Tuberculosis, caused by Mycobacterium tuberculosis infection, results in the development of granulomas in affected tissues. These structures are formed by a myeloid cell core including multinucleated giant cells and surrounded by T lymphocytes. We studied mechanisms of survival, formation and functions of giant cells in Mycobacterium granulomas. Previously, our group showed that the cytokine IL-17A induces the fusion of dendritic cells (DC). Here, we identified molecules induced by the IL-17A genetic program in myeloid cells: BFL1 regulated DC survival, while the chemokines CCL2 and CCL20 directed clustering required for DC fusion. In situ, in human TB granulomas, we found that IL-17A was expressed by T lymphocytes while BFL1, CCL2 and CCL20 were expressed by the mono- and multi-nucleated myeloid cells. Then we characterized phenotype, immune functions and microbicidal activity of IL-17A-treated DC and their derived giant cells. They expressed a mixed DC-macrophage phenotype, retained classical DC functions, synthesized several destructive enzymes and had increased and differential microbicidal activities against Mycobacterium species. We named GMIC (giant myeloid inflammatory cells) these IL-17A-dependent giant cells, and propose that they constitute a new inflammatory myeloid effector with potent microbicidal activities. Altogether, our results show that IL-17A may participate in the maintenance of the myeloid core of human tuberculosis granuloma by promoting the formation of GMIC with potent destructive and microbicidal functions. The molecular mechanisms we have documented should help the development of new tuberculosis therapeutic and vaccination strategies.
