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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Immunol.</journal-id>
<journal-title>Frontiers in Immunology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Immunol.</abbrev-journal-title>
<issn pub-type="epub">1664-3224</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fimmu.2025.1604332</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Immunology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>IL-36/IL-36R signaling promotes CD4<sup>+</sup> T cell-dependent colitis via pro-inflammatory cytokine production</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes" equal-contrib="yes">
<name>
<surname>Maarouf</surname>
<given-names>Maya</given-names>
</name>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/3022885/overview"/>
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<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kuczma</surname>
<given-names>Michal</given-names>
</name>
<uri xlink:href="https://loop.frontiersin.org/people/1271636/overview"/>
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</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Denning</surname>
<given-names>Timothy L.</given-names>
</name>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/551744/overview"/>
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</contrib-group>
<aff id="aff1">
<institution>Institute for Biomedical Sciences, Center for Inflammation, Immunity, and Infection, Georgia State University</institution>, <addr-line>Atlanta, GA</addr-line>,&#xa0;<country>United States</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Ana Maria Gamero, Temple University, United States</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Patrick Walsh, Trinity College Dublin, Ireland</p>
<p>Jos&#xe9; Pablo Romero-L&#xf3;pez, Universidad Nacional Aut&#xf3;noma de M&#xe9;xico, Mexico</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Maya Maarouf, <email xlink:href="mailto:Maya.maarouf@emory.edu">Maya.maarouf@emory.edu</email>
</p>
</fn>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>26</day>
<month>06</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>16</volume>
<elocation-id>1604332</elocation-id>
<history>
<date date-type="received">
<day>01</day>
<month>04</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>11</day>
<month>06</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2025 Maarouf, Kuczma and Denning</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Maarouf, Kuczma and Denning</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Background</title>
<p>Inflammatory bowel disease (IBD) is a multifactorial, chronic disease that affects approximately 1.5 million people in the United States. Several important factors are implicated in the pathogenesis of IBD, one factor being dysregulation of the immune system. This dysregulation results in the accumulation and stimulation of innate and adaptive immune cells, and subsequent release of soluble factors, including pro-inflammatory cytokines. One of these cytokines is a member of the IL-36 cytokine family, IL-36&#x3b3;, which is overexpressed in human IBD and experimental models of colitis. In this study, we explored the role of IL-36&#x3b3; in promoting CD4<sup>+</sup> T cell activation and cytokine secretion.</p>
</sec>
<sec>
<title>Methods</title>
<p>Spleens and lymph nodes were collected from wild-type and IFN&#x3b3;<sup>-/-</sup> mice and were processed into cell suspensions to isolate na&#xef;ve CD4<sup>+</sup> T cells. Na&#xef;ve CD4<sup>+</sup> T cells were stimulated with IL-36 cytokines. IFN&#x3b3; and TNF&#x3b1; were evaluated by ELISA using cell culture supernatants, and cell culture pellets were used to isolate RNA for qPCR. Na&#xef;ve CD4<sup>+</sup> T cells previously stimulated in the presence or absence of IL-36&#x3b3;, from wild type (WT) or IFN&#x3b3;-/- mice were transferred to Rag-/- mice to induce colitis. Fecal pellets were collected from mice during disease to analyze lipocalin (LCN2) levels from fecal supernatants. After euthanasia, colons, spleens, and mesenteric lymph nodes were harvested and processed into cell suspensions for intracellular cytokine staining.</p>
</sec>
<sec>
<title>Results</title>
<p>Our results demonstrate that IL-36&#x3b3; stimulation of naive CD4<sup>+</sup> T cells significantly induced IFN&#x3b3; expression <italic>in vitro</italic> and was associated with augmented intestinal inflammation <italic>in vivo</italic> using the T cell transfer model of colitis. Using IFN&#x3b3;<sup>-/-</sup> naive CD4<sup>+</sup> T cells, we observed a dramatic decrease in the ability of these cells to produce TNF&#x3b1;. Moreover, the transfer of these cells to Rag<sup>-/-</sup> mice did not cause robust colitis.</p>
</sec>
<sec>
<title>Conclusion</title>
<p>These data not only suggest that IL-36&#x3b3; is a regulator of a pro-inflammatory cytokine network involving IFN&#x3b3; and TNF&#x3b1; but also highlights the importance of targeting IL-36&#x3b3; and IFN&#x3b3; as therapeutic approaches. Our studies have broad implications in relation to targeting specific cytokines in human IBD.</p>
</sec>
</abstract>
<kwd-group>
<kwd>inflammatory bowel disease</kwd>
<kwd>T cell mediated colitis</kwd>
<kwd>adoptive transfer</kwd>
<kwd>IL-36G</kwd>
<kwd>IFNg signaling</kwd>
<kwd>Crohn&#x2019;s disease</kwd>
<kwd>ulcerative colitis</kwd>
</kwd-group>
<counts>
<fig-count count="4"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="37"/>
<page-count count="11"/>
<word-count count="5813"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-in-acceptance</meta-name>
<meta-value>Cytokines and Soluble Mediators in Immunity</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<title>Introduction</title>
<p>Inflammatory bowel disease (IBD) is a multifactorial, chronic condition that remains incurable until this day, with its two main forms being Crohn&#x2019;s disease (CD) and ulcerative colitis (UC). While CD affects any part of the gastrointestinal (GI) tract, UC impacts the colon only. Regardless, they are both characterized with intestinal inflammation and epithelial barrier injury (<xref ref-type="bibr" rid="B1">1</xref>). To date, the types of therapeutics currently available primarily work to reduce and suppress inflammation, without curing the disease (<xref ref-type="bibr" rid="B2">2</xref>). Unfortunately, the etiology of IBD remains ambiguous. Several factors play a role in the pathogenesis of IBD, including genetics, environmental factors, the microbiota, and immunological dysregulation (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>).</p>
<p>The intestinal epithelial barrier acts as a defense barrier between the intestinal mucosa and the lumen, composed of a layer of intestinal epithelial cells (IECs) (<xref ref-type="bibr" rid="B5">5</xref>). Disruption of the mucosal barrier increases intestinal permeability (<xref ref-type="bibr" rid="B6">6</xref>, <xref ref-type="bibr" rid="B7">7</xref>), resulting in immune dysregulation with leukocyte infiltration. This triggers intestinal inflammation and a primary immune response in mesenteric lymph nodes, where na&#xef;ve CD4<sup>+</sup> T cells interact with the antigen to differentiate into activated effector cells. The effectors then polarize into any of the different T cell subsets, T helper cell type 1 (Th1), Th2, Th17, or regulatory T cells (Tregs), depending on the microbial challenge (<xref ref-type="bibr" rid="B8">8</xref>). Th1 cells, which are especially seen in CD patients and induced by IL-12, function by producing IFN&#x3b3; and TNF&#x3b1;. On the other hand, UC is thought to have more of a Th2 mediated response, producing IL-4, IL-5, and IL-13. The Th17 subset, also found in IBD patients, is induced by IL-6 production and the cytokine TGF&#x3b2; and plays a role in maintaining commensal microbiota (<xref ref-type="bibr" rid="B9">9</xref>). While the mentioned subsets are classified as pro-inflammatory, Tregs are known for their inhibitory effects and ability to dampen immune responses by producing anti-inflammatory cytokines like IL-10 and expressing the transcription factor Foxp3 (<xref ref-type="bibr" rid="B7">7</xref>). Overall, CD4<sup>+</sup> T cells are strongly associated with IBD pathogenesis (<xref ref-type="bibr" rid="B10">10</xref>), and their cytokine production can cause an imbalance allowing for disease progression (<xref ref-type="bibr" rid="B11">11</xref>).</p>
<p>As mentioned previously, IFN&#x3b3; is upregulated in CD and UC as well as experimental murine colitis (<xref ref-type="bibr" rid="B12">12</xref>) and is thought to be a major driver of the amplified immune response seen in intestinal inflammation. IFN&#x3b3; is produced by several types of immune cells, one of them being T cells. An increased expression of several IFN-regulated genes was observed in many autoimmune diseases (<xref ref-type="bibr" rid="B13">13</xref>). In IBD and experimental Dextran Sulfate Sodium (DSS) colitis, IFN&#x3b3; contributes to vascular barrier disruption, worsening colonic inflammation and increasing intestinal blood vessel permeability which contributes to structural and functional perturbations (<xref ref-type="bibr" rid="B14">14</xref>). Due to the barrier disruption, more luminal antigens are translocated to the lamina propria; thus, exacerbating the immune response. Studies that used endothelial cell-specific IFN&#x3b3; receptor knockout mice with induced DSS colitis showed decreased signs of disease inflammation (<xref ref-type="bibr" rid="B14">14</xref>). Targeting IFN&#x3b3; signaling has been proposed as a potential therapeutic strategy for many autoimmune diseases, though its role in IBD needs further investigation.</p>
<p>In addition to IFN&#x3b3;, the IL-1 superfamily of cytokines is also involved in the pathogenesis of IBD. This superfamily consists of the following cytokines: IL-1&#x3b1;, IL-1&#x3b2;, IL-18, IL-33, and IL-36. Previous studies have explored blocking IL-1 signaling by using Anakinra, a recombinant form of the IL-1 receptor antagonist (IL-1Ra) to inhibit IL-1&#x3b2; activity. Data revealed that Anakinra can alleviate experimental colitis in Winnie-TNF-KO mice. Canakinumab, which targets IL-1&#x3b2; and used to treat several autoimmune diseases, has been found to be effective in treating early onset IBD or older pediatric and adult IBD patients (<xref ref-type="bibr" rid="B15">15</xref>). Given that IL-18 is found in elevated levels in UC patients, a study that used wild type (WT), IL-18<sup>-/-</sup>, and IL-18R<sup>-/-</sup> mice in DSS colitis model found that IFN&#x3b3; production and IL-17 producing CD4<sup>+</sup> T cells were reduced in the colons of both knockout models, along with less severe colitis than WT. Treating these mice with oral IL-18 inhibitor decreased Th1 cells and neutrophils, as well as disease severity (<xref ref-type="bibr" rid="B16">16</xref>). Another study tested the efficacy of a monoclonal anti-mature IL-18 antibody in DSS colitis mice found that it improved acute and chronic DSS colitis, reduced production of IFN&#x3b3; and TNF&#x3b1; and ameliorated the epithelial cell barrier (<xref ref-type="bibr" rid="B17">17</xref>). When tested in combination with anti-TNF&#x3b1;, this regimen significantly reduced body weight loss, ameliorated intestinal inflammation, and decreased leukocyte infiltration, overall improving colitis (<xref ref-type="bibr" rid="B17">17</xref>). IL-33 is also known for its role in intestinal homeostasis, along with its receptor ST2, where their dysregulation has been shown to play a role in IBD pathogenesis, specifically in tissue damage (<xref ref-type="bibr" rid="B18">18</xref>). Studies suggest that IL-33 may have more of a protective role in experimental colitis; IL-33 deficient mice were found to be highly susceptible to colitis. In the 2,4,6-trinitrobenzene sulfonic acid (TNBS) colitis model, some studies found that the administration of recombinant IL-33 ameliorated colitis symptoms, while others showed it attenuated colitis via a Treg driven response. However, IL-33 was also found to play a varying role depending on the stage of the disease (<xref ref-type="bibr" rid="B19">19</xref>).</p>
<p>Finally, the role of the IL-36 cytokine family has been far less explored. This family of cytokines includes three agonists: IL-36&#x3b1;, IL-36&#x3b2;, and IL-36&#x3b3;. These ligands and their receptor, IL-36R, are expressed mostly on epithelial cells, and some of their target cells include IECs and na&#xef;ve CD4<sup>+</sup> T cells (<xref ref-type="bibr" rid="B20">20</xref>, <xref ref-type="bibr" rid="B21">21</xref>). Binding to IL-36R activates nuclear factor kappa B (NF-&#x3ba;B) and mitogen-activated protein kinases (MAPK) (<xref ref-type="bibr" rid="B21">21</xref>), causing inflammation. However, IL-36 cytokines are regulated by their natural inhibitor, IL-36Ra, which inhibits the inflammatory signaling pathway by competing with the IL-36R ligands and inhibiting NF&#x3ba;B activation (<xref ref-type="bibr" rid="B22">22</xref>). IL-36&#x3b1; and IL-36&#x3b3;, specifically, function at barrier tissues, such as the intestines and are pro-inflammatory in IBD. Additionally, IL-36&#x3b1; and IL-36&#x3b3; levels have been found to be elevated in IBD patients and are expressed by IECs, lymphocytes, and macrophages. IL-36 signaling thus promotes inflammation, making IL-36/IL-36R a potential therapeutic target for IBD. Spesolimab, a humanized monoclonal antibody that targets the IL-36 pathway is currently FDA approved for the treatment of autoimmune diseases, such as generalized pustular psoriasis, and has been tested in patients with moderate to severe UC in phase 2 studies to evaluate its safety, efficacy, and mechanism of action. While it was generally well-tolerated by patients, efficacy endpoints were not met (<xref ref-type="bibr" rid="B23">23</xref>).</p>
<p>Although significant progress has been made towards managing IBD, understanding the role of IL-36 cytokine family in IBD pathogenesis is crucial since the antagonist IL-36&#x3b3; is elevated in human IBD and experimental colitis, as well as other inflammatory diseases. While anti-TNF&#x3b1; therapy can induce clinical remission in CD patients (<xref ref-type="bibr" rid="B24">24</xref>), the disease ends up relapsing in more than 60% of patients (<xref ref-type="bibr" rid="B25">25</xref>, <xref ref-type="bibr" rid="B26">26</xref>). Cytokine blockers and immunomodulators have recently been developed to treat intestinal inflammation. However, patients can still go into clinical relapse. Therefore, evaluation of IL-36/IL-36R signaling in T cell-mediated colitis will further narrow down therapeutic targets for intestinal inflammation. Further, the IL-36/IFN&#x3b3; pathway has not been assessed in the adoptive transfer model of colitis.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<title>Materials and methods</title>
<sec id="s2_1">
<title>Mice</title>
<p>The following mice were obtained from the Jackson Laboratory: Wild-type C57BL/6J (B6 WT), B6.129S7-<italic>Rag1<sup>tm1Mom</sup>
</italic>/J (Rag<sup>-/-</sup>), and B6.129S7-<italic>Ifng<sup>tm1Ts</sup>
</italic>/J (IFN&#x3b3;<sup>-/-</sup>). Breeder B6 and Rag<sup>-/-</sup> mice were purchased and subsequently bred at Georgia State University Division of Animal Resources. All animal procedures were performed according to the Guide for the Care of Use of Laboratory Animals, under <italic>institutional animal care and use committee</italic> (IACUC) guidelines. All mice involved in experimental procedures were eight to twelve weeks old, both females and males.</p>
</sec>
<sec id="s2_2">
<title>Cell culture and supernatant harvesting for ELISA</title>
<p>Spleens and lymph nodes were collected from eight-week-old WT and IFN&#x3b3;<sup>-/-</sup> mice, both females and males. These organs were processed into cell suspensions. Splenocytes were resuspended in Ammonium-Chloride-Potassium (ACK) buffer for five minutes to lyse erythrocytes then washed once with PBS. Cells from splenocytes and lymph nodes were combined together to isolate na&#xef;ve CD4<sup>+</sup> T cells via EasySep&#x2122; Mouse Na&#xef;ve CD4<sup>+</sup> T Cell Isolation Kit (Stemcell). The enriched cells were checked for purity by staining for CD4, CD45RB, and CD25. The desired population was CD4<sup>+</sup> CD45RB<sup>hi</sup> CD25<sup>-</sup>. These cells were resuspended in complete medium.</p>
<p>For cell culture, 96-well flat bottom plates were coated with 5 &#x3bc;g/mL &#x3b1;CD3 (BioLegend) and 1 &#x3bc;g/mL &#x3b1;CD28 (BioLegend) and left overnight at 4&#xb0;C for maximum binding. The plate was washed three times with PBS the next day. Na&#xef;ve CD4<sup>+</sup> T cells were plated at 200,000 cells per well, in the presence or absence of IL-36&#x3b1;, IL-36&#x3b2;, and IL-36&#x3b3; (R&amp;D Systems) at a concentration of 100 ng/mL. In the latter experiments, IFN&#x3b3; neutralizing antibody (referred to as &#x3b1;IFN&#x3b3;; clone XMG.1; Thermofisher) was used at a concentration of 2 &#x3bc;g/mL. The plate was then placed in the incubator for 48 hours at 37&#xb0;C.</p>
<p>To harvest supernatant, the 96-well culture plate was spun down at 500 x g for 5 minutes at 4&#xb0;C. The supernatant was aspirated into 1.5 mL Eppendorf tubes and stored at -80&#xb0;C for long-term use. IFN&#x3b3; and TNF&#x3b1; ELISA kits were obtained from Invitrogen and performed according to the manufacturer&#x2019;s protocol.</p>
</sec>
<sec id="s2_3">
<title>Adoptive T cell transfer colitis model</title>
<p>Splenocytes and lymph node cells were harvested from eight-week-old WT and IFN&#x3b3;<sup>-/-</sup> mice, both females and males. Cells were processed and enriched for na&#xef;ve CD4<sup>+</sup> T cell (CD4<sup>+</sup> CD45RB<sup>hi</sup> CD25<sup>-</sup>), as described above.</p>
<p>After enrichment/sorting, cells were checked for purity. This was done by staining for CD4, CD45RB, and CD25. The desired population was CD4<sup>+</sup> CD45RB<sup>hi</sup> CD25<sup>-</sup>. Cells were later resuspended in phosphate buffered saline (PBS) at a concentration of 2.5 x 10<sup>6</sup> cells/mL. 500,000 cells were transferred into each Rag<sup>-/-</sup> mouse via intraperitoneal (IP) injection. Colitis then developed between ten to twelve weeks. Activity, body weight, and stool consistency were recorded weekly for all mice, until euthanasia. Activity was assessed and measured based on changes in behavior, physical activity (e.g lethargy, running around cage, and resistance when trying to scruff), and time in active exploration and social interactions. Stool consistency was based on the physical stool texture, specifically solid pellets, loose/soft stool, or watery diarrhea.</p>
</sec>
<sec id="s2_4">
<title>Hematoxylin and eosin staining and histological score evaluation</title>
<p>At the end of the experiment, colons were harvested from all mice. After removal of fecal matter, pieces of colonic tissue were fixed in 10% formalin at room temperature. Paraffin embedding, sectioning, and H&amp;E staining was performed by HistoWiz. An individual histological score (ranging from 0 to 4) was attributed for degree of inflammation and immune cell infiltration using a scale of colonic inflammation (<xref ref-type="bibr" rid="B27">27</xref>) as a result of cytokine imbalance, as such 0= no infiltrate/inflammation, 1=minimal mucosal infiltrate and minimal hyperplasia, 2= mild mucosal infiltrate with mild hyperplasia and some erosions, 3= moderate mucosal and submucosal infiltrate with moderate hyperplasia and goblet cells loss with some crypt abscesses, 4= marked mucosal and submucosal infiltrate with marked hyperplasia and multiple crypt abscesses.</p>
</sec>
<sec id="s2_5">
<title>Quantification of fecal lipocalin (LCN2) by ELISA</title>
<p>Fecal pellets were collected from mice during the course of disease and frozen at -80&#xb0;C. To harvest fecal supernatants, the frozen fecal samples were resuspended in PBS at a concentration of 100 mg/mL and left at 4&#xb0;C overnight to allow the feces to soften. The next day these samples were homogenized for 1 minute and then centrifuged at maximum speed for 15 minutes at 4&#xb0;C. The supernatant was aliquoted and frozen at -80&#xb0;C.</p>
<p>To analyze LCN2 levels, Mouse Lipocalin-2/NGAL DuoSet ELISA kit by R&amp;D Systems was used and followed according to the manufacturer&#x2019;s protocol. Fecal supernatants were diluted with reagent diluent to fit under the standard curve.</p>
</sec>
<sec id="s2_6">
<title>Intracellular cytokine staining</title>
<p>At the end of the study, colons, spleens, and mesenteric lymph nodes were harvested. To process colon tissue, the tissue was cut for easier cleaning of the feces. Tissue was continuously washed in PBS. The colon tissue was pre-digested in HBSS and 2 mM of EDTA at 37&#xb0;C by shaking for 15 minutes at 150 x g. Then, the colon was cleaned of mucus using a tissue paper and flushed again with PBS. A second HBSS and 2 mM EDTA shaking step was performed as described above. After cleaning the tissue of mucus and flushing with PBS, enzymatic digestion of tissue pieces was done with 1 mg/ml of collagenase type IV and 40 &#x3bc;g/ml of DNAse I and shaking for 30 minutes at 150 x g. The cell suspension was then centrifuged and filtered by running the cell suspension through glass wool.</p>
<p>Spleens were processed as mentioned previously and by lysing erythrocytes with ACK buffer for 5 minutes and washing with PBS. Mesenteric lymph nodes were processed the same way, without the need to lyse for erythrocytes.</p>
<p>The final cell suspensions were resuspended in complete medium. Desired cells were plated in a tissue culture plate to be stimulated for cytokine production. 50 ng/mL phorbol myristate acetate (PMA), 1 &#x3bc;g/mL ionomycin, 1:1000 Brefeldin A, and 1:1000 monensin were added to each well and placed in the incubator at 37&#xb0;C for 4 hours. The cells were then centrifuged and stained with 1:1000 Live/Dead dye for 5 minutes at room temperature. After a PBS wash, the cells were stained for CD4, CD44, and Ly6G for 20 minutes in the dark. The cells were centrifuged again and washed with PBS, then fixed by resuspending the cell in Fixation/Permeabilization Solution for 20&#x2013;30 minutes in the dark at room temperature. The cells were centrifuged and washed in PBS, then stained for cytokines for 20&#x2013;30 minutes in the dark at room temperature. TNF&#x3b1; fluorochrome antibodies were diluted in Permeabilization buffer. The cells were later washed with PBS once and resuspended again in PBS for flow cytometry. Compensation was performed using single-stained cells to account for fluorescence spillover between fluorophores. Additionally, unstimulated samples were included as negative and gating controls for measuring TFN&#x3b1; production. These data were analyzed on Flowjo.</p>
</sec>
<sec id="s2_7">
<title>Statistical analysis</title>
<p>All statistical analyses were performed with GraphPad Prism software, version 9.0 (Graphpad Software). When 2 conditions were present, a t-test (parametric) was performed. If parametric one-way ANOVA for 3 or more groups was performed, normality assumption was met. One-way ANOVA and Tukey&#x2019;s Multiple Comparison Test or Student&#x2019;s t test were used to determine significance. *p &lt; 0.05, **p &lt; 0.01, ***p &lt; 0.001; ****p &lt;0.0001; n.s.= not significant.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<title>Results</title>
<sec id="s3_1">
<title>IL-36<italic>&#x3b3;</italic> increases na&#xef;ve CD4<sup>+</sup> T cell proliferation, clustering, and IFN<italic>&#x3b3;</italic> production <italic>in vitro</italic>
</title>
<p>Previous studies in mice have shown that IL-36&#x3b2; can increase na&#xef;ve CD4<sup>+</sup> T cell proliferation and induce pro-inflammatory cytokine production and Th1 polarization (<xref ref-type="bibr" rid="B22">22</xref>). Given this, we investigated the influence of the three IL-36 ligands, IL-36&#x3b1;, IL-36&#x3b2;, and IL-36&#x3b3;, on na&#xef;ve CD4<sup>+</sup> T cells. To do so, splenocytes were harvested from WT B6 mice, and na&#xef;ve CD4<sup>+</sup> T cells were isolated. These cells were stimulated with &#x3b1;CD3/&#x3b1;CD28 for 48 hours in the presence or absence of the IL-36 ligands. As a negative control, some cells were left unstimulated. Cells were enumerated 48 hours following culture and supernatant was collected to test for IFN&#x3b3; production. We observed an increase in cell numbers that were cultured in the presence of IL-36 ligands, especially in cultures that were stimulated with IL-36&#x3b3; (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1A</bold>
</xref>). As the same number of cells were plated in each group and no difference in cell death was observed, the increase in cell number in IL-36&#x3b3;-stimulated cultures was likely not due to a survival effect (data not shown). To further assess cell activation, we checked for the activation marker CD44 by flow cytometry and observed a robust increase in CD44 expression on the highly activated IL-36&#x3b3;-stimulated cells (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1B</bold>
</xref>). Moreover, cells stimulated in the presence of IL-36&#x3b3; demonstrated a significant induction of the Th1 cytokine, IFN&#x3b3;, (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1C</bold>
</xref>) compared to the control samples (cells stimulated with &#x3b1;CD3/&#x3b1;CD28).</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>IL-36&#x3b3; increases na&#xef;ve CD4+ T cell proliferation, clustering, and IFN&#x3b3; production <italic>In Vitro</italic>. Naive CD4+ T cells were isolated from splenocytes and were stimulated on a pre-coated plate with &#x3b1;CD3/&#x3b1;CD28 in the presence of IL-36&#x3b1;, IL-36&#x3b2;, or IL-36&#x3b3;. Some cells were left unstimulated as a control. These data were collected at 48 hours. <bold>(A)</bold> Cells were counted under a hemocytometer using Trypan Blue. <bold>(B)</bold> The expression of the activation marker CD44 was evaluated after 48 hours, which was found to be highly expressed on cells stimulated with IL-36&#x3b3;. <bold>(C)</bold> Supernatants from these cultures were checked for the pro-inflammatory cytokine IFN&#x3b3; by ELISA. All data are presented as mean &#xb1; SEM; p &lt; 0.05, **p &lt; 0.01, ***p &lt; 0.001; ****p &lt;0.0001; n.s., not significant, one-way ANOVA with Tukey&#x2019;s multiple comparison test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1604332-g001.tif">
<alt-text content-type="machine-generated">Bar and flow cytometry plots showing the effects of various treatments on cell count and IFN&#x3b3; production. (A) Bar graph comparing total cell counts under different conditions, showing significant differences denoted by asterisks. (B) Flow cytometry plots displaying CD44 and CD4 expressions with unstimulated, control, and IL36&#x3b3; treatments. (C) Bar graph showing IFN&#x3b3; levels under the mentioned conditions, with IL-36&#x3b3; resulting in the highest levels, also indicating significance through asterisks. </alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_2">
<title>Transfer of IL-36<italic>&#x3b3;</italic> stimulated na&#xef;ve CD4<sup>+</sup> T cells into Rag<sup>-/-</sup> mice exacerbates T cell-mediated colitis</title>
<p>Next, we evaluated the impact of IL-36&#x3b3;-induced IFN&#x3b3; secretion using the T cell-mediated colitis model. CD4<sup>+</sup> T cells activated in the presence or absence of IL-36&#x3b3; were transferred into Rag<sup>-/-</sup> mice. Unstimulated na&#xef;ve CD4<sup>+</sup> T cells were transferred into Rag<sup>-/-</sup> mice as a control. Weight, activity, stool consistency, and fecal lipocalin (LCN2) levels were monitored over 10 weeks. Mice transferred with IL-36&#x3b3;-activated CD4<sup>+</sup> T cells appeared far less active than counterparts that received unstimulated cells. Recipients of IL-36&#x3b3;-activated CD4<sup>+</sup> T cells also exhibited softer stool consistency and secreted the highest levels of fecal LCN2 (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2A</bold>
</xref>). At 10 weeks post transfer, all mice were euthanized, and their spleens and colons were harvested for downstream analysis. Colons from the IL-36&#x3b3; group were shorter in length than the other two groups and appeared more thickened and inflamed (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2B</bold>
</xref>). The group that received the WT unstimulated cells and anti-CD3/CD28 stimulated cells had colons that measured around 7.5&#x2013;8 cm, while the colon of mice that received IL-36&#x3b3;-stimulated CD4<sup>+</sup> T cells measured around 6.5 cm (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2C</bold>
</xref>). Moreover, colons from the unstimulated group had well-formed solid fecal pellets, while the stool was of a much softer consistency in the other two groups, especially in the group that was treated with IL-36&#x3b3;-stimulated CD4<sup>+</sup> T cells (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2B</bold>
</xref>), which turned into diarrhea 7 weeks post transfer. The recipients of IL-36&#x3b3;-stimulated CD4<sup>+</sup> T cells also harbored a visibly enlarged spleen (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2D</bold>
</xref>). Corroborating this, the total number of splenocytes of recipients of the IL-36-stimulated CD4<sup>+</sup> T cells were increased in comparison to the other groups (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2E</bold>
</xref>). Further, H&amp;E staining revealed robust leukocyte infiltration in this group (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2F</bold>
</xref>), and therefore, the highest histological score (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2G</bold>
</xref>).</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>Transfer of IL-36<italic>&#x3b3;</italic> stimulated na&#xef;ve CD4<sup>+</sup> T cells into rag<sup>-/-</sup> mice exacerbates T cell-mediated colitis. <bold>(A)</bold> Lipocalin 2 (LCN2), a colitis inflammatory biomarker, was measured by enzyme-linked immunosorbent assay (ELISA) from fecal samples at time of sacrifice from mice that were adoptively transferred with unstimulated na&#xef;ve CD4+ T cells or na&#xef;ve CD4+ T cells stimulated with &#x3b1;CD3 +/- IL-36&#x3b3;. <bold>(B, C)</bold> Images of colons and a comparison of their lengths, respectively, collected from the mice, upon euthanasia, show a shorter colon length, along with thickened tissue in mice that received na&#xef;ve CD4+ T cells stimulated with IL-36&#x3b3;. <bold>(D, E)</bold> Images of spleens after mice were euthanized at 10 weeks show splenomegaly and elevate splenocyte number in mice that received IL-36&#x3b3; stimulated naive CD4<sup>+</sup>. <bold>(F)</bold> The H&amp;E staining of colon sections from the mice groups mentioned is shown. <bold>(G)</bold> Histology scoring of colon sections from mice that were treated as mentioned. All data are presented as mean &#xb1; SEM; *p &lt; 0.05, **p &lt; 0.01, ***p &lt; 0.001; ****p &lt;0.0001; n.s., not significant, one-way ANOVA with Tukey&#x2019;s multiple comparison test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1604332-g002.tif">
<alt-text content-type="machine-generated">Composite image displaying experimental results in mice. Graph (A) shows fecal LCN2 levels for WT unstimulated, CD3 stimulated, and Il-36g treated groups, with significant differences noted. Photograph (B) depicts colons from the groups. Graph (C) illustrates colon lengths across treatments, with statistical significance indicated. Image (D) shows spleens from each treatment group. Graph (E) presents splenocyte counts, highlighting significant differences. Panel (F) provides histological sections of colons with varying treatments. Graph (G) reports histological scores, showing significant differences among groups.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_3">
<title>IL-36g-induced TNF<italic>&#x3b1;</italic> production by na&#xef;ve CD4<sup>+</sup> T cells is IFN&#x3b3; dependent</title>
<p>To test the link between IL-36&#x3b3; and IFN&#x3b3;, we carried out a similar <italic>in vitro</italic> experiment using naive CD4<sup>+</sup> T cells and an IFN&#x3b3; neutralizing antibody (&#x3b1;IFN&#x3b3;). The cells were stimulated with &#x3b1;CD3/&#x3b1;CD28 and IL-36&#x3b3; in the presence of &#x3b1;IFN&#x3b3; or an isotype control antibody. As an additional control, some cells were stimulated without IL-36&#x3b3; but received the isotype control antibody. After 48 hours, the cells were counted. We observed a higher cell number in IL-36&#x3b3; stimulated samples, compared to the samples that only received the isotype control antibody (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>). TNF&#x3b1; was also measured via ELISA. While IL-36&#x3b3; induced TNF&#x3b1; production by naive CD4<sup>+</sup> T cells, neutralizing IFN&#x3b3; reduced its secretion (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3B</bold>
</xref>). This suggests that IFN&#x3b3; is a key intermediary in IL-36&#x3b3;-induced TNF&#x3b1; production in CD4<sup>+</sup> T cells.</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>IL-36g-induced TNF<italic>&#x3b1;</italic> production by na&#xef;ve CD4<sup>+</sup> T cells is IFN&#x3b3; dependent. <bold>(A)</bold> Cell number of naive CD4+ T cells stimulated with &#x3b1;CD3/&#x3b1;CD28 +IL-36&#x3b3;, either with &#x3b1;IFN&#x3b3; or an isotype antibody at 48 hours. As a control, some cells were stimulated but only received the isotype. <bold>(B)</bold> TNF&#x3b1; concentrations evaluated by ELISA. All data are presented as mean &#xb1; SEM; ***p &lt; 0.001; ****p &lt;0.0001; n.s., not significant, one-way ANOVA with Tukey&#x2019;s multiple comparison test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1604332-g003.tif">
<alt-text content-type="machine-generated">Composite image displaying experimental results in mice. Graph (A) shows fecal LCN2 levels for WT unstimulated, CD3 stimulated, and Il-36g treated groups, with significant differences noted. Photograph (B) depicts colons from the groups. Graph (C) illustrates colon lengths across treatments, with statistical significance indicated. Image (D) shows spleens from each treatment group. Graph (E) presents splenocyte counts, highlighting significant differences. Panel (F) provides histological sections of colons with varying treatments. Graph (G) reports histological scores, showing significant differences among groups.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3_4">
<title>IL-36g induces robust colitis via the secretion of IFN<italic>&#x3b3;</italic> by CD4<sup>+</sup> T cells</title>
<p>Next, we examined the influence of IL-36&#x3b3; on IFN&#x3b3;-dependent intestinal inflammation by transferring IL-36&#x3b3;-stimulated IFN&#x3b3;<sup>-/-</sup> na&#xef;ve CD4<sup>+</sup> T cells into Rag<sup>-/-</sup> mice. Prior to the transfer, na&#xef;ve WT or IFN&#x3b3;<sup>-/-</sup> CD4<sup>+</sup> T cells were stimulated with &#x3b1;CD3/&#x3b1;CD28 <italic>in vitro</italic> in the presence or absence of IL-36&#x3b3; (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4A</bold>
</xref>). The mice were monitored over 10 weeks for their activity, weight, stool consistency, and LCN2 levels. Over time, mice transferred with WT cells +/- IL-36&#x3b3; became less active and physically weaker. On the other hand, the mice that received IFN&#x3b3;<sup>-/-</sup> cells, in the presence or absence of IL-36&#x3b3;, remained active. Mice that received WT + IL-36&#x3b3; cells lost the most weight, followed by the WT group (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4B</bold>
</xref>). On the other hand, mice that received IL-36&#x3b3;-stimulated IFN&#x3b3;<sup>-/-</sup> cells had minimal weight loss similar to recipients of IFN&#x3b3;<sup>-/-</sup> cells (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4B</bold>
</xref>). Ten weeks post transfer, mice were euthanized, and their colons and spleens were harvested for further analysis. Colons isolated from recipients of WT CD4<sup>+</sup> T cells were noticeably shorter in length, especially WT + IL-36&#x3b3;, when compared to the IFN&#x3b3;<sup>-/-</sup> recipients (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4C, D</bold>
</xref>). Accompanying the shorter colons was splenomegaly (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4E</bold>
</xref>), which is also reflected in splenocyte number (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4F</bold>
</xref>). Stool samples were checked for LCN2 levels. Consistent with the weight loss data, the WT + IL-36&#x3b3; group had the highest LCN2 concentrations (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4G</bold>
</xref>). Unexpectedly, recipients of IL-36&#x3b3;-stimulated IFN&#x3b3;<sup>-/-</sup> cells exhibited elevated levels of LCN2 even though they had minimal weight loss (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4B, G</bold>
</xref>). The other two groups, recipients of WT and IFN&#x3b3;<sup>-/-</sup> CD4<sup>+</sup> T cells, had low levels of fecal LCN2 (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4G</bold>
</xref>). H&amp;E staining further detailed a thickening of the submucosa and leukocyte infiltration predominantly in the WT + IL-36&#x3b3; colons when compared to the other groups (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4H</bold>
</xref>). The same colon tissue was stained for CD4 using immunohistochemistry, where both groups (WT + IL-36&#x3b3; and IFN&#x3b3;<sup>-/-</sup> + IL-36&#x3b3;) had the most CD4 infiltration (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4I</bold>
</xref>). Overall, colons isolated from WT + IL-36&#x3b3; had the highest histological scores (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4J</bold>
</xref>). Corroborating this, when IFN&#x3b3;<sup>-/-</sup> na&#xef;ve CD4<sup>+</sup> T cells were transferred to Rag<sup>-/-</sup> mice to assess intestinal inflammation, we observed a reduction in TNF&#x3b1; levels in mesenteric lymph nodes using ICCS (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4K</bold>
</xref>).</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>IL-36g induces robust colitis via the secretion of IFN<italic>&#x3b3;</italic> by CD4<sup>+</sup> T cells. <bold>(A)</bold> Diagram showing the adoptive transfer model using donor IFN&#x3b3;-/- mice as donors and Rag-/- recipients. Naive CD4+ T cells are isolated and stimulated <italic>in vitro</italic> in the presence or absence of IL-36&#x3b3; for 48 hours prior to the transfer. <bold>(B)</bold> Weight of the recipient mice was monitored during the time of the experiment over the course of 10 weeks. <bold>(C)</bold> Image of the harvested colons show that mice that received cells stimulated with IL-36&#x3b3; cause the most inflammation to the colon, making it the shortest in length <bold>(D)</bold>. <bold>(E, F)</bold> Images of the harvested spleen show an enlarged spleen for the WT+IL-36&#x3b3; group, with elevated splenocyte count. <bold>(G)</bold> Levels of fecal LCN2 levels were evaluated at time of euthanasia by ELISA. <bold>(H)</bold> H&amp;E staining of colon sections from mice that received WT or IFN&#x3b3;-/- na&#xef;ve CD4+ T cells, in the presence or absence of IL-36&#x3b3;. <bold>(I)</bold> Immunohistochemistry staining for CD4, of the same colonic tissue samples. <bold>(J)</bold> Histology scoring of colon sections from the same mice. <bold>(K)</bold> After euthanasia and tissue collection, TNF&#x3b1; production in the mesenteric lymph nodes was evaluated by ICCS. All data are presented as mean &#xb1; SEM; *p &lt; 0.05, **p &lt; 0.01, ***p &lt; 0.001; ****p &lt;0.0001; n.s., not significant, one-way ANOVA with Tukey&#x2019;s multiple comparison test.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1604332-g004.tif">
<alt-text content-type="machine-generated">(A) Diagram showing experimental setup with mice used for a study involving CD4+ T cells and cytokines. (B) Line graph of body weight changes over ten weeks in four groups of mice: WT, WT with IL-36&#x3b3;, IFN&#x3b3;-/-, and IFN&#x3b3;-/- with IL-36&#x3b3;. (C) Image comparing colons from each group. (D) Bar graph showing colon length differences. (E) Spleen comparison between groups. (F) Bar graph comparing splenocyte counts. (G) Bar graph of fecal LCN2 levels. (H, I) Histology and immunochemistry images of colon sections from each group. (J) Bar graph summarizing histological scores. (K) Bar graph showing CD4+ TNF&#x3b1;+ cell percentages.</alt-text>
</graphic>
</fig>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<title>Discussion</title>
<p>IL-36 signaling is known for promoting inflammatory signaling in the skin, lungs, kidneys, and intestinal inflammation during IBD and experimental colitis. In IBD, IL-36 ligands (IL-36&#x3b1;, IL-36&#x3b2;, and IL-36&#x3b3;) are expressed by gut lymphocytes, macrophages, and intestinal epithelial cells. The activation of the IL-36 receptor induces NF-kB and MAPK in a MYD88 dependent manner, which induces other pro-inflammatory pathways by target cells in the colon.</p>
<p>When it comes to IL-36&#x3b3; signaling, some studies show a pathogenic role, while other studies found that IL-36&#x3b3; can aid in healing of the disease. A previous study from our lab suggested a protective role for IL-36&#x3b3; in the DSS colitis model by helping in barrier restoration (<xref ref-type="bibr" rid="B28">28</xref>); however, using an oxazolone model, a pathogenic role for the cytokine has also been observed (<xref ref-type="bibr" rid="B29">29</xref>). The discrepancy in these data may be due to differences in the chemical used to induce colitis. Moreover, as chemical agents are used to promote colitis in the DSS and oxazolone model systems, it is unclear whether the observed role of IL-36&#x3b3; in each system is specific to the model or a &#x201c;double-edged sword&#x201d; role of IL-36 g in colitis in general. Since IBD is heavily mediated by T cell responses, and IL-36 cytokines are known to promote the recruitment of T cells (<xref ref-type="bibr" rid="B30">30</xref>) and induce the secretion of other pro-inflammatory cytokines (<xref ref-type="bibr" rid="B31">31</xref>), we investigated the influence of IL-36&#x3b3; on na&#xef;ve CD4<sup>+</sup> T cells and colitis using a well-known adoptive T cell transfer model of colitis (<xref ref-type="bibr" rid="B10">10</xref>).</p>
<p>Our results demonstrate that stimulating na&#xef;ve CD4<sup>+</sup> T cells with IL-36&#x3b3; significantly induced cell expansion <italic>in vitro</italic> and colitis <italic>in vivo</italic>. This could be due to IL-36&#x3b3; providing survival signals, enhancing proliferation, or both. While deciphering between these scenarios is outside the scope of the current study, the data demonstrating no difference in cell death (data not shown) suggest that IL-36&#x3b3; works by enhancing the proliferative capacity of CD4<sup>+</sup> T cells by increases CD4<sup>+</sup> T cell numbers. Accompanying IL-36&#x3b3; stimulation of CD4<sup>+</sup> T cells was notable expression and production of the Th1 pro-inflammatory cytokine IFN&#x3b3; by na&#xef;ve CD4<sup>+</sup> T cells compared with the other IL-36 family members (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1</bold>
</xref>). This was expected, as previous studies showed IL-36 cytokines induce the production of IFN&#x3b3; (<xref ref-type="bibr" rid="B32">32</xref>, <xref ref-type="bibr" rid="B33">33</xref>). This IL-36&#x3b3; -induced IFN&#x3b3; was responsible, at least in part, for the ability of IL-36&#x3b3; to drive robust colitis induction. Despite the previously reported studies, which highlight the highest IFN&#x3b3; production by na&#xef;ve CD4<sup>+</sup> T cells when stimulated with IL-36&#x3b2; (<xref ref-type="bibr" rid="B30">30</xref>), T cell exhaustion may have occurred due to higher concentrations of the costimulatory molecules, &#x3b1;CD3/&#x3b1;CD28 (<xref ref-type="bibr" rid="B34">34</xref>) in addition to IL-36&#x3b2; which caused a decrease in IFN&#x3b3; production. Further, IFN&#x3b3; was identified as an upstream mediator of IL-36&#x3b3;-induced TNF&#x3b1; production <italic>in vitro</italic>, and potentially <italic>in vivo</italic>.</p>
<p>We evaluated the relationship between IL-36 cytokines and IFN&#x3b3; by neutralizing IFN&#x3b3; <italic>in vitro</italic> in the presence of these cytokines. Our data suggests that blocking IFN&#x3b3; can suppress the expression and secretion of the pro-inflammatory cytokine TNF&#x3b1;. When na&#xef;ve CD4<sup>+</sup> T cells were stimulated with IL-36&#x3b3; and transferred into Rag<sup>-/-</sup> mice, the mice lost weight, developed loose stool consistency over time, and had the highest fecal LCN2 levels. The mice in this group also became visibly weaker over time. They appeared to be less motivated to explore and engage in social interactions. The colon was also notably shorter in length and had thicker tissue. IFN&#x3b3;<sup>-/-</sup> na&#xef;ve CD4<sup>+</sup> T cells were also stimulated with IL-36&#x3b3; and transferred into Rag<sup>-/-</sup> mice. Despite their elevated fecal LCN2 levels, weight loss was not significantly different in mice that received IFN&#x3b3;-/- na&#xef;ve CD4<sup>+</sup> T cells stimulated with IL-36&#x3b3;. However, they did not lose a significant amount of weight. Their colons were longer, and they had mild levels of fecal LCN2. This suggests that IL-36&#x3b3; drives IFN&#x3b3;-dependent T cell mediated colitis.</p>
<p>Based on the available pre-clinical studies on pro-inflammatory cytokines in the T cell mediated colitis model, understanding the role of IL-36&#x3b3; in intestinal inflammation will highlight new therapeutic approaches. While we employed a model for <italic>in vitro</italic> stimulation of CD4<sup>+</sup> T cells with IL-36&#x3b3;, it is likely that during intestinal inflammation, IL-36&#x3b3; is induced by microbiota-dependent stimulation of macrophages or other innate immune cells following barrier disruption. In turn, this leads to CD4<sup>+</sup> T cell activation and differentiation into Th1 and/or pathogenic T cells that produce IFN&#x3b3; and other pro-inflammatory cytokines.</p>
<p>Similar to the findings by Powrie et&#xa0;al., we also found that the role of IFN&#x3b3; is significant in developing intestinal inflammation and colitis, especially in the adoptive transfer model. However, we acknowledge that our adoptive transfer of freshly isolated naive CD4<sup>+</sup> T cells demonstrates milder disease severity than reported in the literature. Outside the scope of the current study, we predict the observed discrepancy in disease severity despite using a similar model system likely due to environmental differences. It is well established that the trajectory and severity of colitis in mice is dependent on the facility in each the mice are housed. Moreover, freshly isolated naive CD4<sup>+</sup> T cells were mock-stimulated <italic>in vitro</italic> prior to transfer to control for the <italic>in vitro</italic> conditions mentioned. Nevertheless, our study presents novelty in the adoptive transfer model described here, highlighted through the stimulation of na&#xef;ve CD4+ T cells <italic>in vitro</italic> before transferring them to the immunocompromised mice.</p>
<p>In conclusion, our results demonstrate a potential for IL-36&#x3b3; and IFN&#x3b3; to be mutually targeted as therapeutics to alleviate colitis symptoms and perhaps prevent IBD, in the long run. Most of the available research targets downstream drivers of IBD, which narrows down the focus to specific molecules or pathways. Such downstream targets include TNF&#x3b1;, the IL-12/IL-23 axis, IL-23/IL-17 axis, JAK inhibitors, integrins and receptor modulators (<xref ref-type="bibr" rid="B35">35</xref>). Some antibodies and biological therapies were developed to interfere with the function of these molecules and pathways, such as Anti-TNF therapy, anti-IL-12/23, anti-integrins, and JAK inhibitors- which have been approved for treating UC or CD. Although this wide variety of therapeutics has improved some patients&#x2019; lives, they are not universally effective. Moreover, many patients lose responsiveness to therapy over time (<xref ref-type="bibr" rid="B36">36</xref>). Previous studies investigated the impact of blocking IL-36 signaling by administering neutralizing monoclonal antibodies or the receptor antagonist IL-36Ra. A humanized monoclonal antibody developed to block IL-36R signaling called Spesolimab, was used in patients with moderate to severe UC. It was well-tolerated by UC patients, although, the efficacy endpoints were not reached, despite it being FDA approved for general pustular psoriasis flares. Alternatively, the administration of IL-36Ra to inhibit the IL-36R signaling pathway in a colon cancer mouse model showed a reduction in tumor cell proliferation. This is consistent with a previous <italic>in vivo</italic> study that showed increased incidence of colon tumorigenesis in the absence of IL-36Ra (<xref ref-type="bibr" rid="B37">37</xref>). These results suggest that targeting upstream drivers, such as IL-36 cytokines, may have better therapeutic effects during intestinal inflammation, as it would target downstream cytokines, such as TNF&#x3b1; and IFN&#x3b3;.</p>
</sec>
</body>
<back>
<sec id="s5" sec-type="data-availability">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding author.</p>
</sec>
<sec id="s6" sec-type="ethics-statement">
<title>Ethics statement</title>
<p>The animal study was approved by Georgia State University IACUC. The study was conducted in accordance with the local legislation and institutional requirements.</p>
</sec>
<sec id="s7" sec-type="author-contributions">
<title>Author contributions</title>
<p>MM: Conceptualization, Data curation, Formal Analysis, Investigation, Methodology, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. MK: Data curation, Supervision, Writing &#x2013; review &amp; editing. TD: Conceptualization, Formal Analysis, Funding acquisition, Resources, Supervision, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing.</p>
</sec>
<sec id="s8" sec-type="funding-information">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research and/or publication of this article. This work was supported by NIH Grant 1R01DK120907 (to TD).</p>
</sec>
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<title>Conflict of interest</title>
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