Numerous intestinal diseases are characterized by immune cell activation and compromised epithelial barrier function. We have shown that cytokine treatment of epithelial monolayers increases myosin II regulatory light chain (MLC) phosphorylation and decreases barrier function and that these are both reversed by MLC kinase (MLCK) inhibition. The aim of this study was to determine the mechanisms by which interferon (IFN)-γ and tumor necrosis factor (TNF)-α regulate MLC phosphorylation and disrupt epithelial barrier function. We developed a model in which both cytokines were required for barrier dysfunction. Barrier dysfunction was also induced by TNF-α addition to IFN-γ-primed, but not control, Caco-2 monolayers. TNF-α treatment of IFN-γ-primed monolayers caused increases in both MLCK expression and MLC phosphorylation, suggesting that MLCK is a TNF-α-inducible protein. These effects of TNF-α were not mediated by nuclear factor-κB. However, at doses below those needed for nuclear factor-κB inhibition, sulfasalazine was able to prevent TNF-α-induced barrier dysfunction, MLCK up-regulation, and MLC phosphorylation. Low-dose sulfasalazine also prevented morphologically evident tight junction disruption induced by TNF-α. These data show that IFN-γ can prime intestinal epithelial monolayers to respond to TNF-α by disrupting tight junction morphology and barrier function via MLCK up-regulation and MLC phosphorylation. These TNF-α-induced events can be prevented by the clinically relevant drug sulfasalazine. Numerous intestinal diseases are characterized by immune cell activation and compromised epithelial barrier function. We have shown that cytokine treatment of epithelial monolayers increases myosin II regulatory light chain (MLC) phosphorylation and decreases barrier function and that these are both reversed by MLC kinase (MLCK) inhibition. The aim of this study was to determine the mechanisms by which interferon (IFN)-γ and tumor necrosis factor (TNF)-α regulate MLC phosphorylation and disrupt epithelial barrier function. We developed a model in which both cytokines were required for barrier dysfunction. Barrier dysfunction was also induced by TNF-α addition to IFN-γ-primed, but not control, Caco-2 monolayers. TNF-α treatment of IFN-γ-primed monolayers caused increases in both MLCK expression and MLC phosphorylation, suggesting that MLCK is a TNF-α-inducible protein. These effects of TNF-α were not mediated by nuclear factor-κB. However, at doses below those needed for nuclear factor-κB inhibition, sulfasalazine was able to prevent TNF-α-induced barrier dysfunction, MLCK up-regulation, and MLC phosphorylation. Low-dose sulfasalazine also prevented morphologically evident tight junction disruption induced by TNF-α. These data show that IFN-γ can prime intestinal epithelial monolayers to respond to TNF-α by disrupting tight junction morphology and barrier function via MLCK up-regulation and MLC phosphorylation. These TNF-α-induced events can be prevented by the clinically relevant drug sulfasalazine. A principal function of epithelial surfaces is the maintenance of a barrier to hydrophilic solutes. In intestinal epithelium, this barrier function is compromised in a spectrum of infectious, immune-mediated, and idiopathic diseases.1Clayburgh DR Shen L Turner JR A porous defense: the leaky epithelial barrier in intestinal disease.Lab Invest. 2004; 84: 282-291Crossref PubMed Scopus (384) Google Scholar In Crohn's disease these barrier defects, measured as increases in paracellular permeability, may precede clinical evidence of disease,2Irvine EJ Marshall JK Increased intestinal permeability precedes the onset of Crohn's disease in a subject with familial risk.Gastroenterology. 2000; 119: 1740-1744Abstract Full Text Full Text PDF PubMed Scopus (226) Google Scholar can serve as markers of impending disease reactivation,3Wyatt J Vogelsang H Hubl W Waldhoer T Lochs H Intestinal permeability and the prediction of relapse in Crohn's disease.Lancet. 1993; 341: 1437-1439Abstract PubMed Scopus (541) Google Scholar and correlate with systemic immune activation.4Yacyshyn BR Meddings JB CD45RO expression on circulating CD19+ B cells in Crohn's disease correlates with intestinal permeability.Gastroenterology. 1995; 108: 132-137Abstract Full Text PDF PubMed Scopus (92) Google Scholar Thus, defects in epithelial barrier function are intimately associated with Crohn's disease pathogenesis. One feature common to Crohn's disease and other intestinal diseases with compromised barrier function is TH1-polarized immune activation, with associated elevations of mucosal interferon (IFN)-γ and tumor necrosis factor (TNF)-α. Several lines of evidence suggest that these cytokine elevations are responsible for the observed barrier defects. First, in vitro studies have shown that, at relatively high doses, IFN-γ and TNF-α can induce barrier dysfunction in cultured epithelial monolayers.5Madara JL Loosening tight junctions.J Clin Invest. 1989; 83: 1089-1094Crossref PubMed Scopus (283) Google Scholar, 6Mullin JM Snock KV Effect of tumor necrosis factor on epithelial tight junctions and transepithelial permeability.Cancer Res. 1990; 50: 2172-2176PubMed Google Scholar, 7Ma TY Iwamoto GK Hoa NT Akotia V Pedram A Boivin MA Said HM TNF-alpha-induced increase in intestinal epithelial tight junction permeability requires NF-kappa B activation.Am J Physiol. 2004; 286: G367-G376Crossref Scopus (20) Google Scholar, 8Bruewer M Luegering A Kucharzik T Parkos CA Madara JL Hopkins AM Nusrat A Proinflammatory cytokines disrupt epithelial barrier function by apoptosis-independent mechanisms.J Immunol. 2003; 171: 6164-6172PubMed Google Scholar, 9Schmitz H Fromm M Bentzel CJ Scholz P Detjen K Mankertz J Bode H Epple HJ Riecken EO Schulzke JD Tumor necrosis factor-alpha (TNFalpha) regulates the epithelial barrier in the human intestinal cell line HT-29/B6.J Cell Sci. 1999; 112: 137-146Crossref PubMed Google Scholar At lower doses, these cytokines can synergize to disrupt barrier function in vitro.8Bruewer M Luegering A Kucharzik T Parkos CA Madara JL Hopkins AM Nusrat A Proinflammatory cytokines disrupt epithelial barrier function by apoptosis-independent mechanisms.J Immunol. 2003; 171: 6164-6172PubMed Google Scholar, 10Taylor CT Dzus AL Colgan SP Autocrine regulation of epithelial permeability by hypoxia: role for polarized release of tumor necrosis factor alpha.Gastroenterology. 1998; 114: 657-668Abstract Full Text Full Text PDF PubMed Scopus (175) Google Scholar, 11Zolotarevsky Y Hecht G Koutsouris A Gonzalez DE Quan C Tom J Mrsny RJ Turner JR A membrane-permeant peptide that inhibits MLC kinase restores barrier function in in vitro models of intestinal disease.Gastroenterology. 2002; 123: 163-172Abstract Full Text Full Text PDF PubMed Scopus (321) Google Scholar In vivo, both in human patients and animal models, TNF-α and IFN-γ antagonism can diminish disease severity and restore barrier function.12Musch MW Clarke LL Mamah D Gawenis LR Zhang Z Ellsworth W Shalowitz D Mittal N Efthimiou P Alnadjim Z Hurst SD Chang EB Barrett TA T cell activation causes diarrhea by increasing intestinal permeability and inhibiting epithelial Na+/K+-ATPase.J Clin Invest. 2002; 110: 1739-1747Crossref PubMed Scopus (155) Google Scholar, 13Brown GR Lindberg G Meddings J Silva M Beutler B Thiele D Tumor necrosis factor inhibitor ameliorates murine intestinal graft-versus-host disease.Gastroenterology. 1999; 116: 593-601Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar, 14Ferrier L Mazelin L Cenac N Desreumaux P Janin A Emilie D Colombel JF Garcia-Villar R Fioramonti J Bueno L Stress-induced disruption of colonic epithelial barrier: role of interferon-gamma and myosin light chain kinase in mice.Gastroenterology. 2003; 125: 795-804Abstract Full Text Full Text PDF PubMed Scopus (166) Google Scholar, 15Suenaert P Bulteel V Lemmens L Noman M Geypens B Van Assche G Geboes K Ceuppens JL Rutgeerts P Anti-tumor necrosis factor treatment restores the gut barrier in Crohn's disease.Am J Gastroenterol. 2002; 97: 2000-2004Crossref PubMed Google Scholar Thus, TNF-α and IFN-γ are critical to the barrier disruption that occurs both in vitro and in vivo. Although both in vitro and in vivo data confirm that TNF-α and IFN-γ can cause dysfunction of the epithelial tight junction barrier, the mechanisms of this effect remain unknown. TNF-α can cause epithelial apoptosis, but this does not appear to be the mechanism by which barrier function is compromised.8Bruewer M Luegering A Kucharzik T Parkos CA Madara JL Hopkins AM Nusrat A Proinflammatory cytokines disrupt epithelial barrier function by apoptosis-independent mechanisms.J Immunol. 2003; 171: 6164-6172PubMed Google Scholar, 11Zolotarevsky Y Hecht G Koutsouris A Gonzalez DE Quan C Tom J Mrsny RJ Turner JR A membrane-permeant peptide that inhibits MLC kinase restores barrier function in in vitro models of intestinal disease.Gastroenterology. 2002; 123: 163-172Abstract Full Text Full Text PDF PubMed Scopus (321) Google Scholar, 16Madara JL Maintenance of the macromolecular barrier at cell extrusion sites in intestinal epithelium: physiological rearrangement of tight junctions.J Membr Biol. 1990; 116: 177-184Crossref PubMed Scopus (201) Google Scholar, 17Rosenblatt J Raff MC Cramer LP An epithelial cell destined for apoptosis signals its neighbors to extrude it by an actin- and myosin-dependent mechanism.Curr Biol. 2001; 11: 1847-1857Abstract Full Text Full Text PDF PubMed Scopus (416) Google Scholar Other mechanisms may be involved in cytokine-induced barrier dysfunction, including down-regulation of the tight junction proteins ZO-1 and occludin,18Mankertz J Tavalali S Schmitz H Mankertz A Riecken EO Fromm M Schulzke JD Expression from the human occludin promoter is affected by tumor necrosis factor alpha and interferon gamma.J Cell Sci. 2000; 113: 2085-2090PubMed Google Scholar, 19Youakim A Ahdieh M Interferon-gamma decreases barrier function in T84 cells by reducing ZO-1 levels and disrupting apical actin.Am J Physiol. 1999; 276: G1279-G1288PubMed Google Scholar decreased Na+-K+ ATPase activity,20Sugi K Musch MW Field M Chang EB Inhibition of Na+,K+-ATPase by interferon gamma down-regulates intestinal epithelial transport and barrier function.Gastroenterology. 2001; 120: 1393-1403Abstract Full Text Full Text PDF PubMed Scopus (133) Google Scholar or nuclear factor (NF)-κB activation.7Ma TY Iwamoto GK Hoa NT Akotia V Pedram A Boivin MA Said HM TNF-alpha-induced increase in intestinal epithelial tight junction permeability requires NF-kappa B activation.Am J Physiol. 2004; 286: G367-G376Crossref Scopus (20) Google Scholar Nonetheless, little is known of the biochemical events that mediate TNF-α- and IFN-γ-induced barrier dysfunction. We and others have shown that myosin II activation, as indicated by phosphorylation of myosin II regulatory light chain (MLC), is involved in physiological and pathophysiological tight junction regulation.21Hecht G Pestic L Nikcevic G Koutsouris A Tripuraneni J Lorimer DD Nowak G Guerriero Jr, V Elson EL Lanerolle PD Expression of the catalytic domain of myosin light chain kinase increases paracellular permeability.Am J Physiol. 1996; 271: C1678-C1684PubMed Google Scholar, 22Yuhan R Koutsouris A Savkovic SD Hecht G Enteropathogenic Escherichia coli-induced myosin light chain phosphorylation alters intestinal epithelial permeability.Gastroenterology. 1997; 113: 1873-1882Abstract Full Text PDF PubMed Scopus (203) Google Scholar, 23Turner JR Angle JM Black ED Joyal JL Sacks DB Madara JL Protein kinase C-dependent regulation of transepithelial resistance: the roles of myosin light chain and myosin light chain kinase.Am J Physiol. 1999; 277: C554-C562PubMed Google Scholar, 24Turner JR Black ED Ward J Tse CM Uchwat FA Alli HA Donowitz M Madara JL Angle JM Transepithelial resistance can be regulated by the intestinal brush border Na+-H+ exchanger NHE3.Am J Physiol. 2000; 279: C1918-C1924Google Scholar, 25Turner JR Cohen DE Mrsny RJ Madara JL Noninvasive in vivo analysis of human small intestinal paracellular absorption: regulation by Na+-glucose cotransport.Dig Dis Sci. 2000; 45: 2122-2126Crossref PubMed Scopus (54) Google Scholar, 26Turner JR Rill BK Carlson SL Carnes D Kerner R Mrsny RJ Madara JL Physiological regulation of epithelial tight junctions is associated with myosin light-chain phosphorylation.Am J Physiol. 1997; 273: C1378-C1385PubMed Google Scholar In the course of studies on this topic, we showed that treatment of intestinal epithelial monolayers with IFN-γ and TNF-α induced both barrier dysfunction and increased MLC phosphorylation.11Zolotarevsky Y Hecht G Koutsouris A Gonzalez DE Quan C Tom J Mrsny RJ Turner JR A membrane-permeant peptide that inhibits MLC kinase restores barrier function in in vitro models of intestinal disease.Gastroenterology. 2002; 123: 163-172Abstract Full Text Full Text PDF PubMed Scopus (321) Google Scholar We have also found that inhibition of MLC kinase (MLCK) both reduces MLC phosphorylation and restores barrier function.11Zolotarevsky Y Hecht G Koutsouris A Gonzalez DE Quan C Tom J Mrsny RJ Turner JR A membrane-permeant peptide that inhibits MLC kinase restores barrier function in in vitro models of intestinal disease.Gastroenterology. 2002; 123: 163-172Abstract Full Text Full Text PDF PubMed Scopus (321) Google Scholar Thus, our previous report suggests that MLCK-mediated MLC phosphorylation is critical to IFN-γ- and TNF-α-induced barrier dysfunction. However, the mechanism by which MLCK increases MLC phosphorylation was not identified. In the present studies we sought to define the mechanisms by which IFN-γ and TNF-α cause increases in MLC phosphorylation and concomitant barrier dysfunction in intestinal epithelia. The data show that IFN-γ primes intestinal epithelia to respond to TNF-α by increasing MLCK expression. This is followed by increases in MLC phosphorylation and barrier dysfunction. Sulfasalazine (SSA), an agent effective in the treatment of inflammatory bowel disease, prevents this barrier dysfunction by blocking MLCK up-regulation as well as increased MLC phosphorylation. However, this protective effect of SSA does not require NF-κB-inhibition. Thus, these data identify MLCK as a cytokine-inducible protein and also provide new insight into the mechanisms of epithelial barrier dysfunction in intestinal disease. Caco-2 cells were grown as monolayers on collagen-coated polycarbonate membrane Transwell supports (Corning-Costar, Acton, MA) and used 17 to 20 days after confluence, as described previously.26Turner JR Rill BK Carlson SL Carnes D Kerner R Mrsny RJ Madara JL Physiological regulation of epithelial tight junctions is associated with myosin light-chain phosphorylation.Am J Physiol. 1997; 273: C1378-C1385PubMed Google Scholar Transwell supports with 0.33- and 5-cm2 surface areas were used for electrophysiological and biochemical studies, respectively. Cytokines (R&D Systems, Minneapolis, MN), were added to the basal chamber without manipulating the apical media. SSA, 5-aminosalicylic acid, sulfapyridine, and 4-aminosalicylic acid (MP Biochemicals, Aurora, OH) and curcumin, triptolide, capsaicin, BAY 11-7085, SN50, and MG132 (Calbiochem, San Diego, CA) were also added to the basal chamber only. Transepithelial resistance (TER) was measured with an epithelial voltohmmeter (EVOM; World Precision Instruments, Sarasota, FL). In all experiments the TER of control monolayers was ∼240 Ω·cm2 after subtraction of fluid resistance (Figure 1A). To facilitate comparisons between experiments, the TER of all monolayers was typically normalized to that of control monolayers in the same experiment. Flux of fluorescein isothiocyanate-labeled dextran (molecular weight, 3kD; Molecular Probes, Eugene, OR) across Caco-2 monolayers was assayed as described previously.10Taylor CT Dzus AL Colgan SP Autocrine regulation of epithelial permeability by hypoxia: role for polarized release of tumor necrosis factor alpha.Gastroenterology. 1998; 114: 657-668Abstract Full Text Full Text PDF PubMed Scopus (175) Google Scholar, 27Sanders SE Madara JL McGuirk DK Gelman DS Colgan SP Assessment of inflammatory events in epithelial permeability: a rapid screening method using fluorescein dextrans.Epithelial Cell Biol. 1995; 4: 25-34PubMed Google Scholar Briefly, monolayers were washed free of media and cytokines and transferred to Hanks’ balanced salt solution. The apical chamber was gently aspirated and replaced with 50 μl of 1 mg/ml of fluorescein isothiocyanate-dextran (1 mg/ml). The monolayers were rotated on an orbital shaker (60 rpm) at 37°C, and samples (50 μl) were removed from the basal chamber after 30 and 60 minutes. Fluorescence of these samples was determined using a fluorescent plate reader (Synergy HT; Bio-Tek Instruments, Winooski, VT). Molar flux was calculated from a standard curve that was prepared daily. Lysates of Caco-2 monolayers grown on 5-cm2 Transwell supports were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) (Bio-Rad, Hercules, CA) and transferred to polyvinylidene difluoride membranes, as described previously.26Turner JR Rill BK Carlson SL Carnes D Kerner R Mrsny RJ Madara JL Physiological regulation of epithelial tight junctions is associated with myosin light-chain phosphorylation.Am J Physiol. 1997; 273: C1378-C1385PubMed Google Scholar For NF-κB analyses, nuclear fractions were prepared by using the NE-PER Nuclear and Cytoplasmic Extraction Reagents kit (Pierce Biotechnology, Inc., Rockford, IL). After blocking the membranes were blotted using antibodies to MLCK (clone K36; Sigma, St. Louis, MO), ZO-1, occludin, claudin-1, and NF-κB RelA p65 (Zymed, South San Francisco, CA), caspase-3, caspase-8, and poly ADP-ribose polymerase (Cell Signaling Technology, Beverly, MA), and total or phosphorylated MLC.28Berglund JJ Riegler M Zolotarevsky Y Wenzl E Turner JR Regulation of human jejunal transmucosal resistance and MLC phosphorylation by Na+-glucose cotransport.Am J Physiol. 2001; 281: G1487-G1493Google Scholar After incubation with peroxidase-conjugated secondary antibodies (Cell Signaling Technology), blots were visualized by enhanced chemiluminescence, as described previously.26Turner JR Rill BK Carlson SL Carnes D Kerner R Mrsny RJ Madara JL Physiological regulation of epithelial tight junctions is associated with myosin light-chain phosphorylation.Am J Physiol. 1997; 273: C1378-C1385PubMed Google Scholar Densitometry of immunoblot data was performed using Metamorph 6.2 (Universal Imaging Corp., Downingtown, PA). Caco-2 monolayers grown on 0.33-cm2 Transwell supports were fixed with 1% paraformaldehyde and permeabilized in 0.1% Triton X-100 in phosphate-buffered saline. After incubation with mouse anti-ZO-1, rabbit anti-occludin, or rabbit anti-claudin-1 antibodies, monolayers were washed and incubated with Alexa 594-conjugated secondary antibodies and Hoechst 33342 (Molecular Probes), as indicated. Monolayers were mounted in Slowfade (Molecular Probes) and imaged using a Leica DMLB epifluorescence microscope equipped with an 88000 filter set (Chroma Technology, Brattleboro, VT) and a Coolsnap HQ camera (Roper Scientific, Tucson, AZ) controlled by MetaMorph 6.2. Postacquisition deconvolution and serial reconstruction used Autodeblur 9 (AutoQuant Imaging, Inc., Watervliet, NY) for 10 iterations. pNFκB-TA-Luc (Clontech, Palo Alto, CA) was transiently transfected into freshly trypsinized Caco-2 cells, in suspension, using Lipofectamine 2000 (Invitrogen, Carlsbad, CA) and the cells were plated on 12-well inserts. This controlled for transfection efficiency because each experiment was performed from a single transfection. Cells were subsequently treated with cytokines or inhibitors, as indicated. Luciferase expression in lysates was detected using luciferin as the substrate (Promega), measured with a Lumat LB 9507 luminometer (Berthold, Oak Ridge, TN), and normalized to total protein (BCA assay, Bio-Rad). Previous in vitro work has clearly established that IFN-γ8Bruewer M Luegering A Kucharzik T Parkos CA Madara JL Hopkins AM Nusrat A Proinflammatory cytokines disrupt epithelial barrier function by apoptosis-independent mechanisms.J Immunol. 2003; 171: 6164-6172PubMed Google Scholar, 20Sugi K Musch MW Field M Chang EB Inhibition of Na+,K+-ATPase by interferon gamma down-regulates intestinal epithelial transport and barrier function.Gastroenterology. 2001; 120: 1393-1403Abstract Full Text Full Text PDF PubMed Scopus (133) Google Scholar, 29Madara JL Stafford J Interferon-gamma directly affects barrier function of cultured intestinal epithelial monolayers.J Clin Invest. 1989; 83: 724-727Crossref PubMed Scopus (652) Google Scholar, 30Adams RB Planchon SM Roche JK IFN-gamma modulation of epithelial barrier function. Time course, reversibility, and site of cytokine binding.J Immunol. 1993; 150: 2356-2363PubMed Google Scholar and TNF-α7Ma TY Iwamoto GK Hoa NT Akotia V Pedram A Boivin MA Said HM TNF-alpha-induced increase in intestinal epithelial tight junction permeability requires NF-kappa B activation.Am J Physiol. 2004; 286: G367-G376Crossref Scopus (20) Google Scholar, 31Hiribarren A Heyman M L'Helgouac'h A Desjeux JF Effect of cytokines on the epithelial function of the human colon carcinoma cell line HT29 cl 19A.Gut. 1993; 34: 616-620Crossref PubMed Scopus (43) Google Scholar, 32Marano CW Laughlin KV Russo LM Soler A Peralta Mullin JM Long-term effects of tumor necrosis factor on LLC-PK1 transepithelial resistance.J Cell Physiol. 1993; 157: 519-527Crossref PubMed Scopus (31) Google Scholar, 33Yoo J Nichols A Song JC Mammen J Calvo I Worrell RT Cuppoletti J Matlin K Matthews JB Bryostatin-1 attenuates TNF-induced epithelial barrier dysfunction: role of novel PKC isozymes.Am J Physiol. 2003; 284: G703-G712Google Scholar, 34Mullin JM Laughlin KV Marano CW Russo LM Soler AP Modulation of tumor necrosis factor-induced increase in renal (LLC-PK1) transepithelial permeability.Am J Physiol. 1992; 263: F915-F924PubMed Google Scholar, 35Rodriguez P Heyman M Candalh C Blaton MA Bouchaud C Tumour necrosis factor-alpha induces morphological and functional alterations of intestinal HT29 cl. 19A cell monolayers.Cytokine. 1995; 7: 441-448Crossref PubMed Scopus (93) Google Scholar, 36Soler AP Marano CW Bryans M Miller RD Garulacan LA Mauldin SK Stamato TD Mullin JM Activation of NF-kappaB is necessary for the restoration of the barrier function of an epithelium undergoing TNF-alpha-induced apoptosis.Eur J Cell Biol. 1999; 78: 56-66Crossref PubMed Scopus (40) Google Scholar are capable of independently reducing barrier function in intestinal epithelial monolayers. However, it is also clear that these cytokines can synergize to induce barrier dysfunction.10Taylor CT Dzus AL Colgan SP Autocrine regulation of epithelial permeability by hypoxia: role for polarized release of tumor necrosis factor alpha.Gastroenterology. 1998; 114: 657-668Abstract Full Text Full Text PDF PubMed Scopus (175) Google Scholar, 11Zolotarevsky Y Hecht G Koutsouris A Gonzalez DE Quan C Tom J Mrsny RJ Turner JR A membrane-permeant peptide that inhibits MLC kinase restores barrier function in in vitro models of intestinal disease.Gastroenterology. 2002; 123: 163-172Abstract Full Text Full Text PDF PubMed Scopus (321) Google Scholar Elevations of both cytokines are seen in intestinal disease in vivo.37Agnholt J Kaltoft K Infliximab downregulates interferon-gamma production in activated gut T-lymphocytes from patients with Crohn's disease.Cytokine. 2001; 15: 212-222Crossref PubMed Scopus (79) Google Scholar Thus, we developed an in vitro model similar to previous reports8Bruewer M Luegering A Kucharzik T Parkos CA Madara JL Hopkins AM Nusrat A Proinflammatory cytokines disrupt epithelial barrier function by apoptosis-independent mechanisms.J Immunol. 2003; 171: 6164-6172PubMed Google Scholar, 9Schmitz H Fromm M Bentzel CJ Scholz P Detjen K Mankertz J Bode H Epple HJ Riecken EO Schulzke JD Tumor necrosis factor-alpha (TNFalpha) regulates the epithelial barrier in the human intestinal cell line HT-29/B6.J Cell Sci. 1999; 112: 137-146Crossref PubMed Google Scholar, 10Taylor CT Dzus AL Colgan SP Autocrine regulation of epithelial permeability by hypoxia: role for polarized release of tumor necrosis factor alpha.Gastroenterology. 1998; 114: 657-668Abstract Full Text Full Text PDF PubMed Scopus (175) Google Scholar, 11Zolotarevsky Y Hecht G Koutsouris A Gonzalez DE Quan C Tom J Mrsny RJ Turner JR A membrane-permeant peptide that inhibits MLC kinase restores barrier function in in vitro models of intestinal disease.Gastroenterology. 2002; 123: 163-172Abstract Full Text Full Text PDF PubMed Scopus (321) Google Scholar in which low, physiologically relevant levels of IFN-γ and TNF-α are both required to decrease barrier function in cultured monolayers of intestinal epithelial Caco-2 cells. In this model TER, a sensitive measure of barrier function, was unaffected by 48 hours of culture with basolateral IFN-γ or TNF-α individually (Figure 1A). However, simultaneous application of both cytokines caused TER to fall, indicating reduced barrier function, within 30 hours (Figure 1A). To determine whether the synergy between IFN-γ and TNF-α required the two cytokines to be present simultaneously, we added one cytokine for 24 hours, washed monolayers free of that cytokine, and then added the second cytokine. Sequential treatment with IFN-γ followed by TNF-α caused TER decreases comparable to those induced by simultaneous treatment with IFN-γ and TNF-α (Figure 1A). In IFN-γ-primed monolayers TER began to decrease within 4 hours after TNF-α addition. In contrast, sequential treatment with TNF-α followed by IFN-γ did not affect TER (Figure 1A). Similarly, paracellular flux of 3-kD dextran was not significantly increased in monolayers treated with either IFN-γ or TNF-α alone, but was increased 21 ± 4-fold in monolayers treated sequentially with IFN-γ followed by TNF-α (Figure 1B). Thus, the synergy between these cytokines is because of the ability of IFN-γ treatment to prime monolayers to respond rapidly to physiologically relevant doses of TNF-α. Priming of Caco-2 monolayers with IFN-γ requires at least 18 hours of IFN-γ treatment (data not shown). Increasing IFN-γ treatment duration (up to 36 hours) or dose (up to 100 ng/ml) did not augment subsequent TNF-α-induced TER decreases (data not shown). In contrast, TER decreases induced by TNF-α addition to IFN-γ-primed monolayers were strongly correlated with TNF-α dose (r = 0.996, Figure 1C). Therefore, IFN-γ primes intestinal epithelial monolayers to respond to TNF-α in a dose-dependent manner. Some studies have suggested that TNF-α reduces epithelial barrier function by inducing apoptosis.38Abreu MT Palladino AA Arnold ET Kwon RS McRoberts JA Modulation of barrier function during Fas-mediated apoptosis in human intestinal epithelial cells.Gastroenterology. 2000; 119: 1524-1536Abstract Full Text Full Text PDF PubMed Scopus (122) Google Scholar, 39Bojarski C Gitter AH Bendfeldt K Mankertz J Schmitz H Wagner S Fromm M Schulzke JD Permeability of human HT-29/B6 colonic epithelium as a function of apoptosis.J Physiol. 2001; 535: 541-552Crossref PubMed Scopus (98) Google Scholar However, others have shown barrier function to be maintained in the face of apoptosis,16Madara JL Maintenance of the macromolecular barrier at cell extrusion sites in intestinal epithelium: physiological rearrangement of tight junctions.J Membr Biol. 1990; 116: 177-184Crossref PubMed Scopus (201) Google Scholar, 17Rosenblatt J Raff MC Cramer LP An epithelial cell destined for apoptosis signals its neighbors to extrude it by an actin- and myosin-dependent mechanism.Curr Biol. 2001; 11: 1847-1857Abstract Full Text Full Text PDF PubMed Scopus (416) Google Scholar and we11Zolotarevsky Y Hecht G Koutsouris A Gonzalez DE Quan C Tom J Mrsny RJ Turner JR A membrane-permeant peptide that inhibits MLC kinase restores barrier function in in vitro models of intestinal disease.Gastroenterology. 2002; 123: 163-172Abstract Full Text Full Text PDF PubMed Scopus (321) Google Scholar and others8Bruewer M Luegering A Kucharzik T Parkos CA Madara JL Hopkins AM Nusrat A Proinflammatory cytokines disrupt epithelial barrier function by apoptosis-independent mechanisms.J Immunol. 2003; 171: 6164-6172PubMed Google Scholar have shown that this is not the mechanism by which IFN-γ and TNF-α induce barrier dysfunction. Consistent with this, caspase-3, caspase-8, and PARP cleavage were not increased by IFN-γ and TNF-α treatment of Caco-2 monolayers (Figure 2A). Thus, we considered the possibility that the barrier dysfunction observed represents disruption of the tight junction, the primary determinant of barrier function in intact monolayers. We first assessed the morphological distribution of tight junction proteins before and after cytokine treatment. In control monolayers the tight junction plaque protein ZO-1 was restricted to the tight junction, whereas the transmembrane proteins occludin and claudin-1 were detected at the tight junction, along lateral membranes, and within intracellular vesicular pools (Figure 2B). These distributions were not changed by incubation with IFN-γ (10 ng/ml) for 24 hours (data not shown). Treatment of IFN-γ-primed monolayers with TNF-α caused striking reorganization of ZO-1, occludin, and claudin-1 such that the en face xy profiles became irregular (Figure 2B). The intensity of staining for ZO-1 and occludin at the tight junction was also reduced, and expanded intracellular pools of occludin and claudin-1 were apparent after treatment of IFN-γ-primed monolayers with TNF-α (Figure 2B). This morphologically evident removal of occludin and claudin-1 from the tight junction was also associated with removal of occludin and claudin-1 from tight junction-enrich