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Santus W, Barresi S, Mingozzi F, Broggi A, Orlandi I, Stamerra G, Vai M, Martorana AM, Polissi A, Köhler JR, Liu N, Zanoni I, Granucci F. Skin infections are eliminated by cooperation of the fibrinolytic and innate immune systems. Sci Immunol 2017; 2:2/15/eaan2725. [PMID: 28939652 DOI: 10.1126/sciimmunol.aan2725] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/21/2017] [Accepted: 07/27/2017] [Indexed: 12/24/2022]
Abstract
Nuclear factor of activated T cells (NFAT) is activated in innate immune cells downstream of pattern recognition receptors, but little is known about NFAT's functions in innate immunity compared with adaptive immunity. We show that early activation of NFAT balances the two major phases of the innate response to Candida albicans skin infections: the protective containment (abscess) and the elimination (expulsion) phases. During the early containment phase, transforming growth factor-β (TGF-β) induces the deposit of collagen around newly recruited polymorphonuclear cells to prevent microbial spreading. During the elimination phase, interferon-γ (IFN-γ) blocks differentiation of fibroblasts into myofibroblasts by antagonizing TGF-β signaling. IFN-γ also induces the formation of plasmin that, in turn, promotes abscess capsule digestion and skin ulceration for microbial discharge. NFAT controls innate IFN-γ production and microbial expulsion. This cross-talk between the innate immune and the fibrinolytic systems also occurs during infection with Staphylococcus aureus and is a protective response to minimize tissue damage and optimize pathogen elimination.
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Affiliation(s)
- William Santus
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Simona Barresi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Francesca Mingozzi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Achille Broggi
- Harvard Medical School and Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA 02115, USA
| | - Ivan Orlandi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Giulia Stamerra
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Marina Vai
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Alessandra M Martorana
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Alessandra Polissi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - Julia R Köhler
- Harvard Medical School and Division of Infectious Diseases, Boston Children's Hospital, Boston, MA 02115, USA
| | - Ningning Liu
- Harvard Medical School and Division of Infectious Diseases, Boston Children's Hospital, Boston, MA 02115, USA
| | - Ivan Zanoni
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy. .,Harvard Medical School and Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA 02115, USA
| | - Francesca Granucci
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy.
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2
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Becker KL, Rösler B, Wang X, Lachmandas E, Kamsteeg M, Jacobs CW, Joosten LA, Netea MG, van de Veerdonk FL. Th2 and Th9 responses in patients with chronic mucocutaneous candidiasis and hyper-IgE syndrome. Clin Exp Allergy 2016; 46:1564-1574. [DOI: 10.1111/cea.12787] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 05/20/2016] [Accepted: 07/16/2016] [Indexed: 01/06/2023]
Affiliation(s)
- K. L. Becker
- Department of Internal Medicine; Radboud University Medical Center; Radboud Center for Infectious Diseases (RCI); Nijmegen The Netherlands
| | - B. Rösler
- Department of Internal Medicine; Radboud University Medical Center; Radboud Center for Infectious Diseases (RCI); Nijmegen The Netherlands
| | - X. Wang
- Department of Internal Medicine; Radboud University Medical Center; Radboud Center for Infectious Diseases (RCI); Nijmegen The Netherlands
- Department of Dermatology; Peking University First Hospital; Beijing China
| | - E. Lachmandas
- Department of Internal Medicine; Radboud University Medical Center; Radboud Center for Infectious Diseases (RCI); Nijmegen The Netherlands
| | - M. Kamsteeg
- Department of Dermatology; Radboud University Medical Center; Nijmegen The Netherlands
| | - C. W. Jacobs
- Department of Internal Medicine; Radboud University Medical Center; Radboud Center for Infectious Diseases (RCI); Nijmegen The Netherlands
| | - L. A. Joosten
- Department of Internal Medicine; Radboud University Medical Center; Radboud Center for Infectious Diseases (RCI); Nijmegen The Netherlands
| | - M. G. Netea
- Department of Internal Medicine; Radboud University Medical Center; Radboud Center for Infectious Diseases (RCI); Nijmegen The Netherlands
| | - F. L. van de Veerdonk
- Department of Internal Medicine; Radboud University Medical Center; Radboud Center for Infectious Diseases (RCI); Nijmegen The Netherlands
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3
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Campois TG, Zucoloto AZ, de Almeida Araujo EJ, Svidizinski TIE, Almeida RS, da Silva Quirino GF, Harano RM, Conchon-Costa I, Felipe I. Immunological and histopathological characterization of cutaneous candidiasis. J Med Microbiol 2015; 64:810-817. [PMID: 26271575 DOI: 10.1099/jmm.0.000095] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Chronic mucocutaneous candidiasis constitutes a heterogeneous group of syndromes, characterized by non-invasive infection of the skin, nails and mucosal membranes by the fungus Candida spp. Although symptoms are heterogeneous, in all cases there is a reduction in protective cytokines, favouring the development of disease. The normal role of cytokines in skin lesions is not well understood. The present study aimed to investigate the progression of disease, understand specific cellular and molecular components involved in immunity to Candida albicans and determine the balance between pro- and anti-inflammatory cytokines over the course of cutaneous infection in immunocompetent mice. BALB/c mice (five per group) were inoculated with 5 × 10(6)C. albicans pseudohyphae in the deep dermis of the paw and analysed over 1-14 days post-infection. The contralateral paws were used for negative controls. Haematoxylin and eosin staining of skin sections during C. albicans infection was performed to analyse structural modifications to the epidermis such as hyperplasia, and infiltration of neutrophils and fibroblasts in the dermis. The cytokine populations were determined by capture ELISA using popliteal lymph node tissue. Pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17) were detected at significant levels during the initial phase of cutaneous infection and correlated with the rapid elimination of C. albicans. Anti-inflammatory cytokines (IL-13, IL-4, IL-10 and transforming growth factor-β) were detected on day 4 post-infection, and prevented exacerbation of inflammation and participated in healing of lesions. Thus, a balance between pro- and anti-inflammatory cytokines was fundamental for the resolution of infection. Importantly, these findings broaden our understanding of the immune mechanisms involved in chronic cutaneous candidiasis.
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Affiliation(s)
- Tacito Graminha Campois
- Department of Pathological Sciences, Center for Biological Sciences, State University of Londrina, Rodovia Celso Garcia Cid km 380 - 86057-970, Londrina, PR, Brazil
| | - Amanda Zaparoli Zucoloto
- Department of Pathological Sciences, Center for Biological Sciences, State University of Londrina, Rodovia Celso Garcia Cid km 380 - 86057-970, Londrina, PR, Brazil
| | - Eduardo José de Almeida Araujo
- Department of Histology, Center for Biological Sciences, State University of Londrina, Rodovia Celso Garcia Cid km 380 - 86057-970, Londrina, PR, Brazil
| | - Terezinha Inez Estivalet Svidizinski
- Department of Clinical Analysis, Center for Health Sciences, State University of Maringá, Av. Colombo, 5790, Bloco111 Sala05 CEP 87020-900, Maringá, PR, Brazil
| | - Ricardo Sergio Almeida
- Department of Microbiology, Center for Biological Sciences, State University of Londrina, Rodovia Celso Garcia Cid km 380 - 86057-970, Londrina, PR, Brazil
| | - Gustavo Fernando da Silva Quirino
- Department of Pathological Sciences, Center for Biological Sciences, State University of Londrina, Rodovia Celso Garcia Cid km 380 - 86057-970, Londrina, PR, Brazil
| | - Raquel Mitie Harano
- Department of Pathological Sciences, Center for Biological Sciences, State University of Londrina, Rodovia Celso Garcia Cid km 380 - 86057-970, Londrina, PR, Brazil
| | - Ivete Conchon-Costa
- Department of Pathological Sciences, Center for Biological Sciences, State University of Londrina, Rodovia Celso Garcia Cid km 380 - 86057-970, Londrina, PR, Brazil
| | - Ionice Felipe
- Department of Pathological Sciences, Center for Biological Sciences, State University of Londrina, Rodovia Celso Garcia Cid km 380 - 86057-970, Londrina, PR, Brazil
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4
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Nielsen J, Kofod-Olsen E, Spaun E, Larsen CS, Christiansen M, Mogensen TH. A STAT1-gain-of-function mutation causing Th17 deficiency with chronic mucocutaneous candidiasis, psoriasiform hyperkeratosis and dermatophytosis. BMJ Case Rep 2015; 2015:bcr-2015-211372. [PMID: 26494717 DOI: 10.1136/bcr-2015-211372] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
During recent years, inborn errors of human IL-17 immunity have been demonstrated to underlie primary immunodeficiencies with chronic mucocutaneous candidiasis (CMC). Various defects in receptors responsible for sensing of Candida albicans or downstream signalling to IL-17 may lead to susceptibility to Candida infection. While CMC is common in patients with profound T cell immunodeficiencies, CMC is also recognised as part of other immunodeficiencies in syndromic CMC, or as relatively isolated CMC disease. We describe a 40-year-old woman with a clinical picture involving cutaneous bacterial abscesses, chronic oral candidiasis and extensive dermatophytic infection of the feet. By whole exome sequencing, we identified a STAT1-gain-of-function mutation. Moreover, the patient's peripheral blood mononuclear cells displayed severely impaired Th17 responses. The patient was treated with antifungals and prophylactic antibiotics, which led to resolution of the infection. We discuss the current knowledge within the field of Th17 deficiency and the pathogenesis and treatment of CMC.
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Affiliation(s)
- Jakob Nielsen
- Department of Dermatology, Aarhus University Hospital, Aarhus N, Denmark
| | - Emil Kofod-Olsen
- Institute of Pathology, Aarhus University Hospital, Aarhus N, Denmark
| | - Eva Spaun
- Institute of Pathology, Aarhus University Hospital, Aarhus N, Denmark
| | - Carsten S Larsen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark
| | - Mette Christiansen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark
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5
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Isfort AH, Banks TA. Atypical Varicella in a Patient With Wolf-Hirschhorn Syndrome. Clin Pediatr (Phila) 2015; 54:1120-2. [PMID: 25673626 DOI: 10.1177/0009922815570625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Anna H Isfort
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Taylor A Banks
- Walter Reed National Military Medical Center, Bethesda, MD, USA
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6
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Gilles S, Traidl-Hoffmann C. The environment-pathogen-host axis in communicable and non-communicable diseases: recent advances in experimental and clinical research. J Dtsch Dermatol Ges 2015; 12:395-9. [PMID: 24797745 DOI: 10.1111/ddg.12345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 02/17/2014] [Indexed: 12/19/2022]
Abstract
Allergies and autoimmune diseases are spreading worldwide. Control of infections, on the other hand, remains an issue, even in the post-antibiotic era. Chronic or poorly controlled infections occur in immune compromised individuals such as HIV patients, hospitalized patients exposed to multi-resistant bacteria, or patients on immunosuppressive treatment. They may become an even more emerging issue in an ageing population. At the same time, profound environmental changes such as global warming, urbanization, increasing environmental pollution and novel food engineering technologies may alter the abundance or aggressiveness of allergens/allergen carriers in our environment. Likewise, changes in dietary habits - and possibly also use of antibiotics - have an impact on the composition of our natural microbial flora in the gut, airways and skin, which may alter susceptibility for common diseases, among them allergies, asthma and atopic eczema. At the recently founded Institute of Environmental Medicine of the Technische Universität Munich, located in Augsburg at the UNIKA-T, experimental, clinical and translational research is focused on the complex interactions of environment, pathogen and host in expression or control of communicable and non-communicable diseases. We present our research concept and recent findings in environment - host interactions.
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Affiliation(s)
- Stefanie Gilles
- Institute of Environmental medicine, UNIKA-T, Klinikum rechts der Isar, Technische Universität München, Germany; CK-Care, Christine Kühne Center for Allergy Research and Education, Davos-Wolfgang, Switzerland
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7
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Borghi M, Renga G, Puccetti M, Oikonomou V, Palmieri M, Galosi C, Bartoli A, Romani L. Antifungal Th Immunity: Growing up in Family. Front Immunol 2014; 5:506. [PMID: 25360137 PMCID: PMC4197763 DOI: 10.3389/fimmu.2014.00506] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 09/28/2014] [Indexed: 12/25/2022] Open
Abstract
Fungal diseases represent an important paradigm in immunology since they can result from either the lack of recognition or over-activation of the inflammatory response. Current understanding of the pathophysiology underlying fungal infections and diseases highlights the multiple cell populations and cell-signaling pathways involved in these conditions. A systems biology approach that integrates investigations of immunity at the systems-level is required to generate novel insights into this complexity and to decipher the dynamics of the host–fungus interaction. It is becoming clear that a three-way interaction between the host, microbiota, and fungi dictates the types of host–fungus relationship. Tryptophan metabolism helps support this interaction, being exploited by the mammalian host and commensals to increase fitness in response to fungi via resistance and tolerance mechanisms of antifungal immunity. The cellular and molecular mechanisms that provide immune homeostasis with the fungal biota and its possible rupture in fungal infections and diseases will be discussed within the expanding role of antifungal Th cell responses.
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Affiliation(s)
- Monica Borghi
- Pathology Section, Department of Experimental Medicine, University of Perugia , Perugia , Italy
| | - Giorgia Renga
- Pathology Section, Department of Experimental Medicine, University of Perugia , Perugia , Italy
| | | | - Vasileios Oikonomou
- Pathology Section, Department of Experimental Medicine, University of Perugia , Perugia , Italy
| | - Melissa Palmieri
- Pathology Section, Department of Experimental Medicine, University of Perugia , Perugia , Italy
| | - Claudia Galosi
- Pathology Section, Department of Experimental Medicine, University of Perugia , Perugia , Italy
| | - Andrea Bartoli
- Pathology Section, Department of Experimental Medicine, University of Perugia , Perugia , Italy
| | - Luigina Romani
- Pathology Section, Department of Experimental Medicine, University of Perugia , Perugia , Italy
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8
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Gilles S, Traidl-Hoffmann C. Die Achse Umwelt-Erreger-Wirt bei übertragbaren und nicht übertragbaren Krankheiten: Jüngste Fortschritte in der experimentellen und klinischen Forschung. J Dtsch Dermatol Ges 2014. [DOI: 10.1111/ddg.12345_suppl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Stefanie Gilles
- Institute of Environmental medicine; UNIKA-T, Klinikum rechts der Isar; Technische Universität München; Germany
- CK-Care, Christine Kühne Center for Allergy Research and Education; Davos-Wolfgang Schweiz
| | - Claudia Traidl-Hoffmann
- Institute of Environmental medicine; UNIKA-T, Klinikum rechts der Isar; Technische Universität München; Germany
- CK-Care, Christine Kühne Center for Allergy Research and Education; Davos-Wolfgang Schweiz
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9
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Inborn errors of human IL-17 immunity underlie chronic mucocutaneous candidiasis. Curr Opin Allergy Clin Immunol 2013; 12:616-22. [PMID: 23026768 DOI: 10.1097/aci.0b013e328358cc0b] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Chronic mucocutaneous candidiasis (CMC) is characterized by recurrent or persistent symptomatic infection of the nails, skin and mucosae mostly by Candida albicans. CMC is common in patients with profound primary T-cell immunodeficiency, who often display multiple infectious and autoimmune diseases. Patients with syndromic CMC, including autosomal dominant hyper IgE syndrome (AD-HIES) and autosomal recessive autoimmune polyendocrinopathy syndrome type I (APS-I), display fewer other infections. Patients with isolated CMC (CMCD) rarely display any other severe disease. We review here recent progress in the genetic dissection of these three types of inherited CMC. RECENT FINDINGS Low IL-17 T-cell proportions were reported in patients with AD-HIES bearing heterozygous STAT3 mutations, prone to CMC and staphylococcal diseases, and in a kindred with autosomal recessive CARD9 deficiency, prone to CMC and other fungal infections. High levels of neutralizing autoantibodies against IL-17 cytokines were documented in patients with APS-I presenting with CMC as their only infectious disease. The first three genetic causes of CMCD were then reported: autosomal recessive IL-17RA and autosomal dominant IL-17F deficiencies and autosomal dominant STAT1 gain-of-function, impairing IL-17-producing T-cell development. SUMMARY Inborn errors of human IL-17 immunity underlie CMC. Impaired IL-17 immunity may therefore account for CMC in other settings, including patients with acquired immunodeficiency.
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10
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Chan SMH, Turcanu V, Stephens AC, Fox AT, Grieve AP, Lack G. Cutaneous lymphocyte antigen and α4β7 T-lymphocyte responses are associated with peanut allergy and tolerance in children. Allergy 2012; 67:336-42. [PMID: 22423373 DOI: 10.1111/j.1398-9995.2011.02765.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It is unclear whether the initial route of allergen exposure in early life could influence the subsequent development of allergy, with cutaneous sensitization leading to peanut allergy (PA), and tolerance induced by oral exposure. The skin- and gastrointestinal (GI)-homing markers, cutaneous lymphocyte antigen (CLA) and α4β7 integrin, are used to determine whether the state of PA correlates with peanut-specific CLA responses, with tolerance associated with predominant α4β7 responses. METHODS CLA+ and α4β7+ memory T cells were isolated and cultured with peanut extract to assess their proliferation. Stimulation indices were compared in peanut allergic and non-allergic (NA) groups, and peanut-specific cytokine production was measured. RESULTS In peanut allergic patients, peanut-specific proliferation predominates in the skin-homing CLA+ subset, whilst peanut-tolerant groups have a mixed CLA/α4β7 response (P = 0.008). Comparison with a control food antigen (ovalbumin) showed that these differences are allergen specific. Cytokine responses showed trends towards Th1 skewing in the GI-homing α4β7+ cells of peanut-tolerant groups and Th2 skewing in the skin-homing CLA+ cells of peanut allergic patients. CONCLUSION The predominance of the CLA+ response to peanut in peanut allergic patients is consistent with the hypothesis that allergic sensitization occurs through the skin. The predominant α4β7+ response in peanut-tolerant groups suggests that allergen exposure through the GI tract induces tolerance.
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Affiliation(s)
| | - V. Turcanu
- King's College London; King's Health Partners; Asthma-UK Centre in Allergic Mechanisms of Asthma; Department of Asthma, Allergy and Respiratory Science; Guy's Hospital; London; UK
| | - A. C. Stephens
- King's College London; King's Health Partners; Asthma-UK Centre in Allergic Mechanisms of Asthma; Department of Asthma, Allergy and Respiratory Science; Guy's Hospital; London; UK
| | - A. T. Fox
- King's College London; King's Health Partners; Asthma-UK Centre in Allergic Mechanisms of Asthma; Department of Asthma, Allergy and Respiratory Science; Guy's Hospital; London; UK
| | | | - G. Lack
- King's College London; King's Health Partners; Asthma-UK Centre in Allergic Mechanisms of Asthma; Department of Asthma, Allergy and Respiratory Science; Guy's Hospital; London; UK
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11
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Neutrophil myeloperoxidase: soldier and statesman. Arch Immunol Ther Exp (Warsz) 2011; 60:43-54. [PMID: 22143159 DOI: 10.1007/s00005-011-0156-8] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 10/05/2011] [Indexed: 01/15/2023]
Abstract
Myeloperoxidase (MPO) is a major protein constituent of the primary granules of vertebrate neutrophils. It catalyses the hydrogen peroxide-mediated oxidation of halide ions to hypohalous acids, especially HOCl. These reactive oxygen species can participate in a variety of secondary reactions, leading to modifications of amino acids and many types of biological macromolecules. The classic paradigm views MPO as a component of the phagocyte oxygen-dependent intracellular microbicidal system, and thus an important arm of the effector phase of innate immune responses. However, the limited immunodeficiency associated with lack of MPO in mouse and human models has challenged this paradigm. In this review we examine more recent information on the interaction between MPO, its bioreactive reaction products, and targets within the inflammatory microenvironment. We propose that two assumptions of the current model may require revisiting. First, many important targets of MPO modification are extracellular, rather than present only within the phagolysosome, such as various components of neutrophil extracellular traps. Second, we suggest that the pro-inflammatory pathological role of MPO may be a particular feature of chronic inflammation. In the physiological setting of acute neutrophil-mediated inflammation MPO may also form part of a negative feedback loop which down-regulates inflammation, limits tissue damage, and facilitates the switch from innate to adaptive immunity. This different perspective on this well-studied enzyme may usefully inform further research into its function in health and disease.
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12
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Chronic mucocutaneous candidiasis and congenital susceptibility to Candida. Curr Opin Allergy Clin Immunol 2011; 10:542-50. [PMID: 20859203 DOI: 10.1097/aci.0b013e32833fd74f] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW To give an overview on the clinical spectrum and the molecular background of host defence against Candida. RECENT FINDINGS For many decades the molecular causes and the pathogenesis for an increased susceptibility to Candida - and fungal infections in general - have been elusive. In 2009 and 2010 interesting reports on the genetic background and the pathomechanisms involved in chronic mucocutaneous candidiasis (CMC) have been published. SUMMARY The susceptibility to recurrent Candida infections can be a monogenetic Mendelian trait. The sensing of Candida cell wall components and the consecutive intracellular signalling in myeloid cells via CARD9, but also the role of Th17 cells and their cytokines take centre stage in the human host defence against Candida.
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13
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Eyerich K, Foerster S, Rombold S, Seidl HP, Behrendt H, Hofmann H, Ring J, Traidl-Hoffmann C. Patients with chronic mucocutaneous candidiasis exhibit reduced production of Th17-associated cytokines IL-17 and IL-22. J Invest Dermatol 2008; 128:2640-2645. [PMID: 18615114 DOI: 10.1038/jid.2008.139] [Citation(s) in RCA: 183] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Chronic mucocutaneous candidiasis (CMC) constitutes a selective inability to clear infection with the yeast Candida, resulting in persistent debilitating inflammation of skin, nails, and mucous membranes. The underlying defect is unknown. Only recently, IL-17-producing T cells have been reported to be involved in clearing Candida infections. In order to characterize T cellular immune response to Candida, we analyzed T-cell cytokine secretion to Candida antigen and mitogenic stimuli in CMC patients, immunocompetent patients suffering from acute Candida infection, and healthy volunteers. Peripheral blood mononuclear cells (PBMCs) from CMC patients produced significantly lower amounts of IL-17 and IL-22 mRNA and protein when stimulated with Candida albicans or mitogen in vitro compared with that in matched healthy individuals. Additionally, PBMCs from immunocompetent Candida-infected patients secreted more IL-17 and IL-22 than those of both CMC patients and healthy, non-infected controls. Flow cytometry revealed a decreased number of CCR6+ IL-17-producing T cells in CMC patients, whereas the amount of CCR6+/CCR4+ cells was not altered. Levels of differentiating cytokines for human Th17 cells, IL-1beta and IL-6, tended to be higher in CMC patients. The inability to clear C. albicans in CMC patients could be due to a defect in the immune response of IL-17-producing T cells.
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MESH Headings
- Adolescent
- Adult
- Antigens, Fungal/pharmacology
- Candida albicans/immunology
- Candidiasis, Chronic Mucocutaneous/immunology
- Candidiasis, Chronic Mucocutaneous/metabolism
- Candidiasis, Chronic Mucocutaneous/pathology
- Case-Control Studies
- Child
- Female
- Humans
- Interleukin-17/metabolism
- Interleukin-1beta/metabolism
- Interleukin-6/metabolism
- Interleukins/metabolism
- Leukocytes, Mononuclear/metabolism
- Leukocytes, Mononuclear/pathology
- Male
- Middle Aged
- Phytohemagglutinins/pharmacology
- Receptors, CCR4/metabolism
- Receptors, CCR6/metabolism
- T-Lymphocytes, Helper-Inducer/drug effects
- T-Lymphocytes, Helper-Inducer/metabolism
- T-Lymphocytes, Helper-Inducer/pathology
- Interleukin-22
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Affiliation(s)
- Kilian Eyerich
- Division of Environmental Dermatology and Allergy Helmholtz Zentrum/TUM, ZAUM-Center for Allergy and Environment, Munich, Germany
| | - Stefanie Foerster
- Division of Environmental Dermatology and Allergy Helmholtz Zentrum/TUM, ZAUM-Center for Allergy and Environment, Munich, Germany
| | - Stephanie Rombold
- Department of Dermatology and Allergy, Technical University Munich, Munich, Germany
| | - Hans-Peter Seidl
- Department of Dermatology and Allergy, Technical University Munich, Munich, Germany
| | - Heidrun Behrendt
- Division of Environmental Dermatology and Allergy Helmholtz Zentrum/TUM, ZAUM-Center for Allergy and Environment, Munich, Germany
| | - Heidelore Hofmann
- Department of Dermatology and Allergy, Technical University Munich, Munich, Germany
| | - Johannes Ring
- Department of Dermatology and Allergy, Technical University Munich, Munich, Germany
| | - Claudia Traidl-Hoffmann
- Division of Environmental Dermatology and Allergy Helmholtz Zentrum/TUM, ZAUM-Center for Allergy and Environment, Munich, Germany.
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