IL-22 mediates mucosal host defense against gram negative bacterial pneumonia

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1 IL-22 mediates mucosal host defense against gram negative bacterial pneumonia Shean J. Aujla, Yvonne R. Chan, Mingquan Zheng, Mingjian Fei, David J. Askew, Derek A. Pociask,Todd A. Reinhart, Florencia McAllister, Jennifer Edeal, Kristi Gaus, Shahid Husain, James L. Kreindler, Patricia J. Dubin, Joseph M. Pilewski, Mike M. Myerburg, Carol A. Mason, Yoichiro Iwakura, and Jay K. Kolls. Supplementary Figure. log CFU H37Rv WT IL-7R KO TNFR deficient Days Lack of susceptibility of IL-7R KO mice to primary Mycobacterium tuberculosis infection. WT or IL-7R KO were challenged with CFU of H37Rv M. tuberculosis and sacrificed at serial time points to determine lung CFU. As a positive control, mice over expressing a soluble human p55 TNFR:Fc fusion protein were infected as well. As opposed to mice deficient in TNFR signaling, IL-7R KO showed control of M tb growth similar to WT mice (n=6-7 mice per group, denotes p <.5 compared to WT control by Mann-Whitney non parametric testing).

2 Supplementary Figure 2. a IL-7R signaling is dispensable for host resistance against Listeria monocytogenes infection Strain -day Survival C57BL/6 / IL-7R KO / P55 TNF-R KO / WT C57Bl/6, IL-7R KO and p55 TNFR KO mice were infected with 5 x e4 CFU of L. monocytogenes and followed daily for days for survival b CFU per spleen IL-7RKO WT TNF p55-/- WT C57Bl/6, IL-7R KO, and p55 TNFR KO mice were infected with 5 x e4 CFU of L. monocytogenes and sacrificed on day 4 of infection (n=6, P <.). 2

3 c Serum Cytokines L. monocytogenes infected mice pg/ml INF-g IL-6 IL-2 (p7) IL-7 WT IL-7R KO d WT C57BL/6 or IL-7R KO mice were infected with 5 x e4 CFU of L. monocytogenes and serum cytokines were measured at 72 hour by Luminex (n=4-6 per group). IL-2p7 pg/ml medium WT IL-7R KO HKLM IFN-g pg/ml 5 5 medium HKLM WT IL-7R KO Normal Th immunity to L. monocytogenes in IL-7R KO mice. WT C57Bl/6 or IL-7R KO mice were infected with 5 x e4 CFU of L. monocytogenes. Spleens were harvested at day 6 and cultured with media or stimulated with heat-killed L. monocytogenes (HKLM). Supernatants were harvested at 24 hours for Il-2p7 and IFN-g by Luminex (n=6 per group, P <.). 3

4 Supplementary data Figure 3 a Fold-change mrna (2^-ddCT).5.5 Media IL-22 IL-7 22/7 Stimulation of HBE cells with IL-22 or IL-7 does not alter IL-22R expression. Primary HBE cells were stimulated with IL-22, IL-7 or both for 24 hours. IL-22R mrna was measured by quantitative real-time PCR (n=5-6 from three individual donors per condition. Error bars represent +/- SEM). b G-CSF mrna, fold change media IL-22 IL-7 IL-22+7 IL-22 and IL-7 synergistically upregulate G-CSF expression. Primary HBE cells were stimulated with IL-22, IL-7 or both for 24 hours and G- CSF mrna was measured by quantitative real time PCR (n=5-6 from three individual donors per condition, P <.5 compared with media control. Error bars represent +/- SEM). 4

5 Supplementary data Figure 4 Time course of Ccl2, Ccl7 and Ccl22 CCL2 mrna, fold change K. pneumoniae uninfected hours post infection CCL7 mrna, fold change K. pneumoniae uninfected hours post infection CCL22 mrna, fold change K. pneumoniae uninfected hours post infection 5

6 Supplementary data Figure 5 a 25 IL-22 pg/mg protein Control Rag2γc2 KO Rag2γc2 KO mice deficient in natural killer (NK), T and B cells are unable to produce IL-22 in K. pneumoniae infection compared to controls. Rag2γc2 KO mice and age-matched controls were infected intratracheally with K. pneumoniae and sacrificed at 24 hours. IL-22 protein was determined by ELISA and normalized per mg of protein (n= 3 per group P <.5 compared with controls. Error bars represent +/- SEM). b Spots/e5 cells CD9+ cells K. pneumoniae uninfected CD9+ T cells from K.pneumoniae infected lung produce significantly more IL-22 compared to cells from uninfected lung. WT mice were infected with K. pneumoniae or control, and lungs were harvested after 24 hrs. IL-22 elispot was performed after CD9+ cells were collected from lung (n= 3 per group, P <.5 compared with controls. Error bars represent +/- SEM). 6

7 Supplementary data Figure 6 IL-7 pg/mg protein Control anti-il-22 IL-7A levels are unchanged in mice given antibody to IL-22 and infected with K. pneumoniae. WT mice were infected with K. pneumoniae and treated with antibody to IL-22 or control intratracheally. At 24 hrs mice were sacrificed and IL- 7A was determined by Bioplex assay and normalized per mg of protein (n= 6 per group. Error bars represent +/- SEM). 7

8 Supplementary Table I Age Sex Organism Transplant Disease IL-22 (pg/ml) CXCL8 (pg/ml) IL-7 (pg/ml) Alpha antitrypsin deficiency < 5 pg/ml 43 F K.pneumoniae DLTx 2 38 F K.pneumoniae DLTx Chronic rejection 46.3 < 5 pg/ml 3 29 F K.pneumoniae DLTx Chronic rejection < 5 pg/ml 4 29 F K.pneumoniae DLTx Chronic rejection < 5 pg/ml 5 55 M K.pneumoniae Single LTx IPF < 5 pg/ml 6 25 M S.aureus DLTx CF M S.aureus DLTx CF < 5 pg/ml 8 5 F P.aeruginosa DLTx Connective tissue < 5 pg/ml 9 47 F S.aureus DLTx COPD < 5 pg/ml DLTx = Double lung transplant Single LTx = Single lung transplant IL-22 protein is not detected in bronchoalveolar lavage (BAL) of immunosuppressed individuals who are status post lung transplant with pneumonia. IL-22 protein levels were measured by ELISA in BAL samples from seven individuals (two had two serial BAL samples) who had lung transplantation.