Abstract
Colchicine has served as a traditional medicine for millennia and remains widely used to treat inflammatory and other disorders. Colchicine binds tubulin and depolymerizes microtubules, but it remains unclear how this mechanism blocks myeloid cell recruitment to inflamed tissues. Here we show that colchicine inhibits myeloid cell activation via an indirect mechanism involving the release of hepatokines. We find that a safe dose of colchicine depolymerizes microtubules selectively in hepatocytes but not in circulating myeloid cells. Mechanistically, colchicine triggers Nrf2 activation in hepatocytes, leading to secretion of anti-inflammatory hepatokines, including growth differentiation factor 15 (GDF15). Nrf2 and GDF15 are required for the anti-inflammatory action of colchicine in vivo. Plasma from colchicine-treated mice inhibits inflammatory signalling in myeloid cells in a GDF15-dependent manner, by positive regulation of SHP-1 (PTPN6) phosphatase, although the precise molecular identities of colchicine-induced GDF15 and its receptor require further characterization. Our work shows that the efficacy and safety of colchicine depend on its selective action on hepatocytes, and reveals a new axis of liver–myeloid cell communication. Plasma GDF15 levels and myeloid cell SHP-1 activity may be useful pharmacodynamic biomarkers of colchicine action.
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Data availability
The data that support the findings of this study are available from the corresponding authors on reasonable request. Source data are provided with this paper.
Change history
05 May 2021
A Correction to this paper has been published: https://doi.org/10.1038/s42255-021-00397-5
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Acknowledgements
We thank S.-J. Lee for the Gdf15−/− mice and J. Kagan for immortalized BMDM cells. The GDF15-blocking antibody was a kind gift from H. Tian of NGM Biopharmaceuticals. We thank W.-T. Kuo of Harvard Medical School for assistance with tissue immunostaining. We thank M. Zhou of NGM Biopharmaceuticals for assistance with animal experiments. This work was supported by grants from the National Institutes of Health (no. GM131753 to T.J.M) and the American Heart Association (no. 8POST34080251 to J.-H.W.).
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Contributions
J.-H.W. designed and conducted the experiments and wrote the manuscript. P.D.K. performed PK-PD modelling and image quantification. H.H.L. and I.N. examined GFRAL neutralization with the peritonitis assay. H.-C.T. generated hepatocyte-specific siRNAs. K.S. and R.J. examined the Open TG-GATEs database. R.V. tested the activity of recombinant GDF15. T.J.M. oversaw the execution of the project and wrote the manuscript.
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H.-C.T. was an employee of Alnylam Pharmaceuticals when the work was done. H.H.L., I.N. and R.V. were employees of NGM Biopharmaceuticals when the work was done. The other authors declare no competing interests.
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Extended data
Extended Data Fig. 1 Selection of colchicine doses for mouse treatment.
a, Dose translation from humans to animal studies based on clinical guidelines. The colchicine doses for mouse via the oral or i.p. routes were calculated according to the guidelines from the Food and Drug Administration and the European League Against Rheumatism, and were listed in the table. i.p., intraperitoneal. i.v., intravascular. b-f, Safety analysis of colchicine based on measurement of gut toxicity. Diarrhea is the dose-limiting toxicity in man. Mice received either vehicle, colchicine at 0.4 mg/kg, or 2.4 mg/kg. b, Intestines were harvested 6 hours after vehicle or colchicine treatment. Scale bars, 1 cm. c, The physiological severity score for diarrhea. d, Colchicine at 0.4 mg/kg did not affect the region of intestine with feces, but 2.4 mg/kg reduced it. Each dot represents one mouse. e, Detection of fecal water content by measuring weight of feces before and after drying. f, Colchicine at 0.4 mg/kg did not affect the fecal water content. Data are represented as mean ± s.d. Two-sided t-tests were used for statistical analysis. A single colchicine dose of 0.4mg/mg i.p. was used in all subsequent experiments unless otherwise indicated.
Extended Data Fig. 2 Colchicine at a safe dose selectively targets hepatocytes.
Additional images related to Fig. 1g. Microtubules in the livers of mice treated with a, vehicle or b, 0.4 mg/kg colchicine. Livers were collected 6 hours after treatment. Colchicine selectively depolymerized microtubules in hepatocytes, identified by HNF4+. The boxed areas are magnified and shown at the bottom. Liver cells from 4 livers with vehicle or colchicine treatment respectively. Scale bars, 10 μm.
Extended Data Fig. 3 Colchicine at a safe dose does not damage microtubules in circulating blood cells.
Six hours after treatment of vehicle or colchicine (0.4 mg/kg or 2.4 mg/kg), the whole blood samples were collected and fixed directly. Microtubules were visualized by immunofluorescence and imaged by confocal microscopy. a, Representative images of microtubules in circulating blood cells. b, Quantification of microtubule staining intensity. Individual cells exhibited a wide range of microtubule intensities that were similar following vehicle or 0.4 mg/kg colchicine (the safe dose). Microtubules were depolymerized in cells from mice receiving 2.4 mg/kg (the toxic dose). AU, arbitrary unit. Scale bar, 5 μm.
Extended Data Fig. 4 Colchicine at a toxic dose targets all cell types in the liver.
Microtubules in a, vehicle- or b, 2.4 mg/kg colchicine-treated livers were visualized, and c, intensities of microtubules were quantified. Microtubules were depolymerized in all cell types after treatment of colchicine at 2.4 mg/kg. The boxed areas are magnified and shown at the bottom. AU, arbitrary unit. Scale bars, 10 μm.
Extended Data Fig. 5 Modeling of human pharmacokinetics-pharmacodynamics (PK-PD) of colchicine.
a, Simulation diagram of two-compartment PK-PD model, based on human pharmacology data from Thomas, G. et al. Two blue boxes represent the central and peripheral compartments, which correspond to plasma and myeloid cell respectively. Light green boxes correspond to reaction species (colchicine concentration in plasma or myeloid cell), and yellow circles correspond to reactions (absorption, urinary elimination, central elimination, and transfer between plasma and myeloid cell). Colchicine absorption takes place from t = 0.22 to t = 1 hour. Tubulin-colchicine binding biochemistry was ignored and all colchicine in the myeloid cells was assumed to bind to tubulin. Fraction bound was calculated based on equations listed in Methods. b, Constants for modeling. c, Human PK-PD modeling of colchicine supported the indirect action of colchicine. The blue line represents colchicine concentrations in plasma over time after colchicine dosing. Magenta lines show the fraction of colchicine-bound tubulin in myeloid cells. Dashed and dotted magenta lines show unbound colchicine concentrated across the cell membrane by a factor of 10 and 100 respectively. The green line marks the 2% threshold of site occupancy for colchicine action.
Extended Data Fig. 6 GDF15 is a novel hepatokine induced by colchicine.
a, Volcano plot for the gene expression changes of rat livers comparing 3 hours after vehicle to colchicine treatment. Biological triplicate data are from the Open TG-GATEs database. Red and gray dots represent genes encoding secreted and non-secreted proteins respectively. GDF15 is highlighted in blue. P, probability value. b, Time course of GDF15 mRNA expression in the rat liver. Data are from Open TG-GATEs. 3 Mice per condition. c, GDF15 was induced in the liver but not kidney collected from colchicine-treated mice. d, ELISA analysis for measurement of plasma GDF15 in both mouse sexes. Induction was reproducibly stronger in males in the C57BL/6J mouse strain. Each dot represents one mouse. 5 Mice per condition. 3 Biological replicates. Data are represented as mean ± s.d. Two-sided t-tests were used for statistical analysis.
Extended Data Fig. 7 GDF15 is a novel anti-inflammatory hepatokine induced by Nrf2 signaling triggered by colchicine.
a, ELISA analysis for measurement of plasma GDF15 in wild-type and Nrf2 germline knockout (Nrf2−/−) mice. Each dot represents one mouse. b, Immunoblotting analysis revealed that induction of GDF15 in livers was blocked by treatment of hepatocyte-specific siRNA (GalNAc-siRNA) against Nrf2. Luc, luciferase. 3 Biological replicates. c, Activation of GDF15 promoter activity by Nrf2. HEK 293T cells were co-transfected with the luciferase reporter driven by the GDF15 promoter and the Nrf2 plasmid. Luciferase activities were determined from three samples. Data from three independent experiments. d, Immunoblotting analysis for detection of CHOP expression in livers collected at the indicated times after colchicine or Tunicamycin treatment. e, The temporal mRNA expression pattern of the integrated stress response regulators in the rat liver. Data are from Open TG-GATEs. 3 Mice per condition. f, The anti-inflammatory effect of colchicine in the MSU (monosodium urate crystals) peritonitis model depended on GDF15 induction in hepatocytes. Mice were challenged with 1 mg MSU. GalNAc-siRNA, hepatocyte-specific siRNA. Luc, luciferase. Each dot represents one mouse. Data are represented as mean ± s.d. Two-sided t-tests were used for statistical analysis.
Extended Data Fig. 8 Colchicine-induced GDF15 inhibits pro-IL-1β expression by activating the immuno-inhibitory signal of SHP-1 in primary neutrophils.
Ex vivo activation of neutrophils evaluated by the levels of (a-b) pro-IL-1β induction or (c-d) phosphorylated SHP-1. Cells were pre-incubated with plasma from the indicated mice and then activated with PMA. a, Induction of GDF15 specifically in hepatocytes was required for the anti-inflammatory activity of post-colchicine plasma, as assayed by pro-IL-1β induction. GalNAc-siLuc, hepatocyte-specific siRNA against luciferase. GalNAc-siGDF15, hepatocyte-specific siRNA against GDF15. b, The anti-inflammatory activity of post-colchicine plasma was blocked by two different clones of antibodies (#2 and #3) against GDF15. ctr, control antibody. veh plasma, plasma from vehicle-treated mice. Colc plasma, plasma from colchicine-treated mice. c, GDF15 neutralization by two clones of anti-GDF15 antibodies (#2 and #3) blocked plasma activity on stabilizing SHP-1 activation. d, Expression of colchicine-induced GDF15 specifically in hepatocytes was required for activating SHP-1. 3 Biological replicates.
Extended Data Fig. 9 Colchicine-induced GDF15 inhibits pro-IL-1β expression and mature IL-1β secretion from macrophages.
Ex vivo activation of immortalized BMDMs evaluated by the levels of (a-b) pro-IL-1β expression and (d-e) IL-1β secretion. a-b, Cells were pre-incubated with plasma from the indicated mice and then activated with Pam3CSK4. Expression of colchicine-induced GDF15 in hepatocytes was required for plasma activity on blocking pro-IL-1β expression. GalNAc-siLuc, hepatocyte-specific siRNA against luciferase. GalNAc-siGDF15, hepatocyte-specific siRNA against GDF15. c, Activation methods for measuring IL-1β production. d, Colchicine did not alter IL-1β production assayed with two activation methods. 5 Samples per condition over 3 biological replicates e, Colchicine-induced GDF15 was required for plasma activity on reducing IL-1β production. 4 Samples per condition over 3 biological replicates Data are represented as mean ± s.d. Two-sided t-tests were used for statistical analysis.
Extended Data Fig. 10 Canonical mature GDF15-GFRAL-RET signaling is not involved in the anti-inflammatory actions of colchicine.
a-c, and f, Ex vivo activation of neutrophils evaluated by the levels of pro-IL-1β expression. Inhibition of the GFRAL-RET signaling by a, RET inhibitor, SPP86 (SPP) and BBT594 (BTT), or b, a GFRAL neutralizing antibody (α-GFRAL) did not alter post-colchicine plasma activity on blocking pro-IL-1β expression. c, Post-colchicine plasma from wild-type and GFRAL germline knockout mice blocked pro-IL-1β expression. d, GFRAL inhibition by a GFRAL neutralizing antibody did not affect the in vivo anti-inflammatory effect of colchicine in the zymosan peritonitis assay. e, Efficacy of recombinant mature GDF15 (rGDF15) measured by the levels of phosphorylated ERK in a GFRAL-RET reporter cell model. 3 Samples per condition. Recombinant GDF15 was a disulfide-linked mature homodimer. Recombinant mature GDF15 did not affect f, ex vivo pro-IL-1β expression, and did not inhibit g, in vivo zymosan-induced neutrophil recruitment as colchicine. Each dot represents one mouse. Data are represented as mean ± s.d. Two-sided t-tests were used for statistical analysis.
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Weng, JH., Koch, P.D., Luan, H.H. et al. Colchicine acts selectively in the liver to induce hepatokines that inhibit myeloid cell activation. Nat Metab 3, 513–522 (2021). https://doi.org/10.1038/s42255-021-00366-y
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DOI: https://doi.org/10.1038/s42255-021-00366-y
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