T cell activation causes diarrhea by increasing intestinal permeability and inhibiting epithelial Na+/K+-ATPase

Mark W. Musch, Lane L. Clarke, Daniel Mamah, Lara R. Gawenis, Zheng Zhang, William Ellsworth, David Shalowitz, Navdha Mittal, Petros Efthimiou, Ziad Alnadjim, Steve D. Hurst, Eugene B. Chang, Terrence A. Barrett*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

159 Scopus citations


Inflammatory bowel disease (IBD) is associated with mucosal T cell activation and diarrhea. We found that T cell activation with anti-CD3 mAb induces profound diarrhea in mice. Diarrhea was quantified by intestinal weight-to-length (wt/l) ratios, mucosal Na+/K+-ATPase activity was determined and ion transport changes were measured in Ussing chambers. Anti-CD3 mAb increased jejunal wt/l ratios by more than 50% at 3 hours, returning to base line after 6 hours. Fluid accumulation was significantly reduced in TNF receptor-1 (TNFR-1-/-), but not IFN-γ-knockout mice. Anti-CD3 mAb decreased mucosal Na+/K+-ATPase activity, which was blocked by anti-TNF mAb and occurred to a lesser degree in TNFR-1-/- mice. Neither α nor β subunits of Na+/K+-ATPase decreased in abundance at 3 hours. Intestinal tissue from anti-CD3-treated mice exhibited increased permeability to mannitol at 1 hour and decreases in electroneutral Na+ absorption, Na+-dependent glucose absorption, and cAMP-stimulated anion secretion at 3 hours. Furthermore, enteral fluid accumulation was observed in CFTR-/- mice, indicating a minor role of active anion secretion. These data suggest that diarrhea in IBD is due to TNF-mediated malabsorption rather than to secretory processes. T cell activation induces luminal fluid accumulation by increasing mucosal permeability and reducing epithelial Na+/K+-ATPase activity leading to decreased intestinal Na+ and water absorption.

Original languageEnglish (US)
Pages (from-to)1739-1747
Number of pages9
JournalJournal of Clinical Investigation
Issue number11
StatePublished - Dec 2002

ASJC Scopus subject areas

  • General Medicine


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