focal necrosis was observed, with a scattered infiltration of lymphocytes, neutrophils, and M{phi} (Fig. 4Gob).



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FIGURE 4. Comparison of liver histopathology of wt (A and C) and gko (B and D) mice in LPS-induced fulminant hepatitis after priming with P. acnes. Livers were obtained from P. acnes-primed mice sequentially injected with LPS at 6 h (A, wt mice; B, gko mice; x50 magnification). Cytolytic and coagulative necrosis of hepatocytes and nuclear fragmentation suggestive of apoptosis are present in A. B shows similar histologic changes, with reduced inflammatory cell infiltration and hepatocyte necrosis/apoptosis in gko mice. At 24 h after LPS administration (C, wt mice; D, gko mice; x50 magnification), large focal necrosis and inflammatory reactions are still observed in C. Inflammatory cell infiltration as well as necrotic reaction are not seen in gko mice at 24 h after LPS challenge, as shown in D.

 
By 24 h after LPS injection, large focal necrosis as well as inflammatory cell infiltration were still observed in livers from wt mice (Fig. 4Goc), whereas inflammatory reactions disappeared and necrosis was reduced in gko mice (Fig. 4God).

These results suggest that IFN-{gamma} plays a role in the establishment and maintenance of acute hepatic inflammatory reaction and in the apoptosis/necrosis of hepatocytes even during the elicitation phase in this model.

Reduction in TNF-{alpha}, IL-12, and IL-18 (IFN-{gamma}-inducing factor) production in gko mice

Because TNF-{alpha}, IL-12, and IL-18 have been presumed to be involved in this model of acute liver injury (10, 17, 18), the serum concentrations of these cytokines were measured. In both untreated wt and gko mice, serum TNF-{alpha} and IL-18 concentrations were undetectable. The IL-12 p70 levels of wt and gko mice were 1.34 ± 0.13 ng/ml and 0.97 ± 0.18 ng/ml, respectively. Priming with P. acnes induced a slight increase in serum TNF-{alpha} and IL-12 p70 levels in both wt and gko mice without an increase in serum IL-18 levels in either strain. Subsequent LPS challenge induced a marked elevation in serum TNF-{alpha} and IL-12 levels in wt mice, reaching a maximum within 1 h and 3 h after LPS challenge, respectively, and declining thereafter (Fig. 5Go, A and B). Serum IL-18 levels increased markedly within 6 h and plateaued until 24 h after LPS challenge in wt mice (Fig. 5GoC). Consequently, the elevation in serum levels of these cytokines preceded the onset of liver injury as represented by an increase in serum ALT levels. In gko mice, the increase in serum TNF-{alpha} levels remained one-hundredth of that in wt mice at 1 h after LPS challenge and decreased rapidly thereafter to below detectable levels (Fig. 5GoA). Moreover, the increase in the serum IL-12 level of gko mice was slower and less evident compared with wt mice (Fig. 5GoB). Furthermore, serum IL-18 remained below detectable levels during the entire course after LPS challenge (Fig. 5GoC).



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FIGURE 5. Changes with time in serum TNF-{alpha} (A), IL-12 (B), and IL-18 (C) levels (mean ± one SE) in P. acnes-primed wt and gko mice after LPS injection. The serum concentrations of cytokines from wt (•; n = 5 at each timepoint) and gko ({circ}; n = 5) mice were measured as described in Materials and Methods. *, p < 0.05; **, p < 0.01.

 
Thus, endogenous IFN-{gamma} is presumably required for the up-regulation of these cytokines and for IL-18 production in particular, and may be involved in causing acute liver injury.

Effect of administration of a neutralizing IFN-{gamma} Ab in the eliciting phase

To clarify the role of IFN-{gamma} in the eliciting phase, mice were treated with a neutralizing rat anti-mouse IFN-{gamma} Ab at 1 h before LPS injection. At 6 h after LPS administration, the serum ALT level of anti-IFN-{gamma} Ab-treated mice (1013 ± 126 IU/L) was significantly less than that of control Ab-treated mice (1413 ± 86 IU/L) (p < 0.05) (Fig. 6GoA) as reported previously (14). Furthermore, anti-IFN-{gamma} Ab-treated mice showed significantly lower serum IL-12 and IL-18 levels than did control mice (Fig. 6Go, B and C). However, no apparent differences were observed in liver pathology between both groups in terms of massive cytolytic and coagulative necrosis, hepatocyte apoptosis, mononuclear cell infiltration, and thrombi in the portal vein (data not shown). Thus, IFN-{gamma} may have a limited but important role in pathologic liver changes during the eliciting phase (induced by LPS injection) by regulating the production of IL-12 and IL-18.



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FIGURE 6. Comparison of serum ALT (A), IL-12 (B), and IL-18 (C) levels in P. acnes-primed wt mice with anti-IFN-{gamma} Ab or control IgG at 6 h after LPS injection (n = 4). Serum ALT levels were measured as described in Materials and Methods.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
IFN-{gamma} exerts pleiotropic effects, including antiviral and bactericidal activity, activation of M{phi} and NK cells, and up-regulation of MHC class II expression and cell surface Ag such as ICAM-1 (19, 20). IFN-{gamma} is produced by NK cells and Th1 cells upon stimulation with IL-12 and IL-18 (17). Aberrant IFN-{gamma} production has been documented in viral hepatitis (2, 3, 4) and experimental liver injury models (5, 6, 7). Enhanced IFN-{gamma} is presumed to induce inflammatory responses and parenchymal toxicity in liver diseases.

Priming with P. acnes renders mice susceptible to subsequent LPS challenge, leading to extensive liver injury mimicking fulminant hepatitis (8). This model consists of two phases: the priming phase, which is induced by P. acnes injection, and the elicitation phase, which follows LPS administration. Rossol et al. reported that a neutralizing Ab to IFN-{gamma} inhibited TNF-{alpha} production by P. acnes-primed PBMCs in vitro (21). Moreover, several independent groups reported that anti-IFN-{gamma} Abs prevented acute lethality and hepatic injury with a concomitant reduction in serum TNF-{alpha} and IL-1{alpha} levels (14, 15). However, because these reports lacked histologic analysis, the effects of IFN-{gamma} deletion on liver pathology remain to be investigated. Thus, to delineate the roles of IFN-{gamma} in liver injury more clearly, we analyzed pathologic changes in gko mice deficient in IFN-{gamma}; mice were challenged with LPS after priming with P. acnes.

Priming with P. acnes induced the infiltration of LFA-1- or Mac-2-positive, activated M{phi} (9, 22), leading to intrahepatic granuloma formation. Granulomas are histologically composed of cells of the monocyte lineage together with lymphocytes (23). Both Th1-derived (IL-2/IFN-{gamma}) and Th2-derived (IL-4/IL-10) cytokines are presumed to be differentially involved in granuloma formation (23). Mycobacterial purified protein derivative- and Leishmania donovani-induced granulomas involve Th1 cytokines, whereas Schistosoma mansoni egg Ag-derived granulomas involve Th2 cytokines (24, 25). L. donovani-infected gko mice failed to exhibit granulomas, implicating IFN-{gamma} as a key mediator of Th1-dependent granuloma formation (26). Hence, a reduction in granuloma number and size in gko mice suggests that the Th1 but not the Th2 response was mainly responsible for granuloma formation in this model. However, a substantial number of granulomas were still present in gko mice, in contrast to the complete absence of granulomas in P. acnes-primed TNF receptor p55-deficient mice (13). Thus, IFN-{gamma}-independent TNF-{alpha} production is also involved in granuloma formation.

In addition to reduced numbers and sizes of granulomas, the cellular composition of intrahepatic granulomas in gko mice was distinct from that seen in wt mice. Granulomas in gko mice consisted mainly of neutrophils and lymphocytes, with few M{phi}. Similar changes were also observed in gko mice infected with Mycobacterium tuberculosis or Listeria monocytogenes. These infections caused granulomatous formations consisting mainly of granulocytes and devoid of M{phi} in gko mice, whereas the granulomas in wt mice were mainly composed of M{phi} (27, 28). Thus, depletion of IFN-{gamma} activity caused a failure of M{phi} infiltration, and granulocytes might have compensated for some of the M{phi} functions and contributed to granuloma formation, thereby limiting microbial invasion.

IL-12, a heterodimer consisting of p35-p40, is produced by M{phi}, dendritic cells, and B cells in response to bacteria and bacterial products (29). Major activities of IL-12 include the induction of IFN-{gamma} production, enhancement of NK activity, and promotion of Th1 cell differentiation (30, 31, 32). Alternatively, IFN-{gamma} can induce LPS-induced IL-12 p40 gene activation (33) and IL-12 synthesis in M{phi} in vitro (34, 35). However, the importance of IFN-{gamma} for IL-12 production in vivo is controversial. Several independent groups claimed that IFN-{gamma} was involved in IL-12 production in vivo, in shistosomal egg Ag infection (25, 36), in tumor rejection (37), in bacillus Calmette-Guérin infection (38), and in acute viral hepatitis (39). In contrast, in Toxoplasma gondii infection, gko mice exhibited levels of IL-12 production that were similar to those seen wt mice (40), suggesting the possibility of IFN-{gamma}-independent IL-12 production. In the present model, LPS challenge after P. acnes priming induced a serum IL-12 elevation even in gko mice, although the magnitude was smaller than in wt mice. Heinzel et al. also demonstrated that IL-12 production by splenic M{phi} was dependent upon IFN-{gamma}, and that LPS induced the generation of similar levels of IL-12 both in gko and wt mice (41). Thus, IL-12 production may require IFN-{gamma} differentially, depending upon the types of cells and stimuli. If splenic M{phi} are a major source of IL-12 even in this model, most IL-12 production may be dependent upon IFN-{gamma}. Hence, IFN-{gamma} deficiency suppressed IL-12 production, and a small amount of IL-12 may be produced by other cells such as Kupffer cells. Nevertheless, these results demonstrated that IL-12 production is largely controlled by endogenously produced IFN-{gamma}, even in this model.

IL-18, originally called an IFN-{gamma}-inducing factor, is a recently identified cytokine synthesized by Kupffer cells and activated M{phi} (17). IL-18 in combination with IL-12 induces IFN-{gamma} production by Th1 and NK cells. M{phi} of gko mice, which are allografted with Meth A tumor cells or administered bacillus Calmette-Guérin, expressed little IL-18 mRNA, in contrast to the enhanced expression of IL-18 seen in wt mice (37). However, IL-18 mRNA is constitutively expressed in the liver (42), and the processing of IL-18 precursor protein by caspases is required for the generation and secretion of bioactive IL-18 (43, 44). Hence, the measurement of secreted IL-18 protein is necessary to evaluate bioactive IL-18 production. In this model, LPS challenge after P. acnes priming failed to increase serum IL-18 levels in gko mice. These results provide the first evidence that IFN-{gamma} can regulate the secretion of bioactive IL-18 in vivo, constituting a feedback loop between these two cytokines.

Diminished liver injury in gko mice, however, cannot exclude the possibility that attenuated pathologic changes could simply reflect the reduction in granulomas available for response to subsequent LPS challenge. Moreover, previous studies using anti-IFN-{gamma} Abs (14, 15) could not define the role of IFN-{gamma} during the eliciting phase, because the Abs were administered during the priming phase or at 24 h before LPS challenge. Hence, to delineate the role of IFN-{gamma} during the eliciting phase, we administered a neutralizing anti-IFN-{gamma} Ab at 1 h before LPS challenge. Although we failed to observe a marked attenuation in pathologic liver changes, serum ALT levels were significantly depressed in anti-IFN-{gamma}-treated mice compared with control ones. Moreover, IL-12 and IL-18 production was also decreased significantly by 6 h after LPS injection. These results suggest that IFN-{gamma} has a limited but important role even during the eliciting phase, probably by inducing the production of several cytokines, such as IL-12 and IL-18.

We demonstrated previously that the TNF receptor p55-mediated signal was indispensable for granuloma formation during priming, and that TNF and Fas systems independently govern the process of hepatocellular apoptotic and necrotic changes at the later phase. Herein, we have demonstrated that IFN-{gamma} is also involved in granuloma formation and in the enhancement of liver injury. Moreover, IFN-{gamma} deficiency resulted in an inhibition of elevation in serum IL-12 and IL-18 levels. These results have provided definitive evidence that the production of IL-12 and IL-18, which are potent inducers of IFN-{gamma} production, requires endogenously produced IFN-{gamma}, and that these three cytokines form a feedback loop. Thus, this interaction may thereby aggravate liver injury. On the basis of these observations, we postulated the mechanism of LPS-induced liver injury in P. acnes-primed mice as shown in Fig. 7Go. Consequently, breaking down this vicious cycle may eventually prevent the acute exacerbation of liver injury.



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FIGURE 7. Proposed sequence of cytokine interactions culminating in hepatic injury in this bacteria-induced fulminant hepatitis model.

 


    Acknowledgments
 
We thank Dr. Joost J. Oppenheim (National Institutes of Health, Frederick, MD) for critically reviewing the manuscript, Dr. Hideo Nariuchi (University of Tokyo, Tokyo, Japan) for the gift of antineutralizing IFN-{gamma} Ab, and Drs. Kiyotaka Yamakawa and Shinichi Nakamura (Kanazawa University, Kanazawa, Japan) for assistance with the bacterial culture.


    Footnotes
 
1 This work is supported in part by grants-in-aid from the Ministry of Education, Science, and Culture of Japan. Back

2 Address correspondence and reprint requests to Dr. Hirokazu Tsuji, First Department of Internal Medicine, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641 Japan. E-mail address: Back

3 Abbreviations used in this paper: M{phi}, macrophage(s); ALT, alanine transferase; wt, wild type; gko, IFN-{gamma} knockout; AP, alkaline phosphatase. Back

Received for publication March 30, 1998. Accepted for publication October 2, 1998.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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