Differential regulation of claudin-2 and claudin-15 expression in children and adults with malabsorptive disease

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Intestinal Na+-nutrient cotransport depends on claudin-2 and claudin-15 mediated Na+ recycling. Expression of these proteins is coordinately regulated during postnatal development. While expression of claudin-2 and claudin-15 has been studied in inflammatory bowel disease (IBD) and celiac disease (CD), it has not been assessed in other malabsorptive diseases, and no reports have compared expression in children and adults. We used quantitative immunofluorescence microscopy to assess claudin-2 and claudin-15 expression in duodenal biopsies from children and adults with malabsorptive disease and healthy controls. Consistent with previous work in rodents, claudin-2 expression in healthy children was markedly greater, and claudin-15 expression was less, than that in adults. Claudin-2 expression was increased in adults with CD and downregulated in children with graft-versus-host disease (GVHD). In contrast, claudin-15 expression was reduced in adults with GVHD and common variable immunodeficiency (CVID). These data show that one of the two Na+/water pore-forming claudins is upregulated in CD and downregulated in GVHD and CVID. The specific claudin whose expression changes, however, reflects the age of the patient (child or adult). We conclude that contributions of claudin-2 and claudin-15 to pathophysiology of and responses to diarrhea in children and adults with GVHD and CVID differ from those in CD and IBD.

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This work was supported by National Institutes of Health (R01DK61631, R01DK68271, R24DK099803), the Harvard Digestive Disease Center (P30DK034854), and the University of Chicago Cancer Center (P30CA014599). AS and JRT were involved in case acquisition and tissue microarray development; MLDM, SPN, SY, and JRT were involved in data acquisition and analysis, figure preparation, and paper creation. All authors approved the final paper.

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Correspondence to Jerrold R. Turner.

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Ong, M.L.D.M., Yeruva, S., Sailer, A. et al. Differential regulation of claudin-2 and claudin-15 expression in children and adults with malabsorptive disease. Lab Invest (2019) doi:10.1038/s41374-019-0324-8

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