Monocyte and T cell plasticity in Crohn’s disease and ulcerative colitis

Crohn’s disease (CD) and ulcerative colitis (UC), the two forms of inflammatory bowel diseases (IBD), are associated with dysregulated immune response in the intestinal tissue. It is mediated by mononuclear phagocytes (MNPs) that dialogue via the cytokine they produce with innate and adaptive immune cells. In mice, MNPs are stratified into conventional dendritic cells (DCs), macrophages (M) and monocyte-derived cells that regroup tissue monocyte-derived DCs, monocyte-derived M and monocytes-like cells. However, the phenotypic, molecular and functional diversity of MNPs and their plasticity remain to be elucidated in IBD patients. Therapies in IBD employ antibodies that block IL12 and IL23, thus control Th17 pathogenicity and plasticity and decrease intestinal inflammation. However, no cure exist nowadays for the treatment of IBD. In-depth study of T cell plasticity and the tissue where it occurs remain to be investigated.  In the first chapter, we revealed the existence of two distinct CD14+ MNP subsets in colon of UC patients. Only, CD163-CD64+ inflammatory monocyte-like cells (P3) but not anti-inflammatory CD163+CD64+ M (P4) accumulate in inflamed UC colon. Our findings further established a link between monocyte-like CD14hiCD172α+ CD163- MNPs, IL12, IL1β and the detection of colonic memory Th17 cells that produce IFN and IL8, which might all contribute to UC pathogenesis. Two CD14+ MNP subsets, resembling their counterparts in UC mucosa at the functional and molecular level, were also detected in CD colon.  In contrast, in the second chapter, we provide evidence that Slan+ monocyte subset may contribute to CD but not UC immunopathogenesis. Frequency, phenotype, and function of Slan+ cells were examined in blood, colon, and mesenteric lymph nodes (MLN) of patients with IBD. We showed that pro-inflammatory CD14hiCD172α+Slan+ cells are a distinguishing feature between CD and UC, as they only accumulate in MLNs and colonic mucosa of CD patients.   In the third chapter, we showed that MLNs of CD and UC, tissues that were hard to access for research use, can also be distinguished by frequencies of CXCR3−CCR6+ Th17 effector memory T cells (TEM) and their molecular profile. Our data further suggested that Th17 plasticity is taking place in MLN, before T cell homing to gut tissues. This investigation has clear implications in furthering our understanding of the disease.  Finally, it has been demonstrated that monocytes are continuously recruited into murine gut mucosa and progressively differentiate into macrophages under homeostatic conditions, a maturation process interrupted in the context of inflammation. However, the environmental cues that regulate tissue inflammatory monocyte “waterfall” remain to be investigated in humans. In the fourth chapter we recapitulated in vitro human monocyte differentiation cascade, from CD163- inflammatory monocyte-like cells (P3) towards anti-inflammatory CD163+ macrophages (P4) and showed their molecular similarities to tissue CD14+ MNPs. Manipulating this pathway might open therapeutic avenues to restore tissue homeostasis.   In conclusion, a better understanding of MNP subsets, function and plasticity in IBD pathogenesis would help identify novel therapeutic targets and shed light for the development of personalized treatments.

Keyphrases: macrophage, monocyte, Th17 cells, Plasticity, Slan cells, Crohn's disease, Ulcerative colitis, Culture, Pathogenecity