Extracellular cold-inducible RNA-binding protein (eCIRP) is a damage-associated molecular pattern, whose effect on macrophages is not entirely elucidated. Here we identified that eCIRP promotes macrophage endotoxin tolerance. Septic mice had higher serum levels of eCIRP; this was associated with a reduced ex vivo immune response of their splenocytes to LPS. Pretreatment of macrophages with recombinant murine (rm) CIRP resulted in a tolerance to LPS stimulation as demonstrated by a significant reduction of TNF-α production. We found that eCIRP increased phosphorylation of STAT3 (pSTAT3) in macrophages. A STAT3 inhibitor, Stattic, rescued macrophages from rmCIRP-induced tolerance by restoring the release of TNF-α in response to LPS stimulation. We discovered strong binding affinity between eCIRP and IL-6R as revealed by Biacore, FRET, and their co-localization in macrophages by immunostaining assays. Blockade of IL-6R with its neutralizing Ab significantly inhibited eCIRP-induced pSTAT3 and restored LPS-stimulated TNF-α release in macrophages. Incubation of macrophages with rmCIRP skewed them towards a M2 phenotype, while treatment with anti-IL-6R Ab prevented rmCIRP-induced M2 polarization. Thus, we have demonstrated that eCIRP activates pSTAT3 via a novel receptor IL-6R to promote macrophage endotoxin tolerance. Targeting eCIRP appears to be a new therapeutic option to correct immune-tolerance in sepsis.
Mian Zhou, Monowar Aziz, Naomi-Liza Denning, Hao-Ting Yen, Gaifeng Ma, Ping Wang