BALANCE BETWEEN ESTROGENS AND PROINFLAMMATORY CYTOKINES REGULATES CHEMOKINE PRODUCTION INVOLVED IN THYMIC GERMINAL CENTER FORMATION

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BALANCE BETWEEN ESTROGE AND PROINFLAMMATORY CYTOKINES REGULATES CHEMOKINE PRODUCTION INVOLVED IN THYMIC GERMINAL CENTER FORMATION Nadine Dragin 1, 2, 3,, Patrice Nancy 4, José Villegas 2, 3, 5, Régine Roussin 6, Rozen Le Panse 2, 3, 5, and Sonia Berrih-Aknin 2, 3, 5, 1 Inovarion, Paris, France 2 Sorbonne Universités, UPMC Univ Paris 6, Paris, France 3 IERM U974, Paris, France 4 Department of Pathology, New York University, School of Medicine, New York, USA 5 AIM, institute of myology, Paris, France 6 Hôpital Marie Lannelongue, Le Plessis-Robinson, France Corresponding author Correspondence and Requests for materials should be addressed to: Dr Nadine Dragin, Inovarion, Centre de Recherche en Myologie, UPMC / IERM UMRS 974, Groupe Hospitalier Pitié-Salpêtrière, 5 Bd de l hôpital, 7513 Paris, France, Tel: 33 ()1 4 77 81 27, Fax: 33 ()1 4 77 81 29; nadine.dragin-mamavi@upmc.fr Keywords: HLA DR, acetylcholine receptor, CXCL13, Thymic epithelial cells, sex hormones, thymus

-AChR mrna expression (AU/GAPDH) Supplementary material Figure S1. Estradiol dose effects on α-achr mrna expression in human primary thymic epithelial cells (TECs). Human primary TECs were treated for 24h with - to -7 M of 17- estradiol. α-achr mrna level was quantified by real time PCR. Primary cultured TECs were obtained from different donors. The results are expressed as mean values (± SEM). P values were obtained using the Man Whitney test.; p<.1 15 5 - -9-8 Estradiol (M) -7

Ratio Ratio Figure S2. Compared expression of clusters of differentiation (CD) and keratins. mrna expression ratios of cluster of differentiation (n= 71) (a) and Keratin (b) (n=26) genes spotted on the arrays for men and women in normal adult thymuses. The expressions were normalized and compared with a thymic reference composed of thymuses from female babies. Each dot corresponds to the median of ratios of five replicates for women, and four replicates for men for a given gene. P values were obtained using the Wilcoxon test. a. b. 3 CD 3 Keratin 2 2 1 1 Male Female Male Female

CXCL12 protein expression (nm/ml of supernatant) CXCL13 mrna expression (AU/GAPDH) CCL21 mrna expression (AU/GAPDH) Figure S3. Estradiol dose effect on CXCL13, CCL21 and CXCL12 expression in primary human thymic epithelial cells. Human primary TECs were treated for 24h with - to -8 M of 17- estradiol. CXCL13 (a), CCL21 (b) mrna levels were quantified by real time PCR. CXCL12 (c) protein levels were evaluated in the cell culture supernatants. Primary cultured TECs were obtained from different donors. The results are expressed as mean values (± SEM). P values were obtained using the Man Whitney test. p<.1 a. b. 15 3 2 5 - -9 Estradiol (M) -8 - -9 Estradiol (M) -8 c. 2. 1.5 1..5. - -9 Estradiol (M) -8

CXCL12 protein level (% of control) CXCL13 protein level (% of control) CCL21 protein level (% of control) Figure S4. Cytokine single dose effect on CXCL13, CCL21 and CXCL12 expression in primary human thymic epithelial cells. Effects of TNF-α ( ng/ml), IL-1β (1 ng/ml recombinant) or IFN-γ (5 U/mL) at 24h of exposure on CXCL13 (a), CCL21 (b) and CXCL12 (c) protein levels in the supernatants of human primary TECs. Primary cultured TECs were obtained from different donors. The results are expressed as mean values (± SEM). P values were obtained using the Man Whitney test. p<.5; p<.1 a. b. 15 25 2 15 5 5 TNF IL1 IFN Mix TNF IL1 IFN Mix c. 15 5 TNF IL1 IFN Mix

CXCL13 protein level (% of control) CCL21 protein level (% of control) CXCL12 protein level (% of control) Figure S5. CXCL13, CCL21 and CXCL12 protein expression by human primary TECs treated with pro-inflammatory cytokines and with estradiol. Effects of a cytokine mix (IFN-γ, IL-1β, and TNF-α) with 17- estradiol ( -8 M) exposure on CXCL13 (a), CCL21 (b) and CXCL12 (c) protein levels in the supernatants of human primary TECs. Primary cultured TECs were obtained from at least five different donors. The results are expressed as mean values (± SEM). P values were obtained using the Wilcoxon test. p<.5; p<.1 a. b. c. 15 Estradiol 15 Estradiol 15 Estradiol 5 5 5 + Cytokine Mix + Cytokine Mix + Cytokine Mix

Figure S6. Graphical representation of Transcription factor binding sites found in promoter of HLA DR, α-achr, CXCL13, CCL21 and CXCL12 genes. Graphic provided by The SABiosciences Champion ChiP Transcription Factor Search Portal that used the database known as DECODE. HLA DR α-achr CXCL13 CCL21 CXCL12

Figure S7. Summary of estrogen effects depending on steady or inflammatory environnement. In steady state, estrogens (estradiol E2) contribute to a reduced tolerisation process to autoantigen such as -AChR and to lesser chemokine expression. However, in a virusinduced inflammation milieu such as found in autoimmune AChR + MG thymuses, estrogen direct effects are overpassed by inflammatory pathways such as toll like receptor (TLR)/IFN and then estrogens collaborate with this pathway to stimulate expression of chemokines involved B cell chemoattraction and germinal center formation. Estrogens act as an opportunist guy that probes the environment and ajusts its effect to or with the combined stimulus. «Steady state» «MG State» E2 TEC ERα Reduced tolerisation to AChR Expression of Aire, AChR, MHC II E2 TEC 1 ERα 3 2 IFN Virus 1 Chemokine mrna Expression of MHC II 5 Chemokine mrna 4 CCL21 SDF1 CXCL13 Reduced chemokine secretion CXCL13 SDF1 CCL21 Increased chemokine secretion

Table S1A: list of Chemokine genes (n= 17) spotted on the arrays Gene Name Female Male 1 CXCL3,7 1, 2 CXCL6,7 1,1 3 CXCL 1,1,9 CXCL 1,3,8 4 CXCL11,8 1,1 5 CXCL13,8 1,1 6 XCL2,7 2, 7 CX3CL1,9 1,2 8 CCL4L2,9 2,2 9 CCL5 1,5 1,2 CCL7,8 1,1 11 CCL11,8,9 12 CCL15 1,2 1,3 13 CCL17,8,7 14 CCL18,4,7 15 CCL19 1,5 1,7 16 CCL21 1, 1,4 17 CCL8,8 1,4

Table S1B: list of Interleukin genes (n= 21) spotted on the arrays Gene Name Female Male 1 Interleukin 1 alpha,7,9 2 Interleukin-1 homolog 1,8 1, 3 Interleukin 1B,8 1,1 4 Interleukin 2,9 1,1 5 Interleukin 3,8,9 6 Interleukin 4,8,8 7 Interleukin 5 1, 1,2 8 Interleukin 6 (complete cds) 1,1,8 Interleukin6 (IFN beta 2) 1, 1,2 9 Interleukin 7 1,,9 Interleukin 8 1,4 1,1 11 Interleukin 11 1, 1,3 12 Interleukin 12A 1, 1,1 13 Interleukin 13,9 1, 14 Interleukin 15,9 1,3 Interleukin 15,7 1, 15 Interleukin 16 1,2,9 16 Interleukin 18 1,3 1, 17 Interleukin 2 1,1,8 18 Interleukin 24 1,1,9 19 Lymphotoxin beta,9,8 2 TNF-beta,8,9 21 GM-CSF,8 1,

Table S2: list of primers used in the study GENE NAME SPECIES PRIMER #1 PRIMER #2 28S GGTAGGGACAGTGGGAATCT CGGGTAAACGGCGGGAGTAA α-achr AAGCTACTGTGAGATCATCGTCAC TGACGAAGTGGTAGGTGATGTCCA CCL21 CAAGCTTAGGCTGCTCCATC TCAGTCCTCTTGCAGCCTTT CXCL13 CTCTGCTTCTCATGCTGCTG TGAGGGTCCACACACACAAT GAPDH GCTGAGTACGTCGTGGAGTC GATGATGTTCTGGAGAGCCC IFNα Human TCCTGCTTGAAGGACAGACA TTTCAGCCTTTTGGAACTGG IFNβ ACGCCGCATTGACCATCTATG CGGAGGTAACCTGTAAGTCTGT HLA DR TGGAGCAGATTAAACACGAGTG CCGCCCGGAACTTTCTGAC MXA ACCTACAGCTGGCTCCTGAA CGGCTAACGGATAAGCAGAG OAS2 ACAGTCCTGCAGCGAAACTT AGTGTCAAAATCCGGCACTC CXCL12 TCAGCCTGAGCTACAGATGC CTTTAGCTTCGGGTCAATGC α-achr GTGCTGGGCTCTTTCATCTC TTCTGTGCGCGTTCTCATAC CCL21 CCCTGGACCCAAGGCAGT AGGCTTAGAGTGCTTCCGGG CXCL13 TGAGGCTCAGCACAGCAA ATGGGCTTCCAGAATACCG Mouse GAPDH ATCACCATCTTCCAGGAGCG CCTGCTTCACCACCTTCTTG HLA DR CCACTGGACATGGAAGACCT GACTTCATTTGCCGTGTCCT CXCL12 GCTCTGCATCAGTGACGGTA ATTTCGGGTCAATGCACACT