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Daniels EC, Eaton WW, Čiháková D, Talor MV, Lemke H, Mo C, Chen S, Notarangelo FM, Rodriguez KM, Kelly DL. The relationship of peripheral inflammation with antibodies to gliadin (AGA IgG) in persons with schizophrenia. Schizophr Res 2023; 256:50-51. [PMID: 37150147 DOI: 10.1016/j.schres.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 05/09/2023]
Affiliation(s)
- Emily C Daniels
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD 21228, United States.
| | - William W Eaton
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States.
| | - Daniela Čiháková
- Department of Pathology, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, United States.
| | - Monica V Talor
- Department of Pathology, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, United States.
| | - Hannah Lemke
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD 21228, United States
| | - Chen Mo
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD 21228, United States.
| | - Shuo Chen
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD 21228, United States.
| | - Francesca M Notarangelo
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD 21228, United States.
| | - Katrina M Rodriguez
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States.
| | - Deanna L Kelly
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD 21228, United States.
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Eaton WW, Rodriguez KM, Thomas MA, Johnson J, Talor MV, Dohan C, Bingham CO, Musci R, Roth K, Kelly DL, Cihakova D, Darrah E. Immunologic profiling in schizophrenia and rheumatoid arthritis. Psychiatry Res 2022; 317:114812. [PMID: 36058039 PMCID: PMC10984252 DOI: 10.1016/j.psychres.2022.114812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 11/20/2022]
Abstract
The negative relationship between schizophrenia (SCZ) and rheumatoid arthritis (RA) has been observed for 85 years, but the mechanisms driving this association are unknown. This study analyzed differences in profiles of cytokines (IL-1β, IL-Ra, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IFNγ, TNFα), selected genes (HLA-DRB1, IL1RN, HP2), and antibodies related to gluten sensitivity (AGA-IgG, AGA-IgA), celiac disease (tTG), and systemic autoimmunity (ANA, anti-CCP, RF) in 40 subjects with SCZ, 40 with RA, and 40 healthy controls (HC). HLA-DRB1*04:01 alleles were enriched in persons with SCZ and RA compared with HC, and the HP2/HP2 genotype was 2-fold more prevalent in AGA/tTG-positive versus negative SCZ patients. Patients with SCZ demonstrated 52.5% positivity for any of the antibodies tested, compared to 90% of RA patients and 30% of HC. Cluster analysis of the cytokines revealed three clusters: one associated with SCZ marked by high levels of IL-1Ra, one associated with HC, and one associated with both SCZ and RA marked by elevated levels of IFNγ, TNFα, and IL-6. These analyses suggest that stratification of SCZ patients by cytokine profile may identify unique SCZ subgroups and enable the use of currently available cytokine-targeted treatment strategies.
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Affiliation(s)
- William W Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, US.
| | - Katrina M Rodriguez
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, US
| | - Mekha A Thomas
- Department of Medicine, Division of Rheumatology, Johns Hopkins School of Medicine, US
| | - Jeanette Johnson
- Department of Medicine, Division of Rheumatology, Johns Hopkins School of Medicine, US
| | - Monica V Talor
- Department of Pathology, Johns Hopkins School of Medicine, US
| | - Curtis Dohan
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, US
| | - Clifton O Bingham
- Department of Medicine, Division of Rheumatology, Johns Hopkins School of Medicine, US
| | - Rashelle Musci
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, US
| | - Kimberly Roth
- Department of Community Medicine, Mercer University School of Medicine, US
| | - Deanna L Kelly
- Maryland Psychiatric Research Center (MPRC), University of Maryland School of Medicine, US
| | | | - Erika Darrah
- Department of Medicine, Division of Rheumatology, Johns Hopkins School of Medicine, US
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Won T, Wood MK, Hughes DM, Talor MV, Ma Z, Schneider J, Skinner JT, Asady B, Goerlich E, Halushka MK, Hays AG, Kim DH, Parikh CR, Rosenberg AZ, Coppens I, Johns RA, Gilotra NA, Hooper JE, Pekosz A, Čiháková D. Endothelial thrombomodulin downregulation caused by hypoxia contributes to severe infiltration and coagulopathy in COVID-19 patient lungs. EBioMedicine 2022; 75:103812. [PMID: 35033854 PMCID: PMC8756077 DOI: 10.1016/j.ebiom.2022.103812] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/28/2021] [Accepted: 12/30/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thromboembolism is a life-threatening manifestation of coronavirus disease 2019 (COVID-19). We investigated a dysfunctional phenotype of vascular endothelial cells in the lungs during COVID-19. METHODS We obtained the lung specimens from the patients who died of COVID-19. The phenotype of endothelial cells and immune cells was examined by flow cytometry and immunohistochemistry (IHC) analysis. We tested the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the endothelium using IHC and electron microscopy. FINDINGS The autopsy lungs of COVID-19 patients exhibited severe coagulation abnormalities, immune cell infiltration, and platelet activation. Pulmonary endothelial cells of COVID-19 patients showed increased expression of procoagulant von Willebrand factor (VWF) and decreased expression of anticoagulants thrombomodulin and endothelial protein C receptor (EPCR). In the autopsy lungs of COVID-19 patients, the number of macrophages, monocytes, and T cells was increased, showing an activated phenotype. Despite increased immune cells, adhesion molecules such as ICAM-1, VCAM-1, E-selectin, and P-selectin were downregulated in pulmonary endothelial cells of COVID-19 patients. Notably, decreased thrombomodulin expression in endothelial cells was associated with increased immune cell infiltration in the COVID-19 patient lungs. There were no SARS-CoV-2 particles detected in the lung endothelium of COVID-19 patients despite their dysfunctional phenotype. Meanwhile, the autopsy lungs of COVID-19 patients showed SARS-CoV-2 virions in damaged alveolar epithelium and evidence of hypoxic injury. INTERPRETATION Pulmonary endothelial cells become dysfunctional during COVID-19, showing a loss of thrombomodulin expression related to severe thrombosis and infiltration, and endothelial cell dysfunction might be caused by a pathologic condition in COVID-19 patient lungs rather than a direct infection with SARS-CoV-2. FUNDING This work was supported by the Johns Hopkins University, the American Heart Association, and the National Institutes of Health.
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Affiliation(s)
- Taejoon Won
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Megan K Wood
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - David M Hughes
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD 21218, USA
| | - Monica V Talor
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Zexu Ma
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Jowaly Schneider
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - John T Skinner
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Beejan Asady
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Erin Goerlich
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Marc K Halushka
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Allison G Hays
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Deok-Ho Kim
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; Department of Biomedical Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD 21218, USA
| | - Chirag R Parikh
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Avi Z Rosenberg
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Isabelle Coppens
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Roger A Johns
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Nisha A Gilotra
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Jody E Hooper
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Daniela Čiháková
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Bracamonte-Baran W, Gilotra NA, Won T, Rodriguez KM, Talor MV, Oh BC, Griffin J, Wittstein I, Sharma K, Skinner J, Johns RA, Russell SD, Anders RA, Zhu Q, Halushka MK, Brandacher G, Čiháková D. Endothelial Stromal PD-L1 (Programmed Death Ligand 1) Modulates CD8 + T-Cell Infiltration After Heart Transplantation. Circ Heart Fail 2021; 14:e007982. [PMID: 34555935 PMCID: PMC8550427 DOI: 10.1161/circheartfailure.120.007982] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The role of checkpoint axes in transplantation has been partially addressed in animal models but not in humans. Occurrence of fulminant myocarditis with allorejection-like immunologic features in patients under anti-PD1 (programmed death cell protein 1) treatment suggests a key role of the PD1/PD-L1 (programmed death ligand 1) axis in cardiac immune homeostasis. METHODS We cross-sectionally studied 23 heart transplant patients undergoing surveillance endomyocardial biopsy. Endomyocardial tissue and peripheral blood mononuclear cells were analyzed by flow cytometry. Multivariate logistic regression analyses including demographic, clinical, and hemodynamic parameters were performed. Murine models were used to evaluate the impact of PD-L1 endothelial graft expression in allorejection. RESULTS We found that myeloid cells dominate the composition of the graft leukocyte compartment in most patients, with variable T-cell frequencies. The CD (cluster of differentiation) 4:CD8 T-cell ratios were between 0 and 1.5. The proportion of PD-L1 expressing cells in graft endothelial cells, fibroblasts, and myeloid leukocytes ranged from negligible up to 60%. We found a significant inverse logarithmic correlation between the proportion of PD-L1+HLA (human leukocyte antigen)-DR+ endothelial cells and CD8+ T cells (slope, -18.3 [95% CI, -35.3 to -1.3]; P=0.030). PD-L1 expression and leukocyte patterns were independent of demographic, clinical, and hemodynamic parameters. We confirmed the importance of endothelial PD-L1 expression in a murine allogeneic heart transplantation model, in which Tie2Crepdl1fl/fl grafts lacking PD-L1 in endothelial cells were rejected significantly faster than controls. CONCLUSIONS Loss of graft endothelial PD-L1 expression may play a role in regulating CD8+ T-cell infiltration in human heart transplantation. Murine model results suggest that loss of graft endothelial PD-L1 may facilitate alloresponses and rejection.
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Affiliation(s)
- William Bracamonte-Baran
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
- Department of Medicine, Texas Tech University Health Sciences Center – Permian Basin, Odessa, TX, 79763, USA
| | - Nisha A Gilotra
- Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Taejoon Won
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Katrina M Rodriguez
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Monica V Talor
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Byoung C Oh
- Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Jan Griffin
- Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
- Current Address: Department of Medicine, Columbia University, New York, NY
| | - Ilan Wittstein
- Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Kavita Sharma
- Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - John Skinner
- Department of Anesthesiology and Critical Care Medicine, Division of Adult Anesthesia, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Roger A Johns
- Department of Anesthesiology and Critical Care Medicine, Division of Adult Anesthesia, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Stuart D Russell
- Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
- Current Address: Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Robert A Anders
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Qingfeng Zhu
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Marc K Halushka
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Daniela Čiháková
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
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Won T, Kalinoski HM, Wood MK, Hughes DM, Talor MV, Reddy J, Cihakova D. Autoimmunity against Cardiac Self-Antigen Drives Immune Checkpoint Inhibitor-Associated Myocarditis Development. The Journal of Immunology 2021. [DOI: 10.4049/jimmunol.206.supp.95.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Abstract
Immune checkpoint inhibitor (ICI) blocking PD-1 has been approved by the Food and Drug Administration for treatment of several types of cancers. However, fulminant myocarditis has occurred in the ICI-treated cancer patients, with low incidence but with 50 percent mortality. In this study, we investigated if PD-1 blockade can induce myocarditis in the mouse mimicking ICI-associated myocarditis in the human. We found that anti-PD-1 mAb treatment caused myocarditis development in A/J mice exhibiting enlarged heart and increased cardiac infiltration. In the cardiac infiltration, CD8+ T cells, CD4+ T cells, monocytes and macrophages were increased in the PD-1 blockade group compared to isotype control. Cardiac damage was confirmed by elevated serum level of cardiac troponin I and anti-myosin IgG. In addition, PD-1 blockade caused arrhythmia, right bundle branch block, while controls showed a normal ECG trace. The A/J mice with PD-1 blockade also developed systemic autoimmune responses such as colitis, sialadenitis, pneumonitis and myositis like immune-related adverse events in the human, supporting the immunotoxicity of PD-1 blockade. Next, using myosin-MHC tetramer staining, we found the increase of autoreactive T cells specific for cardiac myosin in the mouse heart with ICI-associated myocarditis compared to control. In the naïve heart, we were able to detect myosin-specific T cells, which number was very few but expressed a high level of PD-1. Collectively, we have developed the mouse model for human ICI-associated myocarditis and showed that the pathogenesis of this disease is an autoimmune reaction against heart-specific antigens.
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Affiliation(s)
- Taejoon Won
- 1Johns Hopkins University School of Medicine
| | | | - Megan K Wood
- 2Johns Hopkins University Bloomberg School of Public Health
| | | | | | | | - Daniela Cihakova
- 1Johns Hopkins University School of Medicine
- 2Johns Hopkins University Bloomberg School of Public Health
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Wood MK, Talor MV, Won T, Cihakova D. PD-L1 on macrophages protects from severe collagen induced arthritis. The Journal of Immunology 2021. [DOI: 10.4049/jimmunol.206.supp.60.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Abstract
Immune related adverse events linked to severe inflammatory arthritis have been identified in 10–43% of patients receiving immune checkpoint inhibitor therapy, aCTLA-4, aPD-1 and aPD-L1, indicating the importance of immune inhibitory pathways in maintaining homeostasis in the synovium. We found that immune checkpoint, PD-L1, is primarily expressed in the joint compared to other immune checkpoints. Furthermore, blocking of PD-L1 during collagen induced arthritis (CIA) resulted in more severe arthritis. Mice synovial macrophages have the highest PD-L1 expression level at homeostasis and macrophage PD-L1 expression is further increased during CIA. Similarly, in human synovial fluid, macrophages have the highest frequency of PD-L1 expression. We hypothesize that the expression of PD-L1 by macrophages is essential for synovial homeostasis and regulation of joint inflammation. We selectively deleted PD-L1 in macrophages using the cre/flox system and induced CIA analyzing disease severity using flow cytometry. LyzcrePD-L1fl/fl showed more severe CIA with a greater change in paw thickness, higher disease and histology score and a higher frequency of CD4 and CD8 T cells in the synovium. Interestingly, female LyzcrePD-L1fl/fl mice have higher arthritis severity to LyzcrePD-L1fl/fl males. This indicates the importance of sex specific PD-L1 expression by synovial macrophages during CIA. Our project has high translational potential since joint specific PD-L1 expression could be modulated for therapeutic purposes in humans with rheumatoid arthritis or check point inhibitors induced arthritis.
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Affiliation(s)
- Megan Kay Wood
- 1Johns Hopkins School of Public Health
- 2Department of Pathology, Johns Hopkins School of Medicine
| | - Monica V Talor
- 2Department of Pathology, Johns Hopkins School of Medicine
| | - Taejoon Won
- 3Johns Hopkins University School of Medicine
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Won T, Wood MK, Hughes DM, Talor MV, Johns RA, Gilotra NA, Pekosz AS, Hooper JE, Cihakova D. SARS-CoV-2 infection drives endothelial dysfunction indirectly through hypoxia and increased pro-inflammatory cytokine production. The Journal of Immunology 2021. [DOI: 10.4049/jimmunol.206.supp.20.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Abstract
In the Covid-19 patients, vascular thrombosis is observed in the heart, lung, and other organs, leading to multiorgan morbidity and mortality. We obtained heart and lung tissues from autopsies of the patients who died from Covid-19 or unrelated causes as a control. We found that endothelial cells of the hearts and lungs were in dysfunctional state during Covid-19. Cardiac and pulmonary endothelial cells in the Covid-19 group showed decreased level of thrombomodulin, an anticoagulant, and increased level of von Willebrand factor, a procoagulant, compared to non-Covid-19 control. Endothelial cells in the Covid-19 autopsy hearts and lungs also exhibited reduced ICAM-1, VCAM-1, and E-selectin expression. Most of the hearts from the Covid-19 autopsies tested negative for SARS-CoV-2 genome, while all the lungs tested positive. Human coronary artery endothelial cell (HCAEC) in vitro culture was not infected by SARS-CoV-2, showing no dysfunctional phenotype. In the HCAEC culture and in vivo mouse experiments, hypoxia and pro-inflammatory cytokine treatment caused endothelial cell dysfunction including thrombomodulin downregulation similar to what we observed in Covid-19 autopsy tissues. Collectively, endothelial cell dysfunction associated with thrombus formation in Covid-19 is not caused by direct infection with SARS-CoV-2, but it can be induced by pathogenic microenvironments such as hypoxia and increased pro-inflammatory cytokine milieu.
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Affiliation(s)
- Taejoon Won
- 1Johns Hopkins University School of Medicine
| | - Megan K Wood
- 2Johns Hopkins University Bloomberg School of Public Health
| | | | | | | | | | | | | | - Daniela Cihakova
- 1Johns Hopkins University School of Medicine
- 2Johns Hopkins University Bloomberg School of Public Health
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Kalinoski HM, Won T, Rusinkevich V, Talor MV, Hughes DM, Wood MK, Hooper JE, Cihakova D. Myosin specific TRM cells mediate increased severity of immune checkpoint inhibitor myocarditis. The Journal of Immunology 2021. [DOI: 10.4049/jimmunol.206.supp.98.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Abstract
Immune checkpoint blockade has revolutionized the field of cancer immunotherapy; however, it has been also associated with immune-related adverse events (IRAE). Immune checkpoint inhibitor (ICI)-myocarditis occurs in approximately 1% of patients, however, it has a high fatality rate of up to 50%. To prevent life-threatening toxicities, it is imperative to understand what predisposes patients to ICI-myocarditis. We examined if previous cardiac injury increases an individual’s susceptibility to develop ICI-myocarditis. We demonstrated that ischemic injury substantially changes the phenotype of cardiac lymphocytes, causing them to upregulate the well-characterized tissue resident markers such as CD69 and CD103. We were excited to find that these cardiac tissue resident T (TRM) cells express prominent levels of the checkpoint molecule PD-1 and have high TCR specificity for cardiac myosin. TRM cells have been described in the literature to establish residency in non-lymphoid organs where they provide a rapid functional response more efficiently than circulating memory T cells. To investigate the role that cardiac TRM cells play in the occurrence of ICI-myocarditis, we developed a novel two-hit model. In this model cardiac injury is induced through ischemic injury (first hit), mice are allowed to recover before we begin the administration of immune checkpoint antibodies (second hit). Our data suggest that after the administration of PD-1 blocking antibodies, mice with myosin specific TRM cells are more susceptible to ICI-myocarditis. Further characterization of cardiac TRM cells could provide insight into why checkpoint mediated cardiac toxicities are particularly rapid and have high fatality rates.
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Affiliation(s)
| | - Taejoon Won
- 2Department of Pathology, Johns Hopkins School of Medicine
| | | | - Monica V Talor
- 2Department of Pathology, Johns Hopkins School of Medicine
| | | | - Megan K Wood
- 1Johns Hopkins University Bloomberg School of Public Health
| | | | - Daniela Cihakova
- 1Johns Hopkins University Bloomberg School of Public Health
- 2Department of Pathology, Johns Hopkins School of Medicine
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Hughes DM, Won T, Jurcova I, Talor MV, Szarszoi O, Curnova L, Striz I, Hooper JE, Melenovsky V, Cihakova D. Pericardial macrophages and their role in myocardial infarction. The Journal of Immunology 2021. [DOI: 10.4049/jimmunol.206.supp.95.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Abstract
Each year an estimated 790,000 people suffer a heart attack in the United States. With such a high incidence, it is important to understand the underlying cellular mechanisms at play during myocardial infarction. In this project we examined the role of pericardial macrophages in modulating the pathogenesis of myocardial infarction. We found that pericardial macrophages expressing the transcription factor GATA6 make up a majority of the cells in the healthy human’s pericardial fluid and have a regulatory function. However, patients with chronic ischemic cardiac disease had their GATA6+ macrophages replaced by inflammatory monocytes in the pericardial fluid. GATA6+ macrophages can be also isolated from murine pericardial fluid. We modeled myocardial infarction through permanent ligation of the left anterior descending artery in adult mice utilizing GATA6+ macrophage deficient LysCreGATA6fl/fl mice. LysCreGATA6fl/fl mice had worse fibrosis and more severe EKG abnormalities compared to control mice following myocardial infarction. Thrombi were also apparent in the hearts of LysCreGATA6fl/fl mice that were not present in control mice. In addition, mice lacking GATA6+ pericardial macrophages had a higher influx of inflammatory Ly6Chi monocytes to the myocardium during the early inflammatory phase of the disease, while pericardial macrophages did not traffic to the myocardium directly at any point. Therefore, we propose that pericardial macrophages inhibit late-stage cardiac remodeling following myocardial infarction by preventing the trafficking of inflammatory monocytes to the site of injury.
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Affiliation(s)
- David M Hughes
- 1Johns Hopkins Univ
- 2Department of Pathology, Johns Hopkins School of Medicine
| | - Taejoon Won
- 3Johns Hopkins University School of Medicine
| | - Ivana Jurcova
- 4Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Monica V Talor
- 2Department of Pathology, Johns Hopkins School of Medicine
| | - Ondrej Szarszoi
- 4Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Lenka Curnova
- 4Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Ilza Striz
- 4Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | | | - Vojtech Melenovsky
- 4Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
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Hou X, Chen G, Bracamonte-Baran W, Choi HS, Diny NL, Sung J, Hughes D, Won T, Wood MK, Talor MV, Hackam DJ, Klingel K, Davogustto G, Taegtmeyer H, Coppens I, Barin JG, Čiháková D. The Cardiac Microenvironment Instructs Divergent Monocyte Fates and Functions in Myocarditis. Cell Rep 2020; 28:172-189.e7. [PMID: 31269438 PMCID: PMC6813836 DOI: 10.1016/j.celrep.2019.06.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 05/07/2019] [Accepted: 06/03/2019] [Indexed: 12/24/2022] Open
Abstract
Two types of monocytes, Ly6Chi and Ly6Clo, infiltrate the heart in murine experimental autoimmune myocarditis (EAM). We discovered a role for cardiac fibroblasts in facilitating monocyte-to-macrophage differentiation of both Ly6Chi and Ly6Clo cells, allowing these macrophages to perform divergent functions in myocarditis progression. During the acute phase of EAM, IL-17A is highly abundant. It signals through cardiac fibroblasts to attenuate efferocytosis of Ly6Chi monocyte-derived macrophages (MDMs) and simultaneously prevents Ly6Clo monocyte-to-macrophage differentiation. We demonstrated an inverse clinical correlation between heart IL-17A levels and efferocytic receptor expressions in humans with heart failure (HF). In the absence of IL-17A signaling, Ly6Chi MDMs act as robust phagocytes and are less proinflammatory, whereas Ly6Clo monocytes resume their differentiation into MHCII+ macrophages. We propose that MHCII+Ly6Clo MDMs are associated with the reduction of cardiac fibrosis and prevention of the myocarditis sequalae. Hou et al. show that cardiac fibroblasts facilitate infiltrating Ly6Chi and Ly6Clo monocytes to become macrophages. IL-17A trans-signaling through cardiac fibroblasts increases MerTK shedding and promotes a pro-inflammatory and pro-tissue remodeling gene expression profile in Ly6Chi monocyte-derived macrophages. Paradoxically, IL-17A signaling through cardiac fibroblasts can substantially inhibit Ly6Clo monocyte-to-macrophage differentiation.
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Affiliation(s)
- Xuezhou Hou
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Guobao Chen
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | | | - Hee Sun Choi
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Nicola L Diny
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Jungeun Sung
- Institute of Genetic Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - David Hughes
- Department of Chemical and Biomolecular Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Taejoon Won
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Megan Kay Wood
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Monica V Talor
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - David Joel Hackam
- Division of General Pediatric Surgery, Johns Hopkins University and Bloomberg Children's Center, Johns Hopkins Hospital, Baltimore, MD 21218, USA
| | - Karin Klingel
- Cardiopathology, Institute for Pathology and Neuropathology, University of Tübingen, 72076 Tübingen, Germany
| | - Giovanni Davogustto
- Department of Internal Medicine, Division of Cardiovascular Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Heinrich Taegtmeyer
- Department of Internal Medicine, Division of Cardiovascular Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Isabelle Coppens
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Jobert G Barin
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Daniela Čiháková
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
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11
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Wood MK, Talor MV, Won T, Čiháková D. PD-L1 on macrophages protects from severe collagen induced arthritis. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.73.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Immune related adverse events linked to severe inflammatory arthritis have been identified in 10–43% of patients receiving immune checkpoint inhibitor therapy, aCTLA-4, aPD-1 and aPD-L1, indicating the importance of immune inhibitory pathways in maintaining homeostasis in the synovium. We found that immune checkpoint, PD-L1, is primarily expressed in the joint compared to other immune checkpoints. Furthermore, blocking of PD-L1 during collagen induced arthritis (CIA) resulted in more severe arthritis. Mice synovial macrophages have the highest PD-L1 expression level at homeostasis and macrophage PD-L1 expression is further increased during CIA. Similarly, in human synovial fluid, macrophages have the highest frequency of PD-L1 expression. We hypothesize that the expression of PD-L1 by macrophages is essential for synovial homeostasis and regulation of joint inflammation. We selectively deleted PD-L1 in macrophages using the cre/flox system and induced CIA analyzing disease severity using flow cytometry. LyzcrePD-L1fl/fl showed more severe CIA with a greater change in paw thickness, higher disease and histology score and a higher frequency of CD4 and CD8 T cells in the synovium. Interestingly, female LyzcrePD-L1fl/fl mice have higher arthritis severity to LyzcrePD-L1fl/fl males. This indicates the importance of sex specific PD-L1 expression by synovial macrophages during CIA. Our project has high translational potential since joint specific PD-L1 expression could be modulated for therapeutic purposes in humans with rheumatoid arthritis or check point inhibitors induced arthritis.
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Affiliation(s)
- Megan Kay Wood
- 1Johns Hopkins University Bloomberg School of Public Health
| | | | - Taejoon Won
- 2Johns Hopkins University School of Medicine
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12
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Gannon JM, Kelly DL, Besch A, Thakur T, Khurana N, Shurin MR, Shurin GV, Brar JS, Cihakova D, Talor MV, Chengappa KNR. Racial Differences in S100b Levels in Persons with Schizophrenia. Psychiatr Q 2020; 91:137-145. [PMID: 31786729 DOI: 10.1007/s11126-019-09687-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The calcium-binding protein S100b is secreted by glial cells in the brain and is also expressed by melanocytes. In nanomolar concentrations, S100b is considered to be a neurotrophic factor, but in micromolar concentrations, it is thought to reflect CNS injury and inflammation. Seen as a potential biomarker in traumatic brain injury, meta-analytic data from several studies report that S100b levels are significantly higher in persons with long standing schizophrenia, but also among first-episode patients compared to healthy control subjects. However, ethnic or racial differences are typically not mentioned when reporting levels of S100b. We assessed serum S100b levels in persons with schizophrenia (n = 136) who were participants in two independent research studies using the same enzyme-linked immunoassay (ELISA). African-American subjects had significantly higher levels of S100b (41.9 pg/ml ± 62.2) than Caucasian subjects (24.9 pg/ml ± 45.4) in the combined dataset (Mann-Whitney U = 1307, p < 0.001), as well as in each independent study. There were no significant differences in S100b levels between men and women. No significant correlations were observed between S100b levels and demographic or clinical variables. These data suggest that ethnicity or race should be given serious consideration when studying and interpreting S100b levels in persons with schizophrenia.
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Affiliation(s)
- Jessica M Gannon
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA. .,School of Medicine, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Deanna L Kelly
- Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Abigail Besch
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.,School of Medicine, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Tanu Thakur
- Institute of Human Behavior and Allied Sciences, New Delhi, India
| | - Neil Khurana
- University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Michael R Shurin
- Department of Pathology, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Galina V Shurin
- Department of Pathology, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Jaspreet S Brar
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Daniela Cihakova
- Department of Pathology, School of Medicine, Johns Hopkins University, Ross 659, 720 Rutland Ave, Baltimore, MD, 21210, USA
| | - Monica V Talor
- Department of Pathology, School of Medicine, Johns Hopkins University, Ross 659, 720 Rutland Ave, Baltimore, MD, 21210, USA
| | - K N Roy Chengappa
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.,School of Medicine, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
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13
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Kelly DL, Demyanovich HK, Rodriguez KM, Ciháková D, Talor MV, McMahon RP, Richardson CM, Vyas G, Adams HA, August SM, Fasano A, Cascella NG, Feldman SM, Liu F, Sayer MA, Powell MM, Wehring HJ, Buchanan RW, Gold JM, Carpenter WT, Eaton WW. Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study. J Psychiatry Neurosci 2019; 44. [PMID: 30938127 PMCID: PMC6606425 DOI: 10.1503/jpn.180174] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Approximately one-third of people with schizophrenia have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were positive for AGA IgG. METHODS In this pilot feasibility study, 16 participants with schizophrenia or schizoaffective disorder who had elevated AGA IgG (≥ 20 U) but were negative for celiac disease were admitted to an inpatient unit for a 5-week trial. All participants received standardized gluten-free meals and were randomized in a double-blind fashion to receive a shake containing 10 g of gluten flour or 10 g of rice flour each day. Participants were rated for psychiatric, cognitive and gastrointestinal symptoms at baseline and endpoint. RESULTS Of the 16 participants, 14 completed the 5-week trial (2 discontinued early for administrative reasons). Compared with participants on the gluten-containing diet, participants on the gluten-free diet showed improvement on the Clinical Global Impressions scale (Cohen d = –0.75) and in negative symptoms (Cohen d = –0.53). We noted no improvement in positive or global cognitive symptoms, but did observe an improvement in attention favouring the gluten-free diet (Cohen d = 0.60). Robust improvements in gastrointestinal adverse effects occurred in the gluten-free group relative to the glutencontaining group. Adverse effects were similar between groups. LIMITATIONS This study was limited by its small sample size; larger studies are needed. CONCLUSION This feasibility study suggests that removal of gluten from the diet is associated with improvement in psychiatric and gastrointestinal symptoms in people with schizophrenia or schizoaffective disorder.
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Affiliation(s)
- Deanna L. Kelly
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Haley K. Demyanovich
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Katrina M. Rodriguez
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Daniela Ciháková
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Monica V. Talor
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Robert P. McMahon
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Charles M. Richardson
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Gopal Vyas
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Heather A. Adams
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Sharon M. August
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Alessio Fasano
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Nicola G. Cascella
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Stephanie M. Feldman
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Fang Liu
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - MacKenzie A. Sayer
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Megan M. Powell
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Heidi J. Wehring
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Robert W. Buchanan
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - James M. Gold
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - William T. Carpenter
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - William W. Eaton
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
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14
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Bracamonte-Baran W, Chen G, Hou X, Talor MV, Choi HS, Davogustto G, Taegtmeyer H, Sung J, Hackam DJ, Nauen D, Čiháková D. Non-cytotoxic Cardiac Innate Lymphoid Cells Are a Resident and Quiescent Type 2-Commited Population. Front Immunol 2019; 10:634. [PMID: 30984196 PMCID: PMC6450181 DOI: 10.3389/fimmu.2019.00634] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 03/08/2019] [Indexed: 12/13/2022] Open
Abstract
Innate lymphoid cells (ILC) are a subset of leukocytes with lymphoid properties that lack antigen specific receptors. They can be stimulated by and exert their effect via specific cytokine axes, whereas Natural Killers (NK) cells are the only known cytotoxic member of this family. ILCs are considered key in linking the innate and adaptive response in physiologic and pathologic environments. In this study, we investigated the properties of non-cytotoxic cardiac ILCs in physiologic, inflammatory, and ischemic conditions. We found that in healthy humans and mice, non-cytotoxic cardiac ILCs are predominantly a type 2-committed population with progenitor-like features, such as an absence of type-specific immunophenotype, intermediate GATA3 expression, and capacity to transiently express Pro-myelocytic Leukemia Zinc Finger protein (PLZF) upon activation. During myocarditis and ischemia, in both human and mice, cardiac ILCs differentiated into conventional ILC2s. We found that cardiac ILCs lack IL-25 receptor and cannot become inflammatory ILC2s. We found a strong correlation between IL-33 production in the heart and the ability of cardiac ILCs to become conventional ILC2s. The main producer of IL-33 was a subset of CD29+Sca-1+ cardiac fibroblasts. ILC2 expansion and fibroblast-derived IL-33 production were significantly increased in the heart in mouse models of infarction and myocarditis. Despite its progenitor-like status in healthy hearts, cardiac ILCs were unable to become ILC1 or ILC3 in vivo and in vitro. Using adoptive transfer and parabiosis, we demonstrated that the heart, unlike other organs such as lung, cannot be infiltrated by circulating ILCs in adulthood even during cardiac inflammation or ischemia. Thus, the ILC2s present during inflammatory conditions are derived from the heart-resident and quiescent steady-state population. Non-cytotoxic cardiac ILCs are a resident population of ILC2-commited cells, with undifferentiated progenitor-like features in steady-state conditions and an ability to expand and develop pro-inflammatory type 2 features during inflammation or ischemia.
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Affiliation(s)
- William Bracamonte-Baran
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Guobao Chen
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Xuezhou Hou
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Monica V Talor
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Hee Sun Choi
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Giovanni Davogustto
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical School at Houston, Houston, TX, United States
| | - Heinrich Taegtmeyer
- Division of Cardiology, Department of Internal Medicine, University of Texas Medical School at Houston, Houston, TX, United States
| | - Jungeun Sung
- School of Medicine, Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - David Joel Hackam
- Division of General Pediatric Surgery, Johns Hopkins University and Bloomberg Children's Center, Johns Hopkins Hospital, Baltimore, MD, United States
| | - David Nauen
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Daniela Čiháková
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States.,W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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15
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Chen G, Bracamonte-Baran W, Diny NL, Hou X, Talor MV, Fu K, Liu Y, Davogustto G, Vasquez H, Taegtmeyer H, Frazier OH, Waisman A, Conway SJ, Wan F, Čiháková D. Sca-1 + cardiac fibroblasts promote development of heart failure. Eur J Immunol 2018; 48:1522-1538. [PMID: 29953616 DOI: 10.1002/eji.201847583] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/09/2018] [Accepted: 06/25/2018] [Indexed: 12/19/2022]
Abstract
The causative effect of GM-CSF produced by cardiac fibroblasts to development of heart failure has not been shown. We identified the pathological GM-CSF-producing cardiac fibroblast subset and the specific deletion of IL-17A signaling to these cells attenuated cardiac inflammation and heart failure. We describe here the CD45- CD31- CD29+ mEF-SK4+ PDGFRα+ Sca-1+ periostin+ (Sca-1+ ) cardiac fibroblast subset as the main GM-CSF producer in both experimental autoimmune myocarditis and myocardial infarction mouse models. Specific ablation of IL-17A signaling to Sca-1+ periostin+ cardiac fibroblasts (PostnCre Il17rafl/fl ) protected mice from post-infarct heart failure and death. Moreover, PostnCre Il17rafl/fl mice had significantly fewer GM-CSF-producing Sca-1+ cardiac fibroblasts and inflammatory Ly6Chi monocytes in the heart. Sca-1+ cardiac fibroblasts were not only potent GM-CSF producers, but also exhibited plasticity and switched their cytokine production profiles depending on local microenvironments. Moreover, we also found GM-CSF-positive cardiac fibroblasts in cardiac biopsy samples from heart failure patients of myocarditis or ischemic origin. Thus, this is the first identification of a pathological GM-CSF-producing cardiac fibroblast subset in human and mice hearts with myocarditis and ischemic cardiomyopathy. Sca-1+ cardiac fibroblasts direct the type of immune cells infiltrating the heart during cardiac inflammation and drive the development of heart failure.
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Affiliation(s)
- Guobao Chen
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Nicola L Diny
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Xuezhou Hou
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Monica V Talor
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kai Fu
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Yue Liu
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Giovanni Davogustto
- Department of Internal Medicine, Division of Cardiology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hernan Vasquez
- Department of Internal Medicine, Division of Cardiology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Heinrich Taegtmeyer
- Department of Internal Medicine, Division of Cardiology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - O Howard Frazier
- Texas Heart Institute, CHI St. Luke's Health - Baylor St. Luke's Medical Center, MC 2-114A, PO Box 20345, Houston, TX, USA
| | - Ari Waisman
- Institute for Molecular Medicine, University of Mainz, Mainz, Germany
| | - Simon J Conway
- Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Fengyi Wan
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniela Čiháková
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.,W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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16
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Barin JG, Talor MV, Diny NL, Ong S, Schaub JA, Gebremariam E, Bedja D, Chen G, Choi HS, Hou X, Wu L, Cardamone AB, Peterson DA, Rose NR, Čiháková D. Regulation of autoimmune myocarditis by host responses to the microbiome. Exp Mol Pathol 2017; 103:141-152. [PMID: 28822770 PMCID: PMC5721523 DOI: 10.1016/j.yexmp.2017.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/09/2017] [Indexed: 12/27/2022]
Abstract
The extensive, diverse communities that constitute the microbiome are increasingly appreciated as important regulators of human health and disease through inflammatory, immune, and metabolic pathways. We sought to elucidate pathways by which microbiota contribute to inflammatory, autoimmune cardiac disease. We employed an animal model of experimental autoimmune myocarditis (EAM), which results in inflammatory and autoimmune pathophysiology and subsequent maladaptive cardiac remodeling and heart failure. Antibiotic dysbiosis protected mice from EAM and fibrotic cardiac dysfunction. Additionally, mice derived from different sources with different microbiome colonization profiles demonstrated variable susceptibility to disease. Unexpectedly, it did not track with segmented filamentous bacteria (SFB)-driven Th17 programming of CD4+ T cells in the steady-state gut. Instead, we found disease susceptibility to track with presence of type 3 innate lymphoid cells (ILC3s). Ablating ILCs by antibody depletion or genetic tools in adoptive transfer variants of the EAM model demonstrated that ILCs and microbiome profiles contributed to the induction of CCL20/CCR6-mediated inflammatory chemotaxis to the diseased heart. From these data, we conclude that sensing of the microbiome by ILCs is an important checkpoint in the development of inflammatory cardiac disease processes through their ability to elicit cardiotropic chemotaxis.
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Affiliation(s)
- Jobert G Barin
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States
| | - Monica V Talor
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States
| | - Nicola L Diny
- The Johns Hopkins Bloomberg School of Public Health, The W. Harry Feinstone Dept. of Molecular Microbiology & Immunology, United States
| | - SuFey Ong
- The Johns Hopkins Bloomberg School of Public Health, The W. Harry Feinstone Dept. of Molecular Microbiology & Immunology, United States
| | - Julie A Schaub
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States
| | - Elizabeth Gebremariam
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States
| | - Djahida Bedja
- The Johns Hopkins University School of Medicine, Dept. of Cardiology, United States
| | - Guobao Chen
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States
| | - Hee Sun Choi
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States
| | - Xuezhou Hou
- The Johns Hopkins Bloomberg School of Public Health, The W. Harry Feinstone Dept. of Molecular Microbiology & Immunology, United States
| | - Lei Wu
- The Johns Hopkins Bloomberg School of Public Health, The W. Harry Feinstone Dept. of Molecular Microbiology & Immunology, United States
| | - Ashley B Cardamone
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States
| | - Daniel A Peterson
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States
| | - Noel R Rose
- Brigham & Women's Hospital, Harvard Medical School, Dept. of Pathology, Boston, MA 02115, United States
| | - Daniela Čiháková
- The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States; The Johns Hopkins Bloomberg School of Public Health, The W. Harry Feinstone Dept. of Molecular Microbiology & Immunology, United States.
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17
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Fontes JA, Barin JG, Talor MV, Stickel N, Schaub J, Rose NR, Čiháková D. Complete Freund's adjuvant induces experimental autoimmune myocarditis by enhancing IL-6 production during initiation of the immune response. Immun Inflamm Dis 2017; 5:163-176. [PMID: 28474508 PMCID: PMC5418134 DOI: 10.1002/iid3.155] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Complete Freund's Adjuvant (CFA) emulsified with an antigen is a widely used method to induce autoimmune disease in animal models, yet the contribution of CFA to the immune response is not well understood. We compared the effectiveness of CFA with Incomplete Freund's Adjuvant (IFA) or TiterMax Gold Adjuvant (TMax) in experimental autoimmune myocarditis (EAM) in male mice. METHODS EAM was induced in A/J, BALB/c, and IL6KO BALB/c male mice by injection of the myocarditogenic peptide in CFA, IFA, or TMax on days 0 and 7. EAM severity was analyzed by histology on day 21. In addition, specific flow cytometry outcomes were evaluated on day 21. RESULTS Only mice immunized with CFA and myocarditogenic peptide on both days 0 and 7 developed substantial myocarditis as measured by histology. We observed a significantly increased level of IL6 in the spleen 3 days after CFA immunization. In the spleen and heart on day 21, there was an expansion of myeloid cells in CFA-immunized mice, as compared to IFA or TMax-immunized animals. Recombinant IL-6 at the time of IFA immunization partially restored susceptibility of the mice to EAM. We also treated EAM-resistant IL-6 knockout mice with recombinant IL-6 around the time of the first immunization, on days -1 to 2, completely restoring disease susceptibility, showing that the requirement for IL-6 coincides with primary immunization. Examining APC populations in the lymph node draining the immunization site evidenced the contribution of IL-6 to the CFA-dependence of EAM was through controlling local dendritic cell (DC) trafficking. CONCLUSIONS CFA used with myocarditogenic peptide twice is required to induce EAM in both A/J and Balb/c mice. Although IFA and TiterMax induce antibody responses, only CFA preferentially induced autoantigen-specific responses. CFA expands monocytes in the heart and in the spleen. IL-6 signaling is required during short window around primary immunization to induce EAM. In addition, IL-6 deficient mice resistance to EAM could be reversed by injecting IL-6 around first immunization. IL-6 expands dendritic cell and monocytic populations and ultimately leads to a robust T-cell driven immune response in CFA immunized mice.
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Affiliation(s)
- Jillian A. Fontes
- W. Harry Feinstone Department of Molecular Microbiology and ImmunologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
| | - Jobert G. Barin
- Division of Immunology, Department of Pathology, Johns Hopkins UniversitySchool of MedicineBaltimoreMDUSA
| | - Monica V. Talor
- Division of Immunology, Department of Pathology, Johns Hopkins UniversitySchool of MedicineBaltimoreMDUSA
| | - Natalie Stickel
- Department of Hematology, Oncology and Stem Cell TransplantationFreiburg University Medical CenterFreiburgGermany
- Faculty of BiologyAlbert Ludwigs University FreiburgFreiburgGermany
| | - Julie Schaub
- Division of Immunology, Department of Pathology, Johns Hopkins UniversitySchool of MedicineBaltimoreMDUSA
| | - Noel R. Rose
- W. Harry Feinstone Department of Molecular Microbiology and ImmunologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
- Division of Immunology, Department of Pathology, Johns Hopkins UniversitySchool of MedicineBaltimoreMDUSA
| | - Daniela Čiháková
- W. Harry Feinstone Department of Molecular Microbiology and ImmunologyJohns Hopkins University Bloomberg School of Public HealthBaltimoreMDUSA
- Division of Immunology, Department of Pathology, Johns Hopkins UniversitySchool of MedicineBaltimoreMDUSA
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18
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Diny NL, Baldeviano GC, Talor MV, Barin JG, Ong S, Bedja D, Hays AG, Gilotra NA, Coppens I, Rose NR, Čiháková D. Eosinophil-derived IL-4 drives progression of myocarditis to inflammatory dilated cardiomyopathy. J Exp Med 2017; 214:943-957. [PMID: 28302646 PMCID: PMC5379983 DOI: 10.1084/jem.20161702] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/30/2017] [Accepted: 02/07/2017] [Indexed: 01/21/2023] Open
Abstract
Diny et al. report a pathogenic role for eosinophils in autoimmune myocarditis and dilated cardiomyopathy. Eosinophils are required for progression of myocarditis to dilated cardiomyopathy and drive severe disease when present in large numbers. Activated cardiac eosinophils mediate this process through IL-4. Inflammatory dilated cardiomyopathy (DCMi) is a major cause of heart failure in children and young adults. DCMi develops in up to 30% of myocarditis patients, but the mechanisms involved in disease progression are poorly understood. Patients with eosinophilia frequently develop cardiomyopathies. In this study, we used the experimental autoimmune myocarditis (EAM) model to determine the role of eosinophils in myocarditis and DCMi. Eosinophils were dispensable for myocarditis induction but were required for progression to DCMi. Eosinophil-deficient ΔdblGATA1 mice, in contrast to WT mice, showed no signs of heart failure by echocardiography. Induction of EAM in hypereosinophilic IL-5Tg mice resulted in eosinophilic myocarditis with severe ventricular and atrial inflammation, which progressed to severe DCMi. This was not a direct effect of IL-5, as IL-5TgΔdblGATA1 mice were protected from DCMi, whereas IL-5−/− mice exhibited DCMi comparable with WT mice. Eosinophils drove progression to DCMi through their production of IL-4. Our experiments showed eosinophils were the major IL-4–expressing cell type in the heart during EAM, IL-4−/− mice were protected from DCMi like ΔdblGATA1 mice, and eosinophil-specific IL-4 deletion resulted in improved heart function. In conclusion, eosinophils drive progression of myocarditis to DCMi, cause severe DCMi when present in large numbers, and mediate this process through IL-4.
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Affiliation(s)
- Nicola L Diny
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205
| | - G Christian Baldeviano
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205
| | - Monica V Talor
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205
| | - Jobert G Barin
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205
| | - SuFey Ong
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205
| | - Djahida Bedja
- Department of Medicine, Division of Cardiology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205
| | - Allison G Hays
- Department of Medicine, Division of Cardiology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205
| | - Nisha A Gilotra
- Department of Medicine, Division of Cardiology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205
| | - Isabelle Coppens
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205
| | - Noel R Rose
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205.,Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205
| | - Daniela Čiháková
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 .,Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205
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19
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Rowland LM, Demyanovich HK, Wijtenburg SA, Eaton WW, Rodriguez K, Gaston F, Cihakova D, Talor MV, Liu F, McMahon RR, Hong LE, Kelly DL. Antigliadin Antibodies (AGA IgG) Are Related to Neurochemistry in Schizophrenia. Front Psychiatry 2017; 8:104. [PMID: 28674504 PMCID: PMC5474459 DOI: 10.3389/fpsyt.2017.00104] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/29/2017] [Indexed: 12/18/2022] Open
Abstract
Inflammation may play a role in schizophrenia; however, subgroups with immune regulation dysfunction may serve as distinct illness phenotypes with potential different treatment and prevention strategies. Emerging data show that about 30% of people with schizophrenia have elevated antigliadin antibodies of the IgG type, representing a possible subgroup of schizophrenia patients with immune involvement. Also, recent data have shown a high correlation of IgG-mediated antibodies between the periphery and cerebral spinal fluid in schizophrenia but not healthy controls, particularly AGA IgG suggesting that these antibodies may be crossing the blood-brain barrier with resulting neuroinflammation. Proton magnetic resonance spectroscopy (MRS) is a non-invasive technique that allows the quantification of certain neurochemicals in vivo that may proxy inflammation in the brain such as myoinositol and choline-containing compounds (glycerophosphorylcholine and phosphorylcholine). The objective of this exploratory study was to examine the relationship between serum AGA IgG levels and MRS neurochemical levels. We hypothesized that higher AGA IgG levels would be associated with higher levels of myoinositol and choline-containing compounds (glycerophosphorylcholine plus phosphorylcholine; GPC + PC) in the anterior cingulate cortex. Thirty-three participants with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder had blood drawn and underwent neuroimaging using MRS within 9 months. We found that 10/33 (30%) had positive AGA IgG (≥20 U) similar to previous findings. While there were no significant differences in myoinositol and GPC + PC levels between patients with and without AGA IgG positivity, there were significant relationships between both myoinositol (r = 0.475, p = 0.007) and GPC + PC (r = 0.36, p = 0.045) with AGA IgG levels. This study shows a possible connection of AGA IgG antibodies to putative brain inflammation as measured by MRS in schizophrenia.
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Affiliation(s)
- Laura M Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Haley K Demyanovich
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - S Andrea Wijtenburg
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - William W Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Katrina Rodriguez
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Frank Gaston
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Daniela Cihakova
- Immunologic Disorders Laboratory, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Monica V Talor
- Immunologic Disorders Laboratory, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Fang Liu
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Robert R McMahon
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Deanna L Kelly
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
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20
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Diny NL, Hou X, Barin JG, Chen G, Talor MV, Schaub J, Russell SD, Klingel K, Rose NR, Čiháková D. Macrophages and cardiac fibroblasts are the main producers of eotaxins and regulate eosinophil trafficking to the heart. Eur J Immunol 2016; 46:2749-2760. [PMID: 27621211 DOI: 10.1002/eji.201646557] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/26/2016] [Accepted: 09/08/2016] [Indexed: 12/18/2022]
Abstract
Cardiac manifestations are a major cause of morbidity and mortality in patients with eosinophil-associated diseases. Eosinophils are thought to play a pathogenic role in myocarditis. We investigated the pathways that recruit eosinophils to the heart using a model of eosinophilic myocarditis, in which experimental autoimmune myocarditis (EAM) is induced in IFNγ-/- IL-17A-/- mice. Two conditions are necessary for efficient eosinophil trafficking to the heart: high eotaxin (CCL11, CCL24) expression in the heart and expression of the eotaxin receptor CCR3 by eosinophils. We identified cardiac fibroblasts as the source of CCL11 in the heart interstitium. CCL24 is produced by F4/80+ macrophages localized at inflammatory foci in the heart. Expression of CCL11 and CCL24 is controlled by Th2 cytokines, IL-4 and IL-13. To determine the relevance of this pathway in humans, we analyzed endomyocardial biopsy samples from myocarditis patients. Expression of CCL11 and CCL26 was significantly increased in eosinophilic myocarditis compared to chronic lymphocytic myocarditis and positively correlated with the number of eosinophils. Thus, eosinophil trafficking to the heart is dependent on the eotaxin-CCR3 pathway in a mouse model of EAM and associated with cardiac eotaxin expression in patients with eosinophilic myocarditis. Blocking this pathway may prevent eosinophil-mediated cardiac damage.
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Affiliation(s)
- Nicola L Diny
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xuezhou Hou
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jobert G Barin
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Guobao Chen
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Monica V Talor
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julie Schaub
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stuart D Russell
- Department of Medicine Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karin Klingel
- Abteilung für Molekulare Pathologie, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Noel R Rose
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniela Čiháková
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Diny N, Hou X, Barin JG, Talor MV, Rose NR, Cihakova D. The eotaxin-CCR3 pathway is required for eosinophil trafficking to the heart in eosinophilic myocarditis. The Journal of Immunology 2016. [DOI: 10.4049/jimmunol.196.supp.117.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Cardiac manifestations are a major cause of morbidity and mortality in patients with eosinophil-associated diseases. Eosinophils have been proposed to play a pathologic role in the heart. Nevertheless, the pathways that recruit eosinophils to the heart have not been described. In IFNγ−/− IL-17A−/− mice, induction of experimental autoimmune myocarditis results in a Th-2-driven, eosinophilic inflammation. IFNγ−/− IL-17A−/− mice had much higher expression of the eosinophil-attracting chemokines eotaxin-1 (Ccl11) and eotaxin-2 (Ccl24) in the heart than wildtype mice. Genetic ablation of the eotaxin receptor CCR3 resulted in a dramatic decrease in heart infiltrating eosinophils. Adoptive transfer experiments with CCR3+/+ or CCR3−/− eosinophils into eosinophil-deficient ΔdblGATA1 or IFNγ−/− IL-17A−/− ΔdblGATA1 recipients showed that two conditions have to be met for efficient eosinophil trafficking to the inflamed heart: high eotaxin expression in the heart and expression of CCR3 by eosinophils. We identified the source of cardiac eotaxins by RT-PCR of FACS sorted heart cells and by immunohistochemistry. Eotaxin-1 was mainly produced by cardiac fibroblasts with interstitial localization in the heart. In vitro culture of cardiac fibroblasts with IL-4 and IL-13 induced eotaxin-1 expression. In contrast, eotaxin-2 was expressed by multiple inflammatory cell types, located at inflammatory foci, and substantial expression was only found in mice lacking IFNγ and IL-17A during myocarditis. In conclusion, eosinophil trafficking to the heart is dependent on the eotaxin-CCR3 pathway in mice with eosinophilic myocarditis. Blockade of this pathway may be a useful therapeutic approach to prevent eosinophil-mediated heart damage.
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Ricciuti A, Travison TG, Di Dalmazi G, Talor MV, DeVincentiis L, Manley RW, Bhasin S, Caturegli P, Basaria S. A Subset of Men With Age-Related Decline in Testosterone Have Gonadotroph Autoantibodies. J Clin Endocrinol Metab 2016; 101:1535-41. [PMID: 26963952 PMCID: PMC4880156 DOI: 10.1210/jc.2016-1016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
CONTEXT Age-related decline in serum testosterone (T) is being increasingly diagnosed. In most men, it associates with low or inappropriately normal gonadotropin levels, which suggests a hypothalamic-pituitary etiology. Autoantibodies against adenohypophyseal cells have been associated with pituitary dysfunction; however, the prevalence of pituitary autoimmunity in this age-related T decline has not been assessed. OBJECTIVES This is a proof-of-concept study with the objective of determining the prevalence of antibodies to gonadotrophs in older men with age-related low T and compare it with healthy young and older eugonadal men. STUDY DESIGN This is a cross-sectional case-control study of 182 men. Cases included 100 older men (≥65 years) with age-related low T levels; the control groups were composed of 50 young and 32 older healthy eugonadal men. Serum antibodies against the anterior pituitary gland were measured using a two-step approach: 1) single indirect immunofluorescence (ie, participant serum only) to determine the pattern of cytosolic staining; and 2) double indirect immunofluorescence (ie, participant serum plus a commercial adenohypophyseal hormone antibody) to identify the anterior pituitary cell type recognized by the patient's antibodies). RESULTS In participants with positive antipituitary antibodies, the granular cytosolic pattern (highly predictive of pituitary autoimmunity) was only seen in older men with age-related low T (4%) and none in control groups (0%, P = .001). Double indirect immunofluorescence confirmed that pituitary antibodies were exclusively directed against the gonadotrophs. CONCLUSION A subset of older men with age-related low T levels have specific antibodies against the gonadotrophs. Whether these antibodies are pathogenic and contributory to the age-related decline in T remains to be established.
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Wu L, Diny NL, Ong S, Barin JG, Hou X, Rose NR, Talor MV, Čiháková D. Pathogenic IL-23 signaling is required to initiate GM-CSF-driven autoimmune myocarditis in mice. Eur J Immunol 2016; 46:582-92. [PMID: 26660726 PMCID: PMC5153891 DOI: 10.1002/eji.201545924] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/26/2015] [Accepted: 12/08/2015] [Indexed: 01/22/2023]
Abstract
Using a mouse model of experimental autoimmune myocarditis (EAM), we showed for the first time that IL-23 stimulation of CD4(+) T cells is required only briefly at the initiation of GM-CFS-dependent cardiac autoimmunity. IL-23 signal, acting as a switch, turns on pathogenicity of CD4(+) T cells, and becomes dispensable once autoreactivity is established. Il23a(-/-) mice failed to mount an efficient Th17 response to immunization, and were protected from myocarditis. However, remarkably, transient IL-23 stimulation ex vivo fully restored pathogenicity in otherwise nonpathogenic CD4(+) T cells raised from Il23a(-/-) donors. Thus, IL-23 may no longer be necessary to uphold inflammation in established autoimmune diseases. In addition, we demonstrated that IL-23-induced GM-CSF mediates the pathogenicity of CD4(+) T cells in EAM. The neutralization of GM-CSF abrogated cardiac inflammation. However, sustained IL-23 signaling is required to maintain IL-17A production in CD4(+) T cells. Despite inducing inflammation in Il23a(-/-) recipients comparable to wild-type (WT), autoreactive CD4(+) T cells downregulated IL-17A production without persistent IL-23 signaling. This divergence on the controls of GM-CSF-dependent pathogenicity on one side and IL-17A production on the other side may contribute to the discrepant efficacies of anti-IL-23 therapy in different autoimmune diseases.
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Affiliation(s)
- Lei Wu
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Maryland 21205, U.S.A
| | - Nicola L. Diny
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Maryland 21205, U.S.A
| | - SuFey Ong
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Maryland 21205, U.S.A
| | - Jobert G. Barin
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, U.S.A
| | - Xuezhou Hou
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Maryland 21205, U.S.A
| | - Noel R. Rose
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Maryland 21205, U.S.A
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, U.S.A
| | - Monica V. Talor
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, U.S.A
| | - Daniela Čiháková
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Maryland 21205, U.S.A
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, U.S.A
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Hoffman WH, Sharma M, Cihakova D, Talor MV, Rose NR, Mohanakumar T, Passmore GG. Cardiac antibody production to self-antigens in children and adolescents during and following the correction of severe diabetic ketoacidosis. Autoimmunity 2016; 49:188-96. [PMID: 26911924 DOI: 10.3109/08916934.2015.1134509] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Diabetic cardiomyopathy (DC) is an independent phenotype of diabetic cardiovascular disease. The understanding of the pathogenesis of DC in young patients with type 1 diabetes (T1D) is limited. The cardiac insults of diabetic ketoacidosis (DKA) and progression of DC could include development of antibodies (Abs) to cardiac self-antigens (SAgs) such as: myosin (M), vimentin (V) and k-alpha 1 tubulin (Kα1T). The goal of this study is to determine if the insults of severe DKA and its inflammatory cascade are associated with immune responses to SAgs. Development of Abs to the SAgs were determined by an ELISA using sera collected at three time points in relation to severe DKA (pH < 7.2). Results demonstrate significant differences between the development of Abs to VIM and a previously reported diastolic abnormality (DA) during DKA and its treatment and a NDA group at 2-3 months post DKA (p = 0.0452). A significant association is present between T1D duration (<3 years) and Abs to Kα1T (p = 0.0134). Further, Abs to MYO and VIM are associated with inflammatory cytokines. We propose that severe DKA initiates the synthesis of Abs to cardiac SAgs that are involved in the early immunopathogenesis of DC in young patients with T1D.
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Affiliation(s)
- William H Hoffman
- a Department of Pediatrics , Georgia Regents University (Medical College of Georgia) , Augusta , GA , USA
| | - Monal Sharma
- b Department of Surgery , Washington University School of Medicine , St. Louis, MO , USA
| | - Daniela Cihakova
- c Department of Pathology , The Johns Hopkins University School of Medicine, The William H. Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
| | - Monica V Talor
- d Department of Pathology , The Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Noel R Rose
- c Department of Pathology , The Johns Hopkins University School of Medicine, The William H. Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
| | - T Mohanakumar
- e Departments of Surgery , Pathology and Immunology, Washington University School of Medicine , St. Louis, MO , USA , and
| | - Gregory G Passmore
- f Medical Laboratory, Imaging and Radiologic Sciences, Georgia Regents University , Augusta , GA , USA
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Reynolds LM, Ding J, Taylor JR, Lohman K, Soranzo N, de la Fuente A, Liu TF, Johnson C, Barr RG, Register TC, Donohue KM, Talor MV, Cihakova D, Gu C, Divers J, Siscovick D, Burke G, Post W, Shea S, Jacobs DR, Hoeschele I, McCall CE, Kritchevsky SB, Herrington D, Tracy RP, Liu Y. Transcriptomic profiles of aging in purified human immune cells. BMC Genomics 2015; 16:333. [PMID: 25898983 PMCID: PMC4417516 DOI: 10.1186/s12864-015-1522-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/10/2015] [Indexed: 01/08/2023] Open
Abstract
Background Transcriptomic studies hold great potential towards understanding the human aging process. Previous transcriptomic studies have identified many genes with age-associated expression levels; however, small samples sizes and mixed cell types often make these results difficult to interpret. Results Using transcriptomic profiles in CD14+ monocytes from 1,264 participants of the Multi-Ethnic Study of Atherosclerosis (aged 55–94 years), we identified 2,704 genes differentially expressed with chronological age (false discovery rate, FDR ≤ 0.001). We further identified six networks of co-expressed genes that included prominent genes from three pathways: protein synthesis (particularly mitochondrial ribosomal genes), oxidative phosphorylation, and autophagy, with expression patterns suggesting these pathways decline with age. Expression of several chromatin remodeler and transcriptional modifier genes strongly correlated with expression of oxidative phosphorylation and ribosomal protein synthesis genes. 17% of genes with age-associated expression harbored CpG sites whose degree of methylation significantly mediated the relationship between age and gene expression (p < 0.05). Lastly, 15 genes with age-associated expression were also associated (FDR ≤ 0.01) with pulse pressure independent of chronological age. Comparing transcriptomic profiles of CD14+ monocytes to CD4+ T cells from a subset (n = 423) of the population, we identified 30 age-associated (FDR < 0.01) genes in common, while larger sets of differentially expressed genes were unique to either T cells (188 genes) or monocytes (383 genes). At the pathway level, a decline in ribosomal protein synthesis machinery gene expression with age was detectable in both cell types. Conclusions An overall decline in expression of ribosomal protein synthesis genes with age was detected in CD14+ monocytes and CD4+ T cells, demonstrating that some patterns of aging are likely shared between different cell types. Our findings also support cell-specific effects of age on gene expression, illustrating the importance of using purified cell samples for future transcriptomic studies. Longitudinal work is required to establish the relationship between identified age-associated genes/pathways and aging-related diseases. Electronic supplementary material The online version of this article (doi:10.1186/s12864-015-1522-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lindsay M Reynolds
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - Jingzhong Ding
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - Jackson R Taylor
- Department of Gerontology and Geriatric Medicine, J. Paul Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - Kurt Lohman
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | | | - Alberto de la Fuente
- FBN, Leibniz Institute for Farm Animal Biology, Genetics and Biometry, Mecklenburg-Vorpommern, Germany.
| | - Tie Fu Liu
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - Craig Johnson
- Departments of Medicine and Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, 98115, USA.
| | - R Graham Barr
- Departments of Medicine and Epidemiology, Columbia University, New York, New York, 10032, USA.
| | - Thomas C Register
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - Kathleen M Donohue
- Departments of Medicine and Epidemiology, Columbia University, New York, New York, 10032, USA.
| | - Monica V Talor
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, 21205, USA.
| | - Daniela Cihakova
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, 21205, USA.
| | - Charles Gu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, 63110, USA.
| | - Jasmin Divers
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - David Siscovick
- New York Academy of Medicine, New York, New York, 10029, USA.
| | - Gregory Burke
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - Wendy Post
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, 21205, USA.
| | - Steven Shea
- Departments of Medicine and Epidemiology, Columbia University, New York, New York, 10032, USA.
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, 55454, USA.
| | - Ina Hoeschele
- Virginia Bioinformatics Institute, Virginia Tech, Blacksburg, Virginia, 24061, USA.
| | - Charles E McCall
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA. .,Department of Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA. .,Department of Gerontology and Geriatric Medicine, J. Paul Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - David Herrington
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
| | - Russell P Tracy
- Department of Pathology, University of Vermont, Colchester, Vermont, 05446, USA.
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
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Ong S, Ligons DL, Barin JG, Wu L, Talor MV, Diny N, Fontes JA, Gebremariam E, Kass DA, Rose NR, Čiháková D. Natural killer cells limit cardiac inflammation and fibrosis by halting eosinophil infiltration. Am J Pathol 2015; 185:847-61. [PMID: 25622543 DOI: 10.1016/j.ajpath.2014.11.023] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 11/10/2014] [Accepted: 11/18/2014] [Indexed: 12/23/2022]
Abstract
Myocarditis is a leading cause of sudden cardiac failure in young adults. Natural killer (NK) cells, a subset of the innate lymphoid cell compartment, are protective in viral myocarditis. Herein, we demonstrated that these protective qualities extend to suppressing autoimmune inflammation. Experimental autoimmune myocarditis (EAM) was initiated in BALB/c mice by immunization with myocarditogenic peptide. During EAM, activated cardiac NK cells secreted interferon γ, perforin, and granzyme B, and expressed CD69, tumor necrosis factor-related apoptosis-inducing ligand treatment, and CD27 on their cell surfaces. The depletion of NK cells during EAM with anti-asialo GM1 antibody significantly increased myocarditis severity, and was accompanied by elevated fibrosis and a 10-fold increase in the percentage of cardiac-infiltrating eosinophils. The resultant influx of eosinophils to the heart was directly responsible for the increased disease severity in the absence of NK cells, because treatment with polyclonal antibody asialogangloside GM-1 did not augment myocarditis severity in eosinophil-deficient ΔdoubleGATA1 mice. We demonstrate that NK cells limit eosinophilic infiltration both indirectly, through altering eosinophil-related chemokine production by cardiac fibroblasts, and directly, by inducing eosinophil apoptosis in vitro. Altogether, we define a new pathway of eosinophilic regulation through interactions with NK cells.
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Affiliation(s)
- SuFey Ong
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Davinna L Ligons
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jobert G Barin
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lei Wu
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Monica V Talor
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nicola Diny
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Jillian A Fontes
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth Gebremariam
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David A Kass
- Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Noel R Rose
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniela Čiháková
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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27
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Wu L, Ong S, Talor MV, Barin JG, Baldeviano GC, Kass DA, Bedja D, Zhang H, Sheikh A, Margolick JB, Iwakura Y, Rose NR, Ciháková D. Cardiac fibroblasts mediate IL-17A-driven inflammatory dilated cardiomyopathy. ACTA ACUST UNITED AC 2014; 211:1449-64. [PMID: 24935258 PMCID: PMC4076595 DOI: 10.1084/jem.20132126] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IL-17A stimulates cardiac fibroblasts to produce inflammatory mediators critical for the recruitment and differentiation of myeloid cells during inflammatory dilated cardiomyopathy. Inflammatory dilated cardiomyopathy (DCMi) is a major cause of heart failure in individuals below the age of 40. We recently reported that IL-17A is required for the development of DCMi. We show a novel pathway connecting IL-17A, cardiac fibroblasts (CFs), GM-CSF, and heart-infiltrating myeloid cells with the pathogenesis of DCMi. Il17ra−/− mice were protected from DCMi, and this was associated with significantly diminished neutrophil and Ly6Chi monocyte/macrophage (MO/MΦ) cardiac infiltrates. Depletion of Ly6Chi MO/MΦ also protected mice from DCMi. Mechanistically, IL-17A stimulated CFs to produce key chemokines and cytokines that are critical downstream effectors in the recruitment and differentiation of myeloid cells. Moreover, IL-17A directs Ly6Chi MO/MΦ in trans toward a more proinflammatory phenotype via CF-derived GM-CSF. Collectively, this IL-17A–fibroblast–GM-CSF–MO/MΦ axis could provide a novel target for the treatment of DCMi and related inflammatory cardiac diseases.
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Affiliation(s)
- Lei Wu
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - SuFey Ong
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Monica V Talor
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Jobert G Barin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - G Christian Baldeviano
- Department of Parasitology, US Naval Medical Research Unit Six (NAMRU-6), Lima 34031, Peru
| | - David A Kass
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Djahida Bedja
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Hao Zhang
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Asfandyar Sheikh
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Joseph B Margolick
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Yoichiro Iwakura
- Research Institute for Biomedical Sciences, Tokyo University of Science, Noda, Chiba 278-0022, Japan
| | - Noel R Rose
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Daniela Ciháková
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Department of Pathology, and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
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De Remigis A, de Gruijl TD, Uram JN, Tzou SC, Iwama S, Talor MV, Armstrong TD, Santegoets SJAM, Slovin SF, Zheng L, Laheru DA, Jaffee EM, Gerritsen WR, van den Eertwegh AJM, Le DT, Caturegli P. Development of thyroglobulin antibodies after GVAX immunotherapy is associated with prolonged survival. Int J Cancer 2014; 136:127-37. [PMID: 24832153 DOI: 10.1002/ijc.28973] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 04/30/2014] [Indexed: 12/26/2022]
Abstract
Cancer immunotherapy induces a variety of autoinflammatory responses, including those against the thyroid gland, which can be exploited to predict clinical outcomes. Considering the paucity of information about thyroid autoimmunity in patients receiving cancer vaccines, we designed our study to assess the development of thyroglobulin antibodies (TgAbs) in patients treated with GVAX (vaccine made of a tumor cell type transfected with GM-CSF) and/or ipilimumab and correlated seroconversion with survival. Using both in house and commercial ELISA assays, we measured TgAbs in patients with pancreatic (No. = 53), prostate (No. = 35) or colon (No. = 8) cancer, before and after treatment with GVAX only (No. = 34), GVAX plus ipilimumab (No. = 42) or ipilimumab (No. = 20), and correlated their levels with patient's survival, disease status and T-cell surface markers. Antibodies to thyroperoxidase, myeloperoxidase, proteinase 3, insulin and actin were also measured. TgAbs specifically developed after GVAX, independent of the underlying cancer (81% in prostate, 75% colon cancer and 76% pancreatic cancer) and co-administration of ipilimumab (75% in GVAX only and 78% in GVAX plus ipilimumab). This TgAbs seroconversion could be detected mainly by the in house assay, suggesting that the thyroglobulin epitopes recognized by the antibodies induced by GVAX are different from the epitopes seen in the classic form of Hashimoto thyroiditis. Notably, TgAbs seroconversion was associated with significantly prolonged survival (p = 0.01 for pancreas and p = 0.005 for prostate cancer). In conclusion, GVAX immunotherapy induces the appearance of TgAbs that recognize a unique antigenic repertoire and associate with prolonged survival.
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Abstract
A study of IgG4 autoantibody levels in juvenile thyroid disease patients showed evidence of heritability using the ROMP screening method. These levels increased with time despite the fact that total IgG antibody decreased with time. Evidence of heritability was demonstrated only in patients with high titers of autoantibodies to both thyroglobulin (Tg) and thyroperoxidase (TPO) unlike family members who may show high titers of one or the other and be asymptomatic at the time of sampling. Since high and low IgG4 levels give different heritability plots, these findings may represent a more severe fibrotic form of thyroiditis with a distinct genetic background. Hence a simple predictive approach is offered by this screening tool for the disease in patients and family members which may be helpful in the future to identify IgG4-related thyroiditis early in the course of disease without the requirement for biopsy.
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Affiliation(s)
- I M Outschoorn
- Immune Response Unit (Immunology), Instituto de Salud Carlos III, Centro Nacional de Microbiologia , Majadahonda, Madrid , Spain
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30
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Barin JG, Baldeviano GC, Talor MV, Wu L, Ong S, Fairweather D, Bedja D, Stickel NR, LeGault JA, Cardamone AB, Zheng D, Gabrielson KL, Rose NR, Cihakova D. Fatal eosinophilic myocarditis develops in the absence of IFN-γ and IL-17A. J Immunol 2013; 191:4038-47. [PMID: 24048893 PMCID: PMC3927983 DOI: 10.4049/jimmunol.1301282] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CD4(+) T cells play a central role in inflammatory heart disease, implicating a cytokine product associated with Th cell effector function as a necessary mediator of this pathophysiology. IFN-γ-deficient mice developed severe experimental autoimmune myocarditis (EAM), in which mice are immunized with cardiac myosin peptide, whereas IL-17A-deficient mice were protected from progression to dilated cardiomyopathy. We generated IFN-γ(-/-)IL-17A(-/-) mice to assess whether IL-17 signaling was responsible for the severe EAM of IFN-γ(-/-) mice. Surprisingly, IFN-γ(-/-)IL-17A(-/-) mice developed a rapidly fatal EAM. Eosinophils constituted a third of infiltrating leukocytes, qualifying this disease as eosinophilic myocarditis. We found increased cardiac production of CCL11/eotaxin, as well as Th2 deviation, among heart-infiltrating CD4(+) cells. Ablation of eosinophil development improved survival of IFN-γ(-/-)IL-17A(-/-) mice, demonstrating the necessity of eosinophils in fatal heart failure. The severe and rapidly fatal autoimmune inflammation that developed in the combined absence of IFN-γ and IL-17A constitutes a novel model of eosinophilic heart disease in humans. This is also, to our knowledge, the first demonstration that eosinophils have the capacity to act as necessary mediators of morbidity in an autoimmune process.
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Affiliation(s)
- Jobert G. Barin
- Immunology Training Program, The Johns Hopkins University School of Medicine, Baltimore, MD 21205
- Dept. of Pathology, The Johns Hopkins University School of Medicine
- The William H. Feinstone Dept. of Molecular Microbiology & Immunology, The Johns Hopkins University Bloomberg School of Public Health
| | - G. Christian Baldeviano
- The William H. Feinstone Dept. of Molecular Microbiology & Immunology, The Johns Hopkins University Bloomberg School of Public Health
- Dept. of Parasitology, US Naval Medical Research Unit Six (NAMRU-6), Lima, Peru
| | - Monica V. Talor
- Dept. of Pathology, The Johns Hopkins University School of Medicine
| | - Lei Wu
- The William H. Feinstone Dept. of Molecular Microbiology & Immunology, The Johns Hopkins University Bloomberg School of Public Health
| | - SuFey Ong
- The William H. Feinstone Dept. of Molecular Microbiology & Immunology, The Johns Hopkins University Bloomberg School of Public Health
| | - DeLisa Fairweather
- Dept. of Environmental Health Sciences, The Johns Hopkins University Bloomberg School of Public Health
| | - Djahida Bedja
- Dept. of Comparative Medicine, The Johns Hopkins University School of Medicine
| | - Natalie R. Stickel
- Dept. of Hematology & Oncology, University of Freiburg, Freiburg, Germany
| | - Jillian A. LeGault
- The William H. Feinstone Dept. of Molecular Microbiology & Immunology, The Johns Hopkins University Bloomberg School of Public Health
| | | | - Dongfeng Zheng
- Dept. of Pathology, The Johns Hopkins University School of Medicine
| | | | - Noel R. Rose
- Immunology Training Program, The Johns Hopkins University School of Medicine, Baltimore, MD 21205
- Dept. of Pathology, The Johns Hopkins University School of Medicine
- The William H. Feinstone Dept. of Molecular Microbiology & Immunology, The Johns Hopkins University Bloomberg School of Public Health
| | - Daniela Cihakova
- Dept. of Pathology, The Johns Hopkins University School of Medicine
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Hoffman WH, Passmore GG, Hannon DW, Talor MV, Fox P, Brailer C, Haislip D, Keel C, Harris G, Rose NR, Fiordalisi I, Čiháková D. Increased systemic Th17 cytokines are associated with diastolic dysfunction in children and adolescents with diabetic ketoacidosis. PLoS One 2013; 8:e71905. [PMID: 24013901 PMCID: PMC3754936 DOI: 10.1371/journal.pone.0071905] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 07/04/2013] [Indexed: 12/11/2022] Open
Abstract
Diastolic dysfunction suggestive of diabetic cardiomyopathy is established in children with T1DM, but its pathogenesis is not well understood. We studied the relationships of systemic inflammatory cytokines/chemokines and cardiac function in 17 children with T1DM during and after correction of diabetic ketoacidosis (DKA). Twenty seven of the 39 measured cytokines/chemokines were elevated at 6-12 hours into treatment of DKA compared to values after DKA resolution. Eight patients displayed at least one parameter of diastolic abnormality (DA) during acute DKA. Significant associations were present between nine of the cytokine/chemokine levels and the DA over time. Interestingly, four of these nine interactive cytokines (GM-CSF, G-CSF, IL-12p40, IL-17) are associated with a Th17 mediated cell response. Both the DA and CCL7 and IL-12p40, had independent associations with African American patients. Thus, we report occurrence of a systemic inflammatory response and the presence of cardiac diastolic dysfunction in a subset of young T1DM patients during acute DKA.
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Affiliation(s)
- William H. Hoffman
- Section of Pediatric Endocrinology, Georgia Regents University (formerly Georgia Health Sciences University), Augusta, Georgia, United States of America
| | - Gregory G. Passmore
- Medical Laboratory, Imaging, and Radiologic Sciences, Georgia Regents University, Augusta, Georgia, United States of America
| | - David W. Hannon
- Section of Pediatric Cardiology, The Brody School Of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Monica V. Talor
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Pam Fox
- Section of Pediatric Critical Care, The Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Catherine Brailer
- Section of Pediatric Critical Care, The Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Dynita Haislip
- Section of Pediatric Critical Care, The Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Cynthia Keel
- Section of Pediatric Critical Care, The Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Glenn Harris
- Section of Pediatric Endocrinology, The Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Noel R. Rose
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- The W. Harry Feinstone Department of Molecular Microbiology & Immunology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Irma Fiordalisi
- Section of Pediatric Critical Care, The Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Daniela Čiháková
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Wasserman EE, Pillion JP, Duggan A, Nelson K, Rohde C, Seaberg EC, Talor MV, Yolken RH, Rose NR. Childhood IQ, hearing loss, and maternal thyroid autoimmunity in the Baltimore Collaborative Perinatal Project. Pediatr Res 2012; 72:525-30. [PMID: 22918523 DOI: 10.1038/pr.2012.117] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Maternal thyroid autoantibodies during pregnancy have been implicated in neurodevelopmental delays, including early childhood cognitive deficits. We evaluated whether maternal autoantibodies to thyroid peroxidase (TPOaAbs) during late pregnancy were associated with childhood intelligence quotient (IQ) scores in their offspring and how the children's TPOaAb-associated sensorineural hearing loss (HL) might affect the result. METHODS We evaluated banked third-trimester sera corresponding to 1,733 children for whom childhood cognitive test scores and audiology data were available. The mothers and their children participated in the National Institutes of Health (NIH)-sponsored Collaborative Perinatal Project (CPP) that ran from 1959 to 1974. RESULTS A modest, statistically significant, effect of TPOaAbs on cognitive performance observed at 4 y of age lessened in both magnitude and P value by the age of 7 y. Children with sensorineural HL (SNHL) had lower IQ scores at both ages. CONCLUSION Our data suggest that the reported effect of maternal TPOaAbs on IQ may involve early developmental delays or transient effects rather than permanent deficits. Reports associating TPOaAbs directly with IQ may reflect a portion with unexamined TPOaAb-associated SNHL. Whether the TPOaAb-associated SNHL is in the neurodevelopmental pathway of later cognitive delays or is independently associated with IQ requires investigation in other studies.
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Affiliation(s)
- Ellen E Wasserman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Chen P, Baldeviano GC, Ligons DL, Talor MV, Barin JG, Rose NR, Cihakova D. Susceptibility to autoimmune myocarditis is associated with intrinsic differences in CD4(+) T cells. Clin Exp Immunol 2012; 169:79-88. [PMID: 22774982 DOI: 10.1111/j.1365-2249.2012.04598.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
A.SW and B10.S mice share the same major histocompatibility complex (MHC) haplotype (H-2(s)). However, A.SW mice are susceptible to experimental autoimmune myocarditis (EAM) and develop severe disease after immunization with myosin, whereas B10.S mice are resistant. We found that naive A.SW mice have intrinsically increased total CD4(+) T cell counts and increased proportions of CD4(+) T cells in their spleens compared to B10.S mice. Among total CD4(+) T cells, naive A.SW mice have a lower relative frequency of forkhead box protein 3 (FoxP3(+))CD25(+) regulatory T cells (T(regs)). A.SW mice also had a higher proportion of CD4(+) T cells and a lower proportion of T(regs) in their hearts and spleen during EAM, with greater T cell activation and proliferation, compared to B10.S mice. These differences in the T cell compartment were not antigen-specific, as ovalbumin/complete Freund's adjuvant (OVA/CFA) or CFA immunization elicited the same differences in CD4(+) T cells and T(regs) between A.SW and B10.S mice. Moreover, A.SW mice had more T helper type 17 (Th17) cells and B10.S had more Th1 cells in their hearts. The higher percentage of CD4(+) T cells and their enhanced potential to differentiate towards the Th17 pathway was also observed in naive A.SW mice. Interleukin (IL)-6 is required for Th17 induction. Interestingly, IL-6Rα expression was greater on naive A.SW CD4(+) T cells, compared to B10.S CD4(+) T cells, indicating that this intrinsic difference, together with a relatively lower T(reg) proportion of CD4(+) T cells, might lead to heightened Th17 responses and greater susceptibility to autoimmunity in A.SW mice.
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Affiliation(s)
- P Chen
- Department of Pathology, Division of Immunology, Johns Hopkins University School of Medicine, MD, USA
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Guaraldi F, Landek-Salgado MA, Hutfless S, Samoni F, Talor MV, Matos PG, Salvatori R, Rose NR, Caturegli P. Pituitary antibodies in women with Hashimoto's thyroiditis: prevalence in diagnostic and prediagnostic sera. Thyroid 2012; 22:509-15. [PMID: 22468943 PMCID: PMC3338955 DOI: 10.1089/thy.2011.0373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Pituitary antibodies have been reported with greater frequency in patients with Hashimoto's thyroiditis than in healthy controls, although there is significant variability in the strength of the association and the methodologies used. METHODS We designed a nested case-control study to characterize the prevalence of pituitary antibodies at the time of the clinical diagnosis of Hashimoto's thyroiditis, as well as at 2, 5, and 7 years before diagnosis. Active component female service member cases (n=87) and matched female controls (n=107) were selected using the Defense Medical Surveillance System database (DMSSD) between January 1998 and December 2007. Pituitary antibodies were measured by immunofluorescence using human pituitary glands collected at autopsy as the substrate. RESULTS At diagnosis, pituitary antibodies were present in 9% of cases with Hashimoto's (8 of 87) and 3% of controls (3 of 107). When the data were analyzed using a conditional logistic regression model, which takes into account the matching on age and work status, pituitary antibodies increased the odds of having Hashimoto's thyroiditis by sevenfold (95% confidence interval from 1.3 to 40.1, p=0.028), after adjusting for components of the DMSSD-category-termed race and for thyroperoxidase antibodies. Before diagnosis, pituitary antibodies were positive in 3 of the 11 subjects (2 cases and 1 control) at the -2-year time point, and negative in all 11 subjects at the -5- and -7-year time points. CONCLUSIONS In summary, using a nested case-control design, we confirm that pituitary antibodies are more common in Hashimoto's thyroiditis and suggest that they appear late during its natural history.
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Affiliation(s)
- Federica Guaraldi
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
- Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy
| | | | - Susan Hutfless
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland
| | - Francesca Samoni
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Monica V. Talor
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Peter G. Matos
- Joint Munitions Command Surgeon, Joint Munitions Command Headquarters AMSJM-HRS, United States Army, Rock Island, Illinois
| | - Roberto Salvatori
- Division of Endocrinology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Noel R. Rose
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
- Department of Molecular Microbiology and Immunology, School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Patrizio Caturegli
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland
- Department of Molecular Microbiology and Immunology, School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Barin JG, Baldeviano GC, Talor MV, Wu L, Ong S, Quader F, Chen P, Zheng D, Caturegli P, Rose NR, Ciháková D. Macrophages participate in IL-17-mediated inflammation. Eur J Immunol 2012; 42:726-36. [PMID: 22161142 DOI: 10.1002/eji.201141737] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 11/07/2011] [Accepted: 11/30/2011] [Indexed: 12/14/2022]
Abstract
The involvement of macrophages (MΦs) in Th17-cell responses is still poorly understood. While neutrophils are thought to be the predominant effector of Th17-cell responses, IL-17 is also known to induce myelotropic chemokines and growth factors. Other T-cell-derived cytokines induce non-classical functions, suggesting that IL-17 sigxnaling may similarly elicit unique MΦ functions. Here, we characterized the expression of subunits of the IL-17 receptor on primary murine MΦs from different anatomical compartments. The greatest expression of IL-17 receptors was observed on mucosal Ly6C(hi) "inflammatory" MΦs. We further observed upregulation of IL-17 receptors in vitro on bone marrow-derived macrophages (BMMΦs) in response to peptidoglycan or CpG oligonucleotide stimuli, and in vivo, upon CFA administration. Macrophages expressing IL-17 receptors were observed infiltrating the hearts of mice with myocarditis, and genetic ablation of IL-17RA altered MΦ recruitment. Treating primary MΦs from a wide variety of different anatomic sources (as well as cell lines) with IL-17A induced the production of unique profiles of cytokines and chemokines, including GM-CSF, IL-3, IL-9, CCL4/MIP-1β and CCL5/RANTES. IL-17A also induced production of IL-12p70; IL-17-signaling-deficient MΦs elicited diminished IFN-γ production by responding DO11.10 CD4(+) T cells when used as APCs. These data indicate that MΦs from different anatomic locations direct IL-17-mediated responses.
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Affiliation(s)
- Jobert G Barin
- Training Program in Immunology, Johns Hopkins University School of Medicine, Boltimore, MD, USA.
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Abstract
INTRODUCTION Antibodies to thyroglobulin (Tg), thyroperoxidase (TPO), and TSH receptor (TSH-R) are prevalent in autoimmune thyroid diseases. We aimed to assess whether females with Graves disease or Hashimoto thyroiditis are more likely than age-matched controls to have thyroid antibodies before clinical diagnosis and to measure the timing of antibody seroconversion. METHODS This was a nested case-control study using the Department of Defense Serum Repository and the Defense Medical Surveillance System, 1998-2007. We assessed thyroid antibodies in the serum of 522 female, active-duty, military personnel including: 87 Graves disease cases, 87 Hashimoto thyroiditis cases, and 348 age matched controls. One serum sample was available at the time of the clinical diagnosis (±6 months); three additional samples were retrieved from the repository up to 7 yr before the clinical diagnosis, for a total of 2088 samples. RESULTS In Hashimoto thyroiditis, TPO antibodies were found in about 66% of the cases at all time points. Tg antibodies showed a similar stationary trend, at a lower prevalence of about 53%at all time points. No TSH-R antibodies were found. In Graves disease, TPO antibodies gradually increased from 31% at 5-7 yr prior to diagnosis to 57% at diagnosis and Tg antibodies from 18 to 47%. TSH-R antibodies were present before diagnosis and showed an increasing prevalence from 2, 7, 20, to 55%. CONCLUSIONS Antibodies to Tg, TPO, and TSH-R precede by years the development of the diagnostic autoimmune thyroid diseases phenotype. Overall, the presence of thyroid antibodies in apparently healthy individuals should not be neglected.
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Affiliation(s)
- Susan Hutfless
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland 21287, USA.
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Outschoorn IM, Talor MV, Hoffman WH, Rowley MJ, Mackay IR, Rose NR, Burek CL. Autoantibody heritability in thyroiditis: IgG subclass contributions. Autoimmunity 2010; 44:195-200. [PMID: 20883146 DOI: 10.3109/08916934.2010.515275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Using a simple screening technique called regression of offspring on mid-parent (ROMP) to examine the role of IgG subclasses in affected and unaffected siblings of children and adolescents with autoimmune thyroid disease and their parents, both total-restricted and subclass-restricted autoantibodies to thyroglobulin (Tg) were assayed quantitatively for each of the IgG subclasses. There was a significant correlation of anti-Tg titer of probands with parental titers in thyrotoxicosis (TT), (R(2) = 0.569, p = 0.001), but not in chronic lymphocytic thyroiditis. The most striking correlation was in TT patients of African-American ancestry, (R(2) = 0.9863, p = 0.0007). Additional insight is provided by examining the contributions of the IgG subclasses individually, particularly those whose concentrations appear not to have direct influence on the total IgG titers. Thus, using small numbers of patients, and assaying the IgG subclass distributions, as well as any other immunoglobulin isotypes that are significantly altered in autoantibody assays, ROMP can be performed rapidly to ascertain which quantifiable parameters may be usefully extended to predict disease onset and progression.
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Affiliation(s)
- Ingrid M Outschoorn
- Instituto de Salud Carlos III, Centro Nacional de Microbiologia, Unidad de Respuesta Inmune, Majadahonda, Madrid, Spain.
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Barin JG, Talor MV, Baldeviano GC, Kimura M, Rose NR, Ciháková D. Mechanisms of IFNγ regulation of autoimmune myocarditis. Exp Mol Pathol 2010; 89:83-91. [PMID: 20599938 DOI: 10.1016/j.yexmp.2010.06.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 06/25/2010] [Accepted: 06/04/2010] [Indexed: 12/21/2022]
Abstract
A protective effect of interferon-gamma (IFNγ) has been described in a number of models of autoimmune disease, including experimental autoimmune myocarditis (EAM). Some reports have suggested that regulation of apoptosis in autoreactive lymphocytes mediate these protective functions. We examined the potential of IFNγ to regulate apoptotic mechanisms in detail, both in vitro and in vivo in EAM. We observed multiple apoptotic defects in caspase activity, and the expression of TNF superfamily members on CD4(+) T cells. In addition, we observed selective defects in CD4(+) T cell activation in response to antigenic stimulation. These activation and apoptotic defects were CD4(+) cell autonomous, independent of the genotype of APCs. Inhibition of nitric oxide production in vivo did not reproduce the severe form of EAM of IFNγ-deficient mice, indicating that this pathway does not mediate the protective effect of IFNγ. Crosswise adoptive transfer of wild type, IFNγ(-/-), and IFNγR(-/-)EAM demonstrated that IFNγ signaling was critical in CD4(+) cells, but that non-CD4(+) sources of IFNγ production were also involved in the control of disease. Together, these data indicate multiple mechanisms of autonomous and non-autonomous CD4(+) T cell regulation mediated by IFNγ in the control of autoimmune heart disease.
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Affiliation(s)
- Jobert G Barin
- Training Program in Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Baldeviano GC, Barin JG, Talor MV, Srinivasan S, Bedja D, Zheng D, Gabrielson K, Iwakura Y, Rose NR, Cihakova D. Interleukin-17A is dispensable for myocarditis but essential for the progression to dilated cardiomyopathy. Circ Res 2010; 106:1646-55. [PMID: 20378858 DOI: 10.1161/circresaha.109.213157] [Citation(s) in RCA: 226] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
RATIONALE One-third of myocarditis cases progresses to dilated cardiomyopathy (DCM), but the mechanisms controlling this process are largely unknown. CD4(+) T helper (Th)17 cells have been implicated in the pathogenesis of autoimmune diseases, but the role of Th17-produced cytokines during inflammation-induced cardiac remodeling has not been previously studied. OBJECTIVE We examined the importance of interleukin (IL)-17A in the progression of myocarditis to DCM using a mouse model. METHODS AND RESULTS Immunization of mice with myocarditogenic peptide in complete Freund's adjuvant induced the infiltration of IL-17A-producing Th17 cells into the inflamed heart. Unexpectedly, IL-17A-deficient mice developed myocarditis with similar incidence and severity compared to wild-type mice. Additionally, IL-17A deficiency did not ameliorate the severe myocarditis of interferon (IFN)gamma-deficient mice, suggesting that IL-17A plays a minimal role during acute myocarditis. In contrast, IL-17A-deficient mice were protected from postmyocarditis remodeling and did not develop DCM. Flow cytometric and cytokine analysis revealed an important role for IL-17A in heart-specific upregulation of IL-6, TNFalpha, and IL-1beta and the recruitment of CD11b(+) monocyte and Gr1(+) granulocyte populations into the heart. Furthermore, IL-17A-deficient mice had reduced interstitial myocardial fibrosis, downregulated expression of matrix metalloproteinase-2 and -9 and decreased gelatinase activity. Treatment of BALB/c mice with anti-IL-17A monoclonal antibody administered after the onset of myocarditis abrogated myocarditis-induced cardiac fibrosis and preserved ventricular function. CONCLUSIONS Our findings reveal a critical role for IL-17A in postmyocarditis cardiac remodeling and the progression to DCM. Targeting IL-17A may be an attractive therapy for patients with inflammatory dilated cardiomyopathy.
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Affiliation(s)
- G Christian Baldeviano
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Wang GC, Talor MV, Rose NR, Cappola AR, Chiou RB, Weiss C, Walston JD, Fried LP, Caturegli P. Thyroid autoantibodies are associated with a reduced prevalence of frailty in community-dwelling older women. J Clin Endocrinol Metab 2010; 95:1161-8. [PMID: 20061418 PMCID: PMC2841533 DOI: 10.1210/jc.2009-1991] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
CONTEXT The contribution of autoimmunity to the multisystem dysregulation that characterizes the frailty syndrome in older adults is unknown. OBJECTIVE The aim of the study was to investigate the relationship between thyroid antibodies and frailty in older women. DESIGN, SETTING, AND PARTICIPANTS We conducted a cross-sectional study nested within the Women's Health and Aging Studies I and II. Thyroglobulin antibodies (TgAbs), thyroid peroxidase antibodies (TPOAbs), and antinuclear antibodies were measured in the baseline sera of 641 community-dwelling older women. MAIN OUTCOME MEASURE Frailty was defined using a validated five-component measure. RESULTS The prevalence of prefrailty and frailty was lower in TgAb-positive than negative older women (37.1 vs. 47.8% and 6.7 vs.11.9%, respectively; P = 0.01 and 0.03). The prevalence of prefrailty, but not frailty, was lower in TPOAb-positive than negative women (38.9 vs. 48.0% and 10.1 vs. 11.3%; P = 0.04 and 0.34). After adjustment for covariates including serum thyroid stimulation hormone concentration and thyroid medication usage in multinomial regression models, TgAb-positive older women had lower odds of prefrailty and frailty compared with TgAb-negative women (odds ratio 0.57 and 0.30; 95% confidence interval 0.34-0.98 and 0.10-0.85, respectively). Similarly, TPOAb-positive older women had lower odds of frailty compared with TPOAb-negative women (odds ratio 0.44; 95% confidence interval 0.20-0.96). These trends were not observed with antinuclear antibodies. CONCLUSION Independent of thyroid function status, community-dwelling older women who are seropositive for TgAbs and TPOAbs are less likely to be frail than seronegative women.
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Affiliation(s)
- George C Wang
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, 5505 Hopkins Bayview Circle, Baltimore, Maryland 21224, USA.
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Abstract
Sex differences in a NOD.H2(h4) murine model of Sjögren's syndrome were analyzed. Compared to males, female NOD.H2(h4) mice have increased severity of sialoadenitis and have a significantly increased percentage of CD4(+) T cells in salivary gland infiltrates. CD4(+) T cells in female infiltrates produce more Th2 and Th17 cytokines than in males, while males have greater Th1 responses. Females also have enhanced B cell responses, with higher levels of SSA and SSB serum antibodies, and B cell activation factor F (BAFF). Thus, sex has a strong impact on the severity of murine Sjögren's syndrome by affecting the immune mechanisms driving the autoimmune inflammation.
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Affiliation(s)
- Daniela Ciháková
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
Autoimmune thyroiditis is among the most prevalent of all the autoimmunities. Autoimmune thyroiditis is multifactorial with contributions from genetic and environmental factors. Much information has been published about the genetic predisposition to autoimmune thyroiditis both in experimental animals and humans. There is, in contrast, very little data on environmental agents that can serve as the trigger for autoimmunity in a genetically predisposed host. The best-established environmental factor is excess dietary iodine. Increased iodine consumption is strongly implicated as a trigger for thyroiditis, but only in genetically susceptible individuals. However, excess iodine is not the only environmental agent implicated as a trigger leading to autoimmune thyroiditis. There are a wide variety of other synthetic chemicals that affect the thyroid gland or have the ability to promote immune dysfunction in the host. These chemicals are released into the environment by design, such as in pesticides, or as a by-product of industry. Candidate pollutants include polyaromatic hydrocarbons, polybrominated biphenols, and polychlorinated biphenols, among others. Infections are also reputed to trigger autoimmunity and may act alone or in concert with environmental chemicals. We have utilized a unique animal model, the NOD.H2(h4) mouse to explore the influence of iodine and other environmental factors on autoimmune thyroiditis.
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Affiliation(s)
- C Lynne Burek
- Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.
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Wasserman EE, Nelson K, Rose NR, Rhode C, Pillion JP, Seaberg E, Talor MV, Burek L, Eaton W, Duggan A, Yolken RH. Infection and thyroid autoimmunity: A seroepidemiologic study of TPOaAb. Autoimmunity 2009; 42:439-46. [DOI: 10.1080/08916930902787716] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Njoku DB, Li Z, Washington ND, Mellerson JL, Talor MV, Sharma R, Rose NR. Suppressive and pro-inflammatory roles for IL-4 in the pathogenesis of experimental drug-induced liver injury. Eur J Immunol 2009; 39:1652-63. [PMID: 19499520 DOI: 10.1002/eji.200838135] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The pathogenesis of immune-mediated drug-induced liver injury (DILI) following halogenated anesthetics, carbamazepine or alcohol has not been fully elucidated. Detecting cytochrome P450 2E1 (CYP2E1) IgG4 auto-antibodies in anesthetic DILI patients suggests a role for IL-4 in this hapten-mediated process. We investigated IL-4-mediated mechanisms using our model of experimental DILI induced by immunizing BALB/c (WT) and IL-4(-/-) (KO) mice with S100 liver proteins covalently modified by a trifluoroacetyl chloride (TFA) hapten formed following halogenated anesthetic metabolism by CYP2E1. WT mice developed more hepatitis, TFA and S100 antibodies (p<0.01), as well as T-cell proliferation to CYP2E1 and TFA (p<0.01) than KO mice. Additionally, WT CD4(+) T cells adoptively transferred hepatitis to naïve Rag(-/-) mice (p<0.01). Pro-inflammatory cytokines were expectedly decreased in TFA hapten-stimulated KO splenocyte supernatants (p<0.001); however, IL-2 and IFN-gamma (p<0.05), as well as IL-6 and IL-10 (p<0.001) levels were elevated in CYP2E1-stimulated KO splenocyte supernatants, suggesting dual IL-4-mediated pro-inflammatory and regulatory responses. Anti-IL-10 administered to KO mice increased hepatitis, TFA and CYP2E1 antibodies in KO mice confirming a critical role for IL-4. This is the first demonstration of dual roles for IL-4 in the pathogenesis of immune-mediated DILI by suppressing auto-antigen-induced regulatory responses while promoting hapten-induced pro-inflammatory responses.
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Affiliation(s)
- Dolores B Njoku
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
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Chen CS, Sullivan S, Anderson T, Tan AC, Alex PJ, Brant SR, Cuffari C, Bayless TM, Talor MV, Burek CL, Wang H, Li R, Datta LW, Wu Y, Winslow RL, Zhu H, Li X. Identification of novel serological biomarkers for inflammatory bowel disease using Escherichia coli proteome chip. Mol Cell Proteomics 2009; 8:1765-76. [PMID: 19357087 DOI: 10.1074/mcp.m800593-mcp200] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Specific antimicrobial antibodies present in the sera of patients with inflammatory bowel disease (IBD) have been proven to be valuable serological biomarkers for diagnosis/prognosis of the disease. Herein we describe the use of a whole Escherichia coli proteome microarray as a novel high throughput proteomics approach to screen and identify new serological biomarkers for IBD. Each protein array, which contains 4,256 E. coli K12 proteins, was screened using individual serum from healthy controls (n = 39) and clinically well characterized patients with IBD (66 Crohn disease (CD) and 29 ulcerative colitis (UC)). Proteins that could be recognized by serum antibodies were visualized and quantified using Cy3-labeled goat anti-human antibodies. Surprisingly significance analysis of microarrays identified a total of 417 E. coli proteins that were differentially recognized by serum antibodies between healthy controls and CD or UC. Among those, 169 proteins were identified as highly immunogenic in healthy controls, 186 proteins were identified as highly immunogenic in CD, and only 19 were identified as highly immunogenic in UC. Using a supervised learning algorithm (k-top scoring pairs), we identified two sets of serum antibodies that were novel biomarkers for specifically distinguishing CD from healthy controls (accuracy, 86 +/- 4%; p < 0.01) and CD from UC (accuracy, 80 +/- 2%; p < 0.01), respectively. The Set 1 antibodies recognized three pairs of E. coli proteins: Era versus YbaN, YhgN versus FocA, and GabT versus YcdG, and the Set 2 antibodies recognized YidX versus FrvX. The specificity and sensitivity of Set 1 antibodies were 81 +/- 5 and 89 +/- 3%, respectively, whereas those of Set 2 antibodies were 84 +/- 1 and 70 +/- 6%, respectively. Serum antibodies identified for distinguishing healthy controls versus UC were only marginal because their accuracy, specificity, and sensitivity were 66 +/- 5, 69 +/- 5, and 61 +/- 7%, respectively (p < 0.04). Taken together, we identified novel sets of serological biomarkers for diagnosis of CD versus healthy control and CD versus UC.
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Affiliation(s)
- Chien-Sheng Chen
- Department of Pharmacology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
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Ligons DL, Talor MV, Rose NR, Cihakova D. Natural killer cells suppress autoimmune myocarditis in mice (48.23). The Journal of Immunology 2009. [DOI: 10.4049/jimmunol.182.supp.48.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Autoimmune myocarditis is induced by the adoptive immune response; however, there is evidence that the innate immune system plays a major role in modulating disease. Natural killer (NK) cells can function in early innate responses, as well affecting the later adaptive immune response. Depletion of NK cells has been shown to exacerbate the development of virus-induced myocarditis. We hypothesized that NK cells also modulate the virus-free model of myosin-induced experimental autoimmune myocarditis (EAM). To study the action of NK cells, we immunized BALB/c mice on days 0 and 7 with myocarditogenic peptide MyHC (614-629) in complete Freund adjuvant. The mice were treated with PBS, rabbit IgG or anti-asialo GM1 antibody every day for 6 days prior to the first immunization and every 2 days following day 0 until day 21. We found that depleting NK cells significantly increased the severity of disease, and serum antibodies specific to the myocarditogenic peptide. Splenic CD4+ T cells were significantly more activated in NK depleted mice compared to controls. Cytokine analysis of heart homogenates revealed a significant increase in eotaxin and IL-5 in the hearts of mice that were depleted of NK cells. Our data suggest that NK cells suppress the adoptive immune response and modulate eosinophil migration and T cell activation during EAM in mice.
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Affiliation(s)
| | | | - Noel R. Rose
- 1Pathology
- 2Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Medical Institutions, Baltimore, MD
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Njoku DB, Li Z, Mellerson JL, Sharma R, Talor MV, Barat N, Rose NR. IP-10 protects while MIP-2 promotes experimental anesthetic hapten - induced hepatitis. J Autoimmun 2009; 32:52-9. [PMID: 19131211 DOI: 10.1016/j.jaut.2008.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 11/06/2008] [Accepted: 11/07/2008] [Indexed: 01/01/2023]
Abstract
MIP-2 and IFN-gamma inducible protein-10 (IP-10) and their respective receptors, CXCR2 and CXCR3, modulate tissue inflammation by recruiting neutrophils or T cells from the spleen or bone marrow. Yet, how these chemokines modulate diseases such as immune-mediated drug-induced liver injury (DILI) is essentially unknown. To investigate how chemokines modulate experimental DILI in our model we used susceptible BALB/c (WT) and IL-4-/- (KO) mice that develop significantly reduced hepatitis and splenic T cell priming to anesthetic haptens and self proteins following TFA-S100 immunizations. We detected CXCR2+ splenic granulocytes in all mice two weeks following immunizations; by three weeks, MIP-2 levels (p<0.001) and GR1+ cells were elevated in WT livers, suggesting MIP-2-recruited granulocytes. Elevated splenic CXCR3+CD4+T cells were identified after two weeks in KO mice indicating elevated IP-10 levels which were confirmed during T cell priming. This result suggested that IP-10 reduced T cell priming to critical DILI antigens. Increased T cell proliferation following co-culture of TFA-S100-primed WT splenocytes with anti-IP-10 (p<0.05) confirmed that IP-10 reduced T cell priming to CYP2E1 and TFA. We propose that MIP-2 promotes and IP-10 protects against the development of hepatitis and T cell priming in this murine model.
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Affiliation(s)
- Dolores B Njoku
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
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48
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Cihakova D, Barin JG, Afanasyeva M, Kimura M, Fairweather D, Berg M, Talor MV, Baldeviano GC, Frisancho S, Gabrielson K, Bedja D, Rose NR. Interleukin-13 protects against experimental autoimmune myocarditis by regulating macrophage differentiation. Am J Pathol 2008; 172:1195-208. [PMID: 18403598 DOI: 10.2353/ajpath.2008.070207] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report here that interleukin (IL)-13 protects BALB/c mice from myocarditis, whether induced by peptide immunization or by viral infection. In contrast to mild disease in IL-4 knockout (KO) BALB/c mice, IL-13 KO BALB/c mice developed severe coxsackievirus B3 (CVB3)-induced autoimmune myocarditis and myocarditogenic peptide-induced experimental autoimmune myocarditis. Such severe disease was characterized by increased cardiac inflammation, increased total intracardiac CD45(+) leukocytes, elevated anti-cardiac myosin autoantibodies, and increased cardiac fibrosis. Echocardiography revealed that IL-13 KO mice developed severe dilated cardiomyopathy with impaired cardiac function and heart failure. Hearts of IL-13 KO mice had increased levels of the proinflammatory and profibrotic cytokines IL-1beta, IL-18, interferon-gamma, transforming growth factor-beta1, and IL-4 as well as histamine. The hallmark of the disease in IL-13 KO mice was the up-regulation of T-cell responses. CD4(+) T cells were increased in IL-13 KO hearts both proportionally and in absolute number. Splenic T cells from IL-13 KO mice were highly activated, and myosin stimulation additionally increased T-cell proliferation. CD4(+)CD25(+)Foxp3(+) regulatory T-cell numbers were decreased in the spleens of IL-13 KO mice. IL-13 deficiency led to decreased levels of alternatively activated CD206(+) and CD204(+) macrophages and increased levels of classically activated macrophages. IL-13 KO mice had increased caspase-1 activation, leading to increased production of both IL-1beta and IL-18. Therefore, IL-13 protects against myocarditis by modulating monocyte/macrophage populations and by regulating their function.
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Affiliation(s)
- Daniela Cihakova
- Johns Hopkins University, Department of Pathology, Division of Immunology, Ross 648, 720 Rutland Ave., Baltimore, MD 21205, USA.
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Wasserman EE, Nelson K, Rose NR, Eaton W, Pillion JP, Seaberg E, Talor MV, Burek L, Duggan A, Yolken RH. Maternal thyroid autoantibodies during the third trimester and hearing deficits in children: an epidemiologic assessment. Am J Epidemiol 2008; 167:701-10. [PMID: 18156602 DOI: 10.1093/aje/kwm342] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Elevated maternal thyroid autoantibodies during pregnancy are linked to infertility, miscarriage, and neurodevelopmental deficits such as in cognitive function. It has not been established whether autoantibodies to thyroid peroxidase are associated with sensorineural hearing loss (SNHL). The authors tested stored third-trimester maternal serum specimens of 1,736 children for thyroid peroxidase autoantibodies (TPOaAb) by using an enzyme-linked immunosorbent assay technique. The children participated at the Baltimore, Maryland, site of the Collaborative Perinatal Project, which enrolled pregnant women in 1959-1965. An audiology examination was administered to the children at 8 years of age and was used to identify cases of SNHL. Compared with 4.3% of the other children, 22.7% of the children whose mothers had elevated TPOaAb (> or =62.5 IU/ml) had SNHL. The difference was significant after controlling for maternal race, age, and hypothyroidism (exact prevalence odds ratio = 7.5, 95% confidence interval: 2.4, 23.3). When a lower cutoff of TPOaAb > or =31.25 IU/ml was used, there continued to be an association with SNHL (exact prevalence odds ratio = 5.7, 95% confidence interval: 2.1, 15.6). The direction and magnitude of the association were similar when an alternative case definition of SNHL was used. These data suggest that antenatal exposure to maternal TPOaAb during the third trimester of pregnancy is associated with impaired auditory development.
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Affiliation(s)
- Ellen E Wasserman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Li HS, Ligons DL, Guler ML, Talor MV, Cihakova D, Yagita H, Rose NR. Blockade of CD70 Exacerbates Experimental Autoimmune Myocarditis by Suppressing Regulatory T cells. FASEB J 2008. [DOI: 10.1096/fasebj.22.1_supplement.1073.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Haiyan S. Li
- ImmunopathologyJohns Hopkins UniversityBaltimoreMD
| | | | | | | | | | | | - Noel R. Rose
- ImmunopathologyJohns Hopkins UniversityBaltimoreMD
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