Proton-pump inhibitors (PPI), e.g., omeprazole or pantoprazole, are the most widely used drugs for various gastrointestinal diseases. However, more and more side effects, especially an increased risk of infections, have been reported in recent years. The underlying mechanism has still not yet been fully uncovered. Hence, in this study, we analyzed the T cell response after treatment with pantoprazole in vitro. Pantoprazole preincubation reduced the production and secretion of interferon (IFN)-γ and interleukin (IL)-2 after the T cells were activated with phytohemagglutinin (PHA)-L or toxic shock syndrome toxin-1 (TSST-1). Moreover, a lower zinc concentration in the cytoplasm and a higher concentration in the lysosomes were observed in the pantoprazole-treated group compared to the untreated group. We also tested the expression of the zinc transporter Zrt- and Irt-like protein (Zip)8, which is located in the lysosomal membrane and plays a key role in regulating intracellular zinc distribution after T cell activation. Pantoprazole reduced the expression of Zip8. Furthermore, we measured the expression of cAMP-responsive element modulator (CREM) α, which directly suppresses the expression of IL-2, and the expression of the phosphorylated cAMP response element-binding protein (pCREB), which can promote the expression of IFN-γ. The expression of CREMα was dramatically increased, and different isoforms appeared, whereas the expression of pCREB was downregulated after the T cells were treated with pantoprazole. In conclusion, pantoprazole downregulates IFN-γ and IL-2 expression by regulating the expression of Zip8 and pCREB or CREMα, respectively.
Scope Zinc is important for a balanced immune system, but the mechanisms are not yet fully elucidated. One possibility is an interaction of zinc with the tricarboxylic acid cycle (TCA), in which zinc inhibits the mitochondrial aconitase leading to an increase in intracellular citrate concentration as described for prostate cells. Therefore, the immune modulatory effects of zinc and citrate and their interaction in mixed lymphocyte cultures (MLC) are studied. Methods and results After allogeneic (MLC) or superantigen stimulation, the interferon‐γ (IFNγ) production is quantified by ELISA and T cell subpopulations are determined by Western Blot. Intracellular concentrations of citrate and zinc are measured. Zinc and citrate reduce the IFNγ expression and the pro‐inflammatory T helper cells (Th) 1 and Th17 in MLC. While zinc increases regulatory T cells, citrate reduces them. After superantigen stimulation IFNγ production is decreased only by citrate but increased by zinc. Zinc does not affect citrate concentration, while citrate impairs zinc uptake. Thus, zinc and citrate independently regulate IFNy expression. Conclusion These results may explain the immunosuppressive effect of blood products anticoagulated by citrate. In addition, high citrate consumption may lead to immunosuppressive effects, so upper limits for citrate should be established.
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