Inflammatory diseases such as arthritis are chronic conditions that fail to resolve spontaneously. While the cytokine and cellular pathways triggering arthritis are well defined, those responsible for the resolution of inflammation are incompletely characterized. Here we identified interleukin (IL)-9-producing type 2 innate lymphoid cells (ILC2s) as the mediators of a molecular and cellular pathway that orchestrates the resolution of chronic inflammation. In mice, the absence of IL-9 impaired ILC2 proliferation and activation of regulatory T (Treg) cells, and resulted in chronic arthritis with excessive cartilage destruction and bone loss. In contrast, treatment with IL-9 promoted ILC2-dependent Treg activation and effectively induced resolution of inflammation and protection of bone. Patients with rheumatoid arthritis in remission exhibited high numbers of IL-9+ ILC2s in joints and the circulation. Hence, fostering IL-9-mediated ILC2 activation may offer a novel therapeutic approach inducing resolution of inflammation rather than suppression of inflammatory responses.
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The authors thank M. Pascual, K. Dreissigacker, R. Kleinlein, M. Comazzi, D. Weidner and B. Happich for excellent technical assistance. We thank U. Appelt and M. Mroz of the Core Unit Cell Sorting and Immunomonitoring Erlangen for cell sorting. This work was supported by the Deutsche Forschungsgemeinschaft (RA 2506/3-1 and RA 2506/4-1 to A.R.; DI 1537/5-1, DI 1537/7-1, DI 1537/8-1, DI 1537/9-1, AK 144/2-1 and DI 1537/11-1 to J.H.W.D.; SCHE 1583/7-1 to G.S.; SPP1468-IMMUNOBONE and CRC1181 to G.S. and J.H.W.D.), the Bundesministerium für Bildung und Forschung (METHARTHROS to G.S. and J.H.W.D.), the Marie Curie project OSTEOIMMUNE (to G.S. and J.H.W.D.), the TEAM project of the European Union and the IMI-funded project RTCure (to G.S.), Else Kröner-Fresenius-Stiftung 2014_A184 (to A.R.), the Wilhelm Sander Foundation (2013.056.1 to J.H.W.D.), the Interdisciplinary Centre for Clinical Research, Erlangen (A64 to J.H.W.D.; J40 to A.R.), the ELAN Fonds of the Universitätsklinikum Erlangen (16-10-05-1 to A.R.), the Career Support Award of Medicine of the Ernst Jung Foundation (to J.H.W.D.), SNF Sinergia CRSII3_154490 (to O.D.), the UK MRC (UI015178805; to A.N.J.M.), the Wellcome Trust (100963/Z/13/Z to A.N.J.M.) and US NIH grant AI057459 (to M.H.K.).
The authors declare no competing financial interests.
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Rauber, S., Luber, M., Weber, S. et al. Resolution of inflammation by interleukin-9-producing type 2 innate lymphoid cells. Nat Med 23, 938–944 (2017). https://doi.org/10.1038/nm.4373
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