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Abstract
Leprosy is a disease caused by Mycobacterium leprae (ML) with diverse clinical manifestations, which are strongly correlated with the host's immune response. Skin lesions may be accompanied by peripheral neural damage, leading to sensory and motor losses, as well as deformities of the hands and feet. Both innate and acquired immune responses are involved, but the disease has been classically described along a Th1/Th2 spectrum, where the Th1 pole corresponds to the most limited presentations and the Th2 to the most disseminated ones. We discuss this dichotomy in the light of current knowledge of cytokines, Th subpopulations and regulatory T cells taking part in each leprosy presentation. Leprosy reactions are associated with an increase in inflammatory activity both in limited and disseminated presentations, leading to a worsening of previous symptoms or the development of new symptoms. Despite the efforts of many research groups around the world, there is still no adequate serological test for diagnosis in endemic areas, hindering the eradication of leprosy in these regions.
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Affiliation(s)
| | - Maria Angela Bianconcini Trindade
- Departamento de Patologia, University of Sao Paulo, São Paulo, Brazil.,Imunodermatologia, Universidade de São Paulo Hospital das Clínicas, São Paulo, Brazil
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Son M, Diamond B, Volpe BT, Aranow CB, Mackay MC, Santiago-Schwarz F. Evidence for C1q-mediated crosslinking of CD33/LAIR-1 inhibitory immunoreceptors and biological control of CD33/LAIR-1 expression. Sci Rep 2017; 7:270. [PMID: 28325905 PMCID: PMC5412647 DOI: 10.1038/s41598-017-00290-w] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 02/17/2017] [Indexed: 02/03/2023] Open
Abstract
C1q collagen-like region (CLR) engaging and activating the LAIR-1 inhibitory immunoreceptor represents a non-complement mechanism for maintaining immune quiescence. Given the binding promiscuity of C1q’s globular region (gC1q), we hypothesized that C1q concurrently associates with distinct inhibitory immunoreceptors to produce C1q-mediated modulatory networking. Like LAIR-1, CD33 inhibitory immunoreceptors are highly expressed on monocytes. Binding CD33 restricts cell activation/differentiation; however, natural ligands for CD33 remain elusive. CD33 has IgC2-like domains potentially recognized by gC1q. Thus, we asked whether C1q binds to CD33 and if C1q mediates CD33/LAIR-1 crosslinking. Our findings demonstrate that C1q and gC1q interact with CD33 to activate its inhibitory motifs, while CLR does not. Whole C1q is required to crosslink CD33 and LAIR-1 and concurrently activate CD33/LAIR-1 inhibitory motifs. While C1q binds CD33C2 domains, decreased C1q-CD33 interactions resulting from sialic acid masking of CD33C2 domains suggests a process for regulating C1q-CD33 activity. Consistent with defective self-tolerance, CD33/LAIR-1 expression is reduced in systemic lupus erythematosus (SLE) myelomonocytes. The anti-inflammatory cytokine M-CSF, but not DC growth factors, sustains CD33/LAIR-1 expression on both healthy and SLE cells suggesting further biological control of C1q-CD33/LAIR-1 processes.
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Affiliation(s)
- Myoungsun Son
- Center for Autoimmune and Musculoskeletal Diseases, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA
| | - Betty Diamond
- Center for Autoimmune and Musculoskeletal Diseases, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA
| | - Bruce T Volpe
- Center for Biomedical Science, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA
| | - Cynthia B Aranow
- Center for Autoimmune and Musculoskeletal Diseases, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA
| | - Meggan C Mackay
- Center for Autoimmune and Musculoskeletal Diseases, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA
| | - Frances Santiago-Schwarz
- Center for Autoimmune and Musculoskeletal Diseases, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA.
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Polycarpou A, Walker SL, Lockwood DNJ. A Systematic Review of Immunological Studies of Erythema Nodosum Leprosum. Front Immunol 2017; 8:233. [PMID: 28348555 PMCID: PMC5346883 DOI: 10.3389/fimmu.2017.00233] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/17/2017] [Indexed: 01/04/2023] Open
Abstract
Erythema nodosum leprosum (ENL) is a painful inflammatory complication of leprosy occurring in 50% of lepromatous leprosy patients and 5-10% of borderline lepromatous patients. It is a significant cause of economic hardship, morbidity and mortality in leprosy patients. Our understanding of the causes of ENL is limited. We performed a systematic review of the published literature and critically evaluated the evidence for the role of neutrophils, immune complexes (ICs), T-cells, cytokines, and other immunological factors that could contribute to the development of ENL. Searches of the literature were performed in PubMed. Studies, independent of published date, using samples from patients with ENL were included. The search revealed more than 20,000 articles of which 146 eligible studies were included in this systematic review. The studies demonstrate that ENL may be associated with a neutrophilic infiltrate, but it is not clear whether it is an IC-mediated process or that the presence of ICs is an epiphenomenon. Increased levels of tumor necrosis factor-α and other pro-inflammatory cytokines support the role of this cytokine in the inflammatory phase of ENL but not necessarily the initiation. T-cell subsets appear to be important in ENL since multiple studies report an increased CD4+/CD8+ ratio in both skin and peripheral blood of patients with ENL. Microarray data have identified new molecules and whole pathophysiological pathways associated with ENL and provides new insights into the pathogenesis of ENL. Studies of ENL are often difficult to compare due to a lack of case definitions, treatment status, and timing of sampling as well as the use of different laboratory techniques. A standardized approach to some of these issues would be useful. ENL appears to be a complex interaction of various aspects of the immune system. Rigorous clinical descriptions of well-defined cohorts of patients and a systems biology approach using available technologies such as genomics, epigenomics, transcriptomics, and proteomics could yield greater understanding of the condition.
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Affiliation(s)
- Anastasia Polycarpou
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene and Tropical Medicine , London , UK
| | - Stephen L Walker
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene and Tropical Medicine , London , UK
| | - Diana N J Lockwood
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene and Tropical Medicine , London , UK
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Burbano C, Vasquez G, Rojas M. Modulatory Effects of CD14+CD16++ Monocytes on CD14++CD16− Monocytes: A Possible Explanation of Monocyte Alterations in Systemic Lupus Erythematosus. Arthritis Rheumatol 2014; 66:3371-81. [DOI: 10.1002/art.38860] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 08/21/2014] [Indexed: 12/23/2022]
Affiliation(s)
- C. Burbano
- University of Antioquia, Medellín; Antioquia Colombia
| | - G. Vasquez
- University of Antioquia, Medellín; Antioquia Colombia
| | - M. Rojas
- University of Antioquia, Medellín; Antioquia Colombia
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Hou S, Qi J, Liao D, Zhang Q, Fang J, Zhou Y, Liu Y, Bai L, Zhang M, Kijlstra A, Yang P. Copy Number Variations of Complement Component C4 Are Associated With Behçet's Disease but Not With Ankylosing Spondylitis Associated With Acute Anterior Uveitis. ACTA ACUST UNITED AC 2013; 65:2963-70. [PMID: 23918728 DOI: 10.1002/art.38116] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 07/30/2013] [Indexed: 01/05/2023]
Affiliation(s)
- Shengping Hou
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
| | - Jian Qi
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
| | - Dan Liao
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
| | - Qi Zhang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
| | - Jing Fang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
| | - Yan Zhou
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
| | - Yunjia Liu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
| | - Lin Bai
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
| | - Meifen Zhang
- Peking Union Medical College Hospital and Chinese Academy of Medical Sciences; Beijing China
| | - Aize Kijlstra
- University Eye Clinic Maastricht, Maastricht; Limburg The Netherlands
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, and Chongqing Key Laboratory of Ophthalmology; Chongqing China
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Monocyte and macrophage abnormalities in systemic lupus erythematosus. Arch Immunol Ther Exp (Warsz) 2010; 58:355-64. [PMID: 20676786 DOI: 10.1007/s00005-010-0093-y] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Accepted: 04/09/2010] [Indexed: 01/24/2023]
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with profound effects on multiple organ systems. In patients with SLE, the immune system is subverted to target numerous self antigens and the ensuing inflammatory response elicits a vicious cycle of immune-cell activation and tissue damage. Both genetic and environmental factors are essential for the development of this debilitating condition, although the exact cause remains unclear. Early studies on the pathogenesis of lupus centered on the adaptive immune system as lymphocyte abnormalities were thought to be the primary cause of autoimmunity. In the past decade, however, this paradigm has shifted with rapid advances in the field of innate immunity. These developments have yielded important insights into how the autoimmune response in SLE is initiated and maintained. Monocytes and macrophages are an essential arm of the innate immune system with a multitude of immunological functions, including antigen presentation, phagocytosis, and cytokine production. Aberrations of monocyte/macrophage phenotype and function are increasingly recognized in SLE and animal models of the disease. In this review we summarize the current knowledge of monocyte/macrophage abnormalities in human SLE and discuss their implications for understanding the pathogenesis of lupus.
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Abstract
Polymorphonuclear leukocytes (PMNs) are the most abundant white cell in humans and an essential component of the innate immune system. PMNs are typically the first type of leukocyte recruited to sites of infection or areas of inflammation. Ingestion of microorganisms triggers production of reactive oxygen species and fusion of cytoplasmic granules with forming phagosomes, leading to effective killing of ingested microbes. Phagocytosis of bacteria typically accelerates neutrophil apoptosis, which ultimately promotes the resolution of infection. However, some bacterial pathogens alter PMN apoptosis to survive and thereby cause disease. Herein, we review PMN apoptosis and the ability of microorganisms to alter this important process.
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Affiliation(s)
- Adam D Kennedy
- Laboratory of Human Bacterial Pathogenesis, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 903 South 4th Street, Hamilton, MT 59840, USA
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Donnelly S, Roake W, Brown S, Young P, Naik H, Wordsworth P, Isenberg DA, Reid KBM, Eggleton P. Impaired recognition of apoptotic neutrophils by the C1q/calreticulin and CD91 pathway in systemic lupus erythematosus. ACTA ACUST UNITED AC 2006; 54:1543-56. [PMID: 16645988 DOI: 10.1002/art.21783] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE A deficiency in a subcomponent of C1q can result in increased susceptibility to autoimmune diseases such as systemic lupus erythematosus (SLE). The monocyte endocytic receptor CD91 is implicated in the endocytosis of apoptotic neutrophils via interactions with C1q and calreticulin. In this clinical study, we studied the binding of C1q to leukocytes and determined whether C1q bound specifically to calreticulin and CD91 on cells undergoing apoptosis in SLE. METHODS Proximal antibody phage display, calreticulin-transfected cells, and immunocytochemical and confocal techniques were used in a comprehensive analysis of direct binding of C1q to apoptotic neutrophils that were obtained from healthy individuals and from patients with SLE. In addition, apoptotic cellular systems were assessed in vitro. RESULTS C1q appeared to colocalize to apoptotic blebs on the surface of leukocytes in association with both calreticulin and CD91, as determined by phage display and transfected cell studies. However, C1q did not bind to apoptotic cells isolated from SLE patients, despite the positivity of the cells for both calreticulin and CD91. Surface expression of calreticulin decreased on neutrophils as they aged, but increased on monocytes. In an apoptotic phagocytic assay, the addition of C1q and calreticulin significantly enhanced the phagocytosis of apoptotic cell debris by monocyte-derived cells. CONCLUSION These observations indicate that neutrophils from SLE patients have a reduced ability to be recognized and removed by the C1q/calreticulin/CD91-mediated apoptotic pathway, despite the presence of main apoptotic recognition partners. This suggests that an additional component, as yet unidentified, acts as a C1q binding partner on apoptotic cells, and this component may be lacking in cells isolated from SLE patients.
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Bijl M, Reefman E, Horst G, Limburg PC, Kallenberg CGM. Reduced uptake of apoptotic cells by macrophages in systemic lupus erythematosus: correlates with decreased serum levels of complement. Ann Rheum Dis 2005; 65:57-63. [PMID: 15919679 PMCID: PMC1797975 DOI: 10.1136/ard.2005.035733] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Defects in phagocytosis of apoptotic cells have a role in the pathogenesis of autoimmune diseases. Decrease of phagocytosis of apoptotic cells occurs in systemic lupus erythematosus (SLE). Factors underlying this decrease are, presently, unknown. OBJECTIVE To analyse the expression of relevant membrane receptors of monocyte derived macrophages (MDM) from patients with SLE and assess their ability to phagocytose apoptotic cells in comparison with MDM from healthy controls. Additionally, to compare phagocytosis in the presence of SLE sera with that in normal human serum (NHS). METHODS Human peripheral blood monocytes were isolated from patients and controls, and cultured for 7 days to obtain MDM. Membrane expression of CD14, CD18, CD36, and CD51/61 was measured. MDM were incubated with apoptotic Jurkat cells in the presence of NHS or serum from patients with active or inactive disease. RESULTS No differences in phagocytosis capacity were found between MDM from patients and controls. Membrane expression of the respective receptors was comparable in patients and controls. However, when MDM from controls were incubated with apoptotic cells in patient serum, phagocytosis was significantly decreased in comparison with incubation in NHS. This effect depended on the patients' disease activity and could be reversed by addition of NHS. Reduced uptake of apoptotic cells was associated with decreased levels of complement C1q, C4, and C3, but not with levels of complement factor B. CONCLUSIONS Reduced uptake of apoptotic cells by MDM from patients with SLE is not an intrinsic defect but is serum dependent and associated with decreased levels of C1q, C4, and C3.
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Affiliation(s)
- M Bijl
- Department of Internal Medicine, Division of Clinical Immunology, University Hospital, The Netherlands.
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