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Polis B, Cuda CM, Putterman C. Animal models of neuropsychiatric systemic lupus erythematosus: deciphering the complexity and guiding therapeutic development. Autoimmunity 2024; 57:2330387. [PMID: 38555866 DOI: 10.1080/08916934.2024.2330387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/10/2024] [Indexed: 04/02/2024]
Abstract
Systemic lupus erythematosus (SLE) poses formidable challenges due to its multifaceted etiology while impacting multiple tissues and organs and displaying diverse clinical manifestations. Genetic and environmental factors contribute to SLE complexity, with relatively limited approved therapeutic options. Murine models offer insights into SLE pathogenesis but do not always replicate the nuances of human disease. This review critically evaluates spontaneous and induced animal models, emphasizing their validity and relevance to neuropsychiatric SLE (NPSLE). While these models undoubtedly contribute to understanding disease pathophysiology, discrepancies persist in mimicking some NPSLE intricacies. The lack of literature addressing this issue impedes therapeutic progress. We underscore the urgent need for refining models that truly reflect NPSLE complexities to enhance translational fidelity. We encourage a comprehensive, creative translational approach for targeted SLE interventions, balancing scientific progress with ethical considerations to eventually improve the management of NPSLE patients. A thorough grasp of these issues informs researchers in designing experiments, interpreting results, and exploring alternatives to advance NPSLE research.
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Affiliation(s)
- Baruh Polis
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Research Institute, Galilee Medical Center, Nahariya, Israel
| | - Carla M Cuda
- Division of Rheumatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Chaim Putterman
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Research Institute, Galilee Medical Center, Nahariya, Israel
- Division of Rheumatology and Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
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2
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Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses. Microorganisms 2023; 11:microorganisms11020346. [PMID: 36838310 PMCID: PMC9966117 DOI: 10.3390/microorganisms11020346] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a heterogeneous, multiorgan and potentially life-threatening drug-hypersensitivity reaction (DHR) that occurs several days or weeks after drug initiation or discontinuation. DHRs constitute an emerging issue for public health, due to population aging, growing multi-organ morbidity, and subsequent enhanced drug prescriptions. DRESS has more consistently been associated with anticonvulsants, allopurinol and antibiotics, such as sulphonamides and vancomycin, although new drugs are increasingly reported as culprit agents. Reactivation of latent infectious agents such as viruses (especially Herpesviridae) plays a key role in prompting and sustaining aberrant T-cell and eosinophil responses to drugs and pathogens, ultimately causing organ damage. However, the boundaries of the impact of viral agents in the pathophysiology of DRESS are still ill-defined. Along with growing awareness of the multifaceted aspects of immune perturbation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing SARS-CoV-2-related disease (COVID-19) pandemic, novel interest has been sparked towards DRESS and the potential interactions among antiviral and anti-drug inflammatory responses. In this review, we summarised the most recent evidence on pathophysiological mechanisms, diagnostic approaches, and clinical management of DRESS with the aim of increasing awareness on this syndrome and possibly suggesting clues for future research in this field.
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Grötzinger C. Applications of Peptide Microarrays in Autoantibody, Infection, and Cancer Detection. Methods Mol Biol 2023; 2578:1-15. [PMID: 36152276 DOI: 10.1007/978-1-0716-2732-7_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The diversity of the antigen-specific humoral immune response reflects the interaction of the immune system with pathogens and autoantigens. Peptide microarray analysis opens up new perspectives for the use of antibodies as diagnostic biomarkers and provides unique access to a more differentiated view on humoral responses to disease. This review focuses on the latest applications of peptide microarrays for the serologic medical diagnosis of autoimmunity, infectious diseases (including COVID-19), and cancer.
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Affiliation(s)
- Carsten Grötzinger
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
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Choi MY, Costenbader KH. Understanding the Concept of Pre-Clinical Autoimmunity: Prediction and Prevention of Systemic Lupus Erythematosus: Identifying Risk Factors and Developing Strategies Against Disease Development. Front Immunol 2022; 13:890522. [PMID: 35720390 PMCID: PMC9203849 DOI: 10.3389/fimmu.2022.890522] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/04/2022] [Indexed: 12/27/2022] Open
Abstract
There is growing evidence that preceding the diagnosis or classification of systemic lupus erythematosus (SLE), patients undergo a preclinical phase of disease where markers of inflammation and autoimmunity are already present. Not surprisingly then, even though SLE management has improved over the years, many patients will already have irreversible disease-related organ damage by time they have been diagnosed with SLE. By gaining a greater understanding of the pathogenesis of preclinical SLE, we can potentially identify patients earlier in the disease course who are at-risk of transitioning to full-blown SLE and implement preventative strategies. In this review, we discuss the current state of knowledge of SLE preclinical pathogenesis and propose a screening and preventative strategy that involves the use of promising biomarkers of early disease, modification of lifestyle and environmental risk factors, and initiation of preventative therapies, as examined in other autoimmune diseases such as rheumatoid arthritis and type 1 diabetes.
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Affiliation(s)
- May Y Choi
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.,Department of Medicine, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, McCaig Institute for Bone and Joint Health, Calgary, AB, Canada
| | - Karen H Costenbader
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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The Role of Exposomes in the Pathophysiology of Autoimmune Diseases II: Pathogens. PATHOPHYSIOLOGY 2022; 29:243-280. [PMID: 35736648 PMCID: PMC9231084 DOI: 10.3390/pathophysiology29020020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/28/2022] [Accepted: 05/29/2022] [Indexed: 11/21/2022] Open
Abstract
In our continuing examination of the role of exposomes in autoimmune disease, we use this review to focus on pathogens. Infections are major contributors to the pathophysiology of autoimmune diseases through various mechanisms, foremost being molecular mimicry, when the structural similarity between the pathogen and a human tissue antigen leads to autoimmune reactivity and even autoimmune disease. The three best examples of this are oral pathogens, SARS-CoV-2, and the herpesviruses. Oral pathogens reach the gut, disturb the microbiota, increase gut permeability, cause local inflammation, and generate autoantigens, leading to systemic inflammation, multiple autoimmune reactivities, and systemic autoimmunity. The COVID-19 pandemic put the spotlight on SARS-CoV-2, which has been called “the autoimmune virus.” We explore in detail the evidence supporting this. We also describe how viruses, in particular herpesviruses, have a role in the induction of many different autoimmune diseases, detailing the various mechanisms involved. Lastly, we discuss the microbiome and the beneficial microbiota that populate it. We look at the role of the gut microbiome in autoimmune disorders, because of its role in regulating the immune system. Dysbiosis of the microbiota in the gut microbiome can lead to multiple autoimmune disorders. We conclude that understanding the precise roles and relationships shared by all these factors that comprise the exposome and identifying early events and root causes of these disorders can help us to develop more targeted therapeutic protocols for the management of this worldwide epidemic of autoimmunity.
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Kaunisto H, Salmi T, Lindfors K, Kemppainen E. Antibody Responses to Transglutaminase 3 in Dermatitis Herpetiformis: Lessons from Celiac Disease. Int J Mol Sci 2022; 23:ijms23062910. [PMID: 35328331 PMCID: PMC8953297 DOI: 10.3390/ijms23062910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 12/13/2022] Open
Abstract
Dermatitis herpetiformis (DH) is the skin manifestation of celiac disease, presenting with a blistering rash typically on the knees, elbows, buttocks and scalp. In both DH and celiac disease, exposure to dietary gluten triggers a cascade of events resulting in the production of autoantibodies against the transglutaminase (TG) enzyme, mainly TG2 but often also TG3. The latter is considered to be the primary autoantigen in DH. The dynamics of the development of the TG2-targeted autoimmune response have been studied in depth in celiac disease, but the immunological process underlying DH pathophysiology is incompletely understood. Part of this process is the occurrence of granular deposits of IgA and TG3 in the perilesional skin. While this serves as the primary diagnostic finding in DH, the role of these immunocomplexes in the pathogenesis is unknown. Intriguingly, even though gluten-intolerance likely develops initially in a similar manner in both DH and celiac disease, after the onset of the disease, its manifestations differ widely.
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Affiliation(s)
- Helka Kaunisto
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33520 Tampere, Finland; (H.K.); (T.S.); (K.L.)
| | - Teea Salmi
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33520 Tampere, Finland; (H.K.); (T.S.); (K.L.)
- Department of Dermatology, Tampere University Hospital, FI-33520 Tampere, Finland
| | - Katri Lindfors
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33520 Tampere, Finland; (H.K.); (T.S.); (K.L.)
| | - Esko Kemppainen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, FI-33520 Tampere, Finland; (H.K.); (T.S.); (K.L.)
- Correspondence:
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Rekvig OP. The Anti-DNA Antibodies: Their Specificities for Unique DNA Structures and Their Unresolved Clinical Impact-A System Criticism and a Hypothesis. Front Immunol 2022; 12:808008. [PMID: 35087528 PMCID: PMC8786728 DOI: 10.3389/fimmu.2021.808008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is diagnosed and classified by criteria, or by experience, intuition and traditions, and not by scientifically well-defined etiology(ies) or pathogenicity(ies). One central criterion and diagnostic factor is founded on theoretical and analytical approaches based on our imperfect definition of the term “The anti-dsDNA antibody”. “The anti-dsDNA antibody” holds an archaic position in SLE as a unique classification criterium and pathogenic factor. In a wider sense, antibodies to unique transcriptionally active or silent DNA structures and chromatin components may have individual and profound nephritogenic impact although not considered yet – not in theoretical nor in descriptive or experimental contexts. This hypothesis is contemplated here. In this analysis, our state-of-the-art conception of these antibodies is probed and found too deficient with respect to their origin, structural DNA specificities and clinical/pathogenic impact. Discoveries of DNA structures and functions started with Miescher’s Nuclein (1871), via Chargaff, Franklin, Watson and Crick, and continues today. The discoveries have left us with a DNA helix that presents distinct structures expressing unique operations of DNA. All structures are proven immunogenic! Unique autoimmune antibodies are described against e.g. ssDNA, elongated B DNA, bent B DNA, Z DNA, cruciform DNA, or individual components of chromatin. In light of the massive scientific interest in anti-DNA antibodies over decades, it is an unexpected observation that the spectrum of DNA structures has been known for decades without being implemented in clinical immunology. This leads consequently to a critical analysis of historical and contemporary evidence-based data and of ignored and one-dimensional contexts and hypotheses: i.e. “one antibody - one disease”. In this study radical viewpoints on the impact of DNA and chromatin immunity/autoimmunity are considered and discussed in context of the pathogenesis of lupus nephritis.
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Affiliation(s)
- Ole Petter Rekvig
- Section of Autoimmunity, Fürst Medical Laboratory, Oslo, Norway.,Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Martín-Márquez BT, Satoh M, Hernández-Pando R, Martínez-García EA, Petri MH, Sandoval-García F, Pizano-Martinez O, García-Iglesias T, Corona-Meraz FI, Vázquez-Del Mercado M. The DNA co-vaccination using Sm antigen and IL-10 as prophylactic experimental therapy ameliorates nephritis in a model of lupus induced by pristane. PLoS One 2021; 16:e0259114. [PMID: 34705865 PMCID: PMC8550422 DOI: 10.1371/journal.pone.0259114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/12/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies such as anti-Sm. Studies in patients with SLE and murine models of lupus reveal that the most critical anti-Sm autoantibodies are predominantly direct against D1(83–119), D2, and B´/B epitopes. Objectives The present study aimed to analyze the induction of antigen-specific tolerance after prophylactic immunization with a DNA vaccine encoding the epitopes: D183-119, D2, B´/B, and B´/BCOOH in co-vaccination with IFN-γ or IL-10 in a murine model of lupus induced by pristane. Material and methods To obtain endotoxin-free DNA vaccines, direct cloning techniques using pcDNA were performed: D183-119, D2, B´/B, B´/BCOOH, IFN-γ, or IL-10. Lupus was induced by 0.5 mL of pristane via intraperitoneal in BALB/c female mice. Immunoprecipitation with K562 cells was metabolically labeled with 35S and ELISA to detect serum antibodies or mice IgG1, IgG2a isotypes. ELISA determined IL-10 and IFN-γ from splenocytes supernatants. Proteinuria was assessed monthly, and lupus nephritis was evaluated by immunofluorescence, and electron microscopy. Results The prophylactic co-vaccination with D2/IL-10 reduced the expression of kidney damage observed by electron microscopy, direct immunofluorescence, and H & E, along with reduced level of anti-nRNP/Sm antibodies (P = 0.048). Conclusion The prophylactic co-vaccination of IL-10 with D2 in pristane-induced lupus ameliorates the renal damage maybe by acting as prophylactic DNA tolerizing therapy.
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Affiliation(s)
- Beatriz Teresita Martín-Márquez
- Departamento de Biología Molecular, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Departamento de Biología Molecular, UDG-CA-703, "Inmunología y Reumatología", Guadalajara, Mexico
| | - Minoru Satoh
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Rogelio Hernández-Pando
- Departamento de Patología, Sección de Patología Experimental, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Erika Aurora Martínez-García
- Departamento de Biología Molecular, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Departamento de Biología Molecular, UDG-CA-703, "Inmunología y Reumatología", Guadalajara, Mexico
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Marcelo Heron Petri
- Departamento de Biología Molecular, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden
| | - Flavio Sandoval-García
- Departamento de Biología Molecular, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Departamento de Biología Molecular, UDG-CA-701, "Envejecimiento, Inmunometabolismo y estrés oxidativo", Ciudad de La Habana, Cuba
| | - Oscar Pizano-Martinez
- Departamento de Biología Molecular, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Departamento de Biología Molecular, UDG-CA-703, "Inmunología y Reumatología", Guadalajara, Mexico
- Departamento de Morfología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Trinidad García-Iglesias
- Departamento de Fisiología, Laboratorio de Inmunología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Fernanda Isadora Corona-Meraz
- Departamento de Biología Molecular, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Departamento de Biología Molecular, UDG-CA-701, "Envejecimiento, Inmunometabolismo y estrés oxidativo", Ciudad de La Habana, Cuba
- División de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá, Jalisco, México
| | - Monica Vázquez-Del Mercado
- Departamento de Biología Molecular, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Departamento de Biología Molecular, UDG-CA-703, "Inmunología y Reumatología", Guadalajara, Mexico
- División de Medicina Interna, Hospital Civil "Dr. Juan I. Menchaca", Servicio de Reumatología PNPC 004086 CONACyT, Guadalajara, Jalisco, México
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Sharma H, Bose A, Sachdeva R, Malik M, Kumar U, Pal R. Haemoglobin drives inflammation and initiates antigen spread and nephritis in lupus. Immunology 2021; 165:122-140. [PMID: 34549818 DOI: 10.1111/imm.13418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/30/2021] [Accepted: 09/14/2021] [Indexed: 01/15/2023] Open
Abstract
Haemoglobin (Hb) has well-documented inflammatory effects and is normally efficiently scavenged; clearance mechanisms can be overwhelmed during erythrocyte lysis. Whether Hb is preferentially inflammatory in lupus and triggers broad anti-self responses was assessed. Peripheral blood mononuclear cells (PBMCs) derived from SLE patients secreted higher levels of lupus-associated inflammatory cytokines when incubated with human Hb than did PBMCs derived from healthy donors, an effect negated by haptoglobin. Ferric murine Hb triggered the preferential release of lupus-associated cytokines from splenocytes, B cells, CD4 T cells, CD8 T cells and plasmacytoid dendritic cells isolated from ageing, lupus-prone NZM2410 mice, and also had mitogenic effects on B cells. Pull-downs, followed by mass spectrometry, revealed interactions of Hb with several lupus-associated autoantigens; co-incubation of ferric Hb with apoptotic blebs (structures that contain packaged autoantigens) revealed synergies-in terms of cytokine release and autoantibody production in vitro-that were also restricted to the lupus genotype. Murine ferric Hb activated multiple signalling pathways and, in combination with apoptotic blebs, preferentially triggered MAP kinase signalling specifically in splenocytes isolated from lupus-prone mice. Infusion of murine ferric Hb into lupus-prone mice led to enhanced release of lupus-associated cytokines, the generation of a spectrum of autoantibodies and enhanced-onset glomerulosclerosis. Given that the biased recognition of ferric Hb in a lupus milieu, possibly in concert with lupus-associated autoantigens, triggers inflammatory responses and the generation of lupus-associated cytokines, and also stimulates the generation of potentially pathogenic lupus-associated autoantibodies, neutralization of Hb could have beneficial effects.
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Affiliation(s)
- Hritika Sharma
- Immunoendocrinology Lab, National Institute of Immunology, New Delhi, India
| | - Anjali Bose
- Immunoendocrinology Lab, National Institute of Immunology, New Delhi, India
| | - Ruchi Sachdeva
- Immunoendocrinology Lab, National Institute of Immunology, New Delhi, India
| | - Monika Malik
- Immunoendocrinology Lab, National Institute of Immunology, New Delhi, India
| | - Uma Kumar
- Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Pal
- Immunoendocrinology Lab, National Institute of Immunology, New Delhi, India
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Pohlmeyer CW, Shang C, Han P, Cui ZH, Jones RM, Clarke AS, Murray BP, Lopez DA, Newstrom DW, Inzunza MD, Matzkies FG, Currie KS, Di Paolo JA. Characterization of the mechanism of action of lanraplenib, a novel spleen tyrosine kinase inhibitor, in models of lupus nephritis. BMC Rheumatol 2021; 5:15. [PMID: 33781343 PMCID: PMC8008554 DOI: 10.1186/s41927-021-00178-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 01/22/2021] [Indexed: 12/19/2022] Open
Abstract
Background B cells are critical mediators of systemic lupus erythematosus (SLE) and lupus nephritis (LN), and antinuclear antibodies can be found in the serum of approximately 98% of patients with SLE. Spleen tyrosine kinase (SYK) is a nonreceptor tyrosine kinase that mediates signaling from immunoreceptors, including the B cell receptor. Active, phosphorylated SYK has been observed in tissues from patients with SLE or cutaneous lupus erythematosus, and its inhibition is hypothesized to ameliorate disease pathogenesis. We sought to evaluate the efficacy and characterize the mechanism of action of lanraplenib, a selective oral SYK inhibitor, in the New Zealand black/white (NZB/W) murine model of SLE and LN. Methods Lanraplenib was evaluated for inhibition of primary human B cell functions in vitro. Furthermore, the effect of SYK inhibition on ameliorating LN-like disease in vivo was determined by treating NZB/W mice with lanraplenib, cyclophosphamide, or a vehicle control. Glomerulopathy and immunoglobulin G (IgG) deposition were quantified in kidneys. The concentration of proinflammatory cytokines was measured in serum. Splenocytes were analyzed by flow cytometry for B cell maturation and T cell memory maturation, and the presence of T follicular helper and dendritic cells. Results In human B cells in vitro, lanraplenib inhibited B cell activating factor-mediated survival as well as activation, maturation, and immunoglobulin M production. Treatment of NZB/W mice with lanraplenib improved overall survival, prevented the development of proteinuria, and reduced blood urea nitrogen concentrations. Kidney morphology was significantly preserved by treatment with lanraplenib as measured by glomerular diameter, protein cast severity, interstitial inflammation, vasculitis, and frequency of glomerular crescents; treatment with lanraplenib reduced glomerular IgG deposition. Mice treated with lanraplenib had reduced concentrations of serum proinflammatory cytokines. Lanraplenib blocked disease-driven B cell maturation and T cell memory maturation in the spleen. Conclusions Lanraplenib blocked the progression of LN-like disease in NZB/W mice. Human in vitro and murine in vivo data suggest that lanraplenib may be efficacious in preventing disease progression in patients with LN at least in part by inhibiting B cell maturation. These data provide additional rationale for the use of lanraplenib in the treatment of SLE and LN. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-021-00178-3.
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Affiliation(s)
| | - Ching Shang
- Department of Biology, Gilead Sciences, Inc., 333 Lakeside Dr, Foster City, CA, 94404, USA
| | - Pei Han
- Department of Biology, Gilead Sciences, Inc., 333 Lakeside Dr, Foster City, CA, 94404, USA
| | - Zhi-Hua Cui
- Department of Biology, Gilead Sciences, Inc., 333 Lakeside Dr, Foster City, CA, 94404, USA
| | - Randall M Jones
- Department of Biology, Gilead Sciences, Inc., 333 Lakeside Dr, Foster City, CA, 94404, USA
| | - Astrid S Clarke
- Department of Biology, Gilead Sciences, Inc., 333 Lakeside Dr, Foster City, CA, 94404, USA
| | - Bernard P Murray
- Department of Drug Metabolism, Gilead Sciences, Inc., Foster City, CA, USA
| | - David A Lopez
- Department of Biology, Gilead Sciences, Inc., 333 Lakeside Dr, Foster City, CA, 94404, USA
| | - David W Newstrom
- Department of Nonclinical Safety and Pathobiology, Gilead Sciences, Inc., Foster City, CA, USA
| | - M David Inzunza
- Department of Nonclinical Safety and Pathobiology, Gilead Sciences, Inc., Foster City, CA, USA
| | | | - Kevin S Currie
- Department of Chemistry, Gilead Sciences, Inc., Foster City, CA, USA
| | - Julie A Di Paolo
- Department of Biology, Gilead Sciences, Inc., 333 Lakeside Dr, Foster City, CA, 94404, USA
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Van Horebeek N, Vulsteke JB, Bossuyt X, Claeys KG, Dillaerts D, Poesen K, Lenaerts J, Van Damme P, Blockmans D, De Haes P, De Langhe E. Detection of multiple myositis-specific autoantibodies in unique patients with idiopathic inflammatory myopathy: A single centre-experience and literature review: Systematic review. Semin Arthritis Rheum 2021; 51:486-494. [PMID: 33831755 DOI: 10.1016/j.semarthrit.2021.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/23/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Myositis-specific autoantibodies (MSAs) are thought to be mutually exclusive in patients with idiopathic inflammatory myopathies (IIM) based on studies with immunoprecipitation-based (IP) detection methods. Recently, detection of multiple MSAs in unique patients is increasingly reported, but the extent of this phenomenon remains unclear. METHODS At our centre, we reviewed results from two line immunoassays and one dot immunoassay in 145 IIM patients and 240 controls for the presence of multiple MSAs. Pubmed and Embase were systematically searched for articles mentioning detection of multiple MSAs in IIM patients, published until February 2019. We assessed the frequency, detection method, the precise combinations and clinical phenotypes of participants with multiple MSAs. RESULTS At our centre, detection of multiple MSAs occurred in 3.4-8.3% of patients with IIM, depending on the assay. However, no cases with full concordance across all three assays were identified. Forty-four articles reported detection of multiple MSAs, representing a total of 133 cases, including four patients with a connective tissue disease other than IIM and two healthy controls. In 101 cases all MSAs were detected using only one detection method: 40 cases with IP-based methods (most frequently used technique) and 61 cases with other assay types. In most cases the phenotype of patients with multiple MSAs matched the predicted presentation associated with one MSA and in few cases the phenotype matched with both MSAs. CONCLUSION Detection of multiple MSAs in unique IIM patients is less rare than commonly accepted. Specificity issues of the commercially available multiplex immunoassays may, at least partly, explain the higher frequency compared to IP-based methods. 'True multiple MSA-positive' patients may exist, though they are most likely rare.
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Affiliation(s)
- Nele Van Horebeek
- General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Jean-Baptiste Vulsteke
- Rheumatology, University Hospitals Leuven, Leuven, Belgium; KU Leuven Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Laboratory of Tissue Homeostasis and Disease
| | - Xavier Bossuyt
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Clinical and Diagnostic Immunology, KU Leuven, Leuven, Belgium
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium; KU Leuven, Laboratory for Muscle Diseases and Neuropathies, Leuven, Belgium
| | | | - Koen Poesen
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; KU Leuven, Laboratory for Molecular Neurobiomarker Research, Leuven, Belgium
| | - Jan Lenaerts
- Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Philip Van Damme
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium; KU Leuven, Department of Neurosciences, Experimental Neurology, VIB Centre for Brain and Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Daniel Blockmans
- General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Petra De Haes
- Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Ellen De Langhe
- Rheumatology, University Hospitals Leuven, Leuven, Belgium; KU Leuven Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Laboratory of Tissue Homeostasis and Disease.
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12
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Ota T, Ota SI, Uchino A, Nagano S. IgG anti-hinge antibodies against IgG4 F(ab') 2 fragments generated using pepsin are useful diagnostic markers for rheumatoid arthritis: implications of the possible roles of metalloproteinases and IgG subclasses in generating immunogenic hinge epitopes. Arthritis Res Ther 2020; 22:161. [PMID: 32586370 PMCID: PMC7318515 DOI: 10.1186/s13075-020-02251-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Pepsin agglutinators, discovered over 50 years ago, have been recently referred to as anti-hinge antibodies (AHAs) because of their reaction with the IgG hinge epitope. AHAs have different reactivity for each hinge epitope generated by each protease that cleaves the hinge region at different sites. Moreover, AHAs have different reactivity against different hinge epitopes derived from each IgG subclass even when the same protease is used. Since the expression of matrix metalloproteinase-3 (MMP-3) is enhanced in rheumatoid arthritis (RA), AHA production could also be increased. The purpose of this study was to determine whether the levels of AHAs against IgG hinge epitopes produced by MMP-3 are elevated in RA. Methods The serum levels of IgG or IgA AHAs against the IgG1/IgG4 F(ab’)2 fragments, generated by either MMP-3 or pepsin, were measured using ELISA in 111 patients with RA and 81 healthy controls (HC). Receiver operating characteristic (ROC) analysis was used for obtaining optimal cutoff values and cutoff values indicating high specificity (> 95%) of the AHA. The targeted epitope of a specific AHA was investigated through inhibition ELISA. Results Seven AHAs were statistically higher in RA patients than in HC, except IgG AHA against IgG1 F(ab’)2, which was generated by MMP-3 proteolytic cleavage. The areas under the ROC curve were 0.66–0.80, although the sensitivities at high specificity were low (5.4–24.3%). The cumulative number of positive AHAs in each individual was statistically higher in RA patients than in HC, suggesting the extreme extent of AHA repertoires in RA. Inhibition studies revealed that IgG AHAs against IgG4 F(ab’)2 fragments generated by pepsin cross-reacted with IgG1 F(ab’)2 fragments generated by pepsin. Multivariate logistic regression analysis identified the IgG AHA against IgG4 F(ab’)2 fragments generated by pepsin as an independent variable for RA diagnosis, even in RA patients who were negative for both RF and ACPA (odds ratio 1.18, 95% CI 1.06–1.32; P = 0.003). Additional experiments using non-RA patients finally strengthened the diagnostic utility. Conclusion In RA patients, we observed diversification and amplification of AHA repertoires and diagnostic utility of the specific AHA against IgG4 F(ab’)2 fragments generated by pepsin but not MMP-3.
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Affiliation(s)
- Toshiyuki Ota
- Center for Rheumatic Diseases, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-shi, Fukuoka, 820-8505, Japan. .,Department of Laboratory Medicine, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-shi, Fukuoka, 820-8505, Japan.
| | - Shun-Ichiro Ota
- Center for Rheumatic Diseases, Shimonoseki City Hospital, Shimonoseki-shi, Yamaguchi, 750-0041, Japan
| | - Ayumi Uchino
- Department of Internal Medicine (Rheumatic Diseases Division), Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-shi, Fukuoka, 820-8505, Japan
| | - Shuji Nagano
- Department of Internal Medicine (Rheumatic Diseases Division), Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-shi, Fukuoka, 820-8505, Japan
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13
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Pan Q, Liu Z, Liao S, Ye L, Lu X, Chen X, Li Z, Li X, Xu YZ, Liu H. Current mechanistic insights into the role of infection in systemic lupus erythematosus. Biomed Pharmacother 2019; 117:109122. [PMID: 31226637 DOI: 10.1016/j.biopha.2019.109122] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/05/2019] [Accepted: 06/12/2019] [Indexed: 02/07/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by inflammation and abnormal production of autoantibody, but the mechanisms of the aberrant immune responses are currently unknown. Recently, growing evidence has suggested that infection plays a pivotal role in SLE. Here, we investigate the role of infectious agents (e.g., Epstein-Barr virus, parvovirus B19, human T-lymphotropic virus type 1, human immunodeficiency virus type 1, and endogenous retroviruses) in the pathogenesis of SLE. More importantly, we explore the known mechanisms underlying the involvement of infectious agents in the pathogenesis of SLE, including molecular mimicry, epitope spreading, superantigen production, bystander activation, persistent viral infection, altered apoptosis, clearance deficiency, and epigenetic alterations (e.g., DNA methylation and microRNAs). However, some infectious agents (e.g., malaria parasites, hepatitis B virus, Toxoplasma gondii, and Helicobacter pylori) may exert protective effects on SLE. Therefore, the relationship between infection and SLE is multifaceted and multidirectional, including causative and/or protective associations, which warrant further investigation in the future.
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Affiliation(s)
- Qingjun Pan
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China.
| | - Zejian Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Shuzhen Liao
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Lin Ye
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Xing Lu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Xiaoqun Chen
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Zhihang Li
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Xinxin Li
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Yong-Zhi Xu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China
| | - Huafeng Liu
- Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524001, China.
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Vordenbäumen S, Brinks R, Hoyer A, Fischer‐Betz R, Pongratz G, Lowin T, Zucht H, Budde P, Bleck E, Schulz‐Knappe P, Schneider M. Comprehensive Longitudinal Surveillance of the IgG Autoantibody Repertoire in Established Systemic Lupus Erythematosus. Arthritis Rheumatol 2019; 71:736-743. [DOI: 10.1002/art.40788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 11/20/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Stefan Vordenbäumen
- University Hospital Düsseldorf and Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | - Ralph Brinks
- University Hospital Düsseldorf and Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | - Annika Hoyer
- Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | - Rebecca Fischer‐Betz
- University Hospital Düsseldorf and Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | - Georg Pongratz
- University Hospital Düsseldorf and Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | - Torsten Lowin
- University Hospital Düsseldorf and Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | | | | | - Ellen Bleck
- University Hospital Düsseldorf and Heinrich‐Heine University Düsseldorf Düsseldorf Germany
| | | | - Matthias Schneider
- University Hospital Düsseldorf and Heinrich‐Heine University Düsseldorf Düsseldorf Germany
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15
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Autoimmune rheumatic disease IgG has differential effects upon neutrophil integrin activation that is modulated by the endothelium. Sci Rep 2019; 9:1283. [PMID: 30718722 PMCID: PMC6361939 DOI: 10.1038/s41598-018-37852-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/24/2018] [Indexed: 12/14/2022] Open
Abstract
The importance of neutrophils in the pathogenesis of autoimmune rheumatic diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), is increasingly recognised. Generation of reactive oxygen species (ROS) and release of neutrophil extracellular traps (NETs) by activated neutrophils are both thought to contribute to pathology; although the underlying mechanisms, particularly the effects of IgG autoantibodies upon neutrophil function, are not fully understood. Therefore, we determined whether purified IgG from patients with SLE or RA have differential effects upon neutrophil activation and function. We found that SLE- and RA-IgG both bound human neutrophils but differentially regulated neutrophil function. RA- and SLE-IgG both increased PMA-induced β1 integrin-mediated adhesion to fibronectin, whilst only SLE-IgG enhanced αMβ2 integrin-mediated adhesion to fibrinogen. Interestingly, only SLE-IgG modulated neutrophil adhesion to endothelial cells. Both SLE- and RA-IgG increased ROS generation and DNA externalisation by unstimulated neutrophils. Only SLE-IgG however, drove DNA externalisation following neutrophil activation. Co-culture of neutrophils with resting endothelium prevented IgG-mediated increase of extracellular DNA, but this inhibition was overcome for SLE-IgG when the endothelium was stimulated with TNF-α. This differential pattern of neutrophil activation has implications for understanding SLE and RA pathogenesis and may highlight avenues for development of novel therapeutic strategies.
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16
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Hinze C, Wagner N, Tenbrock K. Kollagenosen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2018. [DOI: 10.1007/s00112-018-0498-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Kiripolsky J, Shen L, Liang Y, Li A, Suresh L, Lian Y, Li QZ, Gaile DP, Kramer JM. Systemic manifestations of primary Sjögren's syndrome in the NOD.B10Sn-H2 b/J mouse model. Clin Immunol 2017; 183:225-232. [PMID: 28526333 DOI: 10.1016/j.clim.2017.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/19/2017] [Accepted: 04/26/2017] [Indexed: 12/21/2022]
Abstract
Animal models that recapitulate human disease are crucial for the study of Sjögren's Syndrome (SS). While several SS mouse models exist, there are few primary SS (pSS) models that mimic systemic disease manifestations seen in humans. Similar to pSS patients, NOD.B10Sn-H2b/J (NOD.B10) mice develop exocrine gland disease and anti-nuclear autoantibodies. However, the disease kinetics and spectrum of extra-glandular disease remain poorly characterized in this model. Our objective was to characterize local and systemic SS manifestations in depth in NOD.B10 female mice at early and late disease time points. To this end, sera, exocrine tissue, lung, and kidney were analyzed. NOD.B10 mice have robust lymphocytic infiltration of salivary and lacrimal tissue. In addition, they exhibit significant renal and pulmonary inflammation. We identified numerous autoantibodies, including those directed against salivary proteins. In conclusion, the NOD.B10 model recapitulates both local and systemic pSS disease and represents an excellent model for translational studies.
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Affiliation(s)
- Jeremy Kiripolsky
- Department of Oral Biology, School of Dental Medicine, University of Buffalo, The State University of New York, Buffalo, NY 14214, USA
| | - Long Shen
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen 361003, China; Autoimmune Division, Trinity Biotech, 60 Pineview Drive, Buffalo, NY 14228, USA
| | - Yichen Liang
- Autoimmune Division, Trinity Biotech, 60 Pineview Drive, Buffalo, NY 14228, USA
| | - Alisa Li
- Autoimmune Division, Trinity Biotech, 60 Pineview Drive, Buffalo, NY 14228, USA
| | - Lakshmanan Suresh
- Autoimmune Division, Trinity Biotech, 60 Pineview Drive, Buffalo, NY 14228, USA; Department of Oral Diagnostics Sciences, School of Dental Medicine, University of Buffalo, The State University of New York, Buffalo, NY 14214, USA
| | - Yun Lian
- Microarray Core Facility, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Quan-Zhen Li
- Microarray Core Facility, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Daniel P Gaile
- Department of Biostatistics, School of Public Health and Health Professions, University of Buffalo, The State University of New York, 3435 Main Street, 718 Kimball Tower, Buffalo, NY 14214, USA
| | - Jill M Kramer
- Department of Oral Biology, School of Dental Medicine, University of Buffalo, The State University of New York, Buffalo, NY 14214, USA; Autoimmune Division, Trinity Biotech, 60 Pineview Drive, Buffalo, NY 14228, USA; Department of Oral Diagnostics Sciences, School of Dental Medicine, University of Buffalo, The State University of New York, Buffalo, NY 14214, USA.
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18
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19
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20
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Hu SY, Gu QH, Wang J, Wang M, Jia XY, Cui Z, Zhao MH. The pathogenicity of T cell epitopes on human Goodpasture antigen and its critical amino acid motif. J Cell Mol Med 2017; 21:2117-2128. [PMID: 28296059 PMCID: PMC5571546 DOI: 10.1111/jcmm.13134] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/19/2017] [Indexed: 02/05/2023] Open
Abstract
Goodpasture antigen, the non‐collagenous domain of α3 chain of type IV collagen [α3(IV)NC1], is the target antigen of anti‐glomerular basement membrane (GBM) antibodies. The pathogenicity of T cell epitopes is not elucidated clearly. In this study, we aim to define the nephritogenic T cell epitopes and its critical amino acid residues. Twenty‐four overlapping linear peptides were synthesized covering the whole sequence of human α3(IV)NC1. Wistar–Kyoto rats were immunized with linear peptides, and experimental autoimmune glomerulonephritis was evaluated. Critical amino acid was identified by the loss of nephritogenic function after each amino acid substitution by alanine. Of the 24 peptides, P14 (α3127‐148) could induce 90.5% (19/21) of WKY rats developing anti‐GBM glomerulonephritis with proteinuria, elevated serum urea and creatinine, IgG linear deposit on GBM and substantial (in average 82.4 ± 5.6%) crescent formation in glomeruli. Lymphocytes of immunized rats proliferated in response to α3127‐148 and α3(IV)NC1 in vitro. Sera of these rats recognized α3127‐148 and later on together with intact human α3(IV)NC1. Antibodies towards α3127‐148 and intact α3(IV)NC1 could also be detected from the kidney elutes. These antibodies showed no cross‐reaction with each other, which implies intramolecular epitope spreading during disease progress. After sequential amino acid substitution, the α3127‐148 with substitution of tryptophan136, isoleucine137, leucine139 or tryptophan140 lost its nephritogenicity. Human α3127‐148 is a nephritogenic T cell epitope in WKY rats, with the critical amino acids as W136I137xL139W140. These findings might facilitate future investigation on microbial aetiology and potential specific immunotherapy of anti‐GBM disease.
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Affiliation(s)
- Shui-Yi Hu
- Renal Division, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.,Department of Nephrology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiu-Hua Gu
- Renal Division, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Jia Wang
- Renal Division, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Miao Wang
- Renal Division, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Xiao-Yu Jia
- Renal Division, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Zhao Cui
- Renal Division, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | - Ming-Hui Zhao
- Renal Division, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
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21
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Arora P, Malik M, Sachdeva R, Saxena L, Das J, Ramachandran VG, Pal R. Innate and humoral recognition of the products of cell death: differential antigenicity and immunogenicity in lupus. Clin Exp Immunol 2016; 187:353-368. [PMID: 27783388 DOI: 10.1111/cei.12889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2016] [Indexed: 10/20/2022] Open
Abstract
While apoptotic debris is believed to constitute the original antigenic insult in lupus (which is characterized by a time-dependent diversification of autoreactivity), whether such debris and autoantibodies specifically recognizing its constituents mediate differential effects on innate and humoral responses in lupus-prone mice is currently unknown. Apoptotic blebs (as opposed to cellular lysate) enhanced preferentially the maturation of dendritic cells (DCs) from bone marrow precursors drawn from lupus-prone mice. Murine, somatically mutated, apoptotic cell-reactive immunoglobulin (Ig)G monoclonal antibodies demonstrated enhanced recognition of DCs and also displayed a prominent lupus strain-specific bias in mediating DC maturation. Further, immunization of such antibodies specifically in lupus-prone mice resulted in widespread humoral autoreactivity; hypergammaglobulinaemia (a hallmark of systemic autoimmunity) was observed, accompanied by enhanced antibody titres to cellular moieties. Induced antibodies recognized antigens distinct from those recognized by the antibodies employed for immunization; in particular, nephritis-associated anti-double stranded (ds) DNA antibodies and neonatal lupus-associated anti-Ro60 antibodies were elicited by a non-dsDNA, non-Ro60 reactive antibody, and Sm was a favoured target. Further, only in lupus-prone mice did such immunization enhance the kinetics of humoral anti-self responses, resulting in the advanced onset of glomerulosclerosis. These studies reveal that preferential innate and humoral recognition of the products of cell death in a lupus milieu influence the indices associated with autoimmune pathology.
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Affiliation(s)
- P Arora
- National Institute of Immunology, New Delhi, India
| | - M Malik
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R Sachdeva
- National Institute of Immunology, New Delhi, India
| | - L Saxena
- National Institute of Immunology, New Delhi, India.,Department of Respiratory Virology, V.P. Chest Institute, University of Delhi, Delhi, India
| | - J Das
- National Institute of Immunology, New Delhi, India.,Dr Reddy's Laboratories, Biologics Development Center, Bachupalli, Hyderabad, Andhra Pradesh, India
| | - V G Ramachandran
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R Pal
- National Institute of Immunology, New Delhi, India
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22
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Akatsu C, Shinagawa K, Numoto N, Liu Z, Ucar AK, Aslam M, Phoon S, Adachi T, Furukawa K, Ito N, Tsubata T. CD72 negatively regulates B lymphocyte responses to the lupus-related endogenous toll-like receptor 7 ligand Sm/RNP. J Exp Med 2016; 213:2691-2706. [PMID: 27810925 PMCID: PMC5110020 DOI: 10.1084/jem.20160560] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/05/2016] [Accepted: 09/26/2016] [Indexed: 01/03/2023] Open
Abstract
Akatsu and colleagues show that CD72 specifically recognizes Sm/RNP, a lupus-related self-antigen and an endogenous TLR7 ligand, and inhibits B cell responses to Sm/RNP. In mice, CD72 prevents production of anti-Sm/RNP antibodies crucial for lupus development. Toll-like receptor 7 (TLR7) plays an essential role in development of systemic lupus erythematosus by co-stimulating B cells reactive to the endogenous TLR7 ligand Sm/ribonucleoprotein (RNP), a crucial lupus self-antigen. However, how the TLR7-mediated autoimmune response is regulated is not yet known. In this study, we demonstrate that CD72, an inhibitory B cell co-receptor known to prevent development of lupus, recognizes Sm/RNP at the extracellular C-type lectin-like domain (CTLD) and specifically inhibits B cell response to Sm/RNP. Moreover, the CTLD of CD72c, a lupus-susceptible allele, binds to Sm/RNP less strongly than that of lupus-resistant CD72a. Reduced binding of CD72c is supported by x-ray crystallographic analysis that reveals a considerable alteration in charge at the putative ligand-binding site. Thus, CD72 appears to specifically inhibit B cell response to the endogenous TLR7 ligand Sm/RNP through CTLD-mediated recognition of Sm/RNP, thereby preventing production of anti-Sm/RNP antibody crucial for development of lupus.
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Affiliation(s)
- Chizuru Akatsu
- Department of Immunology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
| | - Kenro Shinagawa
- Department of Structural Biology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
| | - Nobutaka Numoto
- Department of Structural Biology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
| | - Zhihong Liu
- Department of Immunology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan.,Emergency Department, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province 110001, China
| | - Ayse Konuskan Ucar
- Department of Immunology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
| | - Mohammad Aslam
- Department of Immunology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
| | - Shirly Phoon
- Department of Immunology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
| | - Takahiro Adachi
- Department of Immunology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
| | - Koji Furukawa
- Biomedical Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki 305-8566, Japan
| | - Nobutoshi Ito
- Department of Structural Biology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
| | - Takeshi Tsubata
- Department of Immunology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo, Tokyo 113-8510, Japan
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Rekvig OP, Thiyagarajan D, Pedersen HL, Horvei KD, Seredkina N. Future Perspectives on Pathogenesis of Lupus Nephritis: Facts, Problems, and Potential Causal Therapy Modalities. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 186:2772-2782. [PMID: 27664472 DOI: 10.1016/j.ajpath.2016.06.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 06/30/2016] [Indexed: 12/22/2022]
Abstract
Divergent incommensurable models have been developed to explain the pathogenesis of lupus nephritis. Most contemporary models favor a central role for anti-chromatin antibodies. How they exert their pathogenic effect has, however, endorsed conflicts that at least for now preclude insight into definitive pathogenic pathways. The following paradigms are contemporarily in conflict with each other: i) the impact of anti-double-stranded DNA (dsDNA) antibodies that cross-react with inherent renal antigens, ii) the impact of anti-dsDNA antibodies targeting exposed chromatin in glomeruli, and iii) the impact of relative antibody avidity for dsDNA, chromatin fragments, or cross-reacting antigens. Aside from these three themes, the pathogenic role of T cells in lupus nephritis is not clear. These different models should be tested through a collaboration between scientists belonging to the different paradigms. If it turns out that there are different pathogenic pathways in lupus nephritis, the emerging pathogenic mechanism(s) may be encountered with new individual causal therapy modalities. Today, therapy is still unspecific and far from interfering with the cause(s) of the disorder. This review attempts to describe what we know about processes that may cause lupus nephritis and how such basic processes may be affected if we can specifically interrupt them. Secondary inflammatory mechanisms, cytokine signatures, activation of complement, and other contributors to inflammation will not be discussed herein; rather, the events that trigger these factors will be discussed.
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Affiliation(s)
- Ole P Rekvig
- RNA and Molecular Pathology Research Group, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, Norway; Norwegian Center for Molecular Medicine, University of Oslo, Oslo, Norway.
| | - Dhivya Thiyagarajan
- RNA and Molecular Pathology Research Group, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Hege L Pedersen
- RNA and Molecular Pathology Research Group, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Kjersti D Horvei
- RNA and Molecular Pathology Research Group, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Natalya Seredkina
- RNA and Molecular Pathology Research Group, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
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Cruz GI, Shao X, Quach H, Ho KA, Sterba K, Noble JA, Patsopoulos NA, Busch MP, Triulzi DJ, Wong WSW, Solomon BD, Niederhuber JE, Criswell LA, Barcellos LF. A Child's HLA-DRB1 genotype increases maternal risk of systemic lupus erythematosus. J Autoimmun 2016; 74:201-207. [PMID: 27388144 DOI: 10.1016/j.jaut.2016.06.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/23/2016] [Accepted: 06/27/2016] [Indexed: 11/17/2022]
Abstract
Systemic lupus erythematosus (SLE) disproportionately affects women of reproductive age. During pregnancy, women are exposed to various sources of fetal material possibly constituting a significant immunologic exposure relevant to the development of SLE. The objective of this study was to investigate whether having any children who carry DRB1 alleles associated with SLE increase the risk of maternal SLE. This case-control study is based on the University of California, San Francisco Mother-Child Immunogenetic Study and from studies at the Inova Translational Medicine Institute. Analyses were conducted using data for 1304 mothers (219 cases/1085 controls) and their respective 1664 children. We selected alleles based on their known association with risk of SLE (DRB1*03:01, *15:01, or *08:01) or Epstein-Barr virus (EBV) glycoproteins (*04:01) due to the established EBV association with SLE risk. We used logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI) for each allele of interest, taking into account maternal genotype and number of live births. We found an increase in risk of maternal SLE associated with exposure to children who inherited DRB1*04:01 from their father (OR 1.9; 95% CI, 1.1-3.2), among *04:01 allele-negative mothers. Increased risk was only present among mothers who were positive for one or more SLE risk-associated alleles (*03:01, *15:01 and/or *08:01). We did not find increased risk of maternal SLE associated with any other tested allele. These findings support the hypothesis that a child's alleles inherited from the father influence a mother's subsequent risk of SLE.
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Affiliation(s)
- Giovanna I Cruz
- Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA 94720-3220, USA.
| | - Xiaorong Shao
- Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA 94720-3220, USA.
| | - Hong Quach
- Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA 94720-3220, USA.
| | - Kimberly A Ho
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94122, USA.
| | - Kirsten Sterba
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94122, USA.
| | - Janelle A Noble
- Children's Hospital Oakland Research Institute, 5700 M.L.K. Jr. Way, Oakland, CA 94609, USA.
| | - Nikolaos A Patsopoulos
- Division of Genetics, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115, USA; Program in Translational Neuropsychiatric Genomics, Institute for the Neurosciences, Department of Neurology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, 415 Main Street, Cambridge, MA 02142, USA.
| | - Michael P Busch
- Blood Systems Research Institute, 270 Masonic Avenue, San Francisco, CA 94118-4417, USA.
| | - Darrell J Triulzi
- Institute for Transfusion Medicine, Department of Pathology, University of Pittsburgh, 3636 Blvd. of the Allies, Pittsburgh, PA 15213, USA.
| | - Wendy S W Wong
- Division of Medical Genomics, Inova Translational Medicine Institute, 8110 Gatehouse Road, Falls Church, VA 22042, USA.
| | - Benjamin D Solomon
- Division of Medical Genomics, Inova Translational Medicine Institute, 8110 Gatehouse Road, Falls Church, VA 22042, USA.
| | - John E Niederhuber
- Division of Medical Genomics, Inova Translational Medicine Institute, 8110 Gatehouse Road, Falls Church, VA 22042, USA.
| | - Lindsey A Criswell
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94122, USA.
| | - Lisa F Barcellos
- Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA 94720-3220, USA; California Institute for Quantitative Biosciences (QB3), University of California Berkeley, 174 Stanley Hall, Berkeley, CA 94720-3220, USA.
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Abstract
There is a rapid proliferation of new technologies to identify an ever increasing spectrum of autoantibodies in diverse medical conditions that range from organ-specific autoimmune diseases to systemic rheumatic diseases. Although many laboratories have adopted diagnostic platforms, such as enzyme linked immunoassays (ELISAs), to improve turn around times and meet budget constraints, the prevailing evidence is that the rapid adoption of new technologies is not attended by an appropriate balance of assay sensitivity and specificity. Emerging diagnostic technologies include addressable laser bead immunoassays, microarrays in microfluidics platforms and nanobarcode particles. Although these technologies provide advantages of high-throughput, multiplexed autoantibody assays that can be coupled to other disease specific biomarkers (ie, cytokines, single nucleotide polymorphisms) there is a clear need for standardization and internal validation before they are adopted into the clinical diagnostic laboratory.
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Affiliation(s)
- M J Fritzler
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
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26
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Abstract
The diversity of the antigen-specific humoral immune response reflects the interaction of the immune system with pathogens and autoantigens. Peptide microarray analysis opens up new perspectives for the use of antibodies as diagnostic biomarkers and provides unique access to a more differentiated serological diagnosis. This review focusses on latest applications of peptide microarrays for the serologic medical diagnosis of autoimmunity, infectious diseases, and cancer.
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27
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Chida N, Kobayashi I. [Difference in target antigens between central tolerance and peripheral tolerance deficiencies]. ACTA ACUST UNITED AC 2015. [PMID: 26213192 DOI: 10.2177/jsci.38.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Failure of the immunotolerance mechanisms causes multiple organ-specific autoimmune disorders. Mutations of autoimmune regulator (AIRE) gene result in central immunotolerance deficiency named autoimmune polyendocrinopathy, candidiasis, ectodermal dystrophy (APECED). Mutations of FOXP3 genes cause regulatory T cell (Treg) deficiency named immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome. Because T cell tolerance influences B cell tolerance, autoantibodies seem to reflect the presence of autoreactive T cells with the same antigen specificity. To date many differences in both clinical features and autoantibody profiles have been described between APECED and IPEX syndrome. In addition to the differences in target organs, we have found differences in the target antigens in the same organ, small intestine, between both disorders; anti-autoimmune enteropathy-related 75 kDa antigen (AIE-75) antibodies are specific to IPEX syndrome, whereas anti-tryptophan hydroxylase-1 (TPH-1) antibodies are specific to APECED. These facts suggest that immunotolerance to AIE-75 depends on the Treg, whereas the tolerance to TPH-1 depends on the central mechanisms. Furthermore, given the earlier onset and more serious clinical features of IPEX syndrome than APECED, physiological roles of Aire on the selection of Treg may be, if present, limited.
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Affiliation(s)
- Natsuko Chida
- Department of Dentistry for Children and Disabled Persons, Hokkaido University Graduate School of Dental Medicine
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28
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U1-RNP and TLR receptors in the pathogenesis of mixed connective tissue diseasePart I. The U1-RNP complex and its biological significance in the pathogenesis of mixed connective tissue disease. Reumatologia 2015; 53:94-100. [PMID: 27407234 PMCID: PMC4847272 DOI: 10.5114/reum.2015.51509] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/28/2015] [Indexed: 11/17/2022] Open
Abstract
Mixed connective tissue disease (MCTD) is a rare autoimmune syndrome, signified by complex interactions between disease-related phenomena, including inflammation, proliferative vascular arteriopathy, thrombotic events and humoral autoimmune processes. It is still controversial whether MCTD is a distinct clinical entity among systemic connective tissue diseases, although several authors consider that it is distinct and underline characteristic, distinct clinical, serological and immunogenetic features. The putative target of autoimmunity in MCTD is U1-RNP, which is a complex of U1-RNA and small nuclear RNP. Both the U1-RNA component and the specific proteins, particularly U1-70K, engage immune cells and their receptors in a complex network of interactions that ultimately lead to autoimmunity, inflammation, and tissue injury. U1-RNA is capable of inducing manifestations consistent with TLR activation. Stimulation of innate immunity by native RNA molecules with a double-stranded secondary structure may help explain the high prevalence of autoimmunity to RNA binding proteins.
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Shibuya M, Fujio K, Shoda H, Okamura T, Okamoto A, Sumitomo S, Yamamoto K. A new T-cell activation mode for suboptimal doses of antigen under the full activation of T cells with different specificity. Eur J Immunol 2015; 45:1643-53. [DOI: 10.1002/eji.201444965] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 01/29/2015] [Accepted: 03/16/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Mihoko Shibuya
- Department of Allergy and Rheumatology; Graduate School of Medicine, University of Tokyo; Tokyo Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology; Graduate School of Medicine, University of Tokyo; Tokyo Japan
| | - Hirofumi Shoda
- Department of Allergy and Rheumatology; Graduate School of Medicine, University of Tokyo; Tokyo Japan
| | - Tomohisa Okamura
- Department of Allergy and Rheumatology; Graduate School of Medicine, University of Tokyo; Tokyo Japan
| | - Akiko Okamoto
- Department of Allergy and Rheumatology; Graduate School of Medicine, University of Tokyo; Tokyo Japan
| | - Shuji Sumitomo
- Department of Allergy and Rheumatology; Graduate School of Medicine, University of Tokyo; Tokyo Japan
| | - Kazuhiko Yamamoto
- Department of Allergy and Rheumatology; Graduate School of Medicine, University of Tokyo; Tokyo Japan
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30
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Kobayashi N, Takezaki S, Kobayashi I, Iwata N, Mori M, Nagai K, Nakano N, Miyoshi M, Kinjo N, Murata T, Masunaga K, Umebayashi H, Imagawa T, Agematsu K, Sato S, Kuwana M, Yamada M, Takei S, Yokota S, Koike K, Ariga T. Clinical and laboratory features of fatal rapidly progressive interstitial lung disease associated with juvenile dermatomyositis. Rheumatology (Oxford) 2014; 54:784-91. [PMID: 25288783 DOI: 10.1093/rheumatology/keu385] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Rapidly progressive interstitial lung disease (RP-ILD) is a rare but potentially fatal complication of JDM. The aim of this study was to establish markers for the prediction and early diagnosis of RP-ILD associated with JDM. METHODS The clinical records of 54 patients with JDM were retrospectively reviewed: 10 had RP-ILD (7 died, 3 survived), 19 had chronic ILD and 24 were without ILD. Routine tests included a high-resolution CT (HRCT) scan of the chest and measurement of serum levels of creatine phosphokinase, ferritin and Krebs von den Lungen-6 (KL-6). Anti-melanoma differentiation-associated gene 5 (MDA5) antibodies and IL-18 levels were measured by ELISA. RESULTS No differences were found in the ratio of juvenile clinically amyopathic DM between the three groups. Initial chest HRCT scan findings were variable and could not distinguish between RP-ILD and chronic ILD. Anti-MDA5 antibodies were positive in all 8 patients with RP-ILD and 10 of 14 with chronic ILD, but none of the patients without ILD. Serum levels of anti-MDA5 antibody, ferritin, KL-6 and IL-18 were significantly higher in the RP-ILD group than in the chronic ILD and non-ILD groups. Serum levels of IL-18 positively correlated with serum KL-6 (R = 0.66, P < 0.001). CONCLUSION High serum levels of IL-18, KL-6, ferritin and anti-MDA5 antibodies (e.g. >200 units by ELISA) are associated with RP-ILD. These can be used as an indication for early intensive treatment. Both alveolar macrophages and autoimmunity to MDA5 are possibly involved in the development of RP-ILD associated with JDM.
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Affiliation(s)
- Norimoto Kobayashi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shunichiro Takezaki
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Ichiro Kobayashi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Naomi Iwata
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Masaaki Mori
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kazushige Nagai
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Naoko Nakano
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Mari Miyoshi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Noriko Kinjo
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Takuji Murata
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kenji Masunaga
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hiroaki Umebayashi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Tomoyuki Imagawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kazunaga Agematsu
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shinji Sato
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Masataka Kuwana
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Masafumi Yamada
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shuji Takei
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shumpei Yokota
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kenichi Koike
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Tadashi Ariga
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Walden P, Sterry W. New and emerging vaccination strategies for prevention and treatment of dermatological diseases. Expert Rev Vaccines 2014; 3:421-31. [PMID: 15270647 DOI: 10.1586/14760584.3.4.421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Accelerated by the rapid advancements of our understanding of the molecular and cellular pathology of diseases and of the components and mechanisms of cellular and humoral immune responses, new vaccination strategies are being developed and explored for treatment and prevention of infectious diseases, cancer, autoimmune disorders and allergies. Many newly developed vaccination strategies are already in clinical trials, some with very promising results. Although most of these strategies are still at very early stages of their development, it is foreseeable that vaccination will evolve to play an important role in prevention, treatment and management of all the above classes of diseases.
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Affiliation(s)
- Peter Walden
- Clinical Research Group for Tumor Immunology, Department of Dermatology, Venerology and Allergy, Charite - Universitatsmedizin Berlin, Humboldt University, 10098 Berlin, Germany.
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Fritzler MJ, Fritzler ML. Microbead-based technologies in diagnostic autoantibody detection. ACTA ACUST UNITED AC 2013; 3:81-9. [PMID: 23495965 DOI: 10.1517/17530050802651561] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND There is a rapid proliferation of new technologies to identify a spectrum of autoantibodies in medical conditions that range from organ-specific autoimmune diseases to systemic rheumatic diseases. Although many laboratories have adopted high-throughput diagnostic platforms such as enzyme linked immunoassays (ELISA), other technologies such as microbead-based assays are emerging as an alternative diagnostic platform. OBJECTIVE To understand the performance and importance of bead based immunoassays in clinical diagnostics and therapeutics. METHOD Current literature was reviewed using the PubMed search engine combining keywords of immunoassay and Luminex, as well as a personal literature database. Included in the evaluation and commentary are bead-based assays such as addressable laser bead immunoassays and related magnetic bead assays. CONCLUSIONS Comparison with other conventional technologies has indicated that laser microbead immunoassays are reliable, accurate, cost-effective, highly sensitive and have rapid turn around time for results. While there are advantages to this diagnostic platform, there are challenges that must be addressed before wider acceptance or long-term use of this technology platform in the routine clinical diagnostic laboratory.
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Affiliation(s)
- Marvin J Fritzler
- University of Calgary, Faculty of Medicine, 3330 Hospital Dr NW, T2N 4N1, Calgary, AB, Canada +01 403 220 3533 ; +01 403 283 5666 ;
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Simon-Keller K, Barth S, Vincent A, Marx A. Targeting the fetal acetylcholine receptor in rhabdomyosarcoma. Expert Opin Ther Targets 2012; 17:127-38. [PMID: 23231343 DOI: 10.1517/14728222.2013.734500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood and adolescence. Recent efforts to enhance overall survival of patients with clinically advanced RMS have failed and there is a demand for conceptually novel treatments. Immune therapeutic options targeting the fetal nicotinic acetylcholine receptor (fnAChR), which is broadly expressed on RMS, are novel approaches to overcome the therapeutic resistance of RMS. Expression of the fnAChR is restricted to developing fetal muscles, some apparently dispensable ocular muscle fibers and thymic myoid cells. Therefore, after-birth fnAChR is a tumor-associated and almost tumor-specific antigen on RMS cells. AREAS COVERED This review gives an overview on nAChR function and expression pattern in RMS tumor cells, and deals with the immunological significance of fnAChR-expressing cells, including the risk of anti-nAChR autoimmunity as a potential side effect of fnAChR-directed immunotherapies. The article also addresses the advantages and disadvantages of vaccination strategies, immunotoxins and chimeric T cells targeting the fnAChR. EXPERT OPINION Finally, we suggest technical and biological strategies to improve the available immunotherapeutic tools including increasing the in vivo expression of the target fnAChR on RMS cells.
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Affiliation(s)
- Katja Simon-Keller
- University Medical Centre Mannheim, University of Heidelberg, Institute of Pathology, Theodor-Kutzer-Ufer 1-3, D-68135 Mannheim, Germany.
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Recognition of highly restricted regions in the β-propeller domain of αIIb by platelet-associated anti-αIIbβ3 autoantibodies in primary immune thrombocytopenia. Blood 2012; 120:1499-509. [DOI: 10.1182/blood-2012-02-409995] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractPlatelet-associated (PA) IgG autoantibodies play an essential role in primary immune thrombocytopenia (ITP). However, little is known about the epitopes of these Abs. This study aimed to identify critical binding regions for PA anti-αIIbβ3 Abs. Because PA anti-αIIbβ3 Abs bound poorly to mouse αIIbβ3, we created human-mouse chimera constructs. We first examined 76 platelet eluates obtained from patients with primary ITP. Of these, 26 harbored PA anti-αIIbβ3 Abs (34%). Further analysis of 15 patients who provided sufficient materials showed that the epitopes of these Abs were mainly localized in the N-terminal half of the β-propeller domain in αIIb (L1-W235). We could identify 3 main recognition sites in the region; 2 eluates recognized a conformation formed by the W1:1-2 and W2:3-4 loops, 5 recognized W1:2-3, and 4 recognized W3:4-1. The remaining 4 eluates could not be defined by the binding sites. Within these regions, we identified residues critical for binding, including S29 and R32 in W1:1-2; G44 and P45 in W1:2-3; and P135, E136, and R139 in W2:3-4. Of 11 eluates whose recognition sites were identified, 5 clearly showed restricted κ/λ-chain usage. These results suggested that PA anti-αIIbβ3 Abs in primary ITP tended to recognize highly restricted regions of αIIb with clonality.
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Olsen NJ, Li QZ, Quan J, Wang L, Mutwally A, Karp DR. Autoantibody profiling to follow evolution of lupus syndromes. Arthritis Res Ther 2012; 14:R174. [PMID: 22838636 PMCID: PMC3580568 DOI: 10.1186/ar3927] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 07/18/2012] [Accepted: 07/27/2012] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Identification of patients who are in early stages of lupus is currently done through clinical evaluation and is not greatly facilitated by available diagnostic tests. Profiling for patient characteristics and antibody specificities that predict disease would enhance the ability of physicians to identify and treat early cases prior to onset of organ damaging illness. METHODS A group of 22 patients with 4 or fewer diagnostic criteria for lupus were studied for changes in clinical and autoantibody profiles after a mean follow up period of 2.4 years. An array with more than 80 autoantigens was used to profile immunoglobulin G (IgG) and immunoglobulin M (IgM) autoantibodies. Correlations with clinical disease progression were examined. RESULTS 3 of the 22 patients (14%) added sufficient criteria during follow up to satisfy a diagnosis of systemic lupus erythematosus (SLE) or to acquire a diagnosis of SLE renal disease. Patients who progressed were all females and were younger than those who did not progress (P=0.00054). IgG but not IgM autoreactivity showed greater increases in the progressor group than in the non-progressor group (P=0.047). IgG specificities that were higher at baseline in progressors included proliferating cell nuclear antigen (PCNA), beta 2 microglobulin, C1q and hemocyanin (P<0.019). Progressors had significant increases in La/SSB and liver cytosol type 1 (LC1) IgG autoantibodies over the period of evaluation (P≤0.0072). A quantitative risk profile generated from baseline demographic and autoantibody variables yielded highly different scores for the progressor and non-progressor groups (P=1.38 × 10⁻⁷) CONCLUSIONS In addition to demographic features, autoantibody profiles using an expanded array of specificities were correlated with the risk of progressive disease in patients with lupus. These findings suggest the feasibility of developing a simple diagnostic that could be applied by nonspecialists to screen for lupus and permit effective triage for specialty care.
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Affiliation(s)
- Nancy J Olsen
- Division of Rheumatology, Department of Medicine, Penn State MS Hershey Medical Center, 500 University Drive, Hershey PA 17033, USA
| | - Quan-Zhen Li
- Department of Immunology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9093, USA
| | - Jiexia Quan
- Rheumatic Diseases Division, Department of Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8884, USA
| | - Ling Wang
- Department of Immunology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9093, USA
| | - Azza Mutwally
- Rheumatic Diseases Division, Department of Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8884, USA
| | - David R Karp
- Rheumatic Diseases Division, Department of Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8884, USA
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Kobayashi I, Kubota M, Yamada M, Tanaka H, Itoh S, Sasahara Y, Whitesell L, Ariga T. Autoantibodies to villin occur frequently in IPEX, a severe immune dysregulation, syndrome caused by mutation of FOXP3. Clin Immunol 2011; 141:83-9. [PMID: 21741320 DOI: 10.1016/j.clim.2011.05.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 05/29/2011] [Accepted: 05/30/2011] [Indexed: 10/18/2022]
Abstract
Intractable diarrhea is a major symptom of immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome and associated with autoantibodies against enterocytes. Although autoimmune enteropathy (AIE)-related 75 kDa antigen (AIE-75) is a prominent autoantigen involved in the enteropathy associated with IPEX syndrome, some patients with this syndrome demonstrated autoantibody recognizing a 95 kDa protein rather than AIE-75 in the small intestine. We, herewith, identified villin, an actin-binding protein, as the 95 kDa antigen. Four of five sera from patients with IPEX syndrome reacted with a fusion protein of glutathione-S-transferase and full length villin (GST-villin), whereas only three of 98 control sera weakly reacted with GST-villin. Anti-AIE-75 antibody was detected in all five IPEX sera but not in normal or control disease sera. We conclude that both AIE-75 and villin appear to be brush border autoantigens in IPEX syndrome and could be used for the diagnosis of AIE in patients with presumptive IPEX syndrome.
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Affiliation(s)
- Ichiro Kobayashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Japan.
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Eriksson C, Kokkonen H, Johansson M, Hallmans G, Wadell G, Rantapää-Dahlqvist S. Autoantibodies predate the onset of systemic lupus erythematosus in northern Sweden. Arthritis Res Ther 2011; 13:R30. [PMID: 21342502 PMCID: PMC3241374 DOI: 10.1186/ar3258] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 11/17/2010] [Accepted: 02/22/2011] [Indexed: 11/28/2022] Open
Abstract
Introduction Autoantibodies have a central role in systemic lupus erythematosus (SLE). The presence of autoantibodies preceding disease onset by years has been reported both in patients with SLE and in those with rheumatoid arthritis, suggesting a gradual development of these diseases. Therefore, we sought to identify autoantibodies in a northern European population predating the onset of symptoms of SLE and their relationship to presenting symptoms. Methods The register of patients fulfilling the American College of Rheumatology criteria for SLE and with a given date of the onset of symptoms was coanalysed with the register of the Medical Biobank, Umeå, Sweden. Thirty-eight patients were identified as having donated blood samples prior to symptom onset. A nested case-control study (1:4) was performed with 152 age- and sex-matched controls identified from within the Medical Biobank register (Umeå, Sweden). Antibodies against anti-Sjögren's syndrome antigen A (Ro/SSA; 52 and 60 kDa), anti-Sjögren's syndrome antigen B, anti-Smith antibody, ribonucleoprotein, scleroderma, anti-histidyl-tRNA synthetase antibody, double-stranded DNA (dsDNA), centromere protein B and histones were analysed using the AtheNA Multi-Lyte ANA II Plus Test System on a Bio-Plex Array Reader (Luminex200). Antinuclear antibodies test II (ANA II) results were analysed using indirect immunofluorescence on human epidermal 2 cells at a sample dilution of 1:100. Results Autoantibodies against nuclear antigens were detected a mean (±SD) of 5.6 ± 4.7 years before the onset of symptoms and 8.7 ± 5.6 years before diagnosis in 63% of the individuals who subsequently developed SLE. The sensitivity (45.7%) was highest for ANA II, with a specificity of 95%, followed by anti-dsDNA and anti-Ro/SSA antibodies, both with sensitivities of 20.0% at specificities of 98.7% and 97.4%, respectively. The odds ratios (ORs) for predicting disease were 18.13 for anti-dsDNA (95% confidence interval (95% CI), 3.58 to 91.84) and 11.5 (95% CI, 4.54 to 28.87) for ANA. Anti-Ro/SSA antibodies appeared first at a mean of 6.6 ± 2.5 years prior to symptom onset. The mean number of autoantibodies in prediseased individuals was 1.4, and after disease onset it was 3.1 (P < 0.0005). The time predating disease was shorter and the number of autoantibodies was greater in those individuals with serositis as a presenting symptom in comparison to those with arthritis and skin manifestations as the presenting symptoms. Conclusions Autoantibodies against nuclear antigens were detected in individuals who developed SLE several years before the onset of symptoms and diagnosis. The most sensitive autoantibodies were ANA, Ro/SSA and dsDNA, with the highest predictive OR being for anti-dsDNA antibodies. The first autoantibodies detected were anti-Ro/SSA.
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Affiliation(s)
- Catharina Eriksson
- Department of Clinical Immunology, Umeå University, SE-90185 Umeå, Sweden
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B-cell epitopes of the intracellular autoantigens Ro/SSA and La/SSB: Tools to study the regulation of the autoimmune response. J Autoimmun 2010; 35:256-64. [DOI: 10.1016/j.jaut.2010.06.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kattah NH, Kattah MG, Utz PJ. The U1-snRNP complex: structural properties relating to autoimmune pathogenesis in rheumatic diseases. Immunol Rev 2010; 233:126-45. [PMID: 20192997 PMCID: PMC3074261 DOI: 10.1111/j.0105-2896.2009.00863.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The U1 small nuclear ribonucleoprotein particle (snRNP) is a target of autoreactive B cells and T cells in several rheumatic diseases including systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD). We propose that inherent structural properties of this autoantigen complex, including common RNA-binding motifs, B and T-cell epitopes, and a unique stimulatory RNA molecule, underlie its susceptibility as a target of the autoimmune response. Immune mechanisms that may contribute to overall U1-snRNP immunogenicity include epitope spreading through B and T-cell interactions, apoptosis-induced modifications, and toll-like receptor (TLR) activation through stimulation by U1-snRNA. We conclude that understanding the interactions between U1-snRNP and the immune system will provide insights into why certain patients develop anti-U1-snRNP autoimmunity, and more importantly how to effectively target therapies against this autoimmune response.
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Affiliation(s)
- Nicole H Kattah
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA 94305, USA.
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Routsias JG, Kyriakidis N, Latreille M, Tzioufas AG. RNA recognition motif (RRM) of La/SSB: the bridge for interparticle spreading of autoimmune response to U1-RNP. Mol Med 2010; 16:19-26. [PMID: 19838329 PMCID: PMC2762815 DOI: 10.2119/molmed.2009.00106] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 10/12/2009] [Indexed: 11/06/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is characterized by the production of grouped sets of autoantibodies targeting mainly the U1 ribonucleoprotein (RNP) and/or Ro/La RNP particles. Intraparticle diversification of the autoimmune response is believed to occur via epitope spreading. So far, it is not known how the autoimmune response "jumps" from one particle to another. To the extent that the majority of nuclear autoantigens in SLE are RNA binding proteins and major epitopes were previously mapped within their RRM (RNA recognition motifs), conserved sequences within RRM could be involved in the intermolecular and inter-particle diversification process of the autoimmune response. We investigated the potential of RRM of the La/SSB autoantigen to induce antibodies that cross-recognize components of the U1-RNP particle and therefore its capacity to produce interparticle epitope spreading. We immunized New Zealand white rabbits with a peptide corresponding to the epitope 145-164 of La/SSB (belonging to the RRM of La/SSB), attached in four copies on a scaffold carrier. Sera were drawn from 20 sera of patients with SLE and anti-U1-RNP antibodies and 26 sera of primary Sjögren syndrome patients with anti-La/SSB antibodies. All sera were evaluated for reactivity against the major epitope of La/SSB (pep349-364), the RNP antigen and the RRM-related epitope of La/SSB (pep145-164). Specific antibodies against pep145-164 were purified with immunoaffinity columns from selected sera. After the immunization of the animals with pep145-164, a specific IgG antibody response was detected, directed against the La/SSB autoantigen (wks 3-7), the immunizing peptide (wks 3-27), and the RNP autoantigen (wks 7-20). This response gradually decreased to low levels between postimmunization wks 27-42. Purified antibodies against pep145-164 recognized La/SSB and a 70-kD autoantigen in Western blot and exhibited significant reactivity in anti-U1-RNP ELISA. Depletion of anti-pep145-164 antibodies eliminated anti-U1-RNP reactivity from immunized rabbit sera but not from human sera. In addition, pep145-164 was recognized to a greater extent by autoimmune sera with anti-RNP reactivity compared with anti-La/SSB-positive sera, in contrast to pep349-364 of La/SSB, which was recognized almost exclusively by sera with anti-La/SSB reactivity. These data suggest that the RRM region of La/SSB can trigger interparticle B-cell diversification to U1-RNP-70 autoantigen via molecular mimicry. Identification of key sequences that trigger and perpetuate the autoimmune process is particularly important for understanding pathogenetic mechanisms in autoimmunity.
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Affiliation(s)
- John G Routsias
- Department of Pathophysiology, School of Medicine, National University of Athens, 115 27 Athens, Greece.
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Hoffmann MH, Trembleau S, Muller S, Steiner G. Nucleic acid-associated autoantigens: pathogenic involvement and therapeutic potential. J Autoimmun 2009; 34:J178-206. [PMID: 20031372 DOI: 10.1016/j.jaut.2009.11.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Autoimmunity to ubiquitously expressed macromolecular nucleic acid-protein complexes such as the nucleosome or the spliceosome is a characteristic feature of systemic autoimmune diseases. Disease-specificity and/or association with clinical features of some of these autoimmune responses suggest pathogenic involvement which, however, has been proven in only a few cases so far. Although the mechanisms leading to autoimmunity against nucleic acid-containing complexes are still far from being fully understood, there is increasing experimental evidence that the nucleic acid component may act as a co-stimulator or adjuvans via activation of nucleic acid-binding receptor systems such as Toll-like receptors in antigen-presenting cells. Dysregulated apoptosis and inappropriate stimulation of nucleic acid-sensing receptors may lead to loss of tolerance against the protein components of such complexes, activation of autoreactive T cells and formation of autoantibodies. This has been demonstrated to occur in systemic lupus erythematosus and seems to represent a general mechanism that may be crucial for the development of systemic autoimmune diseases. This review provides a comprehensive overview of the most thoroughly-characterized nucleic acid-associated autoantigens, describing their structure and biological function, as well as the nature and pathogenic importance of the reactivities directed against them. Furthermore, recent advances in immunotherapy such as antigen-specific approaches targeted at nucleic acid-binding antigens are discussed.
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Affiliation(s)
- Markus H Hoffmann
- Division of Rheumatology, Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
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Kaneko Y, Suwa A, Hirakata M, Ikeda Y, Kuwana M. Clinical associations with autoantibody reactivities to individual components of U1 small nuclear ribonucleoprotein. Lupus 2009; 19:307-12. [DOI: 10.1177/0961203309355163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The reactivities to individual U1 small nuclear ribonucleoprotein (snRNP) components and their relationship to clinical features in patients with anti-U1 snRNP antibodies were examined. We evaluated 114 patients with connective tissue disease whose sera were positive for anti-U1 snRNP antibodies, but negative for anti-Sm antibodies. Antibodies to the U1 snRNP polypeptides 70K, A, and C were detected using subunit-specific enzyme-linked immunosorbent assays and antibodies to U1 small nuclear RNA (snRNA) were identified by an immunoprecipitation assay using deproteinized HeLa cell extracts. The clinical features were retrospectively obtained by chart review and prospectively collected after study entry. The pattern of antibody reactivities to U1 snRNP components varied among patients. The frequency of anti-70K, anti-A, anti-C, and anti-U1 snRNA antibodies was 60%, 86%, 74%, and 46%, respectively. There was no relationship between each reactivity and the clinical findings, but the presence of reactivities to increasing numbers of U1 snRNP components was correlated with sclerodactyly, shortness of the sublingual frenulum, esophageal dysfunction, and a lack of persistent proteinurea (p < 0.05 for all comparisons). The detection of autoantibody reactivities to individual components of the U1 snRNP particle is potentially useful for predicting the clinical course in patients with connective tissue disease and anti-U1 snRNP antibodies. Lupus (2010) 19, 307—312.
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Affiliation(s)
- Y. Kaneko
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan,
| | - A. Suwa
- Department of Internal Medicine Tokai University School of Medicine, Isehara, Japan
| | - M. Hirakata
- Medical Education Center, Keio University School of Medicine Tokyo, Japan
| | - Y. Ikeda
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - M. Kuwana
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Khan WA, Uddin M, Khan MWA, Chabbra HS. Catecholoestrogens: possible role in systemic lupus erythematosus. Rheumatology (Oxford) 2009; 48:1345-51. [DOI: 10.1093/rheumatology/kep168] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Petrakova N, Gudmundsdotter L, Yermalovich M, Belikov S, Eriksson L, Pyakurel P, Johansson O, Biberfeld P, Andersson S, Isaguliants M. Autoimmunogenicity of the helix-loop-helix DNA-binding domain. Mol Immunol 2009; 46:1467-80. [PMID: 19181386 DOI: 10.1016/j.molimm.2008.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Revised: 12/16/2008] [Accepted: 12/16/2008] [Indexed: 11/30/2022]
Abstract
Nonimmunogenic character of native DNA, and its high immunogenicity when presented in complex with the DNA-binding proteins indicate that the latter might contain molecular triggers of anti-DNA response. To find if this is the case, we have evaluated the autoimmunogenic potential of the main DNA-binding domain of HIV-1 reverse transcriptase that belongs to the canonical helix-loop-helix type. BALB/c mice were immunized with a peptide representing the domain, alone or in complex with the fragmented human DNA in the presence of an adjuvant. Mice were assessed for specific antibodies, autoantibodies against a panel of self-antigens; glomerular immunoglobulin deposition; and for the signs of autoimmune disease, such as proteinuria, and changes in the blood components. Immunization with the adjuvanted peptide-DNA complex induced autoantibodies against double-stranded DNA, histones, heterochromatin, and kidney proteins; glomerular IgG and IgA deposition; proteinuria; thrombocytopenia, and anemia. Altogether, this identifies the helix-loop-helix DNA-binding domain as one of the molecular triggers of autoimmunity to DNA and DNA-associated proteins. The experiments cast new light on the role of the DNA-binding retroviral proteins in the induction of autoimmunity, and on the origins of autoimmune complications in the microbial infections in general. It also implies that choosing the DNA-binding proteins as vaccine candidates should be done with precaution.
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Pathophysiological lessons from rare associations of immunological disorders. Pediatr Nephrol 2009; 24:3-8. [PMID: 18853201 PMCID: PMC2644746 DOI: 10.1007/s00467-008-1009-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Revised: 08/18/2008] [Accepted: 08/20/2008] [Indexed: 11/21/2022]
Abstract
Rare associations of immunological disorders can often tell more than mice and rats about the pathogenesis of immunologically mediated human kidney disease. Cases of glomerular disease with thyroiditis and Graves' disease and of minimal change disease with lymphoepithelioma-like thymic carcinoma and lymphomatoid papulosis were recently reported in Pediatric Nephrology. These rare associations can contribute to the unraveling of the pathogenesis of membranous nephropathy (MN) and minimal change disease (MCD) and lead to the testing of novel research hypotheses. In MN, the target antigen may be thyroglobulin or another thyroid-released antigen that becomes planted in the glomerulus, but other scenarios can be envisaged, including epitope spreading, polyreactivity of pathogenic antibodies, and dysregulation of T regulatory cells, leading to the production of a variety of auto-antibodies with different specificities [immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX syndrome)]. The occurrence of MCD with hemopathies supports the role of T cells in the pathogenesis of proteinuria, although the characteristics of those T cells remain to be established and the glomerular permeability factor(s) identified.
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Monneaux F, Parietti V, Briand JP, Muller S. Importance of spliceosomal RNP1 motif for intermolecular T-B cell spreading and tolerance restoration in lupus. Arthritis Res Ther 2008; 9:R111. [PMID: 17963484 PMCID: PMC2212579 DOI: 10.1186/ar2317] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 08/07/2007] [Accepted: 10/26/2007] [Indexed: 01/07/2023] Open
Abstract
We previously demonstrated the importance of the RNP1 motif-bearing region 131-151 of the U1-70K spliceosomal protein in the intramolecular T-B spreading that occurs in MRL/lpr lupus mice. Here, we analyze the involvement of RNP1 motif in the development and prevention of naturally-occurring intermolecular T-B cell diversification. We found that MRL/lpr peripheral blood lymphocytes proliferated in response to peptides containing or corresponding exactly to the RNP1 motif of spliceosomal U1-70K, U1-A and hnRNP-A2 proteins. We also demonstrated that rabbit antibodies to peptide 131-151 cross-reacted with U1-70K, U1-A and hnRNP-A2 RNP1-peptides. These antibodies recognized the U1-70K and U1-A proteins, and also U1-C and SmD1 proteins, which are devoid of RNP1 motif. Repeated administration of phosphorylated peptide P140 into MRL/lpr mice abolished T-cell response to several peptides from the U1-70K, U1-A and SmD1 proteins without affecting antibody and T-cell responses to foreign (viral) antigen in treated mice challenged with infectious virus. These results emphasized the importance of the dominant RNP1 region, which seems to be central in the activation cascade of B and T cells reacting with spliceosomal RNP1+ and RNP1- spliceosomal proteins. The tolerogenic peptide P140, which is recognized by lupus patients' CD4+ T cells and known to protect MRL/lpr mice, is able to thwart emergence of intermolecular T-cell spreading in treated animals.
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Affiliation(s)
- Fanny Monneaux
- Centre National de Recherche Scientifique UPR9021, Institut de Biologie Moléculaire et Cellulaire, 15 rue René Descartes, 67000 Strasbourg, France
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Affiliation(s)
- GJ Silverman
- UCSD Rheumatic Diseases Core Center, UCSD School of Medicine, La Jolla, California, USA
| | - MD Linnik
- La Jolla Pharmaceutical Company, San Diego, California, USA
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Shah P, Tramontano A, Makker SP. Intramolecular epitope spreading in Heymann nephritis. J Am Soc Nephrol 2007; 18:3060-6. [PMID: 18003776 DOI: 10.1681/asn.2007030342] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Immunization with megalin induces active Heymann nephritis, which reproduces features of human idiopathic membranous glomerulonephritis. Megalin is a complex immunological target with four discrete ligand-binding domains (LBDs) that may contain epitopes to which pathogenic autoantibodies are directed. Recently, a 236-residue N-terminal fragment, termed "L6," that spans the first LBD was shown to induce autoantibodies and severe disease. We used this model to examine epitope-specific contributions to pathogenesis. Sera obtained from rats 4 weeks after immunization with L6 demonstrated reactivity only with the L6 fragment on Western blot, whereas sera obtained after 8 weeks demonstrated reactivity with all four recombinant fragments of interest (L6 and LBDs II, III, and IV). We demonstrated that the L6 immunogen does not contain the epitopes responsible for the reactivity to the LBD fragments. Therefore, the appearance of antibodies directed at LBD fragments several weeks after the primary immune response suggests intramolecular epitope spreading. In vivo, we observed a temporal association between increased proteinuria and the appearance of antibodies to LBD fragments. These data implicate B cell epitope spreading in antibody-mediated pathogenesis of active Heymann nephritis, a model that should prove valuable for further study of autoimmune dysregulation.
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Affiliation(s)
- Pallavi Shah
- Department of Pediatrics, University of California, Davis, School of Medicine, Davis, California 95616, USA
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Monneaux F, Muller S. Peptide-based therapy in lupus: promising data. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2007; 601:105-12. [PMID: 17712997 DOI: 10.1007/978-0-387-72005-0_11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Systemic lupus erythematosus (SLE) is a multisystem chronic inflammatory disease of multifactorial aetiology, characterized by inflammation and damage of various tissues and organs. Current treatments of the disease are mainly based on immunosuppressive drugs such as corticosteroids and cyclophosphamide. Although these treatments have reduced mortality and morbidity, they cause a non-specific immune suppression. To avoid these side effects, our efforts should focus on the development of alternative therapeutic strategies, which consist, for example in specific T cell targeting using autoantigen-derived peptides identified as sequences encompassing major epitopes.
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Affiliation(s)
- Fanny Monneaux
- Institut de Biologie Moléculaire et Cellulaire, 67000 Strasbourg, France
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Liu K, Li QZ, Yu Y, Liang C, Subramanian S, Zeng Z, Wang HW, Xie C, Zhou XJ, Mohan C, Wakeland EK. Sle3 and Sle5 can independently couple with Sle1 to mediate severe lupus nephritis. Genes Immun 2007; 8:634-45. [PMID: 17728789 DOI: 10.1038/sj.gene.6364426] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Genetic analyses of the lupus-prone NZM2410 mouse have identified multiple susceptibility loci on chromosome 7, termed Sle3 and Sle5. Both of these loci were contained within a large congenic interval, originally termed as Sle3 that strongly impacts a variety of myeloid and T-cell phenotypes and mediates fatal lupus nephritis when combined with Sle1. We have now produced two subcongenic strains, B6.Sle3 and B6.Sle5, carrying the Sle3 and Sle5 intervals separately and characterized their phenotypes as monocongenic strains and individually in combination with Sle1. Neither B6.Sle3 nor B6.Sle5 monocongenic strain develop severe autoimmunity; however, both of these intervals cause the development of severe glomerulonephritis when combined with Sle1. Thus, B6.Sle1Sle3 and B6.Sle1Sle5 exhibit splenomegaly, expansion of activated B and CD4+ T-cell populations and high levels of IgG and IgM autoantibodies targeting multiple nuclear antigens, intact glomeruli and various other autoantigens. In addition, B6.Sle1Sle3 mice also produced higher levels of IgA antinuclear autoantibodies, which were implicated in the development of IgA nephropathy. Our results indicate that Sle3 and Sle5 can independently complement with Sle1, through shared and unique mechanisms, to mediate the development of severe autoimmunity.
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Affiliation(s)
- K Liu
- Department of Immunology, The University of Texas Southwestern Medical Center, Dallas, TX 75390-9093, USA.
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