Interleukin 22 mediates interleukin 23-induced pathology in newborn mice by disrupting the function of pancreatic and intestinal cells

Mice expressing IL-23 constitutively in the intestine or skin fail to grow and die prematurely. These phenotypes are associated with marked changes in the levels of circulating cytokines and with changes in the transcriptome of the pancreas and intestine. Marked changes are observed in the expression of molecules involved in digestion and absorption of carbohydrates, proteins, and lipids, resulting in a malabsorptive condition. Genetic ablation of IL-22, or one of the subunits of the IL-22R in mice expressing IL-23, restores normal growth and increases the life span of the animals. Mechanistically, IL-22 acts directly at the level of pancreatic acinar cells to decrease expression of the pancreas associated transcription factor 1a (Ptfla), an important transcription factor controlling expression of genes encoding pancreatic enzymes, and acinar cell identity. The results indicate that dysregulated expression of IL-23 and IL-22 has severe consequences in newborns and reveal an unsuspected role for IL-22 in controlling pancreatic enzyme secretion and food absorption.