Monocytes from infliximab-resistant patients with Crohn's disease exhibit a disordered cytokine profile

Sci Rep. 2020 Jul 22;10(1):12238. doi: 10.1038/s41598-020-68993-1.

Abstract

Crohn's disease (CD) is a chronic inflammatory disorder characterized by immune response dysregulation. Tumor necrosis factor-α (TNFα) is a key cytokine in the pathogenesis of CD, as indicated by the efficacy of anti-TNF-α therapy with infliximab (IFX). However, approximately 30-40% of CD patients fail to respond to IFX with still unclear underlying mechanisms. This study compares the inflammatory phenotype of monocytes from CD patients, who respond or non-respond to IFX. Under basal conditions, the mRNA for the cytokines TNFα, IL-23, IL-1β and the chemokines CXCL8/IL-8, CCL5/RANTES and CCL2/MCP-1 was up-regulated in monocytes from non-responders than responders. The expression of the same cytokines and CCL2/MCP-1 was higher in non-responders also upon LPS treatment. Moreover, higher secretion of TNFα, IL-1β, IFNγ and IL-2 proteins occurred in the supernatants of LPS-treated non-responders cells. Resistance to IFX in CD may result from a transcriptional dysregulation of circulating monocytes, leading to hyperactivation of pro-inflammatory pathways. Monocytes' cytokine profile may thus represent a predictive marker of response to IFX. Monocytes were isolated from blood samples of 19 CD patients (11 responders, 8 non-responders) and incubated with or without LPS. Cytokine profiles were assessed by RT-qPCR and, in the supernatants, by ELISA assay.

MeSH terms

  • Adult
  • Aged
  • Crohn Disease / drug therapy*
  • Crohn Disease / metabolism*
  • Cytokines / metabolism*
  • Drug Resistance / drug effects
  • Drug Resistance / physiology
  • Female
  • Humans
  • Inflammation / metabolism
  • Infliximab / therapeutic use*
  • Male
  • Middle Aged
  • Monocytes / metabolism*
  • Transcription, Genetic / physiology
  • Up-Regulation / physiology
  • Young Adult

Substances

  • Cytokines
  • Infliximab