1
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Zhao R, Luo S, Zhao C. The role of innate immunity in myasthenia gravis. Autoimmun Rev 2021; 20:102800. [PMID: 33722749 DOI: 10.1016/j.autrev.2021.102800] [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: 01/12/2021] [Accepted: 01/22/2021] [Indexed: 12/19/2022]
Abstract
Myasthenia gravis (MG) is a T cell-driven, B cell-mediated and autoantibody-dependent autoimmune disorder against neuromuscular junctions (NMJ). Accumulated evidence has emerged regarding the role of innate immunity in the pathogenesis of MG. In this review, we proposed two hypothesis underlying the pathological mechanism. In the context of gene predisposition, on the one hand, Toll-like receptors (TLRs) pathways were initiated by viral infection in the thymus with MG to generate chemokines and pro-inflammatory cytokines such as Type I interferon (IFN), which facilitate the thymus to function as a tertiary lymphoid organ (TLO). On the another hand, the antibodies against acetylcholine receptors (AChR) generated by thymus then activated the classical pathways on thymus and neuromuscular junction (NMJ). Futher, we also highlight the role of innate immune cells in the pathogenic response. Finally, we provide some future perspectives in developing new therapeutic approaches particularly targeting the innate immunity for MG.
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Affiliation(s)
- Rui Zhao
- Department of Neurology, Huashan hospital Fudan University, 200040 Shanghai, China
| | - Sushan Luo
- Department of Neurology, Huashan hospital Fudan University, 200040 Shanghai, China
| | - Chongbo Zhao
- Department of Neurology, Huashan hospital Fudan University, 200040 Shanghai, China.
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2
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Parody N, Cacheiro-Llaguno C, Osuna C, Renshaw-Calderón A, Alonso C, Carnés J. Circulating immune complexes levels correlate with the progression of canine leishmaniosis in naturally infected dogs. Vet Parasitol 2019; 274:108921. [PMID: 31536867 DOI: 10.1016/j.vetpar.2019.108921] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/03/2019] [Accepted: 09/07/2019] [Indexed: 12/17/2022]
Abstract
Dogs are the main domestic reservoir of Leishmania infantum, and in cases of uncontrolled infection, a strong humoral immune response is elicited, which is inefficient against the parasites. Previous studies have suggested that an adequate antigen/antibody ratio, with a moderate prevalence of antigens with respect to the antibodies, could result in the formation of circulating immune complexes (CIC) in canine leishmaniosis (CanL). Deposition of these complexes in tissues has been associated with vasculitis, uveitis, arthritis, dermatitis and especially glomerulonephritis and renal failure. However, little is known about the relationship between the presence of CIC and disease progression. The aim of this study was to evaluate serum CIC level and its correlation with disease severity in infected dogs with different stages of disease and non-infected animals as a control. A total of 60 dogs were included in the study, classified according to the proposed LeishVet classification criteria: healthy non-infected (n = 13); healthy infected (n = 12); sick stage I (n = 9); sick stage II (n = 17); sick stage III (n = 8); and sick stage IV (n = 1). CIC were isolated from serum samples using a modified polyethylene glycol precipitation method, and their levels measured by ELISA and bicinchoninic acid protein assay. A nanoparticle tracking analysis was performed to investigate the relationship between the molecular size distribution of the CIC and disease progression. In conclusion, the results confirmed a positive association between CIC levels, their molecular size and disease progression that suggests a potential use of CIC as biomarkers of CanL.
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Affiliation(s)
- Nuria Parody
- R&D Department, Laboratorios LETI S.L., Tres Cantos, Madrid, Spain
| | | | - Cristina Osuna
- R&D Department, Laboratorios LETI S.L., Tres Cantos, Madrid, Spain
| | - Ana Renshaw-Calderón
- Centro de Biología Molecular Severo Ochoa, CSIC-Universidad Autónoma de Madrid, Cantoblanco, Madrid, Spain
| | - Carlos Alonso
- Centro de Biología Molecular Severo Ochoa, CSIC-Universidad Autónoma de Madrid, Cantoblanco, Madrid, Spain
| | - Jerónimo Carnés
- R&D Department, Laboratorios LETI S.L., Tres Cantos, Madrid, Spain.
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3
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Cai X, Li Z, Xi J, Song H, Liu J, Zhu W, Guo Y, Jiao Z. Myasthenia gravis and specific immunotherapy: monoclonal antibodies. Ann N Y Acad Sci 2019; 1452:18-33. [PMID: 31393614 DOI: 10.1111/nyas.14195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/23/2019] [Accepted: 06/25/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Xiao‐Jun Cai
- Department of Clinical Pharmacy, Huashan HospitalFudan University Shanghai P. R. China
- Department of Pharmacythe Affiliated Wuxi People's Hospital of Nanjing Medical University Wuxi P. R. China
| | - Zai‐Wang Li
- Department of Neurology, Shenzhen People's Hospital, the Second Clinical Medical College of Jinan Universitythe First Affiliated Hospital of Southern University of Science and Technology Shenzhen P. R. China
- Department of Neurologythe Affiliated Wuxi People's Hospital of Nanjing Medical University Wuxi P. R. China
| | - Jian‐Ying Xi
- Department of Neurology, Huashan HospitalFudan University Shanghai P. R. China
| | - Hui‐Zhu Song
- Department of Pharmacythe Affiliated Wuxi People's Hospital of Nanjing Medical University Wuxi P. R. China
| | - Jue Liu
- Department of Clinical Pharmacy, Huashan HospitalFudan University Shanghai P. R. China
| | - Wen‐Hua Zhu
- Department of Neurology, Huashan HospitalFudan University Shanghai P. R. China
| | - Yi Guo
- Department of Neurology, Shenzhen People's Hospital, the Second Clinical Medical College of Jinan Universitythe First Affiliated Hospital of Southern University of Science and Technology Shenzhen P. R. China
| | - Zheng Jiao
- Department of Clinical Pharmacy, Huashan HospitalFudan University Shanghai P. R. China
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4
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Guidelines for standard preclinical experiments in the mouse model of myasthenia gravis induced by acetylcholine receptor immunization. Exp Neurol 2015; 270:11-7. [DOI: 10.1016/j.expneurol.2015.02.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 01/13/2015] [Accepted: 02/04/2015] [Indexed: 01/25/2023]
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5
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Xu H, Zhang M, Li XL, Li H, Yue LT, Zhang XX, Wang CC, Wang S, Duan RS. Low and high doses of ursolic acid ameliorate experimental autoimmune myasthenia gravis through different pathways. J Neuroimmunol 2015; 281:61-7. [PMID: 25867469 DOI: 10.1016/j.jneuroim.2015.02.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 01/08/2015] [Accepted: 02/28/2015] [Indexed: 10/23/2022]
Abstract
Myasthenia gravis (MG) is an autoimmune disease characterized by fatigable muscle weakness. Ursolic acid (UA) is a pentacyclic triterpenoid with anti-inflammatory and immunomodulatory properties, especially inhibiting IL-17. We found that UA ameliorated the symptoms of experimental autoimmune myasthenia gravis (EAMG), a rat model of MG. Although both the low and high doses of UA shifted Th17 to Th2 cytokines, other mechanisms were dose dependent. The low dose enhanced Fas-mediated apoptosis, whereas the high dose up-regulated Treg cells and reduced the concentrations of IgG2b antibodies. These findings suggest a new strategy to treat EAMG and even human MG.
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Affiliation(s)
- Hua Xu
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China; Department of Neurology, Taian City Central Hospital, Taian 271000, PR China
| | - Min Zhang
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China
| | - Xiao-Li Li
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China
| | - Heng Li
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China
| | - Long-Tao Yue
- Central Laboratory, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China
| | - Xin-Xin Zhang
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China
| | - Cong-Cong Wang
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China
| | - Shan Wang
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China
| | - Rui-Sheng Duan
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, PR China.
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6
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Wu B, Goluszko E, Huda R, Tüzün E, Christadoss P. Experimental Autoimmune Myasthenia Gravis in the Mouse. ACTA ACUST UNITED AC 2013; Chapter 15:Unit 15.8.. [DOI: 10.1002/0471142735.im1508s100] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Bo Wu
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Elzbieta Goluszko
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Ruksana Huda
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Premkumar Christadoss
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
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Syriga M, Mavroidis M. Complement system activation in cardiac and skeletal muscle pathology: friend or foe? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 735:207-18. [PMID: 23402029 DOI: 10.1007/978-1-4614-4118-2_14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A major goal in current cardiology practice is to determine optimal strategies for minimizing myocardial necrosis and optimizing cardiac repair following an acute myocardial infarction. Temporally regulated activation and suppression of innate immunity may be critical for achieving this goal. Extensive experimental data in various animal models have indicated that inhibiting complement activation offers protection to cardiac tissue after ischemia/reperfusion. However, the results of clinical studies using complement inhibitors (mainly at the C5 level) in patients with acute myocardial infarction have largely been disappointing. In cases in which complement activation participates in the initial events of muscle cell destruction, as in autoimmune myocarditis or autoimmune muscle disorders, inhibition of complement activation is expected to prove a successful treatment. In other pathologic conditions in which complement is recruited by degenerating or dying muscle cells, as in ischemia, the ideal approach is probably to modulate rather than abruptly blunt complement activation. Beneficial effects of complement action with regard to waste disposal, recruitment of stem cells, regeneration, angiogenesis, and better utilization of energy sources under hypoxic conditions may also prove important for successful disease treatment. Patient outcome after myocardial infarction almost certainly depend upon the combined activation of several distinct but potentially interrelated signaling pathways, suggesting that a combination of treatments targeted to different pathways should be the therapy of choice, and modulation of complement could be one of them.
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Affiliation(s)
- Msaro Syriga
- Center of Basic Research, Biomedical Research Foundation, Academy of Athens, Athens 11527, Greece
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8
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The increased expression of CD21 on AchR specified B cells in patients with myasthenia gravis. J Neuroimmunol 2012; 256:49-54. [PMID: 23266128 DOI: 10.1016/j.jneuroim.2012.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 11/28/2012] [Accepted: 11/30/2012] [Indexed: 12/15/2022]
Abstract
CD21, a major complement receptor expressed on B cells, is associated with autoimmune disorders. In the present study, we investigated the role of CD21 in pathogenesis of myasthenia gravis (MG) in relationship to anti-acetylcholine receptor (AchR) IgG (anti-AchR IgG) secretion. We detected increased surface expression of CD21 on AchR specified B cells as well as decreased surface expression of CD21 on total B cells in peripheral blood of patients with generalized MG (gMG). In addition, the serum concentrations of soluble secreted CD21 (sCD21) were decreased in patients with gMG. We also found that the level of CD21(+) AchR specified B cells correlated positively with serum anti-AchR IgG level, while the serum concentration of soluble CD21 correlated negatively with serum anti-AchR IgG level. Our data suggests that CD21 might facilitate its function on AchR specified B cell activation, resulting in the secretion of anti-AchR IgG.
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9
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Allman W, Qi H, Saini SS, Li J, Tuzun E, Christadoss P. CD4 costimulation is not required in a novel LPS-enhanced model of myasthenia gravis. J Neuroimmunol 2012; 249:1-7. [PMID: 22626443 DOI: 10.1016/j.jneuroim.2012.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 03/08/2012] [Accepted: 04/04/2012] [Indexed: 01/30/2023]
Abstract
The potential of lipopolysaccharide (LPS) to induce antigen-specific B cell responses to acetylcholine receptor (AChR) in myasthenia gravis (MG) was evaluated in wild type (WT) and CD4-/- C57BL/6 mice. The WT mice immunized with AChR in LPS developed an MG-like disease (LPS-EAMG) similar to that induced by immunization with AChR in complete Freund's adjuvant (CFA-EAMG). CD4-/- mice were resistant to CFA-EAMG but susceptible to LPS-EAMG. LPS abrogated EAMG resistance in CD4-/- mice by increasing high-affinity anti-AChR IgG2b in sera and enhancing immune complex deposition in muscle.
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Affiliation(s)
- Windy Allman
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1070, United States
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10
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Wu B, Goluszko E, Huda R, Tüzün E, Christadoss P. Experimental Autoimmune Myasthenia Gravis in the Mouse. ACTA ACUST UNITED AC 2011; Chapter 15:Unit 15.23. [PMID: 22048803 DOI: 10.1002/0471142735.im1523s95] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bo Wu
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Elzbieta Goluszko
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Ruksana Huda
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Premkumar Christadoss
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
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11
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Tüzün E, Huda R, Christadoss P. Complement and cytokine based therapeutic strategies in myasthenia gravis. J Autoimmun 2011; 37:136-43. [PMID: 21636248 DOI: 10.1016/j.jaut.2011.05.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 05/02/2011] [Indexed: 01/17/2023]
Abstract
Myasthenia gravis (MG) is a T cell-dependent and antibody-mediated disease in which the target antigen is the skeletal muscle acetylcholine receptor (AChR). In the last few decades, several immunological factors involved in MG pathogenesis have been discovered mostly by studies utilizing the experimental autoimmune myasthenia gravis (EAMG) model. Nevertheless, MG patients are still treated with non-specific global immunosuppression that is associated with severe chronic side effects. Due to the high heterogeneity of AChR epitopes and antibody responses involved in MG pathogenesis, the specific treatment of MG symptoms have to be achieved by inhibiting the complement factors and cytokines involved in anti-AChR immunity. EAMG studies have clearly shown that inhibition of the classical and common complement pathways effectively and specifically diminish the neuromuscular junction destruction induced by anti-AChR antibodies. The inborn or acquired deficiencies of IL-6, TNF-α and TNF receptor functions are associated with the lowest EAMG incidences. Th17-type immunity has recently emerged as an important contributor of EAMG pathogenesis. Overall, these results suggest that inhibition of the complement cascade and the cytokine networks alone or in combination might aid in development of future treatment models that would reduce MG symptoms with highest efficacy and lowest side effect profile.
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Affiliation(s)
- Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA
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12
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Kusner LL, Kaminski HJ, Soltys J. Effect of complement and its regulation on myasthenia gravis pathogenesis. Expert Rev Clin Immunol 2010; 4:43-52. [PMID: 20477586 DOI: 10.1586/1744666x.4.1.43] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Myasthenia gravis (MG) is primarily caused by antibodies directed towards the skeletal muscle acetylcholine receptor, leading to muscle weakness. Although these antibodies may induce compromise of neuromuscular transmission by blocking acetylcholine receptor function or antigenic modulation, the predominant mechanism of injury to the neuromuscular junction is complement-mediated lysis of the postsynaptic membrane. The vast majority of data to support the role of complement derives from experimentally acquired MG (EAMG). In this article, we review studies that demonstrate the central role of complement in EAMG and MG pathogenesis along with the emerging role of complement in T- and B-cell function, as well as the potential for complement inhibitor-based therapy to treat human MG.
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Affiliation(s)
- Linda L Kusner
- Department of Neurology & Psychiatry, Saint Louis University, 1438 South Grand Blvd, St Louis, MO 63104, USA.
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13
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Christadoss P, Tüzün E, Li J, Saini SS, Yang H. Classical Complement Pathway in Experimental Autoimmune Myasthenia Gravis Pathogenesis. Ann N Y Acad Sci 2008; 1132:210-9. [DOI: 10.1196/annals.1405.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Inhibitory IgG receptor FcgammaRIIB fails to inhibit experimental autoimmune myasthenia gravis pathogenesis. J Neuroimmunol 2008; 194:44-53. [PMID: 18207575 DOI: 10.1016/j.jneuroim.2007.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Revised: 11/15/2007] [Accepted: 11/16/2007] [Indexed: 12/15/2022]
Abstract
Deficiency of the inhibitory FcgammaRIIB renders mice susceptible to autoimmune disorders characterized with cellular infiltration of target tissue. To analyze the role of FcgammaRIIB in an antibody-mediated autoimmune disease, experimental autoimmune myasthenia gravis (EAMG), FcgammaRIIB knockout (KO) and wild-type mice were immunized with acetylcholine receptor (AChR). In contrast with previous reports, FcgammaRIIB KO mice were mildly resistant to EAMG despite preserved anti-AChR antibody production and neuromuscular junction complement deposition capacity. EAMG resistance was associated with reduced lymph node cell IL-6 and IL-10 production and increased CD4(+)CD25(+) cell ratios in lymph nodes. Our data suggest that FcgammaRIIB promotes antibody-mediated autoimmunity.
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15
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Chon JY, Lee HJ. Changes in Acetylcholine Receptors and Functional Characterization in Muscle by TOF Stimulation in Rat Experimental Autoimmune Myasthenia Gravis (EAMG) Model. Korean J Anesthesiol 2007. [DOI: 10.4097/kjae.2007.52.3.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jin Young Chon
- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hae Jin Lee
- Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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16
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Tüzün E, Li J, Saini SS, Yang H, Christadoss P. Pros and cons of treating murine myasthenia gravis with anti-C1q antibody. J Neuroimmunol 2007; 182:167-76. [PMID: 17137637 DOI: 10.1016/j.jneuroim.2006.10.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2006] [Revised: 10/11/2006] [Accepted: 10/11/2006] [Indexed: 11/26/2022]
Abstract
To test the feasibility of classical complement pathway manipulation in experimental autoimmune myasthenia gravis (EAMG) treatment, C57BL/6 (B6) and RIIIS/J mice with EAMG were treated with 10 microg or 100 microg of anti-C1q Ab or isotype Ab. Treatment with 10 microg anti-C1q Ab significantly reduced the clinical severity, decreased lymph node cell IL-6 production and T cell populations. Conversely, administration of 100 microg anti-C1q Ab caused harmful side effects such as increased serum anti-acetylcholine receptor antibody, immune complex, C3 and lymph node B cell levels and kidney C3 and IgG deposits, which reduced the treatment efficacy.
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Affiliation(s)
- Erdem Tüzün
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1070, United States
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Tüzün E, Saini SS, Morgan BP, Christadoss P. Complement regulator CD59 deficiency fails to augment susceptibility to actively induced experimental autoimmune myasthenia gravis. J Neuroimmunol 2006; 181:29-33. [PMID: 17056125 DOI: 10.1016/j.jneuroim.2006.07.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2006] [Revised: 07/19/2006] [Accepted: 07/26/2006] [Indexed: 11/29/2022]
Abstract
Complement deficient mice are resistant to experimental autoimmune myasthenia gravis (EAMG), suggesting a pivotal role for the membrane attack complex (MAC) in EAMG pathogenesis. To test the significance of MAC regulation in EAMG pathogenesis, CD59 KO and wild type mice were immunized with acetylcholine receptor (AChR). Interestingly, deletion of CD59, the regulator of MAC assembly, failed to augment EAMG susceptibility. The CD59 KO mice had reduced serum anti-AChR IgG1, IgG2b and complement levels. Their lymph node cell IL-2 production and lymphocyte proliferation response to AChR were reduced. The data challenge the current paradigm that CD59 is solely involved in MAC regulation and suggest a role for this molecule in antigen-driven T cell and B cell activation.
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MESH Headings
- Animals
- B-Lymphocytes/cytology
- B-Lymphocytes/immunology
- CD59 Antigens/genetics
- CD59 Antigens/immunology
- CD59 Antigens/metabolism
- Cell Division/immunology
- Complement C3/metabolism
- Complement C4/metabolism
- Complement Membrane Attack Complex/metabolism
- Disease Susceptibility/immunology
- Immunization
- Immunoglobulin G/blood
- Interleukin-2/metabolism
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Myasthenia Gravis, Autoimmune, Experimental/genetics
- Myasthenia Gravis, Autoimmune, Experimental/immunology
- Myasthenia Gravis, Autoimmune, Experimental/metabolism
- Protein Subunits/immunology
- Protein Subunits/metabolism
- Receptors, Cholinergic/immunology
- Receptors, Cholinergic/metabolism
- T-Lymphocytes/cytology
- T-Lymphocytes/immunology
- Torpedo
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Affiliation(s)
- Erdem Tüzün
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1070, USA
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Fostieri E, Kostelidou K, Poulas K, Tzartos SJ. Recent advances in the understanding and therapy of myasthenia gravis. FUTURE NEUROLOGY 2006. [DOI: 10.2217/14796708.1.6.799] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Myasthenia gravis (MG) is a T-cell dependent autoimmune disease mediated by autoantibodies, which mainly target muscle nicotinic acetylcholine receptors (AChR) and cause loss of functional AChRs in the neuromuscular junction. Both MG and its major autoantigen are studied extensively, yet the etiology of the disease remains unclear, although it is known to be associated with the thymus. A genetic predisposition, combined with several unidentified environmental stimuli, likely creates a favorable milieu in which the disease can appear. Current research focusses on elucidating the cellular and molecular pathways of immune dysregulation, which underly MG outburst and progression. Considerable progress has been made concerning the involvement of the thymus, the identification of impaired mechanisms of immune control and the B–T-cell interaction in MG pathogenesis, while the role of chemokines arises as an intriguing new puzzle. Recent findings fueled the development of novel therapeutic approaches with some encouraging, although preliminary, results. This review summarizes recent achievements in the fields of both basic research and therapeutics.
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Affiliation(s)
- Efrosini Fostieri
- Hellenic Pasteur Institute, Department of Biochemistry, 127 Vas. Sofias Avenue, 11521 Athens, Greece
| | - Kalliopi Kostelidou
- Hellenic Pasteur Institute, Department of Biochemistry, 127 Vas. Sofias Avenue 11521 Athens, Greece
| | | | - Socrates J Tzartos
- Hellenic Pasteur Institute, Department of Biochemistry, 127 Vas. Sofias Avenue, 11521 Athens, Greece and, Department of Pharmacy, University of Patras, 26504 Patras, Greece
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19
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Tüzün E, Saini SS, Yang H, Alagappan D, Higgs S, Christadoss P. Genetic evidence for the involvement of Fcγ receptor III in experimental autoimmune myasthenia gravis pathogenesis. J Neuroimmunol 2006; 174:157-67. [PMID: 16527362 DOI: 10.1016/j.jneuroim.2006.01.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Revised: 01/18/2006] [Accepted: 01/20/2006] [Indexed: 11/22/2022]
Abstract
Immune complexes and classical complement pathway play vital roles in experimental autoimmune myasthenia gravis (EAMG). To analyze the role of immune complex receptors in EAMG, FcgammaRIII knockout (KO) mice were immunized with AChR and were found out to be resistant to EAMG induction. This was associated with reduced neuromuscular junction deposits, lymph node cell (LNC) IL-6 production and serum complement levels. EAMG resistance of anti-C1q Ab-administered mice was also associated with reduced LNC IL-6 production and neuromuscular junction deposits, indicating C1q involvement in EAMG resistance. The data provide the first direct genetic evidence for Fcgamma receptor involvement in EAMG pathogenesis.
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MESH Headings
- Animals
- Antibodies/administration & dosage
- Antigens, CD/metabolism
- Complement C1q/immunology
- Complement C1q/metabolism
- Complement C3-C5 Convertases/metabolism
- Complement Membrane Attack Complex/metabolism
- Disease Models, Animal
- Enzyme-Linked Immunosorbent Assay/methods
- Flow Cytometry/methods
- Immunoglobulin G/metabolism
- Immunohistochemistry/methods
- Interleukin-6/metabolism
- Lymph Nodes/drug effects
- Lymph Nodes/metabolism
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Muscle, Skeletal/physiopathology
- Myasthenia Gravis, Autoimmune, Experimental/chemically induced
- Myasthenia Gravis, Autoimmune, Experimental/genetics
- Myasthenia Gravis, Autoimmune, Experimental/pathology
- Myasthenia Gravis, Autoimmune, Experimental/physiopathology
- Neuromuscular Junction/metabolism
- Neuromuscular Junction/pathology
- Radioimmunoassay/methods
- Receptors, IgG/deficiency
- Receptors, IgG/genetics
- Receptors, IgG/physiology
- Receptors, Nicotinic/genetics
- Statistics, Nonparametric
- Time Factors
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Affiliation(s)
- Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77555-1070, USA
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Tüzün E, Saini SS, Ghosh S, Rowin J, Meriggioli MN, Christadoss P. Predictive value of serum anti-C1q antibody levels in experimental autoimmune myasthenia gravis. Neuromuscul Disord 2006; 16:137-43. [PMID: 16427283 DOI: 10.1016/j.nmd.2005.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2005] [Revised: 09/20/2005] [Accepted: 11/14/2005] [Indexed: 11/26/2022]
Abstract
Components of the complement cascade and circulating immune complexes play important roles in both experimental autoimmune myasthenia gravis and myasthenia gravis in humans. Thus far, no serological factor has been identified to predict the clinical severity of either myasthenia gravis. Upon immunization with acetylcholine receptor, levels of complement factors C1q, C3 and CIC increase with time in sera from C57BL/6 (B6) mice. Both these and plasma samples from myasthenia gravis patients also contain anti-C1q antibodies. The serum levels of anti-C1q antibodies but not C1q, C3 and CIC are significantly correlated with the clinical severity in the experimental myasthenia mice. However, this correlation is not observed in myasthenia gravis patients.
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MESH Headings
- Adult
- Animals
- Antibodies, Anti-Idiotypic/blood
- Complement C1/analysis
- Complement C1/immunology
- Complement C1q/analysis
- Complement C1q/immunology
- Complement C3/analysis
- Complement C3/immunology
- Complement Membrane Attack Complex/analysis
- Complement Membrane Attack Complex/immunology
- Enzyme-Linked Immunosorbent Assay
- Female
- Humans
- Immunoglobulin G/blood
- Immunoglobulin G/immunology
- Male
- Mice
- Mice, Inbred C57BL
- Middle Aged
- Muscle Weakness/physiopathology
- Myasthenia Gravis/blood
- Myasthenia Gravis/etiology
- Myasthenia Gravis/immunology
- Myasthenia Gravis/physiopathology
- Myasthenia Gravis, Autoimmune, Experimental/blood
- Myasthenia Gravis, Autoimmune, Experimental/etiology
- Myasthenia Gravis, Autoimmune, Experimental/immunology
- Myasthenia Gravis, Autoimmune, Experimental/physiopathology
- Neuromuscular Junction/chemistry
- Neuromuscular Junction/pathology
- Predictive Value of Tests
- Severity of Illness Index
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Affiliation(s)
- Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1070, USA.
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21
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Yang H, Tüzün E, Alagappan D, Yu X, Scott BG, Ischenko A, Christadoss P. IL-1 receptor antagonist-mediated therapeutic effect in murine myasthenia gravis is associated with suppressed serum proinflammatory cytokines, C3, and anti-acetylcholine receptor IgG1. THE JOURNAL OF IMMUNOLOGY 2005; 175:2018-25. [PMID: 16034147 DOI: 10.4049/jimmunol.175.3.2018] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In myasthenia gravis (MG), TNF and IL-1beta polymorphisms and high serum levels of these proinflammatory cytokines have been observed. Likewise, TNF and IL-1beta are critical for the activation of acetylcholine receptor (AChR)-specific T and B cells and for the development of experimental autoimmune myasthenia gravis (EAMG) induced by AChR immunization. We tested the therapeutic effect of human recombinant IL-1 receptor antagonist (IL-1ra) in C57BL/6 mice with EAMG. Multiple daily injections of 0.01 mg of IL-1ra administered for 2 wk following two AChR immunizations decreased the incidence and severity of clinical EAMG. Furthermore, IL-1ra treatment of mice with ongoing clinical EAMG reduced the clinical symptoms of disease. The IL-1ra-mediated suppression of clinical disease was associated with suppressed serum IFN-gamma, TNF-alpha, IL-1beta, IL-2, IL-6, C3, and anti-AChR IgG1 without influencing total serum IgG. Therefore, IL-1ra could be used as a nonsteroidal drug for the treatment of MG.
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MESH Headings
- Animals
- Cells, Cultured
- Complement C3/antagonists & inhibitors
- Complement C3/physiology
- Cytokines/antagonists & inhibitors
- Cytokines/blood
- Immunity, Cellular
- Immunodominant Epitopes/administration & dosage
- Immunodominant Epitopes/immunology
- Immunoglobulin G/biosynthesis
- Immunoglobulin G/blood
- Immunosuppressive Agents/administration & dosage
- Immunosuppressive Agents/therapeutic use
- Inflammation Mediators/antagonists & inhibitors
- Inflammation Mediators/blood
- Interleukin 1 Receptor Antagonist Protein
- Male
- Mice
- Mice, Inbred C57BL
- Myasthenia Gravis, Autoimmune, Experimental/immunology
- Myasthenia Gravis, Autoimmune, Experimental/prevention & control
- Peptide Fragments/administration & dosage
- Peptide Fragments/immunology
- Protein Subunits/administration & dosage
- Protein Subunits/immunology
- Receptors, Cholinergic/administration & dosage
- Receptors, Cholinergic/immunology
- Receptors, Interleukin-1/antagonists & inhibitors
- Severity of Illness Index
- Sialoglycoproteins/administration & dosage
- Sialoglycoproteins/physiology
- Sialoglycoproteins/therapeutic use
- Torpedo/immunology
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Affiliation(s)
- Huan Yang
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA
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