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Han WGH, Helm K, Poelen MMC, Otten HG, van Els CACM. Ex vivo peptide-MHC II tetramer analysis reveals distinct end-differentiation patterns of human pertussis-specific CD4(+) T cells following clinical infection. Clin Immunol 2015; 157:205-15. [PMID: 25728491 DOI: 10.1016/j.clim.2015.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 01/08/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022]
Abstract
Pertussis is occurring in highly vaccinated populations, suggesting insufficient protective memory CD4(+) T cells to Bordetella (B.) pertussis. P.69 Pertactin (P.69 Prn) is an important virulence factor of B. pertussis, and P.69 Prn7-24 is an immunodominant CD4(+) T cell epitope in mice and broadly recognized in humans. P.69 Prn7-24 peptide-MHC II tetramers (DRB4*0101/IVKT) were designed to ex vivo interrogate the presence and differentiation state of P.69 Prn7-24 specific CD4(+) T cells in six symptomatic pertussis cases. Cases with relatively more CD45RA(-)CCR7(+) central memory CD4(+)DRB4*0101/IVKT(+) T cells secreted Th1 cytokines, while cases with more CD45RA(-)CCR7(-) effector memory CD4(+)DRB4*0101/IVKT(+) T cells secreted both Th1 and Th2 cytokines upon peptide stimulation. CD45RA(+)CCR7(-) terminal differentiation pattern was associated with low or non-functionality based on cytokine secretion. This study provides proof of principle for further peptide-MHC II tetramer guided approaches in the elucidation of limited immunological memory to B. pertussis and the resurgence of pertussis.
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Benedictus L, Otten HG, van Schaik G, van Ginkel WGJ, Heuven HCM, Nielen M, Rutten VPMG, Koets AP. Bovine Neonatal Pancytopenia is a heritable trait of the dam rather than the calf and correlates with the magnitude of vaccine induced maternal alloantibodies not the MHC haplotype. Vet Res 2014; 45:129. [PMID: 25516422 PMCID: PMC4269077 DOI: 10.1186/s13567-014-0129-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 12/03/2014] [Indexed: 01/12/2023] Open
Abstract
Bovine Neonatal Pancytopenia (BNP), a bleeding syndrome of neonatal calves, is caused by alloantibodies absorbed from the colostrum of particular cows. A commercial BVD vaccine is the likely source of alloantigens eliciting BNP associated alloantibodies. We hypothesized that the rare occurrence of BNP in calves born to vaccinated dams could be associated with genetic differences within dams and calves. We found that the development of BNP within calves was a heritable trait for dams, not for calves and had a high heritability of 19%. To elucidate which genes play a role in the development of BNP we sequenced candidate genes and characterized BNP alloantibodies. Alloantigens present in the vaccine have to be presented to the dam’s immune system via MHC class II, however sequencing of DRB3 showed no differences in MHC class II haplotype between BNP and non-BNP dams. MHC class I, a highly polymorphic alloantigen, is an important target of BNP alloantibodies. Using a novel sequence based MHC class I typing method, we found no association of BNP with MHC class I haplotype distribution in dams or calves. Alloantibodies were detected in both vaccinated BNP and non-BNP dams and we found no differences in alloantibody characteristics between these groups, but alloantibody levels were significantly higher in BNP dams. We concluded that the development of BNP in calves is a heritable trait of the dam rather than the calf and genetic differences between BNP and non-BNP dams are likely due to genes controlling the quantitative alloantibody response following vaccination.
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van den Broek T, Hoppenreijs E, Meerding J, Scholman R, Otten HG, Swart JF, Martini A, Prakken B, de Jager W. Cytokine profiling at disease onset: support for classification of young antinuclear antibody-positive patients as a separate category of juvenile idiopathic arthritis. Ann Rheum Dis 2014; 74:470-2. [PMID: 25384964 DOI: 10.1136/annrheumdis-2014-206424] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Otten HG, Joosten I, Allebes WA, van der Meer A, Hilbrands LB, Baas M, Spierings E, Hack CE, van Reekum F, van Zuilen AD, Verhaar MC, Bots ML, Seelen MAJ, Sanders JSF, Hepkema BG, Lambeck AJ, Bungener LB, Roozendaal C, Tilanus MGJ, Vanderlocht J, Voorter CE, Wieten L, van Duijnhoven E, Gelens M, Christiaans M, van Ittersum F, Nurmohamed A, Lardy NM, Swelsen WT, van Donselaar-van der Pant KAMI, van der Weerd NC, Ten Berge IJM, Bemelman FJ, Hoitsma AJ, de Fijter JW, Betjes MGH, Roelen DL, Claas FHJ. The PROCARE consortium: toward an improved allocation strategy for kidney allografts. Transpl Immunol 2014; 31:184-90. [PMID: 25258025 DOI: 10.1016/j.trim.2014.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Kidney transplantation is the best treatment option for patients with end-stage renal failure. At present, approximately 800 Dutch patients are registered on the active waiting list of Eurotransplant. The waiting time in the Netherlands for a kidney from a deceased donor is on average between 3 and 4 years. During this period, patients are fully dependent on dialysis, which replaces only partly the renal function, whereas the quality of life is limited. Mortality among patients on the waiting list is high. In order to increase the number of kidney donors, several initiatives have been undertaken by the Dutch Kidney Foundation including national calls for donor registration and providing information on organ donation and kidney transplantation. The aim of the national PROCARE consortium is to develop improved matching algorithms that will lead to a prolonged survival of transplanted donor kidneys and a reduced HLA immunization. The latter will positively affect the waiting time for a retransplantation. The present algorithm for allocation is among others based on matching for HLA antigens, which were originally defined by antibodies using serological typing techniques. However, several studies suggest that this algorithm needs adaptation and that other immune parameters which are currently not included may assist in improving graft survival rates. We will employ a multicenter-based evaluation on 5429 patients transplanted between 1995 and 2005 in the Netherlands. The association between key clinical endpoints and selected laboratory defined parameters will be examined, including Luminex-defined HLA antibody specificities, T and B cell epitopes recognized on the mismatched HLA antigens, non-HLA antibodies, and also polymorphisms in complement and Fc receptors functionally associated with effector functions of anti-graft antibodies. From these data, key parameters determining the success of kidney transplantation will be identified which will lead to the identification of additional parameters to be included in future matching algorithms aiming to extend survival of transplanted kidneys and to diminish HLA immunization. Computer simulation studies will reveal the number of patients having a direct benefit from improved matching, the effect on shortening of the waiting list, and the decrease in waiting time.
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Schmitz MF, Otten HG, Franssen LE, van Dorp S, Strooisma T, Lokhorst HM, van de Donk NWCJ. Secondary monoclonal gammopathy of undetermined significance after allogeneic stem cell transplantation in multiple myeloma. Haematologica 2014; 99:1846-53. [PMID: 25193963 DOI: 10.3324/haematol.2014.111104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In the course of multiple myeloma, patients may develop a M-protein band different from the original: secondary monoclonal gammopathy of undetermined significance. In this retrospective single center analysis, we describe the occurrence and clinical relevance of secondary monoclonal gammopathy of undetermined significance after allogeneic stem cell transplantation (post-transplant monoclonal gammopathy of undetermined significance). A total of 138 patients who had undergone 139 allogeneic stem cell transplantations (39.6% in the upfront setting and 60.4% for relapsed multiple myeloma) were included in the study. Sixty-seven (48.2%) patients developed secondary monoclonal gammopathy of undetermined significance, after a median latency of 6.9 months. Secondary monoclonal gammopathy of undetermined significance occurred more often in patients who achieved at least very good partial response after allogeneic stem cell transplantation, compared to partial response or less (54.8% vs. 26.5%; P=0.005). The incidence was also higher in the upfront setting as compared to relapsed disease, or with a sibling donor compared to matched unrelated donor, but less often after T-cell depletion. Importantly, development of post-transplant monoclonal gammopathy of undetermined significance as a time-dependent variable independently predicted for superior progression-free and overall survival (median progression-free survival 37.5 vs. 6.3 months, P<0.001; median overall survival 115.3 vs. 31.0 months, P=0.004). Clinicians should be aware of the benign nature of this phenomenon, and secondary monoclonal gammopathy of undetermined significance should not be confused with relapse or progression of disease. (Trial registered with trialregister.nl; HOVON 108: NTR 2958.).
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Mubarak A, Spierings E, Wolters VM, Otten HG, ten Kate FJW, Houwen RHJ. Children with celiac disease and high tTGA are genetically and phenotypically different. World J Gastroenterol 2013; 19:7114-7120. [PMID: 24222955 PMCID: PMC3819547 DOI: 10.3748/wjg.v19.i41.7114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 07/05/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate whether celiac disease (CD) patients with tissue-transglutaminase antibody (tTGA) ≥ 100 U/mL are different from patients with lower tTGA levels.
METHODS: Biopsy-proven (Marsh III) pediatric CD patients (n = 116) were prospectively included between March 2009 and October 2012. The biopsies were evaluated by a single pathologist who was blinded to all of the patients’ clinical data. The patients were distributed into 2 groups according to their tTGA level, which was measured using enzyme-linked immunoassay: tTGA ≥ 100 U/mL and tTGA < 100 U/mL. The patients’characteristics, symptoms, human leukocyte antigen (HLA) genotype and degree of histological involvement were compared between the 2 groups.
RESULTS: A total of 34 (29.3%) children had tTGA values < 100 U/mL and 82 (70.7%) tTGA levels of ≥ 100 U/mL. Patients with high tTGA levels had lower average body weight-for-height standard deviation scores (SDS) than did patients with tTGA < 100 U/mL (-0.20 ± 1.19 SDS vs 0.23 ± 1.03 SDS, P = 0.025). In the low tTGA group, gastrointestinal symptoms were more common (97.1% vs 75.6%, P = 0.006). More specifically, abdominal pain (76.5% vs 51.2%; P = 0.012) and nausea (17.6% vs 3.7%, P = 0.018) were more frequent among patients with low tTGA. In contrast, patients with solely extraintestinal manifestations were only present in the high tTGA group (18.3%, P = 0.005). These patients more commonly presented with aphthous stomatitis (15.9% vs 0.0%, P = 0.010) and anemia (32.9% vs 11.8%, P = 0.019). In addition, when evaluating the number of CD-associated HLA-DQ heterodimers (HLA-DQ2.5, HLA-DQ2.2 and HLA-DQ8), patients with low tTGA levels more commonly had only 1 disease-associated heterodimer (61.8% vs 31.7%, P = 0.005), while patients with high tTGA more commonly had multiple heterodimers. Finally, patients with tTGA ≥ 100 U/mL more often had a Marsh IIIc lesion (73.2% vs 20.6%, P < 0.001) while in patients with low tTGA patchy lesions were more common (42.4% vs 6.8%, P < 0.001).
CONCLUSION: Patients with tTGA ≥ 100 U/mL show several signs of more advanced disease. They also carry a larger number of CD associated HLA-DQ heterodimers.
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Budding K, van de Graaf EA, Hoefnagel T, Hack CE, Otten HG. Anti-BPIFA1/SPLUNC1: a new autoantibody prevalent in patients with endstage cystic fibrosis. J Cyst Fibros 2013; 13:281-8. [PMID: 24269518 DOI: 10.1016/j.jcf.2013.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 09/25/2013] [Accepted: 10/03/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bactericidal/permeability increasing protein fold containing family A (BPIFA) 1, is a secreted protein of the upper airways that shares structural homology with BPI and exhibits comparable antimicrobial capacities. We hypothesized that CF patients have circulating IgG or IgA anti-BPIFA1 autoantibodies, similarly as reported for BPI autoantibodies. METHODS We analyzed pre- and post-transplantation sera from 67 endstage lung disease patients who underwent lung transplantation (LTx) because of COPD (n=27), CF (n=25), and ILD (n=15). RESULTS Anti-BPIFA1 (48%) and anti-BPI (92%) were elevated in CF patients compared to healthy controls, with anti-BPIFA1 IgG isotype being most prevalent, whereas anti-BPI is of the IgA isotype. Levels of anti-BPI autoantibodies significantly declined post-LTx, whereas anti-BPIFA1 did not. No relation was found between autoantibodies against BPIFA1 and BPI. CONCLUSION Our results indicate that BPIFA1 is a novel target for autoantibodies in CF. The function of these autoantibodies needed to be investigated in future studies.
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Otten HG, Verhaar MC, Borst HPE, van Eck M, van Ginkel WGJ, Hené RJ, van Zuilen AD. The significance of pretransplant donor-specific antibodies reactive with intact or denatured human leucocyte antigen in kidney transplantation. Clin Exp Immunol 2013; 173:536-43. [PMID: 23627692 DOI: 10.1111/cei.12127] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2013] [Indexed: 11/30/2022] Open
Abstract
Antibodies recognizing denatured human leucocyte antigen (HLA) can co-react with epitopes on intact HLA or recognize cryptic epitopes which are normally unaccessible to HLA antibodies. Their specificity cannot be distinguished by single antigen beads (SAB) alone, as they carry a mixture of intact and denatured HLA. In this study, we selected pretransplant sera containing donor-specific HLA class I antibodies (DSA) according to regular SAB analysis from 156 kidney transplant recipients. These sera were analysed using a SAB preparation (iBeads) which is largely devoid of denatured HLA class I, and SAB coated with denatured HLA class I antigens. A total of 241 class I DSA were found by regular SAB analysis, of which 152 (63%) were also found by iBeads, whereas 28 (11%) were caused by reactivity with denatured DNA. Patients with DSA defined either by regular SAB or iBeads showed a significantly lower graft survival rate (P = 0·007) compared to those without HLA class I DSA, whereas reactivity to exclusively denatured HLA was not associated with decreased graft survival. In addition, DSA defined by reactivity to class I SAB or class I iBeads occurred more frequently in female patients and in patients with historic HLA sensitization, whereas reactivity to denatured HLA class I was not associated with any of these parameters. Our data suggest that pretransplant donor-specific antibodies against denatured HLA are clinically irrelevant in patients already sensitized against intact HLA.
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Klemans RJB, Broekman HCHP, Knol EF, Bruijnzeel-Koomen CAFM, Otten HG, Pasmans SGMA, Knulst AC. Ara h 2 is the best predictor for peanut allergy in adults. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2013; 1:632-8.e1. [PMID: 24565711 DOI: 10.1016/j.jaip.2013.07.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 07/08/2013] [Accepted: 07/30/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Specific IgE (sIgE) to Ara h 2 as a clinical predictor for peanut allergy in children has a diagnostic value comparable with a prediction model that contains sex, skin prick test (SPT), sIgE to peanut extract, and total IgE minus sIgE. In adults, the diagnostic value of peanut components has not yet been studied. OBJECTIVE To validate a pediatric prediction model in an adult population; to define the diagnostic value of sIgE to peanut components. METHODS Validation was performed by discrimination with an area under the receiver operating characteristic curve (AUC) and calibration with the Hosmer-Lemeshow test. The diagnostic value of the peanut components was assessed with the AUC. RESULTS Validation of the pediatric model in 94 adults showed poor discrimination (AUC, 0.64) but good calibration (P = .48); sIgE to Ara h 2 was the best diagnostic predictor (AUC, 0.76). By using a cutoff value with a 100% positive predictive value (≥1.75 kU/L), 28% of patients could be diagnosed with 100% accuracy. The highest negative predictive value was 63%. A higher negative predictive value could not be calculated for any other test. Although sIgE to Ara h 2 was significantly correlated with severity, it did not discriminate between mild and severe allergy in individual patients (AUC < 0.65). CONCLUSION sIgE to Ara h 2 has the best discriminative ability of all diagnostic tests. It can accurately diagnose peanut allergy in 28% of patients but cannot be used to exclude a peanut allergy in an adult population.
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Otten HG, Calis JJA, Keşmir C, van Zuilen AD, Spierings E. Predicted indirectly recognizable HLA epitopes presented by HLA-DR correlate with the de novo development of donor-specific HLA IgG antibodies after kidney transplantation. Hum Immunol 2012; 74:290-6. [PMID: 23232063 DOI: 10.1016/j.humimm.2012.12.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 11/21/2012] [Accepted: 12/03/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND HLA class-I mismatches selectively induce antibody formation after kidney transplantation. The de novo development of donor-specific IgG HLA class-I antibodies may be dependent on the HLA class-II background of the patient by presenting T-helper epitopes within the recognized HLA class-I antigens. METHODS The correlation between antibody production against mismatched donor human leukocyte antigens (HLA) class I and the number of HLA class II-restricted predicted indirectly recognizable HLA epitopes (PIRCHE-II) in the respective HLA class-I mismatches was investigated. To this end, we analyzed sera taken after nephrectomy from a cohort of 21 non-immunized individuals that received a renal transplant. RESULTS Fourty-nine HLA class-I mismatches were found which all contained immunogenic eplets according to HLAMatchmaker. Donor specific HLA antibody responses were detected against 38 HLA class-I mismatches after nephrectomy. These mismatches were found to contain a larger number of PIRCHE-II when compared to mismatches which did not induce donor specific HLA antibodies. Most PIRCHE-II (68%) were not part of an eplet as defined by HLAMatchmaker. CONCLUSIONS Our data suggest that presentation of donor-derived HLA class-I peptides by recipient HLA class-II molecules plays a significant role in de novo development of donor-specific IgG HLA antibodies.
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Otten HG, Verhaar MC, Borst HPE, Hené RJ, van Zuilen AD. Pretransplant donor-specific HLA class-I and -II antibodies are associated with an increased risk for kidney graft failure. Am J Transplant 2012; 12:1618-23. [PMID: 22404993 DOI: 10.1111/j.1600-6143.2011.03985.x] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Pretransplant risk assessment of graft failure is important for donor selection and choice of immunosuppressive treatment. We examined the relation between kidney graft failure and presence of IgG donor specific HLA antibodies (DSA) or C1q-fixing DSA, detected by single antigen bead array (SAB) in pretransplant sera from 837 transplantations. IgG-DSA were found in 290 (35%) sera, whereas only 30 (4%) sera had C1q-fixing DSA. Patients with both class-I plus -II DSA had a 10 yr graft survival of 30% versus 72% in patients without HLA antibodies (p < 0.001). No significant difference was observed in graft survival between patients with or without C1q-fixing DSA. Direct comparison of both assays showed that high mean fluorescence intensity values on the pan-IgG SAB assay are generally related to C1q-fixation. We conclude that the presence of class-I plus -II IgG DSA as detected by SAB in pretransplant sera of crossmatch negative kidney recipients is indicative for an increased risk for graft failure, whereas the clinical significance of C1q-fixing IgG-DSA could not be assessed due to their low prevalence.
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Paantjens AWM, van de Graaf EA, Kwakkel-van Erp JM, Hoefnagel T, van Kessel DA, van den Bosch JMM, Otten HG. Lung transplantation affects expression of the chemokine receptor type 4 on specific T cell subsets. Clin Exp Immunol 2011; 166:103-9. [PMID: 21910727 DOI: 10.1111/j.1365-2249.2011.04450.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Alloreactive T cells that infiltrate the graft after lung transplantation (LTx) play a role in chronic rejection. Chemokines such as thymus and activation-regulated chemokine (TARC), macrophage-derived chemokine (MDC) and monocyte chemotactic protein-1 (MCP-1) are produced locally in the lung and attract T cells via chemokine receptor 4 (CCR4). In a TARC gradient, cells expressing CCR4(++) migrate more efficiently than CCR4(+) -expressing cells. In this study, we compared the CCR4 expression of T cells in blood from 20 lung transplant recipients to healthy controls. We then examined whether CCR4 expression is associated with the occurrence of chronic rejection. The CCR4(++) expression was decreased on CD4 T cells from LTx patients (P < 0·0001) when compared to healthy controls. The analysis of CD4 T cell subsets showed that this decrease was present on central memory, effector memory and terminally differentiated T cells (P = 0·0007, P < 0·0001 and P = 0·05, respectively), while a trend was found for naive CD4 T cells (P = 0·06). Also, the expression of CCR4(+) on regulatory T cells (T(regs) ) was decreased in LTx patients when compared to healthy controls (P = 0·02). Interestingly, the CCR4(++) expression on CD4 effector memory T cells was decreased in patients developing chronic rejection sometimes more than a year before the clinical diagnosis when compared to patients who did not (P = 0·04). The analysis of CD8 T cell subsets only showed the CCR4(+) expression to be increased significantly on effector memory and terminally differentiated CD8 T cells (P = 0·02, P = 0·03, respectively) in LTx patients, but no relation was found in chronic rejection. In conclusion, the expression of CCR4 on T cell subsets was altered after LTx and appears to be related to chronic rejection.
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Kwakkel-van Erp JM, Paantjens AWM, van Kessel DA, Grutters JC, van den Bosch JMM, van de Graaf EA, Otten HG. Mannose-binding lectin deficiency linked to cytomegalovirus (CMV) reactivation and survival in lung transplantation. Clin Exp Immunol 2011; 165:410-6. [PMID: 21707593 DOI: 10.1111/j.1365-2249.2011.04436.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Despite the use of immunosuppressives mainly influencing T and B cell responses, the prevalence of the bronchiolitis obliterans syndrome (BOS) after lung transplantation is high. Mannose-binding lectin (MBL) is a pattern recognition molecule of complement and an important component of the innate immunity. MBL is associated with rejection, infection and survival in other solid organ transplantations. In this study the relation between functional MBL levels and cytomegalovirus (CMV) reactivations and the development of BOS and survival after lung transplantation was investigated. MBL levels were measured in 85 patients before and in 57 of these patients after lung transplantation. The relation of MBL on survival, CMV reactivation and the development of BOS were investigated with Kaplan-Meier (log-rank) survival analysis. MBL levels decreased on average by 20% (P < 0·001) after transplantation and eventually returned to pretransplant levels. Fourteen of the 85 patients had deficient pretransplant MBL levels and these patients had a tendency towards a better survival compared to those with normal MBL levels (P = 0·08). Although no correlation was found between MBL deficiency and the development of BOS, more CMV reactivations occurred in recipients with deficient versus normal levels of MBL (P = 0·03). Our results suggest that MBL deficiency is associated with CMV reactivations and a longer overall survival, but not with the development of BOS.
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Paantjens AWM, van de Graaf EA, Heerkens HD, Kwakkel-van Erp JM, Hoefnagel T, van Kessel DA, van den Bosch JMM, Otten HG. Chimerism of dendritic cell subsets in peripheral blood after lung transplantation. J Heart Lung Transplant 2011; 30:691-7. [PMID: 21388830 DOI: 10.1016/j.healun.2011.01.706] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 01/06/2011] [Accepted: 01/10/2011] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Passenger leukocytes of donor origin are transferred to the patient resulting in circulatory microchimerism after lung transplantation (LTx). This chimeric state has been shown to occur in the total leukocyte fraction as well as unseparated peripheral blood mononuclear cells (PBMCs). In this study we determined the microchimerism levels of B cells, monocytes, natural killer (NK) and T cells and dendritic cell (DC) subsets (mDC1, mDC2 and pDC) during the first year after lung transplantation. METHODS To identify circulating donor cells, 11 donor-patient combinations were selected, which were mismatched for HLA-B8. Analysis consisted of flow cytometry on a minimum of 1 million PBMCs taken monthly up to 1 year after LTx. RESULTS Levels of microchimerism were found to be stable after LTx for all cell types investigated, although for NK+T cells an above-baseline chimerism of donor cells from the donor lung was observed in the first month after transplantation. Circulating PBMCs consisted of, on average, 0.002%, 1.7%, 0.03% and 0.001% of B cells, monocytes, NK+T cells and DCs, respectively, indicating that overall levels of microchimerism differed between the cell types investigated. In 2 patients no B-cell chimerism and in 1 patient no DC chimerism could be detected. Cell types and DC subsets of recipient origin were normally distributed. Conversely, monocytes, B cells and DCs of donor origin were increased and donor NK+T cells were decreased in number, compared with the recipient ratios. Analysis of circulating recipient DCs showed a normal distribution of mDC1s (70%), mDC2s (5%) and pDCs (25%). However, circulating donor DCs consisted of 80%, 20% and <1% of DC subsets mDC1, MDC2 and pDC, indicating that donor plasmacytoid dendritic cells were not detectable in the circulation. CONCLUSIONS In the first year after lung transplantation a stable microchimerism was detected for all cell types investigated. However, donor pDCs were consistently absent in all samples investigated, which may be linked with graft rejection often observed after LTx.
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Paantjens AWM, van de Graaf EA, van Ginkel WGJ, van den Bosch JMM, Otten HG. Lung transplantation under a tacrolimus/mycophenolate mofetil-based immunosuppressive regimen results in low titers of HLA and MICA IgG antibodies which are not related to development of BOS. J Heart Lung Transplant 2010; 29:596-8. [PMID: 20207170 DOI: 10.1016/j.healun.2009.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 10/06/2009] [Accepted: 10/11/2009] [Indexed: 11/25/2022] Open
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de Jong H, Berlo SE, Hombrink P, Otten HG, van Eden W, Lafeber FP, Heurkens AHM, Bijlsma JWJ, Glant TT, Prakken BJ. Cartilage proteoglycan aggrecan epitopes induce proinflammatory autoreactive T-cell responses in rheumatoid arthritis and osteoarthritis. Ann Rheum Dis 2010; 69:255-62. [PMID: 19213744 DOI: 10.1136/ard.2008.103978] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To explore potential T-cell epitopes of the core protein of human cartilage proteoglycan aggrecan (PG) in patients with rheumatoid arthritis (RA) or osteoarthritis. METHODS Peptide-specific T-cell proliferation and cytokine/chemokine production in response to PG-specific peptides were measured in RA and osteoarthritis patients and in healthy controls. RESULTS Peptides representing amino acid regions 16-39 and 263-282 of PG were most frequently recognised by T cells in a subset of patients with RA or osteoarthritis. Peripheral blood mononuclear cells from these PG-reactive RA and osteoarthritis patients showed increased production of proinflammatory cytokines/chemokines in response to PG peptide stimulation. As PG p263-282 was found to show high sequence homology with Yersinia Yop protein, the corresponding bacterial (Yersinia) peptide was also tested. Remarkably, RA and osteoarthritis patients responding to the Yersinia peptide also responded to p263-282 of PG suggesting a possibility of molecular mimicry in these patients. CONCLUSIONS These results indicate that PG-specific peptides, located in the G1 domain of PG, can induce (auto)antigenic T-cell responses in RA and osteoarthritis patients. These peptides might thus be involved in the immune pathogenesis and/or cartilage degradation in RA and osteoarthritis.
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Heidema J, Rossen JWA, Lukens MV, Ketel MS, Scheltens E, Kranendonk MEG, van Maren WWC, van Loon AM, Otten HG, Kimpen JLL, van Bleek GM. Dynamics of Human Respiratory Virus-Specific CD8+ T Cell Responses in Blood and Airways during Episodes of Common Cold. THE JOURNAL OF IMMUNOLOGY 2008; 181:5551-9. [DOI: 10.4049/jimmunol.181.8.5551] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Paantjens AWM, Kwakkel-van Erp JM, van Ginkel WGJ, van Kessel DA, van den Bosch JMM, van de Graaf EA, Otten HG. Serum thymus and activation regulated chemokine levels post-lung transplantation as a predictor for the bronchiolitis obliterans syndrome. Clin Exp Immunol 2008; 154:202-8. [PMID: 18785972 DOI: 10.1111/j.1365-2249.2008.03764.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The main reason for mortality after lung transplantation is the bronchiolitis obliterans syndrome (BOS), which represents chronic rejection. As soluble CD30, which is produced mainly by activated T helper 2 (Th2) cells, was shown to be related to development of BOS, we aimed to investigate the relation between development of BOS and Th2 chemoattractant thymus and activation regulated chemokine (TARC/CCL17). In 54 patients we measured serum TARC levels prior to transplantation by enzyme-linked immunosorbent assay, and in 44 of these patients sera were analysed at months 1, 2 and 3 after lung transplantation. In addition, longitudinal measurements were performed in sera from eight healthy controls and 14 patients, the latter taken over a period of 2 years post-transplantation from seven patients developing BOS plus seven clinically matched BOS-free patients. Median serum TARC levels post-transplantation of patients who developed BOS were significantly lower than those of the matched BOS-free patients (P = 0.05). A receiver operating characteristics analysis (area under the curve 0.77), together with a Kaplan-Meyer analysis, showed that serum TARC levels below 325 pg/ml in the first month post-transplantation can predict development of BOS post-transplantation (P = 0.001). In contrast, pretransplant serum TARC levels were not significantly different between patients developing BOS, BOS-free patients or healthy controls. In conclusion, pretransplantation serum TARC levels do not predict the development of BOS post-transplantation, but measurement of the serum TARC levels in the first month directly after transplantation can provide us with a tool to identify the group at risk of developing BOS.
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Kwakkel-van Erp JM, van de Graaf EA, Paantjens AW, van Ginkel WG, Schellekens J, van Kessel DA, van den Bosch JM, Otten HG. The Killer Immunoglobulin-Like Receptor (KIR) Group A Haplotype is Associated With Bronchiolitis Obliterans Syndrome After Lung Transplantation. J Heart Lung Transplant 2008; 27:995-1001. [DOI: 10.1016/j.healun.2008.06.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Revised: 06/04/2008] [Accepted: 06/10/2008] [Indexed: 11/26/2022] Open
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van Dijk AMC, Kessler FL, Verdonck LF, Stadhouders-Keet SAE, van Lier RAW, de Gast GC, Otten HG. Primary human keratinocytes as targets in predicting acute graft-versus-host disease following HLA-identical bone marrow transplantation. Br J Haematol 2008. [DOI: 10.1111/j.1365-2141.2000.02446.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Heidema J, Lukens MV, van Maren WWC, van Dijk MEA, Otten HG, van Vught AJ, van der Werff DBM, van Gestel SJP, Semple MG, Smyth RL, Kimpen JLL, van Bleek GM. CD8+ T cell responses in bronchoalveolar lavage fluid and peripheral blood mononuclear cells of infants with severe primary respiratory syncytial virus infections. THE JOURNAL OF IMMUNOLOGY 2008; 179:8410-7. [PMID: 18056387 DOI: 10.4049/jimmunol.179.12.8410] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A protective role for CD8+ T cells during viral infections is generally accepted, but little is known about how CD8+ T cell responses develop during primary infections in infants, their efficacy, and how memory is established after viral clearance. We studied CD8+ T cell responses in bronchoalveolar lavage (BAL) samples and blood of infants with a severe primary respiratory syncytial virus (RSV) infection. RSV-specific CD8+ T cells with an activated effector cell phenotype: CD27+CD28+CD45RO+CCR7-CD38+HLA-DR+Granzyme B+CD127- could be identified in BAL and blood. A high proportion of these CD8+ T cells proliferated and functionally responded upon in vitro stimulation with RSV Ag. Thus, despite the very young age of the patients, a robust systemic virus-specific CD8+ T cell response was elicited against a localized respiratory infection. RSV-specific T cell numbers as well as the total number of activated effector type CD8+ T cells peaked in blood around day 9-12 after the onset of primary symptoms, i.e., at the time of recovery. The lack of a correlation between RSV-specific T cell numbers and parameters of disease severity make a prominent role in immune pathology unlikely, in contrast the T cells might be involved in the recovery process.
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Schellekens J, Rozemuller EH, Borst HPE, Otten HG, van den Tweel JG, Tilanus MGJ. NK-KIR ligand identification: a quick Q-PCR approach for HLA-C epitope typing. ACTA ACUST UNITED AC 2007; 69:334-7. [PMID: 17389017 DOI: 10.1111/j.1399-0039.2007.00809.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Interaction of donor natural killer (NK)-cell-associated killer cell immunoglobulin-like receptors (KIRs) with the patient's human leukocyte antigen-C (HLA-C) ligands can result in an alloreactive NK response after haematopoietic stem cell transplantation. In many retrospective studies, additional HLA-C-typing data are required to predict NK-cell alloreactivity. We developed a Taqman assay using the quantitative polymerase chain reaction (Q-PCR) technique that facilitates HLA-C epitope typing, allowing the assignment of HLA-C group 1 or 2 alleles based on the dimorphism at residues 77 and 80 rather than based on the sequence specific priming (SSP) and sequence-based typing allele types. Q-PCR analysis for HLA-C epitope detection showed three clusters reflecting homozygous group 1 or 2 and heterozygous samples. This new approach introduces a quick HLA-C epitope screening method to define the presence of the ligand for the KIR-HLA-C interaction.
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Reinders J, Rozemuller EH, Otten HG, van der Veken LTJN, Slootweg PJ, Tilanus MGJ. HLA and MICA associations with head and neck squamous cell carcinoma. Oral Oncol 2007; 43:232-40. [PMID: 16857416 DOI: 10.1016/j.oraloncology.2006.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2006] [Revised: 03/08/2006] [Accepted: 03/09/2006] [Indexed: 11/24/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a very aggressive tumour arising from the epithelial lining of the upper aerodigestive tract. The precise mechanisms involved in the pathogenesis of HNSCC have not been elucidated. Previous studies observed aberrant HLA expression patterns on HNSCC tumour cells and this study focused on the allelic polymorphism of HLA genes and the MHC class I chain related gene A (MICA) and HNSCC. We investigated whether associations with HLA and/or MIC alleles or haplotypes are involved in the pathogenesis of HNSCC and could explain the observed HLA expression patterns. Patients and controls were typed for HLA-A, HLA-B, HLA-C, HLA-DRB1 and HLA-DQB1 with sequence specific priming (SSP), supplemented with sequencing based typing (SBT). MICA allelic polymorphism was included and MICA allele assignment was based upon the combination of high resolution SBT of exons 2-4 in combination with repeat analysis and nucleotide polymorphism of exon 5. HLA-B *35 (p=0.014, OR=0.31) and HLA-B *40 (p=0.013, OR=2.9) were significantly associated in respectively the metastasized patients and the oral cavity patients. In addition, the HLA-B *40-DRB1 *13 haplotype (p=0.016, OR=4.1) was more often observed in the oral cavity patient group. The biological significance of the prevalence of specific HLA haplotypes in patients with oral cavity HNSCC and metastasizing HNSCC requires further investigation.
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Schellekens J, Rozemuller EH, Eric Borst H, Otten HG, van den Tweel JG, Tilanus MG. 142-P. Hum Immunol 2006. [DOI: 10.1016/j.humimm.2006.08.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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75
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Haveman LM, Bierings M, Legger E, Klein MR, de Jager W, Otten HG, Albani S, Kuis W, Sette A, Prakken BJ. Novel pan-DR-binding T cell epitopes of adenovirus induce pro-inflammatory cytokines and chemokines in healthy donors. Int Immunol 2006; 18:1521-9. [PMID: 16954167 DOI: 10.1093/intimm/dxl085] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adenovirus can cause fatal infections in the immunocompromised host. To date, no effective anti-viral therapy is available. Adoptive therapy with adenovirus-specific T cells could be a promising treatment, but requires the identification of such T cells. Aim of this study was to identify conserved adenoviral T cell epitopes recognized in a majority of healthy individuals. By using a computer algorithm designed to predict pan-HLA-DR-binding T cell epitopes, we selected 19 peptides of adenovirus serotype 5. PBMCs from 26 healthy subjects were isolated and incubated with these peptides to test epitope-specific T cell proliferation. Six epitopes derived from E1B protein, hexon protein (two epitopes), DNA polymerase, E3A glycoprotein and fiber protein induced a proliferative T cell response in the majority of healthy controls. In vitro MHC binding assays confirmed the potential capacity of the adenovirus epitopes to bind multiple MHC alleles. The cytokine and chemokine profile induced by these epitopes was determined with a multiplex immunoassay and revealed a predominant pro-inflammatory pattern. Based on the broad recognition and the induced cytokine and chemokine profile, the detected epitopes can be regarded as potential candidates to select adenovirus-specific T cells for immune intervention in the immunocompromised host.
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