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Li L, Chen J, Wang Z, Xu Y, Yao H, Lei W, Zhou X, Zheng M. NECA alleviates inflammatory responses in diabetic retinopathy through dendritic cell toll-like receptor signaling pathway. Front Immunol 2024; 15:1415004. [PMID: 38895119 PMCID: PMC11182989 DOI: 10.3389/fimmu.2024.1415004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction This study examined the impact of 5'-(N- ethylcarboxamido)adenosine (NECA) in the peripheral blood of healthy individuals, those with diabetes mellitus, diabetic retinopathy (DR), and C57BL/6 mice, both in vivo and in vitro. Methods Enzyme-linked immunosorbent assay (ELISA) and flow cytometry (FCM) were used to evaluate the effects of NECA on dendritic cells (DCs) and mouse bone marrow-derived dendritic cells (BMDCs) and the effects of NECA-treated DCs on Treg and Th17 cells. The effect of NECA on the Toll-like receptor (TLR) pathway in DCs was evaluated using polymerase chain reaction (PCR) and western blotting (WB). Results FCM and ELISA showed that NECA inhibited the expression of surface markers of DCs and BMDCs, increased anti-inflammatory cytokines and decreased proinflammatory cytokines. PCR and WB showed that NCEA decreased mRNA transcription and protein expression in the TLR-4-MyD88-NF-kβ pathway in DCs and BMDCs. The DR severity in streptozocin (STZ) induced diabetic mice was alleviated. NECA-treated DCs and BMDCs were co-cultivated with CD4+T cells, resulting in modulation of Treg and Th17 differentiation, along with cytokine secretion alterations. Conclusion NECA could impair DCs' ability to present antigens and mitigate the inflammatory response, thereby alleviating the severity of DR.
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Affiliation(s)
| | | | | | | | | | | | - Xiyuan Zhou
- *Correspondence: Xiyuan Zhou, ; Minming Zheng,
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Chambers CD, Song J, da Silva Antunes R, Sette A, Franco A. T Cell Responses in Pregnant Women Who Received mRNA-Based Vaccination to Prevent COVID-19 Revealed Unknown Exposure to the Natural Infection and Numerous SARS-CoV-2-Specific CD4- CD8- Double Negative T Cells and Regulatory T Cells. Int J Mol Sci 2024; 25:2031. [PMID: 38396707 PMCID: PMC10889590 DOI: 10.3390/ijms25042031] [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] [Received: 12/23/2023] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
We studied T-cell responses to SARS-CoV-2 in 19 pregnant subjects at different gestational weeks who received three doses of mRNA-based vaccination to prevent COVID-19. SARS-CoV-2 peptide pools were used for T-cell recognition studies: peptides were 15 amino acids long and had previously been defined in COVID-19-convalescent subjects. T-cell activation was evaluated with the AIM assay. Most subjects showed coordinated, spike-specific CD4+ and CD8+ T-cell responses and the development of T cell memory. Non-spike-specific T cells in subjects who were not aware of previous COVID-19 infection suggested a prior undetected, asymptomatic infection. CD4- CD8- double negative (DN) T cells were numerous, of which a percentage was specific for SARS-CoV-2 spike peptides. Regulatory T cells (Treg), both spike- and non-spike-specific, were also greatly expanded. Two Treg populations were defined: a population differentiated from naïve T cells, and pTreg, reverting from pro-inflammatory T cells. The Treg cells expressed CCR6, suggesting homing to the endometrium and vaginal epithelial cells. The pregnant women responded to SARS-CoV-2 vaccination. Asymptomatic COVID-19 was revealed by the T cell response to the non-spike peptides. The numerous DN T cells and Treg pointed our attention to new aspects of the adaptive immune response in vaccine recipients.
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Affiliation(s)
- Christina D. Chambers
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (C.D.C.); (J.S.)
| | - Jaeyoon Song
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (C.D.C.); (J.S.)
| | - Ricardo da Silva Antunes
- Center for Vaccine Innovation, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA (A.S.)
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92093, USA
| | - Alessandro Sette
- Center for Vaccine Innovation, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA (A.S.)
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92093, USA
| | - Alessandra Franco
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (C.D.C.); (J.S.)
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Jain S, He F, Brown K, Burns JC, Tremoulet AH. Multisystem Inflammatory Syndrome therapies in children (MISTIC): A randomized trial. Contemp Clin Trials Commun 2023; 32:101060. [PMID: 36694613 PMCID: PMC9852262 DOI: 10.1016/j.conctc.2023.101060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/28/2022] [Accepted: 01/14/2023] [Indexed: 01/22/2023] Open
Abstract
Background Multisystem Inflammatory Syndrome in Children (MIS-C), which occurs 2-6 weeks after initial exposure to SARS-CoV-2, was first identified in early 2020 when patients presented with fever and significant inflammation, often requiring management in the intensive care unit. To date, there has been no clinical trial to determine the most effective treatment. This study compares anti-inflammatory treatments that were selected based on current treatments for Kawasaki disease, a coronary artery vasculitis that shares many clinical features with MIS-C. Methods This randomized, comparative effectiveness trial of children with MIS-C uses the small N Sequential Multiple Assignment Randomized Trial (snSMART) design for rare diseases to compare multiple therapies within an individual. Study participants were treated first with intravenous immunoglobulin (IVIG), and if needed, subjects were then randomized to one of three additional treatments (steroids, anakinra, or infliximab). Participants were re-randomized to remaining treatments if they did not demonstrate clinical improvement. Conclusion This trial continues to enroll eligible participants to determine the most effective therapies in addition to IVIG and best order in which to use them to treat MIS-C. Trial Registration NCT04898231.
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Affiliation(s)
- Sonia Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, USA
| | - Feng He
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, USA
| | - Kiana Brown
- Department of Pediatrics, UCSD School of Medicine/Rady Children's Hospital San Diego, 9500 Gilman Dr, Mail Code 0641, La Jolla, CA, 92093-061, USA
| | - Jane C. Burns
- Department of Pediatrics, UCSD School of Medicine/Rady Children's Hospital San Diego, 9500 Gilman Dr, Mail Code 0641, La Jolla, CA, 92093-061, USA
| | - Adriana H. Tremoulet
- Department of Pediatrics, UCSD School of Medicine/Rady Children's Hospital San Diego, 9500 Gilman Dr, Mail Code 0641, La Jolla, CA, 92093-061, USA,Corresponding author. Department of Pediatrics, UCSD School of Medicine, 9500 Gilman Dr, Mail Code 0641, La Jolla, CA, 92093-0641, USA
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Santambrogio L, Franco A. The yin/yang balance of the MHC-self -immunopeptidome. Front Immunol 2022; 13:1035363. [PMID: 36405763 PMCID: PMC9666884 DOI: 10.3389/fimmu.2022.1035363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/07/2022] [Indexed: 07/22/2023] Open
Abstract
The MHC-self immunopeptidome of professional antigen presenting cells is a cognate ligand for the TCRs expressed on both conventional and thymic-derived natural regulatory T cells. In regulatory T cells, the TCR signaling associated with MHC-peptide recognition induces antigen specific as well as bystander immunosuppression. On the other hand, TCR activation of conventional T cells is associated with protective immunity. As such the peripheral T cell repertoire is populated by a number of T cells with different phenotypes and different TCRs, which can recognize the same MHC-self-peptide complex, resulting in opposite immunological outcomes. This article summarizes what is known about regulatory and conventional T cell recognition of the MHC-self-immunopeptidome at steady state and in inflammatory conditions associated with increased T and B cell self-reactivity, discussing how changes in the MHC-ligandome including epitope copy number and post-translational modifications can tilt the balance toward the expansion of pro-inflammatory or regulatory T cells.
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Affiliation(s)
- Laura Santambrogio
- Department of Radiation Oncology, Physiology and Biophysics, Englander Institute of Precision Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Alessandra Franco
- University of California San Diego School of Medicine, Department of Pediatrics, La Jolla, CA, United States
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Hsieh LE, Song J, Grifoni A, Shimizu C, Tremoulet AH, Dummer KB, Burns JC, Sette A, Franco A. T Cells in Multisystem Inflammatory Syndrome in Children (MIS-C) Have a Predominant CD4+ T Helper Response to SARS-CoV-2 Peptides and Numerous Virus-Specific CD4- CD8- Double-Negative T Cells. Int J Mol Sci 2022; 23:7219. [PMID: 35806225 PMCID: PMC9266459 DOI: 10.3390/ijms23137219] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 01/07/2023] Open
Abstract
We studied SARS-CoV-2-specific T cell responses in 22 subacute MIS-C children enrolled in 2021 and 2022 using peptide pools derived from SARS-CoV-2 spike or nonspike proteins. CD4+ and CD8+ SARS-CoV-2-specific T cells were detected in 5 subjects, CD4+ T helper (Th) responses alone were detected in 12 subjects, and CD8+ cytotoxic T cell (CTL) responses alone were documented in 1 subject. Notably, a sizeable subpopulation of CD4- CD8- double-negative (DN) T cells out of total CD3+ T cells was observed in MIS-C (median: 14.5%; IQR 8.65-25.3) and recognized SARS-CoV-2 peptides. T cells bearing the Vβ21.3 T cell receptor (TcRs), previously reported as pathogenic in the context of MIS-C, were detected in high frequencies, namely, in 2.8% and 3.9% of the CD4+ and CD8+ T cells, respectively. However, Vβ21.3 CD8+ T cells that responded to SARS-CoV-2 peptides were detected in only a single subject, suggesting recognition of nonviral antigens in the majority of subjects. Subjects studied 6-14 months after MIS-C showed T cell epitope spreading, meaning the activation of T cells that recognize more SARS-CoV-2 peptides following the initial expansion of T cells that see immunodominant epitopes. For example, subjects that did not recognize nonspike proteins in the subacute phase of MIS-C showed good Th response to nonspike peptides, and/or CD8+ T cell responses not appreciable before arose over time and could be detected in the 6-14 months' follow-up. The magnitude of the Th and CTL responses also increased over time. In summary, patients with MIS-C associated with acute lymphopenia, a classical feature of MIS-C, showed a physiological response to the virus with a prominent role for virus-specific DN T cells.
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Affiliation(s)
- Li-En Hsieh
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (L.-E.H.); (J.S.); (C.S.); (A.H.T.); (K.B.D.); (J.C.B.)
| | - Jaeyoon Song
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (L.-E.H.); (J.S.); (C.S.); (A.H.T.); (K.B.D.); (J.C.B.)
| | - Alba Grifoni
- Division of Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, CA 92037, USA; (A.G.); (A.S.)
| | - Chisato Shimizu
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (L.-E.H.); (J.S.); (C.S.); (A.H.T.); (K.B.D.); (J.C.B.)
| | - Adriana H. Tremoulet
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (L.-E.H.); (J.S.); (C.S.); (A.H.T.); (K.B.D.); (J.C.B.)
- Rady Children’s Hospital, 3020 Children’s Way, San Diego, CA 92123, USA
| | - Kirsten B. Dummer
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (L.-E.H.); (J.S.); (C.S.); (A.H.T.); (K.B.D.); (J.C.B.)
- Rady Children’s Hospital, 3020 Children’s Way, San Diego, CA 92123, USA
| | - Jane C. Burns
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (L.-E.H.); (J.S.); (C.S.); (A.H.T.); (K.B.D.); (J.C.B.)
- Rady Children’s Hospital, 3020 Children’s Way, San Diego, CA 92123, USA
| | - Alessandro Sette
- Division of Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, CA 92037, USA; (A.G.); (A.S.)
- Department of Medicine, University of California, San Diego (UCSD), La Jolla, CA 92037, USA
| | - Alessandra Franco
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA; (L.-E.H.); (J.S.); (C.S.); (A.H.T.); (K.B.D.); (J.C.B.)
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6
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Hsieh LE, Song J, Tremoulet AH, Burns JC, Franco A. Intravenous immunoglobulin induces IgG internalization by tolerogenic myeloid dendritic cells that secrete IL-10 and expand Fc-specific regulatory T cells. Clin Exp Immunol 2022; 208:361-371. [PMID: 35536993 PMCID: PMC9226148 DOI: 10.1093/cei/uxac046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/28/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Intravenous immunoglobulin (IVIG) is used as an immunomodulatory agent in many inflammatory conditions including Multisystem Inflammatory Syndrome-Children (MIS-C) and Kawasaki disease (KD). However, the exact mechanisms underlying its anti-inflammatory action are incompletely characterized. Here, we show that in KD, a pediatric acute vasculitis that affects the coronary arteries, IVIG induces a repertoire of natural Treg that recognize immunodominant peptides in the Fc heavy chain constant region. To address which antigen-presenting cell (APC) populations present Fc peptides to Treg, we studied the uptake of IgG by innate cells in subacute KD patients 2 weeks after IVIG and in children 1.6–14 years after KD. Healthy adults served as controls. IgG at high concentrations was internalized predominantly by two myeloid dendritic cell (DC) lineages, CD14+ cDC2 and ILT-4+ CD4+ tmDC mostly through Fcγ receptor (R) II and to a lesser extent FcγRIII. Following IgG internalization, these two DC lineages secreted IL-10 and presented processed Fc peptides to Treg. The validation of IVIG function in expanding Fc-specific Treg presented by CD14+ cDC2 and ILT-4+ CD4+ tmDC was addressed in a small cohort of patients with MIS-C. Taken together, these results suggest a novel immune regulatory function of IgG in activating tolerogenic innate cells and expanding Treg, which reveals an important anti-inflammatory mechanism of action of IVIG.
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Affiliation(s)
- Li-En Hsieh
- University of California San Diego, School of Medicine, Department of Pediatrics, La Jolla, CA 92093-0641, USA
| | - Jaeyoon Song
- University of California San Diego, School of Medicine, Department of Pediatrics, La Jolla, CA 92093-0641, USA
| | - Adriana H Tremoulet
- University of California San Diego, School of Medicine, Department of Pediatrics, La Jolla, CA 92093-0641, USA.,Rady Children's Hospital, San Diego, CA 92123, USA
| | - Jane C Burns
- University of California San Diego, School of Medicine, Department of Pediatrics, La Jolla, CA 92093-0641, USA.,Rady Children's Hospital, San Diego, CA 92123, USA
| | - Alessandra Franco
- University of California San Diego, School of Medicine, Department of Pediatrics, La Jolla, CA 92093-0641, USA
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7
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Yang J, Jain S, Capparelli EV, Best BM, Son MB, Baker A, Newburger JW, Franco A, Printz BF, He F, Shimizu C, Hoshino S, Bainto E, Moreno E, Pancheri J, Burns JC, Tremoulet AH. Anakinra Treatment in Patients with Acute Kawasaki Disease with Coronary Artery Aneurysms: A Phase I/IIa Trial. J Pediatr 2022; 243:173-180.e8. [PMID: 34953816 DOI: 10.1016/j.jpeds.2021.12.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/08/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To determine the safety, pharmacokinetics, and immunomodulatory effects of 2-6 weeks of anakinra therapy in patients with acute Kawasaki disease with a coronary artery aneurysm (CAA). STUDY DESIGN We performed a Phase I/IIa dose-escalation study of anakinra (2-11 mg/kg/day) in 22 patients with acute Kawasaki disease with CAA. We measured interleukin (IL)-1RA concentrations after the first dose and trough levels up to study week 6. Markers of inflammation and coronary artery z-scores were assessed pretreatment and at 48 hours, 2 weeks, and 6 weeks after initiation of therapy. RESULTS Up to 6 weeks of anakinra (up to 11 mg/kg/day) was safe and well tolerated by the 22 participants (median age, 1.1 years), with no serious adverse events attributable to the study drug. All participants were treated with intravenous immunoglobulin (IVIG), and 20 also received infliximab (10 mg/kg) before initiation of anakinra. Serum levels of IL-6, IL-8, and tumor necrosis factor α decreased similarly in patients with Kawasaki disease treated with IVIG, infliximab, and anakinra compared with age- and sex-matched patients with Kawasaki disease treated only with IVIG and infliximab. Anakinra clearance increased with illness day at diagnosis. Simulations demonstrated that more frequent intravenous (IV) dosing may result in more sustained concentrations without significantly increasing the peak concentration compared with subcutaneous (SC) dosing. CONCLUSIONS Both IV and SC anakinra are safe in infants and children with acute Kawasaki disease and CAA. IV dosing every 8-12 hours during the acute hospitalization of patients with Kawasaki disease may result in a sustained concentration while avoiding frequent SC injections. The efficacy of a short course of IV therapy during hospitalization should be studied. TRIAL REGISTRATION CLINICALTRIALS.GOV: NCT02179853.
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Affiliation(s)
- Jincheng Yang
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA
| | - Sonia Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA
| | - Edmund V Capparelli
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA
| | - Brookie M Best
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA
| | - Mary Beth Son
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Annette Baker
- Department of Cardiology, Boston Children's Hospital, Boston, MA
| | - Jane W Newburger
- Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Alessandra Franco
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA
| | - Beth F Printz
- Division of Pediatric Cardiology, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA
| | - Feng He
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA
| | - Chisato Shimizu
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA
| | - Shinsuke Hoshino
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA
| | - Emelia Bainto
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA
| | - Elizabeth Moreno
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA
| | - Joan Pancheri
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA
| | - Jane C Burns
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA
| | - Adriana H Tremoulet
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA.
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8
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Hsieh L, Grifoni A, Sidney J, Shimizu C, Shike H, Ramchandar N, Moreno E, Tremoulet AH, Burns JC, Franco A. Characterization of SARS-CoV-2 and common cold coronavirus-specific T-cell responses in MIS-C and Kawasaki disease children. Eur J Immunol 2022; 52:123-137. [PMID: 34599760 PMCID: PMC8646471 DOI: 10.1002/eji.202149556] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/01/2021] [Accepted: 09/27/2021] [Indexed: 01/06/2023]
Abstract
The immunopathogenesis of multisystem inflammatory syndrome (MIS-C) in children that may follow exposure to SARS-CoV-2 is incompletely understood. Here, we studied SARS-CoV-2-specific T cells in MIS-C, Kawasaki disease (KD), and SARS-CoV-2 convalescent controls using peptide pools derived from SARS-CoV-2 spike or nonspike proteins, and common cold coronaviruses (CCC). Coordinated CD4+ and CD8+ SARS-CoV-2-specific T cells were detected in five MIS-C subjects with cross-reactivity to CCC. CD4+ and CD8+ T-cell responses alone were documented in three and one subjects, respectively. T-cell specificities in MIS-C did not correlate with disease severity and were similar to SARS-CoV-2 convalescent controls. T-cell memory and cross-reactivity to CCC in MIS-C and SARS-CoV-2 convalescent controls were also similar. The chemokine receptor CCR6, but not CCR9, was highly expressed on SARS-CoV-2-specific CD4+ but not on CD8+ T cells. Only two of 10 KD subjects showed a T-cell response to CCC. Enumeration of myeloid APCs revealed low cell precursors in MIS-C subjects compared to KD. In summary, children with MIS-C mount a normal T-cell response to SARS-CoV-2 with no apparent relationship to antecedent CCC exposure. Low numbers of tolerogenic myeloid DCs may impair their anti-inflammatory response.
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Affiliation(s)
- Li‐En Hsieh
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Alba Grifoni
- Division of Vaccine DiscoveryLa Jolla Institute for ImmunologyLa JollaCAUSA
| | - John Sidney
- Division of Vaccine DiscoveryLa Jolla Institute for ImmunologyLa JollaCAUSA
| | - Chisato Shimizu
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Hiroko Shike
- Department of Pathology and Laboratory MedicinePenn State Milton S. Hershey Medical CenterHersheyPAUSA
| | - Nanda Ramchandar
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Elizabeth Moreno
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Adriana H. Tremoulet
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Jane C. Burns
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Alessandra Franco
- Department of PediatricsSchool of MedicineUniversity of California, San DiegoLa JollaCAUSA
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9
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Zhu YP, Shamie I, Lee JC, Nowell CJ, Peng W, Angulo S, Le LN, Liu Y, Miao H, Xiong H, Pena CJ, Moreno E, Griffis E, Labou SG, Franco A, Broderick L, Hoffman HM, Shimizu C, Lewis NE, Kanegaye JT, Tremoulet AH, Burns JC, Croker BA. Immune response to intravenous immunoglobulin in patients with Kawasaki disease and MIS-C. J Clin Invest 2021; 131:e147076. [PMID: 34464357 DOI: 10.1172/jci147076] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 08/24/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUNDMultisystem inflammatory syndrome in children (MIS-C) is a rare but potentially severe illness that follows exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Kawasaki disease (KD) shares several clinical features with MIS-C, which prompted the use of intravenous immunoglobulin (IVIG), a mainstay therapy for KD. Both diseases share a robust activation of the innate immune system, including the IL-1 signaling pathway, and IL-1 blockade has been used for the treatment of both MIS-C and KD. The mechanism of action of IVIG in these 2 diseases and the cellular source of IL-1β have not been defined.METHODSThe effects of IVIG on peripheral blood leukocyte populations from patients with MIS-C and KD were examined using flow cytometry and mass cytometry (CyTOF) and live-cell imaging.RESULTSCirculating neutrophils were highly activated in patients with KD and MIS-C and were a major source of IL-1β. Following IVIG treatment, activated IL-1β+ neutrophils were reduced in the circulation. In vitro, IVIG was a potent activator of neutrophil cell death via PI3K and NADPH oxidase, but independently of caspase activation.CONCLUSIONSActivated neutrophils expressing IL-1β can be targeted by IVIG, supporting its use in both KD and MIS-C to ameliorate inflammation.FUNDINGPatient Centered Outcomes Research Institute; NIH; American Asthma Foundation; American Heart Association; Novo Nordisk Foundation; NIGMS; American Academy of Allergy, Asthma and Immunology Foundation.
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Affiliation(s)
| | - Isaac Shamie
- Department of Bioengineering, UCSD, La Jolla, California, USA
| | - Jamie C Lee
- Department of Pediatrics and.,Department of Bioengineering, UCSD, La Jolla, California, USA
| | - Cameron J Nowell
- Monash Institute of Pharmaceutical Sciences, Parkville, Victoria, Australia
| | - Weiqi Peng
- Department of Pediatrics and.,Department of Mathematics
| | | | - Linh Nn Le
- Department of Pediatrics and.,Department of Bioengineering, UCSD, La Jolla, California, USA
| | - Yushan Liu
- Department of Pediatrics and.,Department of Computer Science and Engineering
| | | | | | | | | | | | | | | | - Lori Broderick
- Department of Pediatrics and.,Rady Children's Hospital San Diego, San Diego, California, USA
| | - Hal M Hoffman
- Department of Pediatrics and.,Rady Children's Hospital San Diego, San Diego, California, USA
| | | | - Nathan E Lewis
- Department of Pediatrics and.,Department of Bioengineering, UCSD, La Jolla, California, USA
| | - John T Kanegaye
- Department of Pediatrics and.,Rady Children's Hospital San Diego, San Diego, California, USA
| | - Adriana H Tremoulet
- Department of Pediatrics and.,Rady Children's Hospital San Diego, San Diego, California, USA
| | - Jane C Burns
- Department of Pediatrics and.,Rady Children's Hospital San Diego, San Diego, California, USA
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10
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Deng M, Chen H, Liu X, Huang R, He Y, Yoo B, Xie J, John S, Zhang N, An Z, Zhang CC. Leukocyte immunoglobulin-like receptor subfamily B: therapeutic targets in cancer. Antib Ther 2021; 4:16-33. [PMID: 33928233 PMCID: PMC7944505 DOI: 10.1093/abt/tbab002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 02/06/2023] Open
Abstract
Inhibitory leukocyte immunoglobulin-like receptors (LILRBs 1–5) transduce signals via intracellular immunoreceptor tyrosine-based inhibitory motifs that recruit phosphatases to negatively regulate immune activation. The activation of LILRB signaling in immune cells may contribute to immune evasion. In addition, the expression and signaling of LILRBs in cancer cells especially in certain hematologic malignant cells directly support cancer development. Certain LILRBs thus have dual roles in cancer biology—as immune checkpoint molecules and tumor-supporting factors. Here, we review the expression, ligands, signaling, and functions of LILRBs, as well as therapeutic development targeting them. LILRBs may represent attractive targets for cancer treatment, and antagonizing LILRB signaling may prove to be effective anti-cancer strategies.
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Affiliation(s)
- Mi Deng
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Heyu Chen
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Xiaoye Liu
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Ryan Huang
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Yubo He
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Byounggyu Yoo
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Jingjing Xie
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Samuel John
- Department of Pediatrics, Pediatric Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Ningyan Zhang
- Texas Therapeutics Institute, Brown Foundation Institute of Molecular Medicine, University of Texas Houston Health Science Center, Houston, TX 77030, USA
| | - Zhiqiang An
- Texas Therapeutics Institute, Brown Foundation Institute of Molecular Medicine, University of Texas Houston Health Science Center, Houston, TX 77030, USA
| | - Cheng Cheng Zhang
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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11
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Burns JC, Hsieh LE, Kumar J, Behnamfar N, Shimizu C, Sivilay N, Tremoulet AH, Franco A. Characterization of circulating immune cells in acute Kawasaki disease suggests exposure to different antigens. Clin Exp Immunol 2020; 202:263-272. [PMID: 32812215 PMCID: PMC7670149 DOI: 10.1111/cei.13506] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 01/03/2023] Open
Abstract
Kawasaki disease (KD) is an acute pediatric vasculitis of unknown etiology that can cause coronary artery aneurysms, and is the leading cause of acquired heart disease in children. We studied aspects of the innate and adaptive immune response in 17 acute KD children prior to treatment with intravenous immunoglobulin. Distinct patterns within the innate immune response correlated with specific clinical features. Proinflammatory myeloid dendritic cells (mDC) were abundant in four of 17 (23·5%) subjects who were older and manifested severe inflammation with clinical myocarditis and elevated hepatobiliary enzyme levels. Of the nine subjects with low levels of anti‐inflammatory, tolerogenic mDC, six had enlarged cervical lymph nodes at diagnosis. In contrast, the adaptive immune repertoire varied greatly with no discernible patterns or associations with clinical features. Two subjects with aneurysms had numerous circulating CD8+ T cells. Ten subjects showed low CD4+ T cell numbers and seven subjects had CD4+ T cells in the normal range. CD4+ T cells expressed interleukin‐7 receptor (IL‐7R), suggesting repeated antigenic stimulation. Thymic‐derived regulatory T cells (nTreg) and peripherally induced regulatory T cells (iTreg) were also enumerated, with the majority having the nTreg phenotype. Natural killer (NK) and NK T cell numbers were similar across all subjects. Taken together, the results of the immune monitoring suggest that KD may have multiple triggers that stimulate different arms of the innate and adaptive compartment in KD patients. Thus, it is possible that diverse antigens may participate in the pathogenesis of KD.
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Affiliation(s)
- J C Burns
- School of Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - L E Hsieh
- School of Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - J Kumar
- School of Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - N Behnamfar
- School of Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - C Shimizu
- School of Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - N Sivilay
- School of Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - A H Tremoulet
- School of Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - A Franco
- School of Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
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12
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13
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Tremoulet AH, Jain S, Jone PN, Best BM, Duxbury EH, Franco A, Printz B, Dominguez SR, Heizer H, Anderson MS, Glodé MP, He F, Padilla RL, Shimizu C, Bainto E, Pancheri J, Cohen HJ, Whitin JC, Burns JC. Phase I/IIa Trial of Atorvastatin in Patients with Acute Kawasaki Disease with Coronary Artery Aneurysm. J Pediatr 2019; 215:107-117.e12. [PMID: 31561960 PMCID: PMC6878161 DOI: 10.1016/j.jpeds.2019.07.064] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/17/2019] [Accepted: 07/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine the safety, tolerability, pharmacokinetics, and immunomodulatory effects of a 6-week course of atorvastatin in patients with acute Kawasaki disease with coronary artery (CA) aneurysm (CAA). STUDY DESIGN This was a Phase I/IIa 2-center dose-escalation study of atorvastatin (0.125-0.75 mg/kg/day) in 34 patients with Kawasaki disease (aged 2-17 years) with echocardiographic evidence of CAA. We measured levels of the brain metabolite 24(S)-hydroxycholesterol (24-OHC), serum lipids, acute-phase reactants, liver enzymes, and creatine phosphokinase; peripheral blood mononuclear cell populations; and CA internal diameter normalized for body surface area before atorvastatin treatment and at 2 and 6 weeks after initiation of atorvastatin treatment. RESULTS A 6-week course of up to 0.75 mg/kg/day of atorvastatin was well tolerated by the 34 subjects (median age, 5.3 years; IQR, 2.6-6.4 years), with no serious adverse events attributable to the study drug. The areas under the curve for atorvastatin and its metabolite were larger in the study subjects compared with those reported in adults, suggesting a slower rate of metabolism in children. The 24-OHC levels were similar between the atorvastatin-treated subjects and matched controls. CONCLUSIONS Atorvastatin was safe and well tolerated in our cohort of children with acute Kawasaki disease and CAA. A Phase III efficacy trial is warranted in this patient population, which may benefit from the known anti-inflammatory and immunomodulatory effects of this drug.
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Affiliation(s)
- Adriana H. Tremoulet
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA
| | - Sonia Jain
- Biostatistics Research Center, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
| | - Pei-Ni Jone
- Pediatric Cardiology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Brookie M. Best
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA,Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA
| | - Elizabeth H. Duxbury
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA,Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA
| | - Alessandra Franco
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA
| | - Beth Printz
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA
| | - Samuel R. Dominguez
- Pediatric Infectious Disease, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Heather Heizer
- Pediatric Infectious Disease, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Marsha S. Anderson
- Pediatric Infectious Disease, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Mary P. Glodé
- Pediatric Infectious Disease, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Feng He
- Biostatistics Research Center, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
| | - Robert L. Padilla
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA
| | - Chisato Shimizu
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA
| | - Emelia Bainto
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA
| | - Joan Pancheri
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA
| | | | - John C. Whitin
- Department of Pediatrics, Stanford University, Stanford, CA
| | - Jane C. Burns
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, California, USA; Rady Children’s Hospital San Diego, San Diego, California, USA
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14
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Xiao L, van De Worp WR, Stassen R, van Maastrigt C, Kettelarij N, Stahl B, Blijenberg B, Overbeek SA, Folkerts G, Garssen J, Van't Land B. Human milk oligosaccharides promote immune tolerance via direct interactions with human dendritic cells. Eur J Immunol 2019; 49:1001-1014. [PMID: 30900752 PMCID: PMC6619030 DOI: 10.1002/eji.201847971] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/19/2019] [Accepted: 03/19/2019] [Indexed: 12/17/2022]
Abstract
Human milk oligosaccharides (HMOS) are a complex mixture of bioactive components supporting the immune development of breastfed‐infants. Dendritic cells (DCs) play a central role in the regulation of immune responses, being specialized in antigen presentation and driving T‐cell priming as well as differentiation. However, little is known about the direct effects of HMOS on human DC phenotypes and functions. Here, we report that HMOS mixture isolated from pooled human milk, induced semi‐maturation of human monocytes‐derived DCs (moDCs), and elevated levels of IL‐10, IL‐27 and IL‐6 but not IL‐12p70 and TNF‐α. Consistently, HMOS‐conditioned human moDCs promoted Treg generation from naïve CD4+ T cells. Interestingly, HMOS limited LPS‐induced maturation of human moDCs, while maintained IL‐10 and IL‐27 secretion and reduced LPS‐induced production of IL‐12p70, IL‐6 and TNF‐α. Furthermore, HMOS+LPS‐stimulated DCs induced a higher frequency of Tregs and increased IL‐10 production, while a reduction in Tbet+Th1 frequency and IFN‐γ production was detected as compared to LPS‐DCs. The regulatory effects of HMOS seemed to be mediated by interactions of HMOS with receptors, including but not limited to TLR4 and DC‐SIGN on human moDCs. In conclusion, HMOS contain tolerogenic factors influencing human moDCs and thereby modulating the development of the neonatal immune system.
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Affiliation(s)
- Ling Xiao
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Wouter Rph van De Worp
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.,Department of Respiratory Medicine, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Roderick Stassen
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Celine van Maastrigt
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Nienke Kettelarij
- Departments of Immunology and of Human Milk Research & Analytical Science, Danone Nutricia Research, Utrecht, The Netherlands
| | - Bernd Stahl
- Departments of Immunology and of Human Milk Research & Analytical Science, Danone Nutricia Research, Utrecht, The Netherlands
| | - Bernadet Blijenberg
- Departments of Immunology and of Human Milk Research & Analytical Science, Danone Nutricia Research, Utrecht, The Netherlands
| | - Saskia A Overbeek
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.,Departments of Immunology and of Human Milk Research & Analytical Science, Danone Nutricia Research, Utrecht, The Netherlands
| | - Gert Folkerts
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Johan Garssen
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.,Departments of Immunology and of Human Milk Research & Analytical Science, Danone Nutricia Research, Utrecht, The Netherlands
| | - Belinda Van't Land
- Departments of Immunology and of Human Milk Research & Analytical Science, Danone Nutricia Research, Utrecht, The Netherlands.,Laboratory of Translational Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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15
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Silva-Vilches C, Ring S, Mahnke K. ATP and Its Metabolite Adenosine as Regulators of Dendritic Cell Activity. Front Immunol 2018; 9:2581. [PMID: 30473700 PMCID: PMC6237882 DOI: 10.3389/fimmu.2018.02581] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/19/2018] [Indexed: 12/21/2022] Open
Abstract
Adenosine (Ado) is a well-studied neurotransmitter, but it also exerts profound immune regulatory functions. Ado can (i) actively be released by various cells into the tissue environment and can (ii) be produced through the degradation of extracellular ATP by the concerted action of CD39 and CD73. In this sequence of events, the ectoenzyme CD39 degrades ATP into ADP and AMP, respectively, and CD73 catalyzes the last step leading to the production of Ado. Extracellular ATP acts as a “danger” signal and stimulates immune responses, i.e. by inflammasome activation. Its degradation product Ado on the other hand acts rather anti-inflammatory, as it down regulates functions of dendritic cells (DCs) and dampens T cell activation and cytokine secretion. Thus, the balance of proinflammatory ATP and anti-inflammatory Ado that is regulated by CD39+/CD73+ immune cells, is important for decision making on whether tolerance or immunity ensues. DCs express both ectoenzymes, enabling them to produce Ado from extracellular ATP by activity of CD73 and CD39 and thus allow dampening of the proinflammatory activity of adjacent leukocytes in the tissue. On the other hand, as most DCs express at least one out of four so far known Ado receptors (AdoR), DC derived Ado can also act back onto the DCs in an autocrine manner. This leads to suppression of DC functions that are normally involved in stimulating immune responses. Moreover, ATP and Ado production thereof acts as “find me” signal that guides cellular interactions of leukocytes during immune responses. In this review we will state the means by which Ado producing DCs are able to suppress immune responses and how extracellular Ado conditions DCs for their tolerizing properties.
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Affiliation(s)
- Cinthia Silva-Vilches
- Department of Dermatology, Ruprecht-Karls-University Heidelberg, University Hospital, Heidelberg, Germany
| | - Sabine Ring
- Department of Dermatology, Ruprecht-Karls-University Heidelberg, University Hospital, Heidelberg, Germany
| | - Karsten Mahnke
- Department of Dermatology, Ruprecht-Karls-University Heidelberg, University Hospital, Heidelberg, Germany
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