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Fallahi P, Ferrari SM, Ragusa F, Ruffilli I, Elia G, Paparo SR, Antonelli A. Th1 Chemokines in Autoimmune Endocrine Disorders. J Clin Endocrinol Metab 2020; 105:5683662. [PMID: 31863667 DOI: 10.1210/clinem/dgz289] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT The CXC chemokine receptor CXCR3 and its chemokines CXCL10, CXCL9, and CXCL11 are implicated in the pathogenesis of autoimmune diseases. Here, we review these chemokines in autoimmune thyroiditis (AT), Graves disease (GD), thyroid eye disease (TED), type 1 diabetes (T1D), and Addison's disease (AAD). EVIDENCE ACQUISITION A PubMed review of the literature was conducted, searching for the above-mentioned chemokines in combination with AT, GD, TED, T1D, and AAD. EVIDENCE SYNTHESIS Thyroid follicular cells in AT and GD, retroorbital cells in TED (fibroblasts, preadipocytes, myoblasts), β cells and islets in T1D, and adrenal cells in AAD respond to interferon-γ (IFN-γ) stimulation producing large amounts of these chemokines. Furthermore, lymphocytes and peripheral blood mononuclear cells (PBMC) are in part responsible for the secreted Th1 chemokines. In AT, GD, TED, T1D, and AAD, the circulating levels of these chemokines have been shown to be high. Furthermore, these chemokines have been associated with the early phases of the autoimmune response in all the above-mentioned disorders. High levels of these chemokines have been associated also with the "active phase" of the disease in GD, and also in TED. Other studies have shown an association with the severity of hypothyroidism in AD, of hyperthyroidism in GD, with severity of TED, or with fulminant T1D. CONCLUSION The reviewed data have shown the importance of the Th1 immune response in different endocrine autoimmune diseases, and many studies have suggested that CXCR3 and its chemokines might be considered as potential targets of new drugs for the treatment of these disorders.
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Affiliation(s)
- Poupak Fallahi
- Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Francesca Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ilaria Ruffilli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giusy Elia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Purohit S, Sharma A, Hopkins D, Steed L, Bode B, Anderson SW, Reed JC, Steed RD, Yang T, She JX. Large-Scale Discovery and Validation Studies Demonstrate Significant Reductions in Circulating Levels of IL8, IL-1Ra, MCP-1, and MIP-1β in Patients With Type 1 Diabetes. J Clin Endocrinol Metab 2015; 100:E1179-87. [PMID: 26158606 PMCID: PMC4570171 DOI: 10.1210/jc.2015-1388] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/06/2015] [Indexed: 01/26/2023]
Abstract
CONTEXT Previous studies have attempted to elucidate the potential role of various cytokines and chemokines in human type 1 diabetes (T1D); however, the precise role of these serum proteins in T1D is still controversial and undetermined primarily due to the small sample sizes of the previous studies. We profiled a panel of serum cytokines and chemokines using a large-scale, two-stage study design for the discovery and validation of the serum proteins associated with T1D. PARTICIPANTS The participants were patients with T1D and islet autoantibody-negative control subjects from the Phenome and Genome of Diabetes Autoimmunity study. MAIN OUTCOME MEASURES Thirteen cytokines and chemokines were measured in serum of 4424 subjects using multiplex immunoassays. RESULTS Using 1378 samples in Stage 1, we found that four of the 13 proteins are significantly lower in patients with T1D than controls (IL8: odds ratio [OR] = 0.40; P = 5.7 × 10(-19); IL-1Ra: OR = 0.42; P = 1.1 × 10(-13); MCP-1: OR = 0.60; P = 6.7 × 10(-9); and MIP-1β: OR = 0.63; P = 4.2 × 10(-7)). Our confirmation data with 3046 samples in Stage 2 further confirmed the significant negative associations of these four proteins with T1D (IL8: OR = 0.43; P = 8.9 × 10(-32); IL-1Ra: OR = 0.56, P = 3.7 × 10(-27); MCP-1: OR = 0.61, P = 4.3 × 10(-17); and MIP-1β: OR = 0.69, P = 2.4 × 10(-13)). Quartile analyses also suggested that significantly more T1D cases have protein levels in the bottom quartile than in the top quartile for all four proteins: IL8 (OR = 0.09), IL-1Ra (OR = 0.18), MCP-1 (OR = 0.38), and MIP-1β (OR = 0.44). Furthermore, the negative associations between T1D and serum levels of all four proteins are stronger in genetically high-risk groups compared with the moderate and low-risk groups. CONCLUSIONS IL8, IL-1Ra, MCP-1, and MIP-1β are significantly lower in patients with T1D than controls.
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Affiliation(s)
- Sharad Purohit
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - Ashok Sharma
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - Diane Hopkins
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - Leigh Steed
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - Bruce Bode
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - Stephen W Anderson
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - John Chip Reed
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - R Dennis Steed
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - Tao Yang
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
| | - Jin-Xiong She
- Center for Biotechnology and Genomic Medicine (S.P., A.S., D.H., L.S., J-X.S.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Atlanta Diabetes Associates (B.B.), Atlanta, Georgia 30318; Pediatric Endocrine Associates (S.W.A.), Atlanta, Georgia 30342; Southeastern Endocrine and Diabetes (J.C.R., R.D.S.), Atlanta, Georgia 30076; and Department of Endocrinology (T.Y.), First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China 210029
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Antonelli A, Ferrari SM, Corrado A, Ferrannini E, Fallahi P. CXCR3, CXCL10 and type 1 diabetes. Cytokine Growth Factor Rev 2014; 25:57-65. [PMID: 24529741 DOI: 10.1016/j.cytogfr.2014.01.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 01/17/2014] [Indexed: 02/09/2023]
Abstract
Type 1 diabetes (T1D) is due to antigen-specific assaults on the insulin producing pancreatic β-cells by diabetogenic T-helper (Th)1 cells. (C-X-C motif) ligand (CXCL)10, an interferon-γ inducible Th1 chemokine, and its receptor, (C-X-C motif) receptor (CXCR)3, have an important role in different autoimmune diseases. High circulating CXCL10 levels were detected in new onset T1D patients, in association with a Th1 autoimmune response. Furthermore β-cells produce CXCL10, under the influence of Th1 cytokines, that suppresses their proliferation. Viral β-cells infections induce cytokines and CXCL10 expression, inducing insulin-producing cell failure in T1D. CXCL10/CXCR3 system plays a critical role in the autoimmune process and in β-cells destruction in T1D. Blocking CXCL10 in new onset diabetes seems a possible approach for T1D treatment.
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Affiliation(s)
- Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, I-56126 Pisa, Italy.
| | - Silvia Martina Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, I-56126 Pisa, Italy.
| | - Alda Corrado
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, I-56126 Pisa, Italy.
| | - Ele Ferrannini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, I-56126 Pisa, Italy.
| | - Poupak Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, I-56126 Pisa, Italy.
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Antonelli A, Ferrari SM, Giuggioli D, Ferrannini E, Ferri C, Fallahi P. Chemokine (C-X-C motif) ligand (CXCL)10 in autoimmune diseases. Autoimmun Rev 2013; 13:272-80. [PMID: 24189283 DOI: 10.1016/j.autrev.2013.10.010] [Citation(s) in RCA: 388] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 10/24/2013] [Indexed: 12/12/2022]
Abstract
(C-X-C motif) ligand (CXCL)10 (CXCL10) belongs to the ELR(-) CXC subfamily chemokine. CXCL10 exerts its function through binding to chemokine (C-X-C motif) receptor 3 (CXCR3), a seven trans-membrane receptor coupled to G proteins. CXCL10 and its receptor, CXCR3, appear to contribute to the pathogenesis of many autoimmune diseases, organ specific (such as type 1 diabetes, autoimmune thyroiditis, Graves' disease and ophthalmopathy), or systemic (such as rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, mixed cryoglobulinemia, Sjögren syndrome, or systemic sclerosis). The secretion of CXCL10 by cluster of differentiation (CD)4+, CD8+, natural killer (NK) and NK-T cells is dependent on interferon (IFN)-γ, which is itself mediated by the interleukin-12 cytokine family. Under the influence of IFN-γ, CXCL10 is secreted by several cell types including endothelial cells, fibroblasts, keratinocytes, thyrocytes, preadipocytes, etc. Determination of high level of CXCL10 in peripheral fluids is therefore a marker of host immune response, especially T helper (Th)1 orientated T-cells. In tissues, recruited Th1 lymphocytes may be responsible for enhanced IFN-γ and tumor necrosis factor-α production, which in turn stimulates CXCL10 secretion from a variety of cells, therefore creating an amplification feedback loop, and perpetuating the autoimmune process. Further studies are needed to investigate interactions between chemokines and cytokines in the pathogenesis of autoimmune diseases and to evaluate whether CXCL10 is a novel therapeutic target in various autoimmune diseases.
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Affiliation(s)
- Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy.
| | - Silvia Martina Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy.
| | - Dilia Giuggioli
- Department of Medical, Surgical, Maternal, Pediatric and Adult Sciences, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100 Modena, Italy.
| | - Ele Ferrannini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy.
| | - Clodoveo Ferri
- Department of Medical, Surgical, Maternal, Pediatric and Adult Sciences, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100 Modena, Italy.
| | - Poupak Fallahi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy.
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Berg AK, Tuvemo T, Frisk G. Enterovirus markers and serum CXCL10 in children with type 1 diabetes. J Med Virol 2010; 82:1594-9. [PMID: 20648615 DOI: 10.1002/jmv.21868] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Most patients with type 1 diabetes are considered to have a T-cell mediated autoimmune disease. The chemokine CXCL10 promotes the migration of activated T-cells. Virus infections might contribute to the pathogenesis of type 1 diabetes and enterovirus protein and/or genome have been detected in beta-cells from a majority of tested newly diagnosed children with type 1 diabetes. The chemokine CXCL10 is induced in human islet cells by enterovirus infections in vivo and in vitro, but is not expressed in islets from normal organ donors. Since CXCL10 is a chemokine known to be induced by virus infections and/or cellular damage, our aim was to study if levels of CXCL10 are elevated in serum from children with type 1 diabetes and whether it correlates to the presence of enterovirus markers. CXCL10, neutralizing antibody titer rises against certain enterovirus, and antibodies against GAD65 were measured in serum, and enterovirus PCR was performed on whole blood from 83 type 1 diabetes patients at onset, 48 siblings and 69 controls. CXCL10 was also measured in serum from 46 patients with proven enterovirus infection and in serum from 46 patients with other proven virus infections. The CXCL10 serum levels were not elevated in children at onset of type 1 diabetes and there was a considerable overlap between the groups with 99 (8-498) pg/ml in serum from children with type 1 diabetes, 120 (17-538) pg/ml in serum from controls, and 117 (7-448) pg/ml in siblings of the children with type 1 diabetes. The CXCL10 serum levels in patients with proven enterovirus infection were slightly increased compared to the levels in the other groups, 172 (0-585) pg/ml but there was no statistically significant difference. In contrast, CXCL10 serum levels in patients with other proven virus infections were clearly elevated 418 (34-611) pg/ml. Despite that elevated CXCL10 levels have been demonstrated in some groups of patients with type 1 diabetes, in this study the mean CXCL10 serum levels were not elevated in patients with type 1 diabetes neither in patients with proven enterovirus infection. In contrast, in patients with other virus infections the CXCL10 levels were elevated, presumably reflecting the severity or the site of infection. This suggests that local production of CXCL10 in the affected organ cannot be measured reproducible in serum and that its potential use in clinical practice is limited.
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Affiliation(s)
- Anna-Karin Berg
- Department of Oncology, Radiology and Clinical Immunology, Uppsala University, 751 85 Uppsala, Sweden
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Abstract
Chemokines are a group of peptides of low molecular weight that induce the chemotaxis of different leukocyte subtypes. The major function of chemokines is the recruitment of leukocytes to inflammation sites, but they also play a role in tumoral growth, angiogenesis, and organ sclerosis. In the last few years, experimental evidence accumulated supporting the concept that interferon-gamma (IFN-gamma) inducible chemokines (CXCL9, CXCL10, and CXCL11) and their receptor, CXCR3, play an important role in the initial stage of autoimmune disorders involving endocrine glands. The fact that, after IFN-gamma stimulation, endocrine epithelial cells secrete CXCL10, which in turn recruits type 1 T helper lymphocytes expressing CXCR3 and secreting IFN-gamma, thus perpetuating autoimmune inflammation, strongly supports the concept that chemokines play an important role in endocrine autoimmunity. This article reviews the recent literature including basic science, animal models, and clinical studies, regarding the role of these chemokines in autoimmune endocrine diseases. The potential clinical applications of assaying the serum levels of CXCL10 and the value of such measurements are reviewed. Clinical studies addressing the issue of a role for serum CXCL10 measurement in Graves' disease, Graves' ophthalmopathy, chronic autoimmune thyroiditis, type 1 diabetes mellitus, and Addison's disease have been considered. The principal aim was to propose that chemokines, and in particular CXCL10, should no longer be considered as belonging exclusively to basic science, but rather should be used for providing new insights in the clinical management of patients with endocrine autoimmune diseases.
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Affiliation(s)
- Mario Rotondi
- Excellence Center for Research, Transfer and High Education De Novo Therapies, University of Florence, 50121 Florence, Italy.
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