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Dinges SS, Amini K, Notarangelo LD, Delmonte OM. Primary and secondary defects of the thymus. Immunol Rev 2024; 322:178-211. [PMID: 38228406 PMCID: PMC10950553 DOI: 10.1111/imr.13306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
The thymus is the primary site of T-cell development, enabling generation, and selection of a diverse repertoire of T cells that recognize non-self, whilst remaining tolerant to self- antigens. Severe congenital disorders of thymic development (athymia) can be fatal if left untreated due to infections, and thymic tissue implantation is the only cure. While newborn screening for severe combined immune deficiency has allowed improved detection at birth of congenital athymia, thymic disorders acquired later in life are still underrecognized and assessing the quality of thymic function in such conditions remains a challenge. The thymus is sensitive to injury elicited from a variety of endogenous and exogenous factors, and its self-renewal capacity decreases with age. Secondary and age-related forms of thymic dysfunction may lead to an increased risk of infections, malignancy, and autoimmunity. Promising results have been obtained in preclinical models and clinical trials upon administration of soluble factors promoting thymic regeneration, but to date no therapy is approved for clinical use. In this review we provide a background on thymus development, function, and age-related involution. We discuss disease mechanisms, diagnostic, and therapeutic approaches for primary and secondary thymic defects.
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Affiliation(s)
- Sarah S. Dinges
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kayla Amini
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Luigi D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ottavia M. Delmonte
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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Christoph R, Giovanni A, Arne S, Sebastian V, Gerhard D, Angelika M, Marc S, Sonja H, Marie S, Lydia J, Michael F, Gerhardt H, Frank D, Martin A, Sonnleitner S, Walder G, Martin F, Martina P. Immunogenicity of tick-borne-encephalitis-virus-(TBEV)-vaccination and impact of age on humoral and cellular TBEV-specific immune responses in patients with rheumatoid arthritis. Vaccine 2024; 42:745-752. [PMID: 38242736 DOI: 10.1016/j.vaccine.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 01/21/2024]
Abstract
Inactivated vaccines, such as tick-borne-encephalitis-virus-(TBEV) vaccine, have been discussed as less immunogenic in elderly and in immunocompromised patients. In this controlled cross-sectional cohort study, the antibody and cellular responses after TBEV-vaccination were investigated in 36 rheumatoid arthritis (RA) patients and 112 healthy controls (HC) by evaluating IgG-anti-TBEV concentration, neutralization and relative avidity index (RAI). Cellular reactivity was assessed by IFNgamma-producing spot-forming-units (SFU) by ELISPOT assay and flow cytometry. RA patients showed lower IgG-anti-TBEV compared to HC, which were influenced by age at and time since last TBEV vaccination and disease duration. High-responders regarding cellular immunity and avidity were less frequent in RA compared to HC. RA patients who had received booster vaccinations were more likely to demonstrate higher IgG-anti-TBEV responses compared to those who had not. In conclusion, RA patients showed a negative effect of age on anti-TBEV-IgG and immunological benefits of timely booster vaccination are suggested.
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Affiliation(s)
- Rack Christoph
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Almanzar Giovanni
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Schäfer Arne
- Department of Internal Medicine II, Department of Rheumatology/Clinical Immunology, University of Würzburg, 97080 Würzburg, Germany; Diabetes Zentrum Mergengtheim, Bad Mergentheim, Germany
| | - Völkl Sebastian
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Dobler Gerhard
- Institut für Mikrobiologie der Bundeswehr, 80937 Munich, Germany
| | - Mutterer Angelika
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Schmalzing Marc
- Department of Internal Medicine II, Department of Rheumatology/Clinical Immunology, University of Würzburg, 97080 Würzburg, Germany
| | - Hick Sonja
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Steimer Marie
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Jahn Lydia
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Fladerer Michael
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Hartmann Gerhardt
- General Medical Practice Dr. Hartmann, Hauptstraße 34, 97204 Höchberg, Germany
| | - Deininger Frank
- Rheumatology Practice Dr. Deininger, Haugerpfarrgasse 7, 97070 Würzburg, Germany
| | - Arbogast Martin
- Center of Rheumatology and Orthopedics, Hubertusstraße 40, 82487 Oberammergau, Germany
| | - Sissy Sonnleitner
- Laboratory for Hygiene and Microbiology, 9931 Außervillgraten, Austria
| | - Gernot Walder
- Laboratory for Hygiene and Microbiology, 9931 Außervillgraten, Austria
| | - Feuchtenberger Martin
- Department of Internal Medicine II, Department of Rheumatology/Clinical Immunology, University of Würzburg, 97080 Würzburg, Germany; Department of Rheumatology, MED|BAYERN OST Medical Center Altötting Burghausen, Rheumatologie Krankenhausstraße 1, 84489 Burghausen, Germany
| | - Prelog Martina
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany.
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3
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Gudmundsdottir JA, Thorgeirsdottir S, Lundbäck V, Göngrich C, Lingman Framme J, Kindgren E, Rydenman K, Ludviksson BR, Bjarnadottir H, Runarsdottir S, Nilsson S, Zetterström RH, Ekwall O, Lindgren S. Normal neonatal TREC and KREC levels in early onset juvenile idiopathic arthritis. Clin Immunol 2023; 249:109277. [PMID: 36878420 DOI: 10.1016/j.clim.2023.109277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/18/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE Dysregulated central tolerance predisposes to autoimmune diseases. Reduced thymic output as well as compromised central B cell tolerance checkpoints have been proposed in the pathogenesis of juvenile idiopathic arthritis (JIA). The aim of this study was to investigate neonatal levels of T-cell receptor excision circles (TRECs) and kappa-deleting element excision circles (KRECs), as markers of T- and B-cell output at birth, in patients with early onset JIA. METHODS TRECs and KRECs were quantitated by multiplex qPCR from dried blood spots (DBS), collected 2-5 days after birth, in 156 children with early onset JIA and in 312 matched controls. RESULTS When analysed from neonatal dried blood spots, the median TREC level was 78 (IQR 55-113) in JIA cases and 88 (IQR 57-117) copies/well in controls. The median KREC level was 51 (IQR 35-69) and 53 (IQR 35-74) copies/well, in JIA cases and controls, respectively. Stratification by sex and age at disease onset did not reveal any difference in the levels of TRECs and KRECs. CONCLUSION T- and B-cell output at birth, as measured by TREC and KREC levels in neonatal dried blood spots, does not differ in children with early onset JIA compared to controls.
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Affiliation(s)
- Judith A Gudmundsdottir
- Children's Medical Center, Landspitali, The National University Hospital, Reykjavik, Iceland
| | - Sigridur Thorgeirsdottir
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Veroniqa Lundbäck
- Centre for Inherited Metabolic Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Christina Göngrich
- Centre for Inherited Metabolic Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Jenny Lingman Framme
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; The Department of Pediatrics, Halland Hospital Halmstad, Halmstad, Region Halland, Sweden
| | - Erik Kindgren
- Division of Pediatrics, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Pediatrics, Skaraborgs Hospital Skövde, Region Västra Götaland, Sweden
| | - Karin Rydenman
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Bjorn Runar Ludviksson
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Helga Bjarnadottir
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Saga Runarsdottir
- Department of Genetics and Molecular Medicine, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Staffan Nilsson
- Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Rolf H Zetterström
- Centre for Inherited Metabolic Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Olov Ekwall
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Susanne Lindgren
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
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4
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Patrick AE, Shoaff K, Esmond T, Patrick DM, Flaherty DK, Graham TB, Crooke PS, Thompson S, Aune TM. Increased Development of Th1, Th17, and Th1.17 Cells Under T1 Polarizing Conditions in Juvenile Idiopathic Arthritis. Front Immunol 2022; 13:848168. [PMID: 35860254 PMCID: PMC9290377 DOI: 10.3389/fimmu.2022.848168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/06/2022] [Indexed: 01/17/2023] Open
Abstract
In juvenile idiopathic arthritis (JIA) inflammatory T cells and their produced cytokines are drug targets and play a role in disease pathogenesis. Despite their clinical importance, the sources and types of inflammatory T cells involved remain unclear. T cells respond to polarizing factors to initiate types of immunity to fight infections, which include immunity types 1 (T1), 2 (T2), and 3 (T17). Polarizing factors drive CD4+ T cells towards T helper (Th) cell subtypes and CD8+ T cells towards cytotoxic T cell (Tc) subtypes. T1 and T17 polarization are associated with autoimmunity and production of the cytokines IFNγ and IL-17 respectively. We show that JIA and child healthy control (HC) peripheral blood mononuclear cells are remarkably similar, with the same frequencies of CD4+ and CD8+ naïve and memory T cell subsets, T cell proliferation, and CD4+ and CD8+ T cell subsets upon T1, T2, and T17 polarization. Yet, under T1 polarizing conditions JIA cells produced increased IFNγ and inappropriately produced IL-17. Under T17 polarizing conditions JIA T cells produced increased IL-17. Gene expression of IFNγ, IL-17, Tbet, and RORγT by quantitative PCR and RNA sequencing revealed activation of immune responses and inappropriate activation of IL-17 signaling pathways in JIA polarized T1 cells. The polarized JIA T1 cells were comprised of Th and Tc cells, with Th cells producing IFNγ (Th1), IL-17 (Th17), and both IFNγ-IL-17 (Th1.17) and Tc cells producing IFNγ (Tc1). The JIA polarized CD4+ T1 cells expressed both Tbet and RORγT, with higher expression of the transcription factors associated with higher frequency of IL-17 producing cells. T1 polarized naïve CD4+ cells from JIA also produced more IFNγ and more IL-17 than HC. We show that in JIA T1 polarization inappropriately generates Th1, Th17, and Th1.17 cells. Our data provides a tool for studying the development of heterogeneous inflammatory T cells in JIA under T1 polarizing conditions and for identifying pathogenic immune cells that are important as drug targets and diagnostic markers.
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Affiliation(s)
- Anna E. Patrick
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States,*Correspondence: Anna E. Patrick,
| | - Kayla Shoaff
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Tashawna Esmond
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - David M. Patrick
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States,Department of Veterans Affairs, Nashville, TN, United States
| | - David K. Flaherty
- Office of Research (OOR) Shared Resources Department, Vanderbilt University Medical Center, Nashville, TN, United States
| | - T Brent Graham
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Philip S. Crooke
- Department of Mathematics, Vanderbilt University, Nashville, TN, United States
| | - Susan Thompson
- Department of Pediatrics, Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Thomas M. Aune
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States,Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
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5
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Zaripova LN, Midgley A, Christmas SE, Beresford MW, Baildam EM, Oldershaw RA. Juvenile idiopathic arthritis: from aetiopathogenesis to therapeutic approaches. Pediatr Rheumatol Online J 2021; 19:135. [PMID: 34425842 PMCID: PMC8383464 DOI: 10.1186/s12969-021-00629-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/25/2021] [Indexed: 12/11/2022] Open
Abstract
Juvenile idiopathic arthritis (JIA) is the most common paediatric rheumatological disorder and is classified by subtype according to International League of Associations for Rheumatology criteria. Depending on the number of joints affected, presence of extra-articular manifestations, systemic symptoms, serology and genetic factors, JIA is divided into oligoarticular, polyarticular, systemic, psoriatic, enthesitis-related and undifferentiated arthritis. This review provides an overview of advances in understanding of JIA pathogenesis focusing on aetiology, histopathology, immunological changes associated with disease activity, and best treatment options. Greater understanding of JIA as a collective of complex inflammatory diseases is discussed within the context of therapeutic interventions, including traditional non-biologic and up-to-date biologic disease-modifying anti-rheumatic drugs. Whilst the advent of advanced therapeutics has improved clinical outcomes, a considerable number of patients remain unresponsive to treatment, emphasising the need for further understanding of disease progression and remission to support stratification of patients to treatment pathways.
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Affiliation(s)
- Lina N Zaripova
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK
| | - Angela Midgley
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, University Department, Liverpool Women's Hospital, First Floor, Crown Street, Liverpool, L8 7SS, UK
| | - Stephen E Christmas
- Department of Clinical Infection, Microbiology and Immunology, Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, The Ronald Ross Building, 8 West Derby Street, Liverpool, L69 7BE, UK
| | - Michael W Beresford
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, University Department, Liverpool Women's Hospital, First Floor, Crown Street, Liverpool, L8 7SS, UK
- Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, East Prescott Road, Liverpool, L14 5AB, UK
| | - Eileen M Baildam
- Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, East Prescott Road, Liverpool, L14 5AB, UK
| | - Rachel A Oldershaw
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, William Henry Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK.
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6
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Stojić-Vukanić Z, Pilipović I, Arsenović-Ranin N, Dimitrijević M, Leposavić G. Sex-specific remodeling of T-cell compartment with aging: Implications for rat susceptibility to central nervous system autoimmune diseases. Immunol Lett 2021; 239:42-59. [PMID: 34418487 DOI: 10.1016/j.imlet.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/12/2021] [Accepted: 08/12/2021] [Indexed: 11/15/2022]
Abstract
The incidence of multiple sclerosis (MS) and susceptibility of animals to experimental autoimmune encephalomyelitis (EAE), the most commonly used experimental model of MS, decrease with aging. Generally, autoimmune diseases develop as the ultimate outcome of an imbalance between damaging immune responses against self and regulatory immune responses (keeping the former under control). Thus, in this review the age-related changes possibly underlying this balance were discussed. Specifically, considering the central role of T cells in MS/EAE, the impact of aging on overall functional capacity (reflecting both overall count and individual functional cell properties) of self-reactive conventional T cells (Tcons) and FoxP3+ regulatory T cells (Tregs), as the most potent immunoregulatory/suppressive cells, was analyzed, as well. The analysis encompasses three distinct compartments: thymus (the primary lymphoid organ responsible for the elimination of self-reactive T cells - negative selection and the generation of Tregs, compensating for imperfections of the negative selection), peripheral blood/lymphoid tissues ("afferent" compartment), and brain/spinal cord tissues ("target" compartment). Given that the incidence of MS and susceptibility of animals to EAE are greater in women/females than in age-matched men/males, sex as independent variable was also considered. In conclusion, with aging, sex-specific alterations in the balance of self-reactive Tcons/Tregs are likely to occur not only in the thymus/"afferent" compartment, but also in the "target" compartment, reflecting multifaceted changes in both T-cell types. Their in depth understanding is important not only for envisaging effects of aging, but also for designing interventions to slow-down aging without any adverse effect on incidence of autoimmune diseases.
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Affiliation(s)
- Zorica Stojić-Vukanić
- Department of Microbiology and Immunology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Ivan Pilipović
- Immunology Research Centre "Branislav Janković", Institute of Virology, Vaccines and Sera "Torlak", Belgrade, Serbia
| | - Nevena Arsenović-Ranin
- Department of Microbiology and Immunology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Mirjana Dimitrijević
- Department of Immunology, University of Belgrade - Institute for Biological Research "Siniša Stanković" - National Institute of Republic of Serbia, Belgrade, Serbia
| | - Gordana Leposavić
- Department of Pathobiology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia.
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Fessler J, Fasching P, Raicht A, Hammerl S, Weber J, Lackner A, Hermann J, Dejaco C, Graninger WB, Schwinger W, Stradner MH. Lymphopenia in primary Sjögren's syndrome is associated with premature aging of naïve CD4+ T cells. Rheumatology (Oxford) 2021; 60:588-597. [PMID: 32227243 DOI: 10.1093/rheumatology/keaa105] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/13/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate peripheral lymphopenia, a frequent finding in primary Sjögren's syndrome (pSS) associated with higher disease activity and increased mortality. METHODS Prospective, cross-sectional study of consecutive patients with pSS (n = 66) and healthy controls (n = 181). Lymphocyte subsets were analysed by flow cytometry, naïve (CD45RA+) and memory (CD45RO+) CD4+ T cells were purified by MACS technology. In vitro proliferation and senescence-associated β-galactosidase (SABG) were assessed by flow cytometry. Telomere length and TCR excision circles (TREC) were measured by real-time PCR. Telomerase activity was analysed according to the telomeric repeat amplification protocols (TRAP). RESULTS In pSS, lymphopenia mainly affected naïve CD4+ T cells. We noted a lower frequency of proliferating naïve CD4+ T cells ex vivo and decreased homeostatic proliferation in response to IL-7 stimulation in vitro. Furthermore, naïve CD4+ T cells exhibited signs of immune cell aging including shortened telomeres, a reduction in IL-7R expression and accumulation of SABG. The senescent phenotype could be explained by telomerase insufficiency and drastically reduced levels of T-cell receptor excision circles (TRECs), indicating a history of extensive post-thymic cell division. TRECs correlated with the number of naïve CD4+ T cells linking the extend of earlier proliferation to the inability to sustain normal cell numbers. CONCLUSION In pSS, evidence for increased proliferation of naïve CD4+ T cells earlier in life is associated with a senescent phenotype unable to sustain homeostasis. The lack of naïve CD4+ T cells forms the basis of lymphopenia frequently observed in pSS.
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Affiliation(s)
- Johannes Fessler
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria.,Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Harvard, MA, USA
| | - Patrizia Fasching
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Andrea Raicht
- Department of Pediatric Hemato-Oncology, Medical University of Graz, Graz, Austria
| | - Sabrina Hammerl
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Jennifer Weber
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Angelika Lackner
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Josef Hermann
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Christian Dejaco
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria.,Servizio di Reumatologia, Azienda Sanitaria dell'Alto Adige, Ospedale di Brunico, Brunico, Italy
| | - Winfried B Graninger
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Wolfgang Schwinger
- Department of Pediatric Hemato-Oncology, Medical University of Graz, Graz, Austria
| | - Martin H Stradner
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
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8
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Lymphopenia, Lymphopenia-Induced Proliferation, and Autoimmunity. Int J Mol Sci 2021; 22:ijms22084152. [PMID: 33923792 PMCID: PMC8073364 DOI: 10.3390/ijms22084152] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023] Open
Abstract
Immune homeostasis is a tightly regulated system that is critical for defense against invasion by foreign pathogens and protection from self-reactivity for the survival of an individual. How the defects in this system might result in autoimmunity is discussed in this review. Reduced lymphocyte number, termed lymphopenia, can mediate lymphopenia-induced proliferation (LIP) to maintain peripheral lymphocyte numbers. LIP not only occurs in normal physiological conditions but also correlates with autoimmunity. Of note, lymphopenia is also a typical marker of immune aging, consistent with the fact that not only the autoimmunity increases in the elderly, but also autoimmune diseases (ADs) show characteristics of immune aging. Here, we discuss the types and rates of LIP in normal and autoimmune conditions, as well as the coronavirus disease 2019 in the context of LIP. Importantly, although the causative role of LIP has been demonstrated in the development of type 1 diabetes and rheumatoid arthritis, a two-hit model has suggested that the factors other than lymphopenia are required to mediate the loss of control over homeostasis to result in ADs. Interestingly, these factors may be, if not totally, related to the function/number of regulatory T cells which are key modulators to protect from self-reactivity. In this review, we summarize the important roles of lymphopenia/LIP and the Treg cells in various autoimmune conditions, thereby highlighting them as key therapeutic targets for autoimmunity treatments.
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9
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Cao M, Ruan L, Huang Y, Wang J, Yan J, Sang Y, Li S, Wang G, Wu X. Premature CD4 + T Cells Senescence Induced by Chronic Infection in Patients with Acute Coronary Syndrome. Aging Dis 2020; 11:1471-1480. [PMID: 33269101 PMCID: PMC7673853 DOI: 10.14336/ad.2020.0203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 02/03/2020] [Indexed: 01/10/2023] Open
Abstract
Acquired immune responses mediated by CD4+ T cells contribute to the initiation and progression of acute coronary syndrome (ACS). ACS patients show acquired immune system abnormalities that resemble the characteristics of autoimmune dysfunction described in the elderly. This study aimed to investigate the role of premature CD4+ T cells senescence in ACS and the underlying mechanism. We compared the immunological status of 25 ACS patients, 15 young healthy individuals (C1), and 20 elderly individuals with absence of ACS (C2). The percentages of CD4+ T lymphocyte subsets (including naïve, regulatory, memory and effector T cells) in peripheral blood were analyzed. In ACS patients, a significant expansion of CD4+CD28null effector T cells and a decline of CD4+CD25+CD62L+Treg cells were observed. In addition, patients with ACS showed an accelerated loss of CD4+CD45RA+CD62L+ naïve T cells and a compensatory increase in the number of CD4+CD45RO+ memory T cells. ACS patients demonstrated no significant difference in frequency of T cell receptor excision circles (TRECs) compared to age-matched healthy volunteers. The expression of p16Ink4a was increased while CD62L was decreased in CD4+CD28null T cells of ACS patients. Compared to healthy donors, ACS patients demonstrated the lowest telomerase activity in both CD4+CD28+and CD4+CD28null T cells. The serum levels of C-reactive protein, Cytomegalovirus IgG, Helicobactor pylori IgG and Chlamydia pneumonia IgG were significantly higher in ACS patients. The results suggested that the percentage of CD4+ T cell subpopulations correlated with chronic infection, which contributes to immunosenescence. In conclusion, chronic infection induced senescence of premature CD4+T cells, which may be responsible for the development of ACS.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Xiaofen Wu
- Department of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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10
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Kwok CHT, Learoyd AE, Canet-Pons J, Trang T, Fitzgerald M. Spinal interleukin-6 contributes to central sensitisation and persistent pain hypersensitivity in a model of juvenile idiopathic arthritis. Brain Behav Immun 2020; 90:145-154. [PMID: 32791212 PMCID: PMC7575902 DOI: 10.1016/j.bbi.2020.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/27/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022] Open
Abstract
Pain is the most debilitating symptom in juvenile idiopathic arthritis. As pain correlates poorly to the extent of joint pathology, therapies that control joint inflammation are often inadequate as analgesics. We test the hypothesis that juvenile joint inflammation leads to sensitisation of nociceptive circuits in the central nervous system, which is maintained by cytokine expression in the spinal cord. Here, transient joint inflammation was induced in postnatal day (P)21 and P40 male Sprague-Dawley rats with a single intra-articular ankle injection of complete Freund's adjuvant. Hindpaw mechanical pain sensitivity was assessed using von Frey hair and weight bearing tests. Spinal neuron activity was measured using in vivo extracellular recording and immunohistochemistry. Joint and spinal dorsal horn TNFα, IL1β and IL6 protein expression was quantified using western blotting. We observed greater mechanical hyperalgesia following joint inflammation in P21 compared to P40 rats, despite comparable duration of swelling and joint inflammatory cytokine levels. This is mirrored by spinal neuron hypersensitivity, which also outlasted the duration of active joint inflammation. The cytokine profile in the spinal cord differed at the two ages: prolonged upregulation of spinal IL6 was observed in P21, but not P40 rats. Finally, spinal application of anti-IL-6 antibody (30 ng) reduced the mechanical hyperalgesia and neuronal activation. Our results indicate that persistent upregulation of pro-inflammatory cytokines in the spinal dorsal horn is associated with neuronal sensitisation and mechanical hyperalgesia in juvenile rats, beyond the progress of joint pathology. In addition, we provide proof of concept that spinal IL6 is a key target for treating persistent pain in JIA.
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Affiliation(s)
- Charlie H T Kwok
- Physiology and Pharmacology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Annastazia E Learoyd
- Department of Neuroscience, Physiology and Pharmacology, University College London, UK
| | - Julia Canet-Pons
- Physiology and Pharmacology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tuan Trang
- Physiology and Pharmacology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Comparative Biology and Experimental Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Maria Fitzgerald
- Department of Neuroscience, Physiology and Pharmacology, University College London, UK
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11
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Zahran AM, Abdallah AM, Saad K, Osman NS, Youssef MAM, Abdel-Raheem YF, Elsayh KI, Abo Elgheet AM, Darwish SF, Alblihed MA, Elhoufey A. Peripheral Blood B and T Cell Profiles in Children with Active Juvenile Idiopathic Arthritis. Arch Immunol Ther Exp (Warsz) 2019; 67:427-432. [PMID: 31535168 DOI: 10.1007/s00005-019-00560-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/09/2019] [Indexed: 02/07/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is one of the most common autoimmune diseases in children. Our study aimed to evaluate the peripheral blood B and T lymphocyte subpopulations in children with JIA. This case-control study included 20 children with JIA as well as 20 healthy children with matching age and sex as a control group. All patients included in the study were in activity as determined by visual analog scale. In addition to complete clinical evaluation, basic investigations, peripheral blood B and T lymphocyte subpopulations were done to all participants by flow cytometry. JIA patients displayed a significant decrease in IgM memory B lymphocytes, switched memory B lymphocytes, and total memory B lymphocytes when compared to the healthy controls. The percentages of naïve B lymphocytes were significantly increased in JIA patients than in controls. Total T lymphocytes, CD8+CD28null cells, and CD4+CD28null cells were significantly increased in JIA patients as compared to controls. In conclusion; JIA patients have an alteration in both B and T lymphocytes with the predisposition of memory cells which may have a role in sustaining the JIA disease activity.
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Affiliation(s)
- Asmaa M Zahran
- Department of Clinical Pathology, South Egypt Cancer Institute, Assiut, Egypt
| | - Alameldin M Abdallah
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | - Khaled Saad
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.
| | - Naglaa S Osman
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | - Mervat A M Youssef
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | | | - Khalid I Elsayh
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | - Amir M Abo Elgheet
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | - Sanaa F Darwish
- Department of Microbiology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Mohamd A Alblihed
- Department of Medical Biochemistry, School of Medicine Taif University, Taif, Kingdom of Saudi Arabia
| | - Amira Elhoufey
- Department of Community Health Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt
- Department of Community Health Nursing, Sabia University College, Jazan University, Jazan, Kingdom of Saudi Arabia
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12
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Nacka-Aleksić M, Stojanović M, Pilipović I, Stojić-Vukanić Z, Kosec D, Leposavić G. Strain differences in thymic atrophy in rats immunized for EAE correlate with the clinical outcome of immunization. PLoS One 2018; 13:e0201848. [PMID: 30086167 PMCID: PMC6080797 DOI: 10.1371/journal.pone.0201848] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/22/2018] [Indexed: 01/03/2023] Open
Abstract
An accumulating body of evidence suggests that development of autoimmune pathologies leads to thymic dysfunction and changes in peripheral T-cell compartment, which, in turn, perpetuate their pathogenesis. To test this hypothesis, thymocyte differentiation/maturation in rats susceptible (Dark Agouti, DA) and relatively resistant (Albino Oxford, AO) to experimental autoimmune encephalomyelitis (EAE) induction was examined. Irrespective of strain, immunization for EAE (i) increased the circulating levels of IL-6, a cytokine causally linked with thymic atrophy, and (ii) led to thymic atrophy reflecting partly enhanced thymocyte apoptosis associated with downregulated thymic IL-7 expression. Additionally, immunization diminished the expression of Thy-1, a negative regulator of TCRαβ-mediated signaling and activation thresholds, on CD4+CD8+ TCRαβlo/hi thymocytes undergoing selection and thereby impaired thymocyte selection/survival. This diminished the generation of mature CD4+ and CD8+ single positive TCRαβhi thymocytes and, consequently, CD4+ and CD8+ recent thymic emigrants. In immunized rats, thymic differentiation of natural regulatory CD4+Foxp3+CD25+ T cells (nTregs) was particularly affected reflecting a diminished expression of IL-7, IL-2 and IL-15. The decline in the overall thymic T-cell output and nTreg generation was more pronounced in DA than AO rats. Additionally, differently from immunized AO rats, in DA ones the frequency of CD28- cells secreting cytolytic enzymes within peripheral blood CD4+ T lymphocytes increased, as a consequence of thymic atrophy-related replicative stress (mirrored in CD4+ cell memory pool expansion and p16INK4a accumulation). The higher circulating level of TNF-α in DA compared with AO rats could also contribute to this difference. Consistently, higher frequency of cytolytic CD4+ granzyme B+ cells (associated with greater tissue damage) was found in spinal cord of immunized DA rats compared with their AO counterparts. In conclusion, the study indicated that strain differences in immunization-induced changes in thymopoiesis and peripheral CD4+CD28- T-cell generation could contribute to rat strain-specific clinical outcomes of immunization for EAE.
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Affiliation(s)
- Mirjana Nacka-Aleksić
- Department of Physiology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Marija Stojanović
- Department of Physiology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Ivan Pilipović
- Immunology Research Centre “Branislav Janković”, Institute of Virology, Vaccines and Sera “Torlak”, Belgrade, Serbia
| | - Zorica Stojić-Vukanić
- Department of Microbiology and Immunology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Duško Kosec
- Immunology Research Centre “Branislav Janković”, Institute of Virology, Vaccines and Sera “Torlak”, Belgrade, Serbia
| | - Gordana Leposavić
- Department of Physiology, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
- * E-mail:
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The influence and impact of ageing and immunosenescence (ISC) on adaptive immunity during multiple sclerosis (MS) and the animal counterpart experimental autoimmune encephalomyelitis (EAE). Ageing Res Rev 2018; 41:64-81. [PMID: 29101043 DOI: 10.1016/j.arr.2017.10.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/23/2017] [Accepted: 10/25/2017] [Indexed: 12/21/2022]
Abstract
The human ageing process encompasses mechanisms that effect a decline in homeostasis with increased susceptibility to disease and the development of chronic life-threatening illness. Increasing age affects the immune system which undergoes a progressive loss of efficiency, termed immunosenescence (ISC), to impact on quantitative and functional aspects of innate and adaptive immunity. The human demyelinating disease multiple sclerosis (MS) and the corresponding animal model experimental autoimmune encephalomyelitis (EAE) are strongly governed by immunological events that primarily involve the adaptive arm of the immune response. MS and EAE are frequently characterised by a chronic pathology and a protracted disease course which thereby creates the potential for exposure to the inherent, on-going effects and consequences of ISC. Collective evidence is presented to confirm the occurrence of established and unendorsed biological markers of ISC during the development of both diseases. Moreover, results are discussed from studies during the course of MS and EAE that reveal a premature upregulation of ISC-related biomarkers which indicates untimely alterations to the adaptive immune system. The effects of ISC and a prematurely aged immune system on autoimmune-associated neurodegenerative conditions such as MS and EAE are largely unknown but current evaluation of data justifies and encourages further investigation.
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Jose SS, Bendickova K, Kepak T, Krenova Z, Fric J. Chronic Inflammation in Immune Aging: Role of Pattern Recognition Receptor Crosstalk with the Telomere Complex? Front Immunol 2017; 8:1078. [PMID: 28928745 PMCID: PMC5591428 DOI: 10.3389/fimmu.2017.01078] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/18/2017] [Indexed: 12/22/2022] Open
Abstract
Age-related decline in immunity is characterized by stem cell exhaustion, telomere shortening, and disruption of cell-to-cell communication, leading to increased patient risk of disease. Recent data have demonstrated that chronic inflammation exerts a strong influence on immune aging and is closely correlated with telomere length in a range of major pathologies. The current review discusses the impact of inflammation on immune aging, the likely molecular mediators of this process, and the various disease states that have been linked with immunosenescence. Emerging findings implicate NF-κB, the major driver of inflammatory signaling, in several processes that regulate telomere maintenance and/or telomerase activity. While prolonged triggering of pattern recognition receptors is now known to promote immunosenescence, it remains unclear how this process is linked with the telomere complex or telomerase activity. Indeed, enzymatic control of telomere length has been studied for many decades, but alternative roles of telomerase and potential influences on inflammatory responses are only now beginning to emerge. Crosstalk between these pathways may prove to be a key molecular mechanism of immunosenescence. Understanding how components of immune aging interact and modify host protection against pathogens and tumors will be essential for the design of new vaccines and therapies for a wide range of clinical scenarios.
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Affiliation(s)
- Shyam Sushama Jose
- Cellular and Molecular Immunoregulation Group (CMI), Center for Translational Medicine (CTM), International Clinical Research Center (ICRC), St. Anne’s University Hospital Brno, Brno, Czechia
- Department of Biology, Faculty of Medicine, Masaryk University, Czechia
| | - Kamila Bendickova
- Cellular and Molecular Immunoregulation Group (CMI), Center for Translational Medicine (CTM), International Clinical Research Center (ICRC), St. Anne’s University Hospital Brno, Brno, Czechia
| | - Tomas Kepak
- Pediatric Oncology Translational Research (POTR), International Clinical Research Center (ICRC), St. Anne’s University Hospital Brno, Brno, Czechia
- Pediatric Hematology and Oncology, University Hospital Brno, Brno, Czechia
| | - Zdenka Krenova
- Pediatric Oncology Translational Research (POTR), International Clinical Research Center (ICRC), St. Anne’s University Hospital Brno, Brno, Czechia
- Pediatric Hematology and Oncology, University Hospital Brno, Brno, Czechia
| | - Jan Fric
- Cellular and Molecular Immunoregulation Group (CMI), Center for Translational Medicine (CTM), International Clinical Research Center (ICRC), St. Anne’s University Hospital Brno, Brno, Czechia
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15
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Picarelli MM, Danzmann LC, Grun LK, Júnior NTR, Lavandovsky P, Guma FTCR, Stein RT, Barbé-Tuana F, Jones MH. Arterial stiffness by oscillometric device and telomere lenght in juvenile idiopathic artrhitis with no cardiovascular risk factors: a cross-sectional study. Pediatr Rheumatol Online J 2017; 15:34. [PMID: 28472973 PMCID: PMC5418721 DOI: 10.1186/s12969-017-0165-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 04/20/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Advances in juvenile idiopathic arthritis (JIA) treatment is promoting free disease survival. Cardiovascular disease (CVD) may emerge as an important cause of morbidity and mortality. Pulse wave velocity (PWV), a surrogate marker of arterial stiffness, and telomere length (TL) are considered as potential predictors of CVD and its outcomes. The study aim was to assess PWV, TL in a JIA population and to test its correlation. In a cross sectional study, 24 JIA patients, 21 controls for TL and 20 controls for PWV were included. PWV was assessed by an oscillometric device. TL was assessed by qPCR. JIA activity was accessed by JADAS-27. Smoking, diabetes, obesity, renal impairment, hypertension, dyslipidemia and inflammatory diseases were excluded. FINDINGS Between cases and controls for TL, there was significant difference in age. No differences in gender, ethnics and bone mass index between JIA and control groups for PWV and TL. The JADAS-27 median was 8. TL was significantly reduced in JIA (0.85 ± 0.34 vs. 1. 67 ± 1.38, P = 0.025). When age adjusted by ANCOVA, the difference remained significant (P = 0,032). PWV was normal in all patients (5.1 ± 0.20 m/s vs. 4.98 ± 0.06 m/s, P = 0, 66). There was no correlation between TL, PWV or JADAS-27. CONCLUSION Compared to controls, JIA with high disease activity and no CVD risk factors have shorter telomeres and normal PWV. As far as we know, this first time this correlation is being tested in rheumatic disease and in paediatrics.
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Affiliation(s)
- Maria Mercedes Picarelli
- Rheumatology Department, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Ipiranga Avenue, 6690/220, Porto Alegre, 90610 000, Brazil.
| | | | - Lucas Kich Grun
- 0000 0001 2200 7498grid.8532.cUniversidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Patrícia Lavandovsky
- 0000 0001 2200 7498grid.8532.cUniversidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Renato T. Stein
- 0000 0001 2198 7041grid.411379.9Rheumatology Department, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Ipiranga Avenue, 6690/220, Porto Alegre, 90610 000 Brazil
| | - Florência Barbé-Tuana
- 0000 0001 2200 7498grid.8532.cUniversidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcus Herbert Jones
- 0000 0001 2198 7041grid.411379.9Rheumatology Department, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Ipiranga Avenue, 6690/220, Porto Alegre, 90610 000 Brazil
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16
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Pasini AM, Gagro A, Roić G, Vrdoljak O, Lujić L, Žutelija-Fattorini M. Ataxia Telangiectasia and Juvenile Idiopathic Arthritis. Pediatrics 2017; 139:peds.2016-1279. [PMID: 28082406 DOI: 10.1542/peds.2016-1279] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2016] [Indexed: 11/24/2022] Open
Abstract
We report, to the best of our knowledge, the first case of a child with typical ataxia telangiectasia (A-T) who developed juvenile idiopathic arthritis (JIA). The patient was a 15-year-old boy with A-T who presented with noninfectious polyarthritis. A-T is a rare, autosomal recessive disorder characterized by cerebellar atrophy, oculocutaneous telangiectasia, immunodeficiency, radiosensitivity, and predisposition to cancer. The gene responsible for A-T is the A-T mutated (ATM) gene. Clinical manifestations of the disorder are the result of lacking ATM protein, which is involved in DNA repair, apoptosis, various checkpoints in the cell cycle, gene regulation, translation, initiation, and telomere maintenance. There are a few articles that describe deficiency of the DNA repair enzyme, ATM, in rheumatoid arthritis, but the connection between the absence of ATM protein and JIA has not been presented or studied yet. JIA is a heterogeneous group of diseases characterized by arthritis of unknown origin with onset before the age of 16 years. It is the most common childhood chronic rheumatic disease and causes significant disability. Because immunodeficiency can be part of A-T, infectious arthritis can occur, but chronic autoimmune arthritis in these patients is rare. We report a rare case of a 15-year-old boy with A-T and JIA. This case shows a possible relationship between altered function of ATM protein and the pathogenesis of JIA.
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Affiliation(s)
| | | | - Goran Roić
- Children's Hospital Zagreb, Zagreb, Croatia
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17
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Holder A, Mella S, Palmer DB, Aspinall R, Catchpole B. An Age-Associated Decline in Thymic Output Differs in Dog Breeds According to Their Longevity. PLoS One 2016; 11:e0165968. [PMID: 27824893 PMCID: PMC5100965 DOI: 10.1371/journal.pone.0165968] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/20/2016] [Indexed: 01/08/2023] Open
Abstract
The age associated decline in immune function is preceded in mammals by a reduction in thymic output. Furthermore, there is increasing evidence of a link between immune competence and lifespan. One approach to determining thymic output is to quantify signal joint T cell receptor excision circles (sj-TRECs), a method which has been developed and used in several mammalian species. Life expectancy and the rate of aging vary in dogs depending upon their breed. In this study, we quantified sj-TRECs in blood samples from dogs of selected breeds to determine whether there was a relationship between longevity and thymic output. In Labrador retrievers, a breed with a median expected lifespan of 11 years, there was an age-associated decline in sj-TREC values, with the greatest decline occurring before 5 years of age, but with sj-TREC still detectable in some geriatric animals, over 13 years of age. In large short-lived breeds (Burnese mountain dogs, Great Danes and Dogue de Bordeaux), the decline in sj-TREC values began earlier in life, compared with small long-lived breeds (Jack Russell terriers and Yorkshire terriers), and the presence of animals with undetectable sj-TRECs occurred at a younger age in the short-lived breeds. The study findings suggest that age-associated changes in canine sj-TRECs are related to breed differences in longevity, and this research highlights the use of dogs as a potential model of immunosenescence.
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Affiliation(s)
- Angela Holder
- Department of Pathology and Pathogen Biology, Royal Veterinary College, North Mymms, Hertfordshire, United Kingdom
| | - Stephanie Mella
- Department of Pathology and Pathogen Biology, Royal Veterinary College, North Mymms, Hertfordshire, United Kingdom
| | - Donald B. Palmer
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
| | - Richard Aspinall
- Health and Wellbeing Academy, Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, Essex, United Kingdom
| | - Brian Catchpole
- Department of Pathology and Pathogen Biology, Royal Veterinary College, North Mymms, Hertfordshire, United Kingdom
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18
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Klein M, Schmalzing M, Almanzar G, Benoit S, Hamm H, Tony HP, Goebeler M, Prelog M. Contribution of CD8+ T cells to inflammatory cytokine production in systemic sclerosis (SSc). Autoimmunity 2016; 49:532-546. [PMID: 27560622 DOI: 10.1080/08916934.2016.1217997] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Only limited attention has been paid to the role of CD8 + T cells in the etiopathogenesis and progression of systemic sclerosis (SSc). CD8 + T cells may have autoantigen-specific and pro-inflammatory but also immunomodulatory properties. To investigate the differentiation of CD8 + T cells, staining of cell surface factors and of chemokine receptors were performed. In addition, the cytokine-producing ability of circulating CD8 + T cells and their sensitivity to suppression by regulatory T cells (Tregs) were compared between patients with diffuse (dcSSc) or limited cutaneous SSc (lcSSc) and healthy individuals. We identified CD8 + T cells as producers of pro-inflammatory type-2 cytokines with a significant contribution of memory CD8 + T cells. Memory CD8 + T cells of SSc patients stayed unaltered after suppression with autologous Tregs. Expression of chemokine receptors was significantly correlated with intracellular cytokine production in CD8 + T cells with a clear dichotomy of type 1 and type 2 cytokines. High levels of intracellular cytokines, such as interleukin-(IL)-4, IL-13 and tumor-necrosis-factor-alpha (TNFalpha) were positively associated with the presence of Scl-70 or anti-centromere antibodies and negatively with the administration of glucocorticoids. Administration of glucocorticoids was positively associated with higher IFNgamma production. Lack of anti-centromere antibodies and therapy with methotrexate were positively associated with higher intracellular IL-10 production. CD8 + T cells may significantly contribute to inflammation in SSc. Our findings suggest to not only focus on T helper cells in the development of therapeutic strategies but also to consider the role of CD8 + T cells in the etiopathogenesis and perpetuation of SSc.
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Affiliation(s)
- Matthias Klein
- a Department of Pediatrics, Pediatric Rheumatology and Special Immunology , University Hospital Wuerzburg , Wuerzburg , Germany
| | - Marc Schmalzing
- b Department of Internal Medicine II, Division of Rheumatology and Clinical Immunology , University Hospital Wuerzburg , Wuerzburg , Germany , and
| | - Giovanni Almanzar
- a Department of Pediatrics, Pediatric Rheumatology and Special Immunology , University Hospital Wuerzburg , Wuerzburg , Germany
| | - Sandrine Benoit
- c Department of Dermatology, Venereology and Allergology , University Hospital Wuerzburg , Wuerzburg , Germany
| | - Henning Hamm
- c Department of Dermatology, Venereology and Allergology , University Hospital Wuerzburg , Wuerzburg , Germany
| | - Hans-Peter Tony
- b Department of Internal Medicine II, Division of Rheumatology and Clinical Immunology , University Hospital Wuerzburg , Wuerzburg , Germany , and
| | - Matthias Goebeler
- c Department of Dermatology, Venereology and Allergology , University Hospital Wuerzburg , Wuerzburg , Germany
| | - Martina Prelog
- a Department of Pediatrics, Pediatric Rheumatology and Special Immunology , University Hospital Wuerzburg , Wuerzburg , Germany
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19
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Prelog M, Hilligardt D, Schmidt CA, Przybylski GK, Leierer J, Almanzar G, El Hajj N, Lesch KP, Arolt V, Zwanzger P, Haaf T, Domschke K. Hypermethylation of FOXP3 Promoter and Premature Aging of the Immune System in Female Patients with Panic Disorder? PLoS One 2016; 11:e0157930. [PMID: 27362416 PMCID: PMC4928917 DOI: 10.1371/journal.pone.0157930] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/07/2016] [Indexed: 02/02/2023] Open
Abstract
Immunological abnormalities associated with pathological conditions, such as higher infection rates, inflammatory diseases, cancer or cardiovascular events are common in patients with panic disorder. In the present study, T cell receptor excision circles (TRECs), Forkhead-Box-Protein P3 gene (FOXP3) methylation of regulatory T cells (Tregs) and relative telomere lengths (RTLs) were investigated in a total and subsamples of 131 patients with panic disorder as compared to 131 age- and sex-matched healthy controls in order to test for a potential dysfunction and premature aging of the immune system in anxiety disorders. Significantly lower TRECs (p = 0.004) as well as significant hypermethylation of the FOXP3 promoter region (p = 0.005) were observed in female (but not in male) patients with panic disorder as compared to healthy controls. No difference in relative telomere length was discerned between patients and controls, but significantly shorter telomeres in females, smokers and older persons within the patient group. The presently observed reduced TRECs in panic disorder patients and FOXP3 hypermethylation in female patients with panic disorder potentially reflect impaired thymus and immunosuppressive Treg function, which might partly account for the known increased morbidity and mortality of anxiety disorders conferred by e.g. cancer and cardiovascular disorders.
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Affiliation(s)
- Martina Prelog
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Deborah Hilligardt
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | | | - Grzegorz K. Przybylski
- Clinic for Internal Medicine C, University of Greifswald, Greifswald, Germany
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Johannes Leierer
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Giovanni Almanzar
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Nady El Hajj
- Institute of Human Genetics, University of Wuerzburg, Wuerzburg, Germany
| | - Klaus-Peter Lesch
- Molecular Psychiatry, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
| | - Peter Zwanzger
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universtät Munich, Munich, Germany
- kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Germany
| | - Thomas Haaf
- Institute of Human Genetics, University of Wuerzburg, Wuerzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany
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20
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Almanzar G, Schmalzing M, Trippen R, Höfner K, Weißbrich B, Geissinger E, Meyer T, Liese J, Tony HP, Prelog M. Significant IFNγ responses of CD8+ T cells in CMV-seropositive individuals with autoimmune arthritis. J Clin Virol 2016; 77:77-84. [PMID: 26921739 DOI: 10.1016/j.jcv.2016.02.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/27/2016] [Accepted: 02/16/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Latent Cytomegalovirus (CMV) infection accelerates immunosenescence in elderly with reactivations reported in Rheumatoid Arthritis (RA) and abnormal responses towards CMV in Juvenile Idiopathic Arthritis (JIA). OBJECTIVES Considering the signs of premature T-cell immunosenescence in arthritis patients, the known effect of CMV latency on speeding up many of these signs in an age-dependent manner and the role of CMV on IFNγ-mediated inflammation in healthy elderly and RA, we hypothesized that latent CMV infection accelerates TCR repertoire restriction, loss of CD28, peripheral T-cell proliferation and aberrant IFNγ responses in arthritis patients. STUDY DESIGN Unspecific and CMVpp65-specific IFNγ responses were investigated in peripheral CD8+ T-cells in RA or JIA patients and healthy, age-matched controls. RESULTS Despite higher prevalence and concentrations of IgG-anti-CMV, arthritis patients showed lower unspecific IFNγ production, lower CD69-mediated activation and lower CD8+ T-cell proliferation. CMV-seropositive RA patients showed higher intracellular IFNγ production and increased proportions of CD28-CD8+ T-cells after specific CMVpp65 long-term stimulation which was not altered by in vitro blockade of TNFα or IL-6. A skewed TCR repertoire towards oligoclonality and less polyclonality was found in JIA. DISCUSSION CMVpp65-specific IFNγ production with expansion of CD28-CD8+ T-cells suggests an efficient control of latent CMV regardless of immunosuppressive therapy or in vitro blockade of TNFα or IL-6 in CMV-seropositive arthritis patients. Increased IgG-anti-CMV antibody concentrations and increased proportions of intracellular IFNγ-producing CMVpp65-specific CD8+ T-cells in long-term cultures propose a possibly role of endogenous CMV reactivations boosting antibody levels and a higher possibly CMV-driven IFNγ-mediated inflammatory potential of CD8+ T-cells in arthritis patients.
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Affiliation(s)
- Giovanni Almanzar
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany.
| | - Marc Schmalzing
- Department of Internal Medicine II, Rheumatology and Immunology, University Hospital Würzburg, Würzburg, Germany
| | - Raimund Trippen
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Kerstin Höfner
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Benedikt Weißbrich
- Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Eva Geissinger
- Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Thomas Meyer
- Pediatric Surgery Unit, Department of Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Johannes Liese
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Hans-Peter Tony
- Department of Internal Medicine II, Rheumatology and Immunology, University Hospital Würzburg, Würzburg, Germany
| | - Martina Prelog
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
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Influence of the delivery modus on subpopulations and replication of lymphocytes in mothers and newborns. Early Hum Dev 2015; 91:663-70. [PMID: 26513626 DOI: 10.1016/j.earlhumdev.2015.09.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 09/14/2015] [Accepted: 09/22/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Several studies reported that the mode of delivery may induce changes to the immune system. Our hypothesis was that the delivery mode may influence mainly the naive T cell subpopulation. AIMS Particular focus was set on the proportions and peripheral replicative history of naive T cells and cord blood serum concentrations of IL-7, a cytokine involved in peripheral naive T cell homeostasis. STUDY DESIGN, SUBJECTS AND OUTCOME MEASURES In a prospective cohort study, proportions of lymphocyte populations were measured in mothers and newborns delivered by spontaneous vaginal delivery (SD), vacuum extraction (VE), primary (PCS) and secondary Cesarean sections (SCS) by flow cytometry. T-cell-receptor-excision-circles (TRECs) and relative telomere lengths (RTLs) were used to estimate the replicative history of peripheral naive T cells. The cytokine profile was assessed by ELISA. RESULTS The study demonstrated that leukocytes, neutrophils and NK cells were increased in spontaneously delivered newborns compared to PCS, whereas circulating T cells were relatively lower. TRECs and RTLs were not significantly influenced by the delivery mode. IL-2, IL-8 and IFN-γ were increased in VD. IL-7 production tends to be increased in more stress-associated delivery modes, such as VE and SCS. CONCLUSIONS Our results demonstrate proportional changes in newborns delivered by PCS and diminished cytokine production. It has to be proven whether these alterations may be of disadvantage regarding early defense of infectious diseases. Understanding the physiological role of these changes may help to find preventive strategies for neonatal infectious risks and the development of atopy or other immune diseases.
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Fessler J, Raicht A, Husic R, Ficjan A, Duftner C, Schwinger W, Dejaco C, Schirmer M. Premature senescence of T-cell subsets in axial spondyloarthritis. Ann Rheum Dis 2015; 75:748-54. [PMID: 25688074 PMCID: PMC4819616 DOI: 10.1136/annrheumdis-2014-206119] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 01/13/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate the possible occurrence of early thymic failure and premature senescence of naïve and memory T-cells in patients with axial spondyloarthritis (aSpA). METHODS Prospective, cross-sectional study of consecutive patients with aSpA (n=51), rheumatoid arthritis (RA, n=51) and healthy controls (HCs, n=50). Demographic, clinical and laboratory parameters were collected in all patients and we isolated naïve (CD45RA(+)) and memory (CD45RO(+)) CD4(+) and CD8(+) T-cell subsets by MACS technology. T-cell receptor rearrangement excision circle (TREC) and telomere length were measured by real-time PCR. We used TRECs as a surrogate for thymus function and telomere length as an indicator of cellular senescence. Telomerase activity was analysed with the Telomeric Repeat Amplification Protocols. RESULTS We observed a premature decline of thymic output in patients with aSpA and patients with RA compared with HCs as indicated by a reduction of TREC levels in naive T-cells (aSpA: age adjusted regression coefficient (regcoeff) for CD4(+)CD45RA(+) T-cells -2.566, p=0.023; RA regcoeff=-2.844, p=0.008). Telomere length of all CD4(+) and CD8(+) T-cell subsets was reduced in young patients with aSpA compared with HCs, whereas data for patients with RA were comparable with HCs. Telomerase activity was inversely correlated with telomere length in HCs (correlation coefficient (corcoeff)=-0.532, p<0.001) but not in patients with aSpA (corcoeff=-0.056, p=0.697) and RA (corcoeff=-0.003, p=0.982). CONCLUSIONS Our data indicate an age-inappropriate shrinkage of thymic output, an inappropriate shortening of telomeres in young patients with aSpA and an impaired telomerase enzyme in patients with aSpA and RA.
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Affiliation(s)
- Johannes Fessler
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Andrea Raicht
- Department of Pediatric Hemato-Oncology, Medical University of Graz, Graz, Austria
| | - Rusmir Husic
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Anja Ficjan
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Christina Duftner
- Department of Internal Medicine VI, Innsbruck Medical University, Innsbruck, Austria
| | - Wolfgang Schwinger
- Department of Pediatric Hemato-Oncology, Medical University of Graz, Graz, Austria
| | - Christian Dejaco
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
| | - Michael Schirmer
- Department of Internal Medicine VI, Innsbruck Medical University, Innsbruck, Austria
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Strawa K, Markowska A, Miśkiewicz P, Kuś A, Ambroziak U, Szymański K, Zbiec R, Spólnicka M, Krajewski P, Bednarczuk T, Płoski R. Increased concentration of T-cell receptor rearrangement excision circles (TREC) in peripheral blood in Graves' disease. Clin Endocrinol (Oxf) 2014; 81:769-74. [PMID: 24815998 DOI: 10.1111/cen.12492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 01/06/2014] [Accepted: 05/01/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND T-cell receptor rearrangement excision circles (TREC) are circular DNA molecules generated during T-cell maturation in the thymus. Recent studies suggested that a decreased TREC concentration in peripheral blood may be a general feature of autoimmunity. Our purpose was to assess the TREC concentration in Graves' disease (GD). METHODS TREC concentration was assessed by real time PCR in DNA samples isolated from peripheral blood leucocytes among younger (n = 94, age range 6-29 years) and older patients with GD (n = 93, age range 57-80 years) and age-matched controls (n = 206). RESULTS TREC concentration decreased with age in all subjects, but it was significantly higher in GD compared with controls (P = 9·4 × 10(-10) ). TREC concentration was higher (P = 0·0038) in hyperthyroid (n = 78) than euthyroid (n = 82) patients with GD, but in both groups, it remained increased relative to controls (P = 2·2 × 10(-11) and P = 4·4 ×10(-7) , respectively). CONCLUSIONS Patients with GD, particularly those with hyperthyroidism, have increased concentration of TREC which may suggest increased rather than decreased thymic activity. Thus, GD does not follow the paradigm suggested for other autoimmune disorders which links autoimmunity with thymic senescence.
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Affiliation(s)
- Katarzyna Strawa
- Department of Medical Genetics, Centre for Biostructure, Medical University of Warsaw, Warsaw, Poland
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Lu IN, Meyer-Olson D, Stoll M, Witte T, Schmidt RE, Baerlecken NT. Increased T-cell turnover is associated with spondyloarthritis in virally suppressed patients with HIV-1 infection. HIV Med 2014; 16:255-60. [PMID: 25252008 DOI: 10.1111/hiv.12199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Spondyloarthritis (SpA) is one of the most frequently observed inflammatory joint diseases in HIV-1-seropositive patients. T-cells were described frequently as one of the major driving forces in SpA, therefore we tried to look for T-cell aberrancies in our HIV-positive patients with SpA. METHODS A total of 1098 files for HIV-positive patients who attended the HIV out-patient clinic of the Department of Clinical Immunology and Rheumatology at the Medical University Hanover for at least one visit between January 2004 and December 2010 were screened for the presence of a diagnosis of SpA. A cross-sectional study was conducted to investigate aberrancies in T-cell homeostasis induced by HIV-1 in these subjects. RESULTS The prevalence of SpA in the HIV-positive patients was 1.6% (18 of 1098). Interestingly, the percentage of patients with SpA who were human leucocyte antigen (HLA)-B27 negative in our HIV-positive cohort was 80%. Despite combination antiretroviral therapy (cART) and viral suppression, an incomplete immune recovery of T-cell naïve/memory distribution and turnover, as identified by intracellular Ki-67 expression, was observed in HIV-positive patients with SpA. CONCLUSIONS Independent of HLA-B27 status and despite cART, HIV-positive patients can develop SpA and exhibit an increased T-cell turnover rate.
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Affiliation(s)
- I-N Lu
- Department of Clinical Immunology and Rheumatology, Medical University Hanover, Hanover, Germany; Laboratory of Immunology, Center for Public Health Research (CRP-Santé), Luxembourg
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Sheu TT, Chiang BL, Yen JH, Lin WC. Premature CD4+ T cell aging and its contribution to lymphopenia-induced proliferation of memory cells in autoimmune-prone non-obese diabetic mice. PLoS One 2014; 9:e89379. [PMID: 24586733 PMCID: PMC3935863 DOI: 10.1371/journal.pone.0089379] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 01/21/2014] [Indexed: 01/15/2023] Open
Abstract
Lymphopenia-induced proliferation (LIP), a mechanism to maintain a constant number of T cells in circulation, occurs in both normal aging and autoimmune disease. The incidence of most autoimmune diseases increases with age, and premature CD4(+) T cell aging has been reported in several autoimmune diseases. In this study, we tested the hypothesis that premature CD4(+) T cell aging can cause autoimmune disease by examining whether premature CD4(+) T cell aging exists and causes LIP in our mouse model. Non-obese diabetic (NOD) mice were used because, in addition to Treg defects, the LIP of T cells has been shown to plays a causative role in the development of insulin-dependent diabetes mellitus (IDDM) in these mice. We found that with advancing age, NOD mice exhibited an accelerated decrease in the number of CD4(+) T cells due to the loss of naïve cells. This was accompanied by an increase in the percentage of memory cells, leading to a reduced naïve/memory ratio. In addition, both the percentage of CD28(+) cells in CD4(+) T cells and IL-2 production decreased, while the percentage of FAS(+)CD44(+) increased, suggesting that NOD mice exhibit premature CD4(+) T cell aging. This process preferentially contributed to LIP of memory cells. Therefore, our results suggest that premature CD4(+) T cell aging underlies the development of IDDM in NOD mice. Given that CD28 and IL-2 play important roles in Treg function, the relationships between premature CD4(+) T cell aging and lymphopenia as well as Treg defects in autoimmune-prone NOD mice are proposed.
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Affiliation(s)
- Ting-Ting Sheu
- Department of Immunology, Tzu Chi University, Hualien, Taiwan, Republic of China
- Institute of Microbiology, Immunology and Biochemistry, Tzu Chi University, Hualien, Taiwan, Republic of China
- * E-mail:
| | - Bor-Luen Chiang
- Graduate Institute of Immunology, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Jui-Hung Yen
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan, Republic of China
| | - Wen-Chi Lin
- Institute of Microbiology, Immunology and Biochemistry, Tzu Chi University, Hualien, Taiwan, Republic of China
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Mitsui T, Kuroda Y, Ueno SI, Matsui N, Kaji R. FK506 attenuates thymic output in patients with myasthenia gravis. Arch Med Sci 2013; 9:1090-6. [PMID: 24482655 PMCID: PMC3902727 DOI: 10.5114/aoms.2013.39797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 04/21/2011] [Accepted: 05/11/2011] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Myasthenia gravis (MG) is an antibody-mediated, T-cell-dependent autoimmune disease. The symptoms are caused by high-affinity IgG against the muscle acetylcholine receptor (AChR) at the neuromuscular junction. The production of these antibodies in B-cells depends on AChR-specific CD4(+) T-cells and the thymus gland seems to play a significant role in the pathogenesis of MG. Altered thymic T-cell export seems to be associated with a pathological mechanism in myasthenia gravis. Tacrolimus (FK506) has recently been used to treat MG. MATERIAL AND METHODS We examined the effects of tacrolimus on thymic T-cell export in patients with MG. Sixteen patients with nonthymomatous and/or thymectomized MG were treated with oral administrations of tacrolimus. To assess the effect of tacrolimus on the thymic output, we assayed the levels of T-cell receptor excision circle (TREC), a molecular marker of thymus emigrants. RESULTS T-cell receptor excision circle was not significantly different from those in age-matched controls before tacrolimus therapy, but they were partially decreased 4 months after tacrolimus therapy. T-cell receptor excision circle levels were significantly decreased in the thymomatous group (p < 0.05), but not in the nonthymomatous group. Tacrolimus treatment significantly attenuated TREC levels in cultured CD4(-)CD8(+) cells (p < 0.05), but total cell counts were not significantly changed. CONCLUSIONS These results indicate that TREC levels may become a marker of the curative effect of tacrolimus therapy for thymomatous MG, and that tacrolimus suppresses not only activating T-lymphocytes, but also naïve T-cells.
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Affiliation(s)
- Takao Mitsui
- Tokushima National Hospital, National Hospital Organization, Tokushima, Japan
- Department of Clinical Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yukiko Kuroda
- Tokushima National Hospital, National Hospital Organization, Tokushima, Japan
- Department of Clinical Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Shu-ichi Ueno
- Department of Psychiatry, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Naoko Matsui
- Department of Clinical Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Ryuji Kaji
- Department of Clinical Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
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Dvergsten JA, Mueller RG, Griffin P, Abedin S, Pishko A, Michel JJ, Rosenkranz ME, Reed AM, Kietz DA, Vallejo AN. Premature cell senescence and T cell receptor-independent activation of CD8+ T cells in juvenile idiopathic arthritis. ACTA ACUST UNITED AC 2013; 65:2201-10. [PMID: 23686519 DOI: 10.1002/art.38015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 05/07/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE CD8+ T cells lacking CD28 were originally reported to be a characteristic feature of juvenile idiopathic arthritis (JIA), but the relevance of these unusual cells to this disease remains to be elucidated. Because of recent evidence that loss of CD28 cells is typical of terminally differentiated lymphocytes, the aim of this study was to examine functional subsets of CD8+ T cells in patients with JIA. METHODS Blood and/or waste synovial fluid samples were collected from children with a definite diagnosis of JIA (n = 98). Deidentified peripheral blood (n = 33) and cord blood (n = 13) samples from healthy donors were also collected. CD8+ and CD4+ T cells were screened for novel receptors, and where indicated, bioassays were performed to determine the functional relevance of the identified receptor. RESULTS JIA patients had a naive T cell compartment with shortened telomeres, and their entire T cell pool had reduced proliferative capacity. They had an overabundance of CD31+CD28(null) CD8+ T cells, which was a significant feature of oligoarticular JIA (n = 62) as compared to polyarticular JIA (n = 36). CD31+ CD28(null) CD8+ T cells had limited mitotic capacity and expressed high levels of the senescence antigens histone γH2AX and/or p16. Ligation of CD31, which was independent of the T cell receptor (TCR), sufficiently induced tyrosine phosphorylation, vesicle exocytosis, and production of interferon-γ and interleukin-10. CONCLUSION These data provide the first evidence of cell senescence, as represented by CD31+CD28(null) CD8+ T cells, in the pathophysiology of JIA. Activation of these unusual cells in a TCR-independent manner suggests that they are maladaptive and could be potential targets for immunotherapy.
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Affiliation(s)
- Jeffrey A Dvergsten
- Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, USA
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Prelog M, Schönlaub J, Würzner R, Koppelstaetter C, Almanzar G, Brunner A, Gasser M, Prommegger R, Häusler G, Kapelari K, Högler W. Lower CD28+ T cell proportions were associated with CMV-seropositivity in patients with Hashimoto's thyroiditis. BMC Endocr Disord 2013; 13:34. [PMID: 24006909 PMCID: PMC3844619 DOI: 10.1186/1472-6823-13-34] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 09/03/2013] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Alterations in the naive T cell subpopulations have been demonstrated in patients with T cell mediated autoimmune disorders, reminiscent of immunological changes found in the elderly during immunosenescence, including the switch from CD45RA + to CD45RO + T cells and decreased thymic function with increased compensatory proliferative mechanisms, partly associated with latent Cytomegalovirus (CMV) infection. The present study was aimed to investigate proportions of lymphocytes, their relation to CMV-seropositivity and the replicative history of CD45RA + expressing T cells in Hashimoto's thyroiditis (HT, n = 18) and healthy controls (HC, n = 70). METHODS Proportions of peripheral T cells were investigated by flow cytometry. The replicative history was assessed by T cell receptor excision circles (TRECs) and relative telomere length (RTL). Expression of CD62L was analyzed by immunohistochemistry in thyroid sections. The role of CMV was assessed by serology, ELISPOT assay and in situ hybridization. RESULTS Our results demonstrated a significant increase of CD28-negative T cells, associated with CMV-seropositivity in HT patients. HT showed abundant CD45RO + T cells with peripheral loss of CD62L-expressing CD8 + CD45RA + T cells, the latter mainly depending on disease duration. CD62L was expressed in thyroid lymphocyte infiltrations. The diagnosis of HT and within the HT group CMV-seropositivity were the main determinants for the loss of CD28 expression. RTL was not different between HC and HT. HT showed significantly lower TRECs in CD4 + CD45RA + T cells compared to HC. CONCLUSIONS Patients with HT display a peripheral T cell phenotype reminiscent of findings in elderly persons or other autoimmune disorders. Whether these mechanisms are primary or secondary to the immunological alterations of autoimmune conditions should be investigated in longitudinal studies which may open research on new therapeutic regimes for treatment of HT and associated autoimmune diseases.
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Affiliation(s)
- Martina Prelog
- Department of Pediatrics, University of Würzburg, Josef-Schneider-Str. 2, Würzburg, Germany
- Department of Pediatrics, Medical University Innsbruck, Anichstr. 35, Innsbruck, Austria
| | - Jörn Schönlaub
- Department of Pediatrics, University of Würzburg, Josef-Schneider-Str. 2, Würzburg, Germany
- Department of Pediatrics, Medical University Innsbruck, Anichstr. 35, Innsbruck, Austria
| | - Reinhard Würzner
- Department of Hygiene and Medical Microbiology, Medical University Innsbruck, Fritz-Pregl-Str. 3, Innsbruck, Austria
| | | | - Giovanni Almanzar
- Department of Pediatrics, University of Würzburg, Josef-Schneider-Str. 2, Würzburg, Germany
| | - Andrea Brunner
- Department of Pathology, Medical University Innsbruck, Müllerstr. 44, Innsbruck, Austria
| | - Martin Gasser
- Department of Surgery, University of Würzburg, Oberdürrbacherstr. 6, Würzburg, Germany
| | - Rupert Prommegger
- Department of Surgery, Medical University Innsbruck, Anichstr. 35, Innsbruck, Austria
| | - Gabriele Häusler
- Department of Pediatrics, Medical University Vienna, Währinger Gürtel 18-20, Vienna, Austria
| | - Klaus Kapelari
- Department of Pediatrics, Medical University Innsbruck, Anichstr. 35, Innsbruck, Austria
| | - Wolfgang Högler
- Department of Endocrinology and Diabetes, Birmingham, Children’s Hospital, Steelhouse Lane, Birmingham, United Kingdom
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Almanzar G, Zlamy M, Koppelstaetter C, Brunner A, Jeller V, Duftner C, Dejaco C, Brunner J, Prelog M. Increased replication of CD4+ naive T cells and changes in T cell homeostasis in a case of acute exacerbation of juvenile idiopathic arthritis: a case comparison study. J Med Case Rep 2013; 7:135. [PMID: 23692985 PMCID: PMC3686624 DOI: 10.1186/1752-1947-7-135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 04/05/2013] [Indexed: 11/15/2022] Open
Abstract
Introduction Juvenile idiopathic arthritis is a heterogeneous T cell-mediated autoimmune disease with symptoms of premature aging of the immune system (immunosenescence). The present work is an investigation of immunosenescence parameters, such as quantity of naive and CD28- T cells, T cell receptor excision circles, relative telomere length and alterations of peripheral T cell replication, and was performed via comparison of a case of acute exacerbation of juvenile idiopathic arthritis against six patients with juvenile idiopathic arthritis with disease remission and six age-matched healthy donors over a follow-up course of 12 months. Case presentation Phenotypical T cell characterization and intracellular interferon γ, tumor necrosis factor α, and interleukin 2 production were studied in peripheral blood mononuclear cells from seven patients with juvenile idiopathic arthritis and six healthy control donors, with findings determined by flow cytometry. T cell receptor excision circles and relative telomere length quantification were performed on deoxyribonucleic acid isolated from naive (CD4+CD28+CD45RA+) T cells and investigated via reverse transcription polymerase chain reaction. Ki67 expression was studied by immunohistochemistry on naive T cells. The non-parametric Mann-Whitney U test and Wilcoxon test for two independent groups of variables were used to compare healthy donors with patients with juvenile idiopathic arthritis. During follow-up, patients with juvenile idiopathic arthritis showed lower total counts of naive and CD28-expressing T cells compared to healthy donors. Acute exacerbation led to low naive and CD28+ T cell populations and elevated proportions of Ki67-expressing CD4+ naive T cells. In conditions of exacerbation, T cell receptor excision circle numbers were in the lower range in patients with juvenile idiopathic arthritis and increased after follow-up. Healthy donors showed significantly higher relative telomere lengths compared to patients with juvenile idiopathic arthritis. Conclusions This investigation illustrates that the changes in T cell homeostasis in patients with juvenile idiopathic arthritis may be the result of several mechanisms, such as diminished thymus function and peripheral exertions to maintain the peripheral T cell pool. The results also demonstrate that hallmarks of immunosenescence such as decreased naive T cell levels and lower T cell receptor excision circle numbers can only be interpreted together with replication markers such as relative telomere length or Ki67 expression.
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Affiliation(s)
- Giovanni Almanzar
- Department of Pediatrics, University of Würzburg, Würzburg, Germany.
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Maternal cigarette smoking and its effect on neonatal lymphocyte subpopulations and replication. BMC Pediatr 2013; 13:57. [PMID: 23597118 PMCID: PMC3644263 DOI: 10.1186/1471-2431-13-57] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 04/16/2013] [Indexed: 11/29/2022] Open
Abstract
Background Significant immunomodulatory effects have been described as result of cigarette smoking in adults and pregnant women. However, the effect of cigarette smoking during pregnancy on the lymphocyte subpopulations in newborns has been discussed, controversially. Methods In a prospective birth cohort, we analyzed the peripheral lymphocyte subpopulations of smoking (SM) and non-smoking mothers (NSM) and their newborns and the replicative history of neonatal, mostly naive CD4 + CD45RA + T cells by measurements of T-cell-receptor-excision-circles (TRECs), relative telomere lengths (RTL) and the serum cytokine concentrations. Results SM had higher lymphocyte counts than NSM. Comparing SM and NSM and SM newborns with NSM newborns, no significant differences in proportions of lymphocyte subpopulations were seen. Regardless of their smoking habits, mothers had significantly lower naive T cells and higher memory and effector T cells than newborns. NSM had significantly lower percentages of CD4 + CD25++ T cells compared to their newborns, which was not significant in SM. There were no differences regarding cytokine concentrations in newborns of SM and NSM. However, NSM had significantly higher Interleukin-7 concentrations than their newborns. Regardless of smoking habits of mothers, newborns had significantly longer telomeres and higher TRECs than their mothers. Newborns of SM had significantly longer telomeres than newborns of NSM. Conclusions Apart from higher lymphocyte counts in SM, our results did not reveal differences between lymphocyte subpopulations of SM and NSM and their newborns, respectively. Our finding of significantly longer RTL in newborns of SM may reflect potential harm on lymphocytes, such as cytogenetic damage induced by smoking.
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Vassiliadis S. De materia medica versus codex alimentarius for the reinforcement of the gynecologic immune system: the case of endometriosis. CLINICAL MEDICINE INSIGHTS. WOMEN'S HEALTH 2013; 6:31-5. [PMID: 24665212 PMCID: PMC3941187 DOI: 10.4137/cmwh.s11214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Since the first Pharmacopoeia under the title "De Materia Medica," the importance of the utilization of plants and herbs has been an invaluable medicinal tool successfully employed for strengthening the immune system for combating a number of diseases in general, or assisting fertility and reproductive issues in particular. The beneficial use of herbal extracts, constituting the basis of modern medicines, is lately under the shadow of Codex Alimentarius that threatens, if not properly applied, serious immunity features rendering the host defenseless for intercepting harmful invaders, one of which is the mesenchymal endometriotic stem cell causing endometriosis.
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Affiliation(s)
- Simon Vassiliadis
- Association of Greek Immunology Graduates (AGIG), Maroussi, Athens, Greece
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Cantisán S, Torre-Cisneros J, Lara R, Zarraga S, Montejo M, Solana R. Impact of cytomegalovirus on early immunosenescence of CD8+ T lymphocytes after solid organ transplantation. J Gerontol A Biol Sci Med Sci 2012; 68:1-5. [PMID: 22552369 DOI: 10.1093/gerona/gls130] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The increasing number of elderly people eligible for solid organ transplants has made it necessary to reevaluate how the decline in immune function associated to ageing (immunosenescence) affects solid organ transplants. Some immunosenescence biomarkers, such as the expansion of CD28(-)CD8+ T lymphocytes, have been associated to cytomegalovirus infection and are related to a form of accelerated immune senescence in transplant recipients. However, the impact of cytomegalovirus replication on downregulation of CD28 on total CD8+ T cells is independent of patients' age, whereas downregulation on cytomegalovirus-specific CD8+ T cells depends on patients' age, inducing early immunosenescence of cytomegalovirus-specific CD8+ T cells in young but not elderly solid organ transplants recipients. Although immunosenescence in transplant recipients should be considered a two-edged sword as it is a risk factor for the development of tumors after transplantation, it has a beneficial effect in attenuating acute allograft rejection and correlates with better clinical outcomes.
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Affiliation(s)
- Sara Cantisán
- BSc, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
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Arismendi MI, Kallás EG, Santos BAND, Carneiro-Sampaio MMS, Kayser C. Thymopoiesis and regulatory T cells in healthy children and adolescents. Clinics (Sao Paulo) 2012; 67:425-9. [PMID: 22666784 PMCID: PMC3351266 DOI: 10.6061/clinics/2012(05)04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 01/11/2012] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The purpose of this study was to investigate the association between T cell receptor excision circle levels in peripheral blood mononuclear cells and regulatory T cells that co-express CD25 and Foxp3 in healthy children and adolescents of different ages. MATERIALS AND METHODS The quantification of signal-joint T-cell receptor excision circle levels in the genomic DNA of peripheral blood mononuclear cells was performed using real-time quantitative PCR. The analysis of CD4, CD8, CD25, and Foxp3 expression was performed using flow cytometry. RESULTS Ninety-five healthy controls (46 females and 49 males) ranging in age from 1 to 18 years were analyzed. The mean T-cell receptor excision circle count in all individuals was 89.095 ± 36.790 T-cell receptor excision circles per microgram of DNA. There was an inverse correlation between T-cell receptor excision circles counts and age (r = -0.846; p<0.001) as well as between the proportion of CD4(+)CD25(+)Foxp3(+) T cells and age (r = -0.467; p = 0.04). In addition, we observed a positive correlation between the amount of CD4(+)CD25(+)Foxp3(+) T cells and the amount of T-cell receptor excision circles per microgram of DNA in individuals of all ages (r = -0.529; p = 0.02). CONCLUSIONS In this study, we observed a decrease in the thymic function with age based on the fact that the level of T-cell receptor excision circles in the peripheral blood positively correlated with the proportion of regulatory T cells in healthy children and adolescents. These findings indicate that although T-cell receptor excision circles and regulatory T cells levels decrease with age, homeostasis of the immune system and relative regulatory T cells population levels are maintained in the peripheral blood.
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Affiliation(s)
- Maria Izabel Arismendi
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Departamento de Pediatria, Instituto da Criança, Brasil
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Immunopathogenesis of primary biliary cirrhosis: an old wives' tale. IMMUNITY & AGEING 2011; 8:12. [PMID: 22136162 PMCID: PMC3238302 DOI: 10.1186/1742-4933-8-12] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 12/02/2011] [Indexed: 12/15/2022]
Abstract
Primary biliary cirrhosis (PBC) is a cholestatic liver disease characterised by the autoimmune destruction of the small intrahepatic bile ducts. The disease has an unpredictable clinical course, but may progress to fibrosis and cirrhosis. Although medical treatment with urseodeoxycholic acid is largely successful, some patients may progress to liver failure requiring liver transplantation. PBC is characterised by the presence of disease specific anti-mitochondrial (AMA) antibodies, which are pathognomonic for PBC development. The disease demonstrates an overwhelming female preponderance and virtually all women with PBC present in middle age. The reasons for this are unknown; however several environmental and immunological factors may be involved. As the immune systems ages, it become less self tolerant, and mounts a weaker response to pathogens, possibly leading to cross reactivity or molecular mimicry. Some individuals display immunological changes which encourage the development of autoimmune disease. Risk factors implicated in PBC include recurrent urinary tract infection in females, as well as an increased prevalence of reproductive complications. These risk factors may work in concert with and possibly even accelerate, immune system ageing, contributing to PBC development. This review will examine the changes that occur in the immune system with ageing, paying particular attention to those changes which contribute to the development of autoimmune disease with increasing age. The review also discusses risk factors which may account for the increased female predominance of PBC, such as recurrent UTI and oestrogens.
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Outcome and safety of TNFα antagonist therapy in 475 consecutive outpatients (with rheumatoid arthritis or spondyloarthropathies) treated by a single physician according to their eligibility for clinical trials. Joint Bone Spine 2011; 77:564-9. [PMID: 20621538 DOI: 10.1016/j.jbspin.2010.05.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2010] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the effectiveness and safety of TNFα antagonists in patients with rheumatoid arthritis (RA) or spondyloarthropathies (SpA) treated by a single physician, according to the presence of the inclusion and non-inclusion criteria used to select patients for pivotal clinical trials. METHODS Effectiveness was evaluated based on four categories defined by the DAS28-ESR and BASDAI values, from a very good response (mean DAS-28-ESR less than 3.2 and mean BASDAI less than 2.0) to failure (DAS28-ESR unchanged or greater than 5.1 and BASDAI unchanged). Serious adverse events were defined as events that required permanent TNFα antagonist discontinuation or that led to sequelae, hospital admission, or death. RESULTS The study included 475 patients, 230 with RA, 226 with SpA, 10 with juvenile-onset arthritis, and nine with unclassifiable arthritis. Mean number of TNFα antagonists used per patient was 1.3 and mean duration of TNFα antagonist treatment was 28±23 months. Overall, 41% of patients met the inclusion and non-inclusion criteria used in pivotal trials; the proportion was 43% in the RA group and 40% in the SpA group. These patients had a 3-fold higher rate of very good responses (54 versus 19%) and a 5-fold lower rate of failures (5 versus 25%) compared to the other patients. Of the 15 (3%) patients who died, none met pivotal trial criteria. The group that met pivotal trial criteria had a significantly lower rate of serious adverse events (11 versus 16%; Chi(2), p=0.0001), although age was similar in the two groups (53±16 years versus 57±14 years). CONCLUSION Patients meeting the selection criteria used in pivotal trials had a higher response rate and significantly fewer serious adverse events.
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Seksenyan A, Ron-Harel N, Azoulay D, Cahalon L, Cardon M, Rogeri P, Ko MK, Weil M, Bulvik S, Rechavi G, Amariglio N, Konen E, Koronyo-Hamaoui M, Somech R, Schwartz M. Thymic involution, a co-morbidity factor in amyotrophic lateral sclerosis. J Cell Mol Med 2010; 14:2470-82. [PMID: 19650830 PMCID: PMC3823164 DOI: 10.1111/j.1582-4934.2009.00863.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Accepted: 07/10/2009] [Indexed: 12/12/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating disease, characterized by extremely rapid loss of motor neurons. Our studies over the last decade have established CD4(+) T cells as important players in central nervous system maintenance and repair. Those results, together with recent findings that CD4(+) T cells play a protective role in mouse models of ALS, led us to the current hypothesis that in ALS, a rapid T-cell malfunction may develop in parallel to the motor neuron dysfunction. Here, we tested this hypothesis by assessing thymic function, which serves as a measure of peripheral T-cell availability, in an animal model of ALS (mSOD1 [superoxide dismutase] mice; G93A) and in human patients. We found a significant reduction in thymic progenitor-cell content, and abnormal thymic histology in 3-4-month-old mSOD1 mice. In ALS patients, we found a decline in thymic output, manifested in the reduction in blood levels of T-cell receptor rearrangement excision circles, a non-invasive measure of thymic function, and demonstrated a restricted T-cell repertoire. The morbidity of the peripheral immune cells was also manifested in the increase of pro-apoptotic BAX/BCXL2 expression ratio in peripheral blood mononuclear cells (PBMCs) of these patients. In addition, gene expression screening in the same PBMCs, revealed in the ALS patients a reduction in key genes known to be associated with T-cell activity, including: CD80, CD86, IFNG and IL18. In light of the reported beneficial role of T cells in animal models of ALS, the present observation of thymic dysfunction, both in human patients and in an animal model, might be a co-pathological factor in ALS, regardless of the disease aetiology. These findings may lead to the development of novel therapeutic approaches directed at overcoming the thymic defect and T-cell deficiency.
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Affiliation(s)
- Akop Seksenyan
- Maxine-Dunitz Neurosurgical Institute, Cedars-Sinai Medical CenterLos Angeles, CA, USA
| | - Noga Ron-Harel
- Department of Neurobiology, the Weizmann Institute of ScienceRehovot, Israel
| | - David Azoulay
- Maxine-Dunitz Neurosurgical Institute, Cedars-Sinai Medical CenterLos Angeles, CA, USA
| | - Liora Cahalon
- Department of Neurobiology, the Weizmann Institute of ScienceRehovot, Israel
| | - Michal Cardon
- Department of Neurobiology, the Weizmann Institute of ScienceRehovot, Israel
| | - Patricia Rogeri
- Maxine-Dunitz Neurosurgical Institute, Cedars-Sinai Medical CenterLos Angeles, CA, USA
| | - Minhee K Ko
- Maxine-Dunitz Neurosurgical Institute, Cedars-Sinai Medical CenterLos Angeles, CA, USA
| | - Miguel Weil
- Department of Cell Research and Immunology, The George S. Wise Faculty of Life Sciences, Tel Aviv UniversityTel Aviv, Israel
| | - Shlomo Bulvik
- Hematology Department, Laniado HospitalNetanya, Israel
| | - Gideon Rechavi
- Cancer Research Center, Sheba Medical Center, Tel Hashomer and Sackler School of MedicineTel Aviv, Israel
| | - Ninette Amariglio
- Cancer Research Center, Sheba Medical Center, Tel Hashomer and Sackler School of MedicineTel Aviv, Israel
| | - Eli Konen
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer and Sackler School of MedicineTel Aviv, Israel
| | - Maya Koronyo-Hamaoui
- Maxine-Dunitz Neurosurgical Institute, Cedars-Sinai Medical CenterLos Angeles, CA, USA
| | - Raz Somech
- Cancer Research Center, Sheba Medical Center, Tel Hashomer and Sackler School of MedicineTel Aviv, Israel
- Pediatric Immunology Service, Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer and Sackler School of MedicineTel Aviv, Israel
| | - Michal Schwartz
- Maxine-Dunitz Neurosurgical Institute, Cedars-Sinai Medical CenterLos Angeles, CA, USA
- Department of Neurobiology, the Weizmann Institute of ScienceRehovot, Israel
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Plumbagin-induced apoptosis in lymphocytes is mediated through increased reactive oxygen species production, upregulation of Fas, and activation of the caspase cascade. Toxicol Appl Pharmacol 2010; 247:41-52. [DOI: 10.1016/j.taap.2010.05.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 05/03/2010] [Accepted: 05/18/2010] [Indexed: 12/23/2022]
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Abstract
Aging is accompanied by a progressive decline in the integrity of the immune system, a process known as immunosenescence. Pathological features typical of immune dysfunction in older adults, encompassing dysregulation of innate and adaptive immune responses, characterize rheumatoid arthritis (RA), an autoimmune disease whose incidence increases with age. Recent evidence suggests that certain features of immunosenescence, such as the decrease in T-cell generation and diversity, may contribute to the development of RA. Thus, physiological immunosenescence may render older adults susceptible to RA, and premature immunosenescence may contribute to the development of RA in young adults. In addition, other features of immunosenescence may result from the chronic immune stimulation that occurs in RA and lead to worsening of the disease. This article reviews the immunopathological features common to aging and RA and discusses the mechanisms by which immunosenescence may contribute to the development or progression of RA.
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Affiliation(s)
- Tamsin M Lindstrom
- Geriatric Research Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
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Georgin-Lavialle S, Aouba A, Mouthon L, Londono-Vallejo JA, Lepelletier Y, Gabet AS, Hermine O. The telomere/telomerase system in autoimmune and systemic immune-mediated diseases. Autoimmun Rev 2010; 9:646-51. [PMID: 20435169 DOI: 10.1016/j.autrev.2010.04.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Accepted: 04/22/2010] [Indexed: 12/22/2022]
Abstract
Telomeres are specialized nucleoproteic structures that cap and protect the ends of chromosomes. They can be elongated by the telomerase enzyme, but in telomerase negative cells, telomeres shorten after each cellular division because of the end replicating problem. This phenomenon leads ultimately to cellular senescence, conferring to the telomeres a role of biological clock. Oxidative stress, inflammation and increased cell renewal are supplementary environmental factors that accelerate age-related telomere shortening. Similar to other types of DNA damage, very short/dysfunctional telomeres activate a DNA response pathway leading to different outcomes: DNA repair, cell senescence or apoptosis. During the last 10 years, studies on the telomere/telomerase system in autoimmune and/or systemic immune-mediated diseases have revealed its involvement in relevant physiopathological processes. Here, we present a literature review of telomere and telomerase homeostasis in systemic inflammatory diseases including systemic lupus erythematosus, rheumatoid arthritis and granulomatous diseases. The available data indicate that both telomerase activity and telomere length are modified in various systemic immune-mediated diseases and appear to be connected with premature immunosenescence. Studies on the telomere/telomerase system open new research avenues for the basic understanding and for therapeutic approaches of these pathologies.
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Affiliation(s)
- Sophie Georgin-Lavialle
- Department of Adult Haematology, Necker Enfants-Malades Hospital, Mastocytosis Reference Center, Paris Descartes University, Paris, France
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Brunner J, Herrmann M, Metzler M, Gaipl U, Reuter G, Haas JP. The turnover of synovial T cells is higher than in T cells in the peripheral blood in persistent oligoarticular juvenile idiopathic arthritis. Rheumatol Int 2010; 30:1529-32. [PMID: 20352219 DOI: 10.1007/s00296-010-1465-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Accepted: 03/12/2010] [Indexed: 11/30/2022]
Abstract
Juvenile idiopathic arthritis (JIA) summarizes a group of inflammatory diseases of childhood. The etiology remains still unclear. In JIA, T cells have been demonstrated to play key roles in the pathogenesis. T-cell proliferation in JIA may be different in the peripheral blood (PB) and the synovial fluid (SF). The aim of this study is to demonstrate the turnover of T cells in the PB and SF of patients with persistent oligoarticular JIA (oJIA) compared to controls. Matched pairs of samples were investigated derived from PB and SF of nine patients with persistent oJIA. The cells from PB and SF were determined by flow cytometry. The majority of the PBMC and IAMC were in phase G0/G1, with fewer than 1% in S phase. In the SF, the percentage of cells in the S phase are higher than in the PB. The percentage of cells in the S phase in SF are equal to the result in the control group. In conclusion, the turnover of synovial T cells in persistent oJIA is higher than in the PB.
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Affiliation(s)
- Juergen Brunner
- Department of Pediatrics, Innsbruck Medical School, Anichstrasse 35, 6020, Innsbruck, Austria.
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Mayerl C, Prelog M. Immunosenescence and juvenile idiopathic arthritis. Autoimmun Rev 2010; 11:297-300. [PMID: 20172056 DOI: 10.1016/j.autrev.2010.02.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 02/15/2010] [Indexed: 11/17/2022]
Abstract
Aging of the immune system (immunosenescence) is characterized by diminished thymus function, decreased output of recent thymic emigrants, compensatory peripheral proliferation of mature T cells and oligoclonal expansions of specific CD28(-) T cells. Clinical consequences are poor responses to new antigens or vaccinations, increased infection rates with higher morbidity and mortality, and increasing incidence of autoimmune diseases with advancing age. Premature immunosenescence is suggested to play a role in the pathogenesis of adult rheumatoid arthritis and in children with juvenile idiopathic arthritis (JIA). However, so far, there is not enough evidence for supporting one of the two theories: the first, favoring premature immunosenscence in children developing autoimmune conditions as the primary defect causing break-down of self-tolerance; the second, that premature immunosenescence in children with autoimmune disorders is secondary to chronic stimulation and activation of the immune system by inflammatory processes by the autoimmune disease itself. This contradictory view of etiology and pathogenesis of autoimmune diseases in the very young underlines the need for population-based longitudinal studies on immune-risk factors for autoimmune diseases beginning at infancy.
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Affiliation(s)
- Christina Mayerl
- Division of Experimental Pathophysiologie and Immunology, Department Biocenter, Medical University Innsbruck, Austria
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Zlamy M, Prelog M. Thymectomy in early childhood: a model for premature T cell immunosenescence? Rejuvenation Res 2010; 12:249-58. [PMID: 19673593 DOI: 10.1089/rej.2009.0864] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The thymus is the main source of recent thymic emigrants (RTE) and naïve T cells. The aging of the immune system (immunosenescence) is characterized by loss of thymic function, decreased numbers of RTE, peripheral proliferation of mature T cells, and oligoclonal expansions of specific T cell subpopulations. As shown in several studies, thymectomized patients demonstrate signs of premature immunosenescence reminiscent of aged people, such as decreased proportions of naïve T cells and RTE, a compensatory increase of mature T cell subpopulations with increased proliferation rates, restriction of the T cell receptor repertoire, and a delayed response to new antigens and vaccinations. This review demonstrates that, despite some limitations, childhood thymectomy may serve as an useful model for premature immunosenescence, mimicking changes expected after physiological thymus involution in the elderly. Thus, it may prove an insightful tool for obtaining better understanding of human naïve T cell development, thymic function, and maintenance of the naïve T cell pool.
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Affiliation(s)
- Manuela Zlamy
- Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Austria
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Andrews NP, Fujii H, Goronzy JJ, Weyand CM. Telomeres and immunological diseases of aging. Gerontology 2009; 56:390-403. [PMID: 20016137 DOI: 10.1159/000268620] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 09/07/2009] [Indexed: 12/14/2022] Open
Abstract
A defining feature of the eukaryotic genome is the presence of linear chromosomes. This arrangement, however, poses several challenges with regard to chromosomal replication and maintenance. To prevent the loss of coding sequences and to suppress gross chromosomal rearrangements, linear chromosomes are capped by repetitive nucleoprotein structures, called telomeres. Each cell division results in a progressive shortening of telomeres that, below a certain threshold, promotes genome instability, senescence, and apoptosis. Telomeric erosion, maintenance, and repair take center stage in determining cell fate. Cells of the immune system are under enormous proliferative demand, stressing telomeric intactness. Lymphocytes are capable of upregulating telomerase, an enzyme that can elongate telomeric sequences and, thus, prolong cellular lifespan. Therefore, telomere dynamics are critical in preserving immune function and have become a focus for studies of immunosenescence and autoimmunity. In this review, we describe the role of telomeric nucleoproteins in shaping telomere architecture and in suppressing DNA damage responses. We summarize new insights into the regulation of telomerase activity, hereditary disorders associated with telomere dysfunction, the role of telomere loss in immune aging, and the impact of telomere dysfunction in chronic inflammatory disease.
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Affiliation(s)
- Nicolas P Andrews
- Lowance Center for Human Immunology, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
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Abstract
Juvenile idiopathic arthritis (JIA) refers to a group of chronic childhood arthropathies of unknown etiology, currently classified into subtypes primarily on the basis of clinical features. Research has focused on the hypothesis that these subtypes arise through distinct etiologic pathways. In this Review, we discuss four subtypes of JIA: persistent oligoarticular, extended oligoarticular, rheumatoid-factor-positive polyarticular and rheumatoid-factor-negative polyarticular. These subtypes differ in prevalence between ethnic groups and are associated with different HLA alleles. Non-HLA genetic risk factors have also been identified, some of which reveal further molecular differences between these subtypes, while others suggest mechanistic overlap. Investigations of immunophenotypes also provide insights into subtype differences: adaptive immunity seems to have a prominent role in both polyarticular and oligoarticular JIA, and the more-limited arthritis observed in persistent oligoarticular JIA as compared with extended oligoarticular JIA may reflect more-potent immunoregulatory T-cell activity in the former. Tumor necrosis factor seems to be a key mediator of both polyarticular and oligoarticular JIA, especially in the extended oligoarticular subtype, although elevated levels of other cytokines are also observed. Limited data on monocytes, dendritic cells, B cells, natural killer T cells and neutrophils suggest that the contributions of these cells differ across subtypes of JIA. Within each subtype, however, common pathways seem to drive joint damage.
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Hofer J, Hofer S, Zlamy M, Jeller V, Koppelstaetter C, Brandstätter A, Kern H, Köhle J, Zimmerhackl LB, Prelog M. Elevated Proportions of Recent Thymic Emigrants in Children and Adolescents with Type 1 Diabetes. Rejuvenation Res 2009; 12:311-20. [DOI: 10.1089/rej.2009.0863] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Johannes Hofer
- Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Innsbruck, Austria
| | - Sabine Hofer
- Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Innsbruck, Austria
| | - Manuela Zlamy
- Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Innsbruck, Austria
| | - Verena Jeller
- Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Innsbruck, Austria
| | | | - Anita Brandstätter
- Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology, Medical University Innsbruck, Innsbruck, Austria
| | - Hannelore Kern
- Department of Pediatrics, Pediatrics II, Medical University Innsbruck, Innsbruck, Austria
| | - Julia Köhle
- Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Innsbruck, Austria
| | | | - Martina Prelog
- Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Innsbruck, Austria
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Astrauskiene D, Bernotiene E, Bytautiene J, Sakalinskas V, Panaviene V, Venaliene J, Lesinskas E. Recurrent tonsillitis and tonsillectomy in juvenile idiopathic arthritis. Scand J Rheumatol 2009; 38:349-52. [PMID: 19579150 DOI: 10.1080/03009740902911664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To compare the clinical and bacteriological features of recurrent tonsillitis between patients with and without juvenile idiopathic arthritis (JIA). METHODS A total of 122 participants, aged 2-18 years, were consecutively recruited into four groups: (i) JIA and recurrent tonsillitis; (ii) JIA; (iii) recurrent tonsillitis; and (iv) healthy. All the patients with recurrent tonsillitis underwent tonsillectomy. Swabs from tonsillar surface crypts of all children and samples from tonsillar core tissue in case of tonsillectomy were processed for culturing. Mycoplasma pneumoniae was determined by polymerase chain reaction (PCR). RESULTS Significantly lower rates of recurrences but more frequent tonsillar detritus, paratonsillar scars, and more intensive bleeding during tonsillectomy were found in patients with JIA and recurrent tonsillitis, versus patients with recurrent tonsillitis without arthritis. In JIA patients with recurrent tonsillitis, Staphylococcus aureus was cultured from the tonsillar surface in 36%, and from the core tissue in 92% of cases (p = 0.0000). In patients suffering from recurrent tonsillitis alone, this pathogen was cultured from the core in 55.9% of cases (p = 0.0066 compared to JIA patients with recurrent tonsillitis). No M. pneumoniae was revealed by PCR in samples from the tonsillar surface and the core tissue. CONCLUSIONS The increased rate of S. aureus in the core tissue of tonsils, the higher frequency of tonsillar detritus, the more pronounced paratonsillar scarring, and more intensive bleeding during tonsillectomy, associated with the lower frequency of tonsillitis recurrences, are characteristic for recurrent tonsillitis in JIA as compared to recurrent tonsillitis without arthritis.
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Affiliation(s)
- D Astrauskiene
- Institute of Experimental and Clinical Medicine at Vilnius University, Department of Rheumatology, Vilnius, Lithuania.
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BOHGAKI TOSHIYUKI, ATSUMI TATSUYA, BOHGAKI MIYUKI, FURUSAKI AKIRA, KONDO MAKOTO, SATO-MATSUMURA KAZUKOC, ABE RIICHIRO, KATAOKA HIROSHI, HORITA TETSUYA, YASUDA SHINSUKE, AMASAKI YOSHIHARU, NISHIO MITSUFUMI, SAWADA KENICHI, SHIMIZU HIROSHI, KOIKE TAKAO. Immunological Reconstitution after Autologous Hematopoietic Stem Cell Transplantation in Patients with Systemic Sclerosis: Relationship Between Clinical Benefits and Intensity of Immunosuppression. J Rheumatol 2009; 36:1240-8. [DOI: 10.3899/jrheum.081025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective.To analyze the relationship between clinical benefits and immunological changes in patients with systemic sclerosis (SSc) treated with autologous hematopoietic stem cell transplantation (HSCT).Methods.Ten patients with SSc were treated with high-dose cyclophosphamide followed by highly purified CD34+ cells (n = 5) or unpurified grafts (n = 5). Two groups of patients were retrospectively constituted based on their clinical response (good responders, n = 7; and poor responders, n = 3). As well as clinical findings, immunological reconstitution through autologous HSCT was assessed by fluorescence-activated cell sorter analysis, quantification of signal joint T cell receptor rearrangement excision circles (sjTREC), reflecting the thymic function, andfoxp3, a key gene of regulatory T cells, mRNA levels.Results.Patients’ clinical and immunological findings were similar between good and poor responders, or CD34-purified and unpurified groups at inclusion. The sjTREC values were significantly suppressed at 3 months after autologous HSCT in good responders compared with poor responders (p = 0.0152). Reconstitution of CD4+CD45RO− naive T cells was delayed in good responders compared with poor responders. The phenotype of other lymphocytes, cytokine production in T cells, andfoxp3gene expression levels after autologous HSCT did not correlate with clinical response in good or poor responders. Clinical and immunological findings after autologous HSCT were similar between CD34-purified and unpurified groups.Conclusion.Our results suggest that immunosuppression intensity, sufficient to induce transient suppression of thymic function, is attributable to the feasible clinical response in patients with SSc treated with autologous HSCT. Appropriate monitoring of sjTREC values may predict clinical benefits in transplanted SSc patients after autologous HSCT.
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Lorenzi AR, Foster HE, Isaacs JD. Thymic function and immune senescence in juvenile idiopathic arthritis: comment on the article by Prelog et al. ARTHRITIS AND RHEUMATISM 2009; 60:310-312. [PMID: 19116926 DOI: 10.1002/art.24254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Premature senescence of T lymphocytes from patients with beta-thalassemia major. Immunol Lett 2008; 122:84-8. [PMID: 19118576 DOI: 10.1016/j.imlet.2008.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2008] [Revised: 11/27/2008] [Accepted: 12/01/2008] [Indexed: 11/20/2022]
Abstract
Several researches have demonstrated a suppressed cell mediated immunity in patients with beta-thalassemia major. To know whether the premature aging of T cells is involved in abnormalities of cell mediated immunity, the biomarkers of immunosenescence including telomerase activity, apoptosis, and the expression of CD28 and CD95 were evaluated in T lymphocytes from beta-thalassemia major patients. The ex vivo spontaneous apoptosis in CD4(+) or CD8(+) T cells from patients and healthy subjects was assessed by an in situ TdT mediated dUTP-biotin nick end labelling (TUNEL) assay after 24h incubation in medium. Flow cytometric data revealed that lymphocytes from beta-thalassemia patients were resistant to spontaneous apoptosis compared to the normal lymphocytes. Moreover, the percentages of TUNEL(+)CD4(+) or TUNEL(+)CD8(+) T cells from patients were significantly lower than those control cells. Quantitative determination of telomerase activity in resting and activated T cells was performed using the Telomeric Repeat Amplification Protocol (TRAP). The results showed a decreased telomerase activity of activated T cells in patients with thalassemia major compared to that in healthy controls. However, the percentages of CD8(+)CD28(-) and CD3(+)CD95(+) T lymphocytes were significantly higher in thalassemia patients, indicating the phenotypes associated with senescent T lymphocytes. These data provide evidences for the occurrence of accelerated aging of T cells in beta-thalassemia major; possibly result in abnormal T cell function leading to suppressed cell mediated immunity.
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Prelog M, Schwarzenbrunner N, Tengg E, Sailer-Höck M, Kern H, Zimmerhackl LB, Brunner J. Quantitative alterations of CD8+ T cells in juvenile idiopathic arthritis patients in remission. Clin Rheumatol 2008; 28:385-9. [PMID: 19093142 DOI: 10.1007/s10067-008-1057-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 11/13/2008] [Indexed: 11/29/2022]
Abstract
The study was aimed to investigate whether quantities of CD8(+) T cell subsets are normal in juvenile idiopathic arthritis (JIA) patients with disease remission compared to age-matched healthy donors (HD) and whether chronological age may have an impact on proportions of naive CD8(+) T cells. CD8(+) T cell subsets were analyzed in 17 JIA patients and 32 age-matched HD by flow cytometry. JIA patients showed lower CD3(+)CD8(+) T cells compared to HD. Total counts of CD8(+)CD28(+) and CD8(+)CD28(+)CD45RA(+) T cells were inversely correlated to chronological age in JIA patients and HD. In JIA patients, percentages of CD8(+)CD28(+)CD45RA(+) T cells and of CD62L-expressing CD8(+)CD28(+)CD45RA(+) T cells showed a negative correlation with age. The trend to lower CD28(+)CD45RA(+) T cell proportions in aged JIA patients in remission may reflect a disturbed T cell homeostasis independently of disease activity and may be due to an intrinsic effect in reconstitution of the peripheral T cells.
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Affiliation(s)
- Martina Prelog
- Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
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