Duy Pham, PhD, Sarita Sehra, PhD, Xin Sun, PhD, Mark H. Kaplan, PhD

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The transcription factor Etv5 controls TH17 cell development and allergic airway inflammation Duy Pham, PhD, Sarita Sehra, PhD, Xin Sun, PhD, Mark H. Kaplan, PhD Journal of Allergy and Clinical Immunology Volume 134, Issue 1, Pages 204-214.e2 (July 2014) DOI: 10.1016/j.jaci.2013.12.021 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Characterization of mice with Etv5-deficient T cells. A, Naive CD4+CD62+ T cells from control and Etv5fl/fl CD4-Cre+ mice were activated with anti-CD3 and anti-CD28 for 5 days. Nuclear lysates were extracted and immunoblotted for Etv5 and β-actin as a control. B and C, Total cells were isolated from the thymus, spleen, and lymph nodes of control and Etv5 mutant mice and stained for cell-surface markers, with the percentage of positive cells (Fig 1, B) and cell numbers (Fig 1, C) shown. Data are representative of 2 independent experiments with similar results (Fig 1, A and B) or are means ± SEMs of 3 mice per group and representative of 2 independent experiments with similar results (Fig 1, C). Journal of Allergy and Clinical Immunology 2014 134, 204-214.e2DOI: (10.1016/j.jaci.2013.12.021) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Helper T-cell differentiation in the absence of Etv5 in T cells. Naive control and Etv5-deficient CD4+CD62L+ T cells were activated (TH0) or cultured under TH1, TH2, TH17, and Treg cell polarizing conditions. Etv5 expression was measured in helper T-cell subsets by using qRT-PCR before and after 6 hours of anti-CD3 stimulation (A), immunoblotting (B), or intracellular staining (C) before anti-CD3 stimulation. Δ Mean fluorescence intensity was calculated by subtracting the background from the signal of Etv5 antibody. TH1, TH2, and TH17 cells were used for assessing cytokine production by means of ELISA after 24 hours of anti-CD3 stimulation (D) and gene expression analysis after (Ifng, Il4, and Il17a; E) or before (Tbx21, Gata3, and Rorc; F) 6 hours of anti-CD3 stimulation by means of qRT-PCR. Data are means ± SEMs of 4 independent experiments (Fig 2, D-F) or means ± SDs of replicate samples (Fig 2, A) and representative of 3 independent experiments with similar results (Fig 2, A-C). *P < .05. NS, Not significant. Journal of Allergy and Clinical Immunology 2014 134, 204-214.e2DOI: (10.1016/j.jaci.2013.12.021) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Etv5 mutant mice have reduced HDM-induced allergic airway inflammation. A, Wild-type mice were immunized (intranasally [i.n.]) with HDM for 5 weeks to induced allergic inflammation and treated with anti–IL-17A or IgG1 antibodies (intraperitoneally [i.p.]). B, Total and inflammatory cell counts in the lungs and BAL fluid of HDM-induced airway inflammation in wild-type mice. C, Total cells from lungs of wild-type mice were used for gene expression analysis by means of qRT-PCR. D-G, Control and Etv5 mutant mice were sensitized and challenged (intranasally) with HDM for 5 weeks to induce allergic inflammation. Inflammatory cells in the lung tissue and BAL fluid of control and Etv5 mutant mice were as follows: DC, dendritic cells; Eos, eosinophils; Lymph, lymphocytes; Mac, macrophages; Neu, neutrophils. Fig 3, F, Cell infiltration in the lungs and mucus in the airways of control and Etv5 mutant mice were evaluated by means of hematoxylin and eosin (H&E) and periodic acid–Schiff (PAS) staining. Fig 3, G, Total cells from lungs of control and Etv5 mutant mice were used for gene expression analysis by means of qRT-PCR. Data are means ± SEMs of 5 to 6 mice per group (Fig 3, A-G) and representative of 2 independent experiments with similar results. *P < .05. NS, Not significant. Journal of Allergy and Clinical Immunology 2014 134, 204-214.e2DOI: (10.1016/j.jaci.2013.12.021) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Etv5 regulates TH17 cells in HDM-induced allergic airway inflammation. A-C, Lung and BAL cells from HDM-induced allergic airway inflammation in control and Etv5 mutant mice (from Fig 3) were stimulated with PMA and ionomycin for 6 hours to assess cytokine production (Fig 4, A-C) by using intracellular staining, with the average percentage of positive cells (Fig 4, B) and cell numbers (Fig 4, C) shown. D and E, Cells from mediastinal lymph nodes (MLN) were stimulated with HDM for 5 days. BAL fluid (Fig 4, D) and cell-free supernatant (Fig 4, E) were used to assess cytokine production by using ELISA. Data are means ± SEMs of 6 mice per group and representative of 2 independent experiments with similar results. *P < .05. Journal of Allergy and Clinical Immunology 2014 134, 204-214.e2DOI: (10.1016/j.jaci.2013.12.021) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 IL-17 cytokine contributes to HDM-induced allergic airway inflammation. Control and Etv5 mutant mice were immunized (intranasally [i.n.]) with HDM for 5 weeks to induce allergic inflammation. A, Mice were treated with IL-17A/F cytokine or PBS on weeks 3, 4, and 5. B, Total and inflammatory cells (eosinophils and neutrophils) in the lung tissue and BAL fluid of control and Etv5 mutant mice. C, Total cells from lungs of control and Etv5 mutant mice were used for gene expression analysis by means of qRT-PCR. Data are means ± SEMs of 5 mice per group and representative of 2 independent experiments with similar results. *P < .05. Journal of Allergy and Clinical Immunology 2014 134, 204-214.e2DOI: (10.1016/j.jaci.2013.12.021) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Etv5 is regulated by STAT3-activating cytokines in TH17 cells. Naive wild-type CD4+CD62L+ T cells were cultured under TH17-polarizing conditions. A, Kinetics of Etv5 gene expression during TH17 cell differentiation. B and C, TH17 cells were stimulated with IL-6, IL-23, and IL-12 for 2 hours before gene expression analysis by means of qRT-PCR (Fig 6, B) or protein expression by means of intracellular staining (Fig 6, C). D, Naive control and Stat3-deficient CD4+ T cells were activated with anti-CD3 and anti-CD28 in the presence or absence of IL-6 for 48 hours, rested overnight, and restimulated with IL-6, IL-12, or IL-23 for 2 hours before gene expression analysis by using qRT-PCR. E, Schematic of Etv5 promoter–containing STAT3-binding sites. F, Cells prepared as in Fig 6, B, were used for ChIP analysis with STAT3 antibody and IgG as a control. Data are means ± SDs of replicate samples and representative of 3 independent experiments with similar results (Fig 6, A-F). *P < .05. Journal of Allergy and Clinical Immunology 2014 134, 204-214.e2DOI: (10.1016/j.jaci.2013.12.021) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 7 Etv5 promotes cytokine production in TH17 cells. A-C, Naive CD4+CD62L+ T cells were isolated from wild-type mice and differentiated under neutral conditions (TH0) or TH17 culture conditions. On day 2, cells were transduced with either control or Etv5-YFP (Etv5)–expressing retrovirus. On day 5, TH17 cells were stimulated with PMA and ionomycin for 6 hours before intracellular staining for cytokine production (Fig 7, A), with the percentage positive cells shown in Fig 7, B. Data are gated on YFP+ cells. Fig 7, C, Cytokine production from sorted YFP+ TH0 cells was assessed by using ELISA after 24 hours of stimulation with anti-CD3. D and F, Wild-type TH17 cells were transfected with control or siRNA-specific Etv5, rested overnight, and restimulated with anti-CD3 to assess cytokine production by means of ELISA (Fig 7, D) and gene expression by using qRT-PCR (Fig 7, F). E and G, Control and Etv5-deficient TH17 cells were restimulated with anti-CD3 to assess cytokine production by using ELISA (Fig 7, E) and gene expression by using qRT-PCR (Fig 7, G). Data are means ± SEMs of 4 independent experiments. *P < .05 and **P < .01. NS, Not significant. Journal of Allergy and Clinical Immunology 2014 134, 204-214.e2DOI: (10.1016/j.jaci.2013.12.021) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 8 Etv5 binds the Il17a-Il17f locus in TH17 cells. A, Schematic of the Il17a-Il17f locus containing ETS-binding sites. B and D, Naive CD4+CD62L+ T cells were isolated from control and Etv5 mutant mice and differentiated under TH17 culture conditions. ChIP analyses were performed by using differentiated control TH17 cells to examine transcription factor binding (Fig 8, B) or differentiated control and Etv5-deficient TH17 cells to assess histone modification and the association of histone-modifying enzyme (Fig 8, D) at the Il17a-Il17f locus. C, Luciferase activity in Jurkat T cells transfected with increased concentrations of plasmid encoding Etv5 along with IL17A, IL17F, or NFAT luciferase reporters and then activated for 6 hours with PMA and ionomycin. Data were normalized to control samples. Data are means ± SDs of replicate samples and representative of 3 to 4 independent experiments with similar results. RU, Relative unit. Journal of Allergy and Clinical Immunology 2014 134, 204-214.e2DOI: (10.1016/j.jaci.2013.12.021) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions