1
|
Teniou A, Rhouati A, Marty JL. Recent Advances in Biosensors for Diagnosis of Autoimmune Diseases. SENSORS (BASEL, SWITZERLAND) 2024; 24:1510. [PMID: 38475046 DOI: 10.3390/s24051510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/01/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024]
Abstract
Over the last decade, autoimmune diseases (ADs) have undergone a significant increase because of genetic and/or environmental factors; therefore, their simple and fast diagnosis is of high importance. The conventional diagnostic techniques for ADs require tedious sample preparation, sophisticated instruments, a dedicated laboratory, and qualified personnel. For these reasons, biosensors could represent a useful alternative to these methods. Biosensors are considered to be promising tools that can be used in clinical analysis for an early diagnosis due to their high sensitivity, simplicity, low cost, possible miniaturization (POCT), and potential ability for real-time analysis. In this review, recently developed biosensors for the detection of autoimmune disease biomarkers are discussed. In the first part, we focus on the main AD biomarkers and the current methods of their detection. Then, we discuss the principles and different types of biosensors. Finally, we overview the characteristics of biosensors based on different bioreceptors reported in the literature.
Collapse
Affiliation(s)
- Ahlem Teniou
- Bioengineering Laboratory, Higher National School of Biotechnology, Constantine 25100, Algeria
| | - Amina Rhouati
- Bioengineering Laboratory, Higher National School of Biotechnology, Constantine 25100, Algeria
| | - Jean-Louis Marty
- Laboratoire BAE, Université de Perpignan through Domitia, 66860 Perpignan, France
| |
Collapse
|
2
|
Potorac A, Varlas VN, Borș RG, Baroș A, Cirstoiu M. The Management and Diagnosis of Anti-NMDA Receptor Autoimmune Encephalitis in Pregnant Women: A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2110. [PMID: 38138213 PMCID: PMC10744478 DOI: 10.3390/medicina59122110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
Rationale: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a form of autoimmune synaptic encephalitis, often mediated by neuronal surface antibodies. Clinically, it manifests through a diverse range of neurological and psychiatric symptoms, primarily affecting young women with ovarian teratoma, which is rare in pregnant women. Patient concerns: We report a case of a 35-year-old multiparous pregnant patient at 38 weeks of gestation presented to the emergency room with seizure, psychiatric symptoms like delirious speech with mystical visual and auditory hallucinations, bradylalia, and retrograde amnesia. Diagnosis: The diagnosis of autoimmune encephalitis with anti-NMDA antibodies was concluded by considering the lumbar puncture results, brain imaging, and the patient's persistent symptoms. Outcomes: This case is noteworthy for its rarity and the symptoms' breadth. At 38 weeks of gestation, the patient underwent a cesarean section, resulting in excellent maternal recovery observed during the 6-month follow-up and good neonatal adaptation. Lessons: Our goals include raising awareness about this condition and emphasizing the significance of early diagnosis. This encephalitis is treatable and potentially reversible, underscoring the importance of prompt identification.
Collapse
Affiliation(s)
- Alina Potorac
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (R.G.B.)
| | - Valentin Nicolae Varlas
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.B.); (M.C.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Roxana Georgiana Borș
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.P.); (R.G.B.)
| | - Alexandru Baroș
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.B.); (M.C.)
- Department of Obstetrics and Gynecology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Monica Cirstoiu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.B.); (M.C.)
- Department of Obstetrics and Gynecology, University Emergency Hospital, 050098 Bucharest, Romania
| |
Collapse
|
3
|
Athanassiou L, Kostoglou-Athanassiou I, Kaiafa G, Tsakiridis P, Koukosias N, Mitsoulis S, Savopoulos C, Athanassiou P. Thyroid Disease and Systemic Lupus Erythematosus. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1911. [PMID: 38003960 PMCID: PMC10673127 DOI: 10.3390/medicina59111911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Thyroid disease has been associated with autoimmune disorders. As systemic lupus erythematosus (SLE) is a systemic autoimmune disease with diverse manifestations spanning across all organ systems, the relationship of SLE with thyroid disorders needs investigation. In particular, the relationship of SLE with autoimmune thyroid disease has attracted the interest of the research community. The aim was to evaluate the relationship of SLE with autoimmune thyroid disease. Materials and Methods: A cohort of 45 consecutive patients with a mean age of 47.97 years (range 21-79 years) and 45 age- and sex-matched controls were prospectively studied over a period of 12 months for the presence of thyroid disease and the prevalence of antithyroid antibodies. Results: Four patients (8.9%) were found to suffer from primary hypothyroidism, five (11.11%) from subclinical hypothyroidism and one (2.22%) from hyperthyroidism, whereas one (2.22%) of the controls had primary hypothyroidism and one (2.22%) had hyperthyroidism. Five patients (11.11%) had a thyroid hormone profile that was compatible with the presence of euthyroid sick syndrome. Thyroid peroxidase (TPOab) and thyroglobulin (Tgab) antibodies were detected in 20/45 and 15/45 of the SLE population and in 7/45 and 5/45 of the controls, respectively (p < 0.05, chi-square test). Conclusions: In conclusion, the incidence of clinical thyroid disease is greater amongst SLE patients than in a control population, and in a significant number of these patients, antithyroid antibodies are detectable. Thus, a subset of lupus patients appears to be predisposed to the development of thyroid disease, and this should be considered when evaluating patients with SLE.
Collapse
Affiliation(s)
- Lambros Athanassiou
- Department of Rheumatology, Asclepeion Hospital, Voula, 16673 Athens, Greece;
| | | | - Georgia Kaiafa
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (G.K.); (C.S.)
| | - Pavlos Tsakiridis
- Department of Rheumatology, St. Paul’s Hospital, 55134 Thessaloniki, Greece; (P.T.); (N.K.); (S.M.)
| | - Nikolaos Koukosias
- Department of Rheumatology, St. Paul’s Hospital, 55134 Thessaloniki, Greece; (P.T.); (N.K.); (S.M.)
| | - Spyridon Mitsoulis
- Department of Rheumatology, St. Paul’s Hospital, 55134 Thessaloniki, Greece; (P.T.); (N.K.); (S.M.)
| | - Christos Savopoulos
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (G.K.); (C.S.)
| | - Panagiotis Athanassiou
- Department of Rheumatology, St. Paul’s Hospital, 55134 Thessaloniki, Greece; (P.T.); (N.K.); (S.M.)
| |
Collapse
|
4
|
Sirufo MM, Magnanimi LM, Ginaldi L, De Martinis M. Anorexia nervosa and autoimmune comorbidities: A bidirectional route? CNS Neurosci Ther 2022; 28:1921-1929. [PMID: 36114699 PMCID: PMC9627382 DOI: 10.1111/cns.13953] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 02/06/2023] Open
Abstract
Immunological dysfunctions in eating disorders have recently gained increasing scientific attention. Furthermore, the reciprocal association between anorexia and autoimmune diseases is of particular interest and suggests a role of autoimmunity in the pathogenesis of eating disorders. Anorexia nervosa (AN) and autoimmune diseases are linked by a bidirectional relationship based on common immunopathological mechanisms. In this review, in addition to reporting the numerous cases described in which autoimmune disorders are associated with anorexia or vice versa, we summarize the many aspects of this relationship between the immune system (IS) and AN. We describe how the microbiota affects the IS, disrupts gut-brain communication, and possibly triggers eating disorders. We also describe the shared immunological pathways of autoimmune and eating disorders and in particular the occurrence of disrupted T cell tolerance and autoantibodies in AN. The described observations represent the starting point for possible, future research directions.
Collapse
Affiliation(s)
- Maria M. Sirufo
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly,Allergy and Clinical Immunology UnitCenter for the Diagnosis and Treatment of OsteoporosisTeramoItaly
| | - Lina M. Magnanimi
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Lia Ginaldi
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly,Allergy and Clinical Immunology UnitCenter for the Diagnosis and Treatment of OsteoporosisTeramoItaly
| | - Massimo De Martinis
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly,Allergy and Clinical Immunology UnitCenter for the Diagnosis and Treatment of OsteoporosisTeramoItaly
| |
Collapse
|
5
|
Gildner TE. Reproductive hormone measurement from minimally invasive sample types: Methodological considerations and anthropological importance. Am J Hum Biol 2020; 33:e23535. [PMID: 33174269 DOI: 10.1002/ajhb.23535] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/19/2022] Open
Abstract
Energetic investment in human reproduction has long been recognized as costly, influencing developmental, physiological, and behavioral patterns in males and females. These effects are largely coordinated through the actions of reproductive hormones (eg, testosterone, estradiol, and progesterone). Here, the utility and limitations of minimally invasive sampling techniques are explored, providing a novel perspective on how reproductive hormone measurements can enhance reproductive endocrinology research. Salivary steroid measures are most commonly used, although several dried blood spot and urine assays are also available, and researchers continue to explore the efficacy of other sample types. These relatively simple measures have facilitated the collection of multiple samples from a single participant, allowing researchers to more accurately track the diurnal and cyclical variation exhibited by many reproductive hormones. Ultimately, the ability to collect fine-grained participant data allows biological anthropologists to better test questions central to human reproductive ecology, life history theory, and public health. For example, fieldwork using these techniques suggests that testosterone profile variation across populations is influenced by energetic constraints and reproductive status. Moreover, hormone concentrations shape the development of sex characteristics, with implications for evolutionary questions related to sexual selection. Hormone levels also can be used to identify a range of medical concerns (eg, suppressed hormone production levels linked with psychosocial stress). These findings highlight how minimally invasive collection techniques can be applied to test diverse evolutionary hypotheses and identify important health concerns. Still, more work is needed to standardize collection and laboratory analysis procedures, thereby enabling more direct data comparisons between researchers.
Collapse
Affiliation(s)
- Theresa E Gildner
- Department of Anthropology, Dartmouth College, Hanover, New Hampshire, USA
| |
Collapse
|
6
|
Epigenetics, pregnancy and autoimmune rheumatic diseases. Autoimmun Rev 2020; 19:102685. [PMID: 33115633 DOI: 10.1016/j.autrev.2020.102685] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 06/27/2020] [Indexed: 12/14/2022]
Abstract
Autoimmune rheumatic diseases (ARDs) are chronic conditions with a striking female predominance, frequently affecting women of childbearing age. Sex hormones and gender dimorphism of immune response are major determinants in the multifactorial pathogenesis of ARDs, with significant implications throughout reproductive life. Particularly, pregnancy represents a challenging condition in the context of autoimmunity, baring profound hormonal and immunologic changes, which are responsible for the bi-directional interaction between ARDs outcome and pregnancy course. In the latest years epigenetics has proven to be an important player in ARDs pathogenesis, finely modulating major immune functions and variably tuning the significant gender effects in autoimmunity. Additionally, epigenetics is a recognised influencer of the physiological dynamic modifications occurring during pregnancy. Still, there is currently little evidence on the pregnancy-related epigenetic modulation of immune response in ARDs patients. This review aims to overview the current knowledge of the role of epigenetics in the context of autoimmunity, as well as during physiologic and pathologic pregnancy, discussing under-regarded aspects in the interplay between ARDs and pregnancy pathology. The outline of a new ongoing European project will be presented.
Collapse
|
7
|
Lenti MV, Rugge M, Lahner E, Miceli E, Toh BH, Genta RM, De Block C, Hershko C, Di Sabatino A. Autoimmune gastritis. Nat Rev Dis Primers 2020; 6:56. [PMID: 32647173 DOI: 10.1038/s41572-020-0187-8] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 02/07/2023]
Abstract
Autoimmune gastritis (AIG) is an increasingly prevalent, organ-specific, immune-mediated disorder characterized by the destruction of gastric parietal cells, leading to the loss of intrinsic factor and reduced acid output. These alterations result in malabsorption of iron, vitamin B12 (pernicious anaemia) and potentially other micronutrients. For several years, most studies have focused on pernicious anaemia only, generating confusion between the two entities. In AIG, the gastric proton pump, H+/K+ ATPase, is the major autoantigen recognized by autoreactive T cells. The T cell-dependent activation of B cells stimulates the production of anti-parietal cell antibodies, the serological hallmark of AIG. The role of Helicobacter pylori infection in activating or favouring the autoimmune process is still uncertain. Early histopathological alterations allowing a more precise and prompt recognition have recently been described. AIG is burdened by a substantial diagnostic delay as it can present with varied clinical signs including, among others, gastrointestinal symptoms and neuropsychiatric manifestations. In advanced stages, AIG might progress to neuroendocrine tumours and gastric adenocarcinoma. Management includes early detection through a proactive case-finding strategy, micronutrient supplementation and endoscopic surveillance. This Primer comprehensively describes the most important insights regarding the epidemiology, pathophysiology, diagnosis and management of AIG, focusing on the most controversial, outstanding issues and future directions.
Collapse
Affiliation(s)
- Marco Vincenzo Lenti
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Massimo Rugge
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy
| | - Edith Lahner
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Emanuela Miceli
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Ban-Hock Toh
- Centre for Inflammatory Diseases, Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Robert M Genta
- Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas, USA
| | - Christophe De Block
- Department of Endocrinology, Diabetology and Metabolism, Faculty of Medicine, Antwerp University Hospital and University of Antwerp, Antwerpen, Belgium
| | - Chaim Hershko
- Department of Hematology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.,Hematology Clinic and Central Clinical Laboratories, Clalit Health Services, Jerusalem, Israel
| | - Antonio Di Sabatino
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
| |
Collapse
|
8
|
Chang R, Chu KA, Lin MC, Chu YH, Hung YM, Wei JCC. Newly diagnosed iron deficiency anemia and subsequent autoimmune disease: a matched cohort study in Taiwan. Curr Med Res Opin 2020; 36:985-992. [PMID: 32223346 DOI: 10.1080/03007995.2020.1748585] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To explore whether newly diagnosed iron deficiency anemia (IDA) is associated with subsequent systemic autoimmune disease onset.Methods: The study identified 22,440 patients who received a diagnosis of IDA between 2000 and 2012 from a random sample of 1 million people from Taiwan's National Health Insurance Research Database. The patients with IDA were randomly matched with 89,528 patients with no IDA by age, gender, and index year. We followed the 2 groups until systemic autoimmune disease onset. Cox proportional hazards analysis was used to determine autoimmune disease risk by age, gender, and comorbidities, in terms of hazard ratios (HRs) and 95% confidence intervals (CIs).Results: Adjusted HR (95% CI) of autoimmune disease in the IDA group was 2.37 (1.92-2.92) compared with the non-IDA group. The subgroup analysis indicated that a patient with IDA had a significantly greater risk of autoimmune disease if they were female or had the comorbidities of hypertension, hyperlipidemia, cancer, allergic rhinitis, urticaria, chronic obstructive pulmonary disease, or chronic liver disease. The autoimmune disease was significantly more likely to occur within 2 years after a new diagnosis of IDA.Conclusions: IDA significantly increases autoimmune disease risk, particularly in female patients and patients with certain comorbidities. Clinicians should conduct further clinical evaluations and laboratory tests of autoimmune disease in patients with IDA.
Collapse
Affiliation(s)
- Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Recreation Sports Management, Tajen University, Pingtung, Taiwan
| | - Kuo-An Chu
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
- Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Mei-Chen Lin
- Management Office for Health Data, Medical University Hospital, Taichung, Taiwan
| | - Yi-Hsin Chu
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yao-Min Hung
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
- Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| |
Collapse
|
9
|
Yan CY, Ma YR, Sun F, Zhang RJ, Fang Y, Zhang QY, Wu FY, Zhao SX, Song HD. Candidate gene associations reveal sex-specific Graves' disease risk alleles among Chinese Han populations. Mol Genet Genomic Med 2020; 8:e1249. [PMID: 32342657 PMCID: PMC7336758 DOI: 10.1002/mgg3.1249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND With several susceptibility single nucleotide polymorphisms identified by case-control association studies, Graves' disease is one of the most common forms of autoimmune thyroid disease. In this study, we aimed to determine whether any observed differences in genetic associations are influenced by sex in Chinese Han populations. METHODS A total of 8,835 patients with Graves' disease and 9,936 sex-matched healthy controls were enrolled in the study. Confirmed by a two-staged association analysis, sex-specific analyses among 20 Graves' disease susceptibility loci were conducted. RESULTS A significant sex-gene interaction was detected primarily at rs5912838 on Xq21.1 between the GPR174 and ITM2A genes, whereby male Graves' disease patients possessed a significantly higher frequency of risk alleles than their female counterparts. Interestingly, compared to women, male patients with Graves' disease had a higher cumulative genetic risk and higher persistent thyroid stimulating hormone receptor antibody-positive rate after receiving antithyroid drug therapy for at least 1 year. CONCLUSION The findings of this study suggest the existence of one potential sex-specific Graves' disease variant on Xq21.1. This could increase our understanding of the pivotal mechanism behind Graves' disease and ultimately aid in identifying possible therapeutic targets.
Collapse
Affiliation(s)
- Chen-Yan Yan
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Ru Ma
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Sun
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui-Jia Zhang
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ya Fang
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian-Yue Zhang
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng-Yao Wu
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuang-Xia Zhao
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huai-Dong Song
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
10
|
DNA methylation was involved in total glucosides of paeony regulating ERα for the treatment of female systemic lupus erythematosus mice. J Pharmacol Sci 2019; 140:187-192. [PMID: 31345653 DOI: 10.1016/j.jphs.2019.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/25/2019] [Accepted: 07/03/2019] [Indexed: 02/05/2023] Open
Abstract
Total glucosides of paeony (TGP) is a bioactive compound extracted from paeony roots and has been used in therapy for autoimmune diseases. However the molecular mechanism of TGP in the therapy of autoimmune diseases remains unclear. ERα has a pro-inflammatory role in SLE disease. In this study, we found that TGP treatment significantly decreased the expression of ERα by up-regulating ERα promoter methylation levels. Further investigation revealed that treatment with TGP increased the expression of DNMT in lupus mice. We also used DNA methyltransferase inhibitors to verify whether DNA methylation was involved in these process. HE staining results showed that TGP can reduce renal injury in SLE mice. Moreover, cytokines including IFN-γ, IL6 and IL12 expression and dsDNA levels in serum were inhibited by TGP treatment. These findings indicate that TGP inhibits autoimmunity in SLE mice possibly by downregulate ERα expression, which may in turn be due to its ability to regulate the methylation status of the ERα promoter.
Collapse
|
11
|
Pérez D, Gilburd B, Cabrera-Marante Ó, Martínez-Flores JA, Serrano M, Naranjo L, Pleguezuelo D, Morillas L, Shovman O, Paz-Artal E, Shoenfeld Y, Serrano A. Predictive autoimmunity using autoantibodies: screening for anti-nuclear antibodies. Clin Chem Lab Med 2019. [PMID: 28628475 DOI: 10.1515/cclm-2017-0241] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Abstract
Background:
Early detection of antinuclear antibodies (ANA) in asymptomatic subjects is useful to predict autoimmune diseases years before diagnosis. ANA have been determined by indirect immunofluorescence (IIF) using human epithelial type 2 (HEp-2) cells, which is considered the gold standard technique. Multiplex technology (BioPlex ANA Screen) has been introduced for ANA evaluation in recent years. Nevertheless, concordance between BioPlex and IIF is low and there is no harmonization between both methods for detection of autoantibodies. This study has aimed to clarify the clinical significance of autoantibodies detected by BioPlex ANA Screen in subjects with undiagnosed clinical suspicion of autoimmune disease and to determine the predictive value of autoantibodies detected by BioPlex ANA Screen.
Methods:
A 3-year follow-up study was performed of 411 subjects without a clear diagnosis of autoimmune diseases in whom autoantibodies were detected by BioPlex ANA Screen that were negative by IIF on HEp-2 cells.
Results:
At 3 years of follow-up, 312 (76%) subjects were positive for autoantibodies by IIF and 99 subjects continued to be negative. A diagnosis of autoimmune disease was found in most of the subjects (87%).
Conclusions:
BioPlex ANA Screen has greater sensitivity than IIF on HEp-2 cells for autoantibodies detection. Early detection of these antibodies by BioPlex can predict possible development of autoimmune diseases.
Collapse
Affiliation(s)
- Dolores Pérez
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.,Department of Immunology, Instituto de Investigación, Madrid, Spain
| | - Boris Gilburd
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | | | | | - Manuel Serrano
- Department of Immunology, Instituto de Investigación, Madrid, Spain
| | - Laura Naranjo
- Department of Immunology, Instituto de Investigación, Madrid, Spain
| | | | - Luis Morillas
- Department of Rheumatology, Hospital Universitario, Madrid, Spain
| | - Ora Shovman
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Estela Paz-Artal
- Department of Immunology, Instituto de Investigación, Madrid, Spain
| | - Yehuda Shoenfeld
- MaACR, Head of Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer 52621, Israel, Phone: (972) 52-6669020, Fax: (972-3) 5352855; Sackler Faculty of Medicine, Tel-Aviv University, Israel; Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Antonio Serrano
- Department of Immunology, Instituto de Investigación, Madrid, Spain
| |
Collapse
|
12
|
Abstract
Autoimmune diseases are very diverse and include many common diseases of unknown etiology.Diagnosis can be challenging but can be facilitated by the identification of characteristic autoantibodies (AuAbs), which are present in varying frequencies. Identification of such AuAbs requires a range of different techniques, depending on the autoantigens in question. Each individual AuAb assay is characterized by analytical sensitivity and specificity, which in turn determines clinical sensitivity and specificity in relation to diseases. Clinical sensitivities and specificities vary much, but many AuAb analyses can be of significant help in establishing correct diagnoses. It remains unsettled whether AuAbs are generally pathogenic, but it is generally agreed that autoimmune diseases are caused by a combination of genetic and environmental factors, and that early and correct diagnosis facilitates treatment.
Collapse
|
13
|
Patients with small-vessel vasculitides have the highest mortality among systemic autoimmune diseases patients treated in intensive care unit: A retrospective study with 5-year follow-up. J Crit Care 2018; 48:166-171. [DOI: 10.1016/j.jcrc.2018.08.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 08/24/2018] [Accepted: 08/25/2018] [Indexed: 01/06/2023]
|
14
|
Shi YC, Chen XJ, Zhang HM, Wang Z, Du DY. Anti-N-Methyl- d -Aspartate receptor (NMDAR) encephalitis during pregnancy: Clinical analysis of reported cases. Taiwan J Obstet Gynecol 2017; 56:315-319. [DOI: 10.1016/j.tjog.2017.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2016] [Indexed: 11/26/2022] Open
|
15
|
Zhang X, Zambrano A, Lin ZT, Xing Y, Rippy J, Wu T. Immunosensors for Biomarker Detection in Autoimmune Diseases. Arch Immunol Ther Exp (Warsz) 2016; 65:111-121. [PMID: 27592176 DOI: 10.1007/s00005-016-0419-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/04/2016] [Indexed: 01/17/2023]
Abstract
Autoimmune diseases occur when the immune system generates proinflammatory molecules and autoantibodies that mistakenly attack their own body. Traditional diagnosis of autoimmune disease is primarily based on physician assessment combined with core laboratory tests. However, these tests are not sensitive enough to detect early molecular events, and quite often, it is too late to control these autoimmune diseases and reverse tissue damage when conventional tests show positivity for disease. It is fortunate that during the past decade, research in nanotechnology has provided enormous opportunities for the development of ultrasensitive biosensors in detecting early biomarkers with high sensitivity. Biosensors consist of a biorecognition element and a transducer which are able to facilitate an accurate detection of proinflammatory molecules, autoantibodies and other disease-causing molecules. Apparently, novel biosensors could be superior to traditional metrics in assessing the drug efficacy in clinical trials, especially when specific biomarkers are indicative of the pathogenesis of disease. Furthermore, the portability of a biosensor enables the development of point-of-care devices. In this review, various types of biomolecule sensing systems, including electrochemical, optical and mechanical sensors, and their applications and future potentials in autoimmune disease treatment were discussed.
Collapse
Affiliation(s)
- Xuezhu Zhang
- Department Biomedical Engineering, University of Houston, 3605 Cullen Blvd, Houston, TX, 77204, USA
| | - Amarayca Zambrano
- Department Biomedical Engineering, University of Houston, 3605 Cullen Blvd, Houston, TX, 77204, USA
| | - Zuan-Tao Lin
- Department Biomedical Engineering, University of Houston, 3605 Cullen Blvd, Houston, TX, 77204, USA
| | - Yikun Xing
- Department Biomedical Engineering, University of Houston, 3605 Cullen Blvd, Houston, TX, 77204, USA
| | - Justin Rippy
- Department Biomedical Engineering, University of Houston, 3605 Cullen Blvd, Houston, TX, 77204, USA
| | - Tianfu Wu
- Department Biomedical Engineering, University of Houston, 3605 Cullen Blvd, Houston, TX, 77204, USA.
| |
Collapse
|
16
|
Shamriz O, Mizrahi H, Werbner M, Shoenfeld Y, Avni O, Koren O. Microbiota at the crossroads of autoimmunity. Autoimmun Rev 2016; 15:859-69. [PMID: 27392501 DOI: 10.1016/j.autrev.2016.07.012] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 06/01/2016] [Indexed: 12/20/2022]
Abstract
Autoimmune diseases have a multifactorial etiology including genetic and environmental factors. Recently, there has been increased appreciation of the critical involvement of the microbiota in the pathogenesis of autoimmunity, although in many cases, the cause and the consequence are not easy to distinguish. Here, we suggest that many of the known cues affecting the function of the immune system, such as genetics, gender, pregnancy and diet, which are consequently involved in autoimmunity, exert their effects by influencing, at least in part, the microbiota composition and activity. This, in turn, modulates the immune response in a way that increases the risk for autoimmunity in predisposed individuals. We further discuss current microbiota-based therapies.
Collapse
Affiliation(s)
- Oded Shamriz
- Pediatric Division, Hadassah-Hebrew University Medical Center, Ein Kerem, POB 12000 Kiryat Hadassah, 91120 Jerusalem, Israel
| | - Hila Mizrahi
- Faculty of Medicine, Bar-Ilan University, Henrietta Szold 8, Safed 1311502, Israel
| | - Michal Werbner
- Faculty of Medicine, Bar-Ilan University, Henrietta Szold 8, Safed 1311502, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Affiliated to the Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel
| | - Orly Avni
- Faculty of Medicine, Bar-Ilan University, Henrietta Szold 8, Safed 1311502, Israel.
| | - Omry Koren
- Faculty of Medicine, Bar-Ilan University, Henrietta Szold 8, Safed 1311502, Israel.
| |
Collapse
|
17
|
Horváth A, Páll N, Molnár K, Kováts T, Surján G, Vicsek T, Pollner P. A nationwide study of the epidemiology of relapsing polychondritis. Clin Epidemiol 2016; 8:211-30. [PMID: 27418855 PMCID: PMC4934462 DOI: 10.2147/clep.s91439] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Relapsing polychondritis (RP) is a rare autoimmune inflammatory disease that attacks mainly cartilaginous structures or causes serious damage in proteoglycan-rich structures (the eyes, heart, blood vessels, inner ear). This study shows results regarding the epidemiology, progression, and associations of this highly variable disease by collecting all cases from a 124-million-person-year Central European nationwide cohort. METHODS We used the Hungarian Health Care Database to identify all persons with possible RP infection. We followed patients who had International Classification of Diseases 10th edition code M94.1 at least once in their inpatient or outpatient records between January 1, 2002 and December 31, 2013 in Hungary. We classified these patients into disease severity groups by their drug consumption patterns between January 1, 2010 and December 31, 2013. We analyzed the regional distribution of RP incidences as well. Overall maps of comorbidity are presented with network layouts. RESULTS We identified 256 patients with RP among cumulatively 11.5 million registered inhabitants. We classified these patients into four severity classes as "extremely mild" (n=144), "mild" (n=22), "moderate" (n=41), and "severe" (n=4). Two additional groups were defined for patients without available drug data as "suspected only" (n=23) and "confirmed but unknown treatment" (n=22). The age and sex distributions of patients were similar to worldwide statistics. Indeed, the overall survival was good (95% confidence interval for 5 years was 83.6%-92.9% and for 10 years was 75.0%-88.3% which corresponds to the overall survival of the general population in Hungary), and the associations with other autoimmune disorders were high (56%) in Hungary. Almost any disease can occur with RP; however, the symptoms of chromosomal abnormalities are only incidental. Spondylosis can be a sign of the activation of RP, while Sjögren syndrome is the most frequent autoimmune association. Regional distribution of incidences suggests arsenic drinking water and sunlight exposure as possible triggering factors. CONCLUSION The good survival rate of RP in Hungary is probably associated with the early diagnosis of the disease.
Collapse
Affiliation(s)
- Anna Horváth
- 3rd Department of Internal Medicine, Semmelweis University
| | - Nóra Páll
- Regional Science Center, Faculty of Science, Eötvös Loránd University
| | - Katalin Molnár
- 3rd Department of Internal Medicine, Semmelweis University
| | | | | | - Tamás Vicsek
- MTA-ELTE Statistical and Biological Physics Research Group; Department of Biological Physics, Eötvös Loránd University Budapest, Hungary
| | - Péter Pollner
- Regional Science Center, Faculty of Science, Eötvös Loránd University; MTA-ELTE Statistical and Biological Physics Research Group
| |
Collapse
|
18
|
Drehmer MN, Suterio DG, Muniz YCN, de Souza IR, Löfgren SE. BAFF Expression is Modulated by Female Hormones in Human Immune Cells. Biochem Genet 2016; 54:722-30. [PMID: 27306360 DOI: 10.1007/s10528-016-9752-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/08/2016] [Indexed: 08/30/2023]
Abstract
Among several autoimmune diseases, one of the main risk factors is the female gender, and much consideration has been given to the involvement of female hormones in their etiology. B-cell activating factor (BAFF) is a key factor in survival and maturation of B cells and is overexpressed in several autoimmune patients although the mechanism behind this feature is unclear. In murine models, BAFF expression could be upregulated by exogenous estrogen treatment in splenocytes; however, no evidence of this relationship was available in humans. Here, leukocytes from healthy male and female individuals were collected and cultivated in the presence or absence of estrogen or progesterone. BAFF gene expression was accessed by quantitative PCR and compared between treated and untreated group of cells. In the presence of estrogen, BAFF expression was upregulated by more than 5 times in both genders. When exposed to progesterone, the female-originated cells showed increased expression, while the cells of male origin a significant downregulation of BAFF. Our results suggest that female hormones can modulate the expression of BAFF, a key cytokine in autoimmune pathways, in human immune cells. These data might contribute to the understanding of the etiology as well as the gender bias featured by several autoimmune disorders.
Collapse
Affiliation(s)
- Manuela N Drehmer
- Department of Cell Biology, Embryology and Genetics, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Dalila G Suterio
- Department of Cell Biology, Embryology and Genetics, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Yara C N Muniz
- Department of Cell Biology, Embryology and Genetics, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Iliada R de Souza
- Department of Cell Biology, Embryology and Genetics, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Sara E Löfgren
- Department of Cell Biology, Embryology and Genetics, Federal University of Santa Catarina, Florianopolis, Brazil.
| |
Collapse
|
19
|
Gender-specific incidence of autoimmune diseases from national registers. J Autoimmun 2016; 69:102-6. [PMID: 26994904 DOI: 10.1016/j.jaut.2016.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/08/2016] [Accepted: 03/08/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND It is widely believed that autoimmune diseases affect predominantly in women, but the available evidence came from case control study with potential selection and recall bias. We aimed to examine the gender-specific incidence of autoimmune diseases by using national wide registers in Sweden. METHODS Swedish Hospital Discharge Register and Outpatient Register were used to identify a set of autoimmune diseases between 1987 and 2010. Gender-specific incidence rate was standardized directly according to the Swedish age distribution in 2000. RESULTS A total of 403,757 individuals were diagnosed with autoimmune diseases between 1987 and 2010 in Sweden. The overall incidence of 32 autoimmune disease was 60% higher in women than men. Female predominance was noted in 18 specific diseases, whereas the rest of them showed no difference or male predominance. The age of onset was different between men and women in 27 autoimmune diseases. CONCLUSIONS Our study suggested that the classical view of female predominance of autoimmune diseases may be far from striking than previously believed. Further studies are needed to examine whether there is true difference between men and women.
Collapse
|
20
|
Wang J, Yang G, Dubrovsky AM, Choi J, Leung PSC. Xenobiotics and loss of tolerance in primary biliary cholangitis. World J Gastroenterol 2016; 22:338-348. [PMID: 26755880 PMCID: PMC4698496 DOI: 10.3748/wjg.v22.i1.338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/15/2015] [Accepted: 12/01/2015] [Indexed: 02/06/2023] Open
Abstract
Data from genome wide association studies and geoepidemiological studies established that a combination of genetic predisposition and environmental stimulation is required for the loss of tolerance in primary biliary cholangitis (PBC). The serologic hallmark of PBC are the presence of high titer anti-mitochondrial autoantibodies (AMA) that recognize the lipoyl domain of the mitochondrial pyruvate dehydrogenase E2 (PDC-E2) subunit. Extensive efforts have been directed to investigate the molecular basis of AMA. Recently, experimental data has pointed to the thesis that the breaking of tolerance to PDC-E2 is a pivotal event in the initial etiology of PBC, including environmental xenobiotics including those commonly found in cosmetics and food additives, suggesting that chemical modification of the PDC-E2 epitope may render its vulnerable to become a neo-antigen and trigger an immune response in genetically susceptible hosts. Here, we will discuss the natural history, genetics and immunobiology of PBC and structural constraints of PDC-E2 in AMA recognition which makes it vulnerable to chemical modification.
Collapse
|
21
|
Sun Y, Haapanen K, Li B, Zhang W, Van de Water J, Gershwin ME. Women and primary biliary cirrhosis. Clin Rev Allergy Immunol 2016; 48:285-300. [PMID: 25241227 DOI: 10.1007/s12016-014-8449-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Primary biliary cirrhosis occurs more frequently in women, and previous studies indicated that the average age of primary biliary cirrhosis (PBC) onset makes pregnancy in PBC patients uncommon. However, more recently, improved diagnostic testing has enabled detection of PBC in younger women, including those of childbearing age. This has led investigators to become increasingly interested in the relationship between the ontogeny of PBC and pregnancy. Published cases indicate that the typical age for pregnant women to be diagnosed with PBC is in the early 30s, and that during gestation, pruritus and jaundice are the most common symptoms. During gestation, susceptible women may experience onset of PBC resulting from the drastic changes in female hormones; this would include not only the mitochondrial damage due to accumulation of bile acids but also changes in the immune response during the different stages of pregnancy that might play an important role in the breakdown of self-tolerance. The mechanisms underlying the potential relationship between PBC and pregnancy warrant further investigation. For women first diagnosed with PBC during gestation, or those for whom first appearance of a flare up occurs during and postpartum, investigation of the immune response throughout gestation could provide new avenues for immunologic therapeutic intervention and the discovery of new treatment strategies for PBC.
Collapse
Affiliation(s)
- Ying Sun
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA
| | | | | | | | | | | |
Collapse
|
22
|
Abstract
There have been significant advances in our understanding of human autoimmunity that have led to improvements in classification and diagnosis and, most importantly, research advances in new therapies. The importance of autoimmunity and the mechanisms that lead to clinical disease were first recognized about 50 years ago following the pioneering studies of Macfarlane Burnett and his Nobel Prize-winning hypothesis of the 'forbidden clone'. Such pioneering efforts led to a better understanding not only of autoimmunity, but also of lymphoid cell development, thymic education, apoptosis and deletion of autoreactive cells. Contemporary theories suggest that the development of an autoimmune disease requires a genetic predisposition and environmental factors that trigger the immune pathways that lead, ultimately, to tissue destruction. Despite extensive research, there are no genetic tools that can be used clinically to predict the risk of autoimmune disease. Indeed, the concordance of autoimmune disease in identical twins is 12-67%, highlighting not only a role for environmental factors, but also the potential importance of stochastic or epigenetic phenomena. On the other hand, the identification of cytokines and chemokines, and their cognate receptors, has led to novel therapies that block pathological inflammatory responses within the target organ and have greatly improved the therapeutic effect in patients with autoimmune disease, particularly rheumatoid arthritis. Further advances involving the use of multiplex platforms for diagnosis and identification of new therapeutic agents should lead to major breakthroughs within the next decade.
Collapse
Affiliation(s)
- Lifeng Wang
- Research Center for Biological Therapy, The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, China
| | - Fu-Sheng Wang
- Research Center for Biological Therapy, The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, China
| | - M Eric Gershwin
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, Davis, CA, USA
| |
Collapse
|
23
|
DeMarshall CA, Han M, Nagele EP, Sarkar A, Acharya NK, Godsey G, Goldwaser EL, Kosciuk M, Thayasivam U, Belinka B, Nagele RG. Potential utility of autoantibodies as blood-based biomarkers for early detection and diagnosis of Parkinson's disease. Immunol Lett 2015; 168:80-8. [PMID: 26386375 DOI: 10.1016/j.imlet.2015.09.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/14/2015] [Accepted: 09/14/2015] [Indexed: 12/13/2022]
Abstract
INTRODUCTION There is a great need to identify readily accessible, blood-based biomarkers for Parkinson's disease (PD) that are useful for accurate early detection and diagnosis. This advancement would allow early patient treatment and enrollment into clinical trials, both of which would greatly facilitate the development of new therapies for PD. METHODS Sera from a total of 398 subjects, including 103 early-stage PD subjects derived from the Deprenyl and Tocopherol Antioxidative Therapy of Parkinsonism (DATATOP) study, were screened with human protein microarrays containing 9,486 potential antigen targets to identify autoantibodies potentially useful as biomarkers for PD. A panel of selected autoantibodies with a higher prevalence in early-stage PD was identified and tested using Random Forest for its ability to distinguish early-stage PD subjects from controls and from individuals with other neurodegenerative and non-neurodegenerative diseases. RESULTS Results demonstrate that a panel of selected, blood-borne autoantibody biomarkers can distinguish early-stage PD subjects (90% confidence in diagnosis) from age- and sex-matched controls with an overall accuracy of 87.9%, a sensitivity of 94.1% and specificity of 85.5%. These biomarkers were also capable of differentiating patients with early-stage PD from those with more advanced (mild-moderate) PD with an overall accuracy of 97.5%, and could distinguish subjects with early-stage PD from those with other neurological (e.g., Alzheimer's disease and multiple sclerosis) and non-neurological (e.g., breast cancer) diseases. CONCLUSION These results demonstrate, for the first time, that a panel of selected autoantibodies may prove to be useful as effective blood-based biomarkers for the diagnosis of early-stage PD.
Collapse
Affiliation(s)
- Cassandra A DeMarshall
- Biomarker Discovery Center, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Graduate School of Biomedical Sciences, Rowan University, Stratford, NJ, USA; Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Min Han
- Biomarker Discovery Center, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Graduate School of Biomedical Sciences, Rowan University, Stratford, NJ, USA; Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Eric P Nagele
- Biomarker Discovery Center, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Durin Technologies, Inc., New Brunswick, NJ, USA
| | - Abhirup Sarkar
- Biomarker Discovery Center, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Graduate School of Biomedical Sciences, Rowan University, Stratford, NJ, USA; Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Nimish K Acharya
- Biomarker Discovery Center, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - George Godsey
- Graduate School of Biomedical Sciences, Rowan University, Stratford, NJ, USA; Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Eric L Goldwaser
- Biomarker Discovery Center, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Graduate School of Biomedical Sciences, Rowan University, Stratford, NJ, USA; Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Mary Kosciuk
- Biomarker Discovery Center, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | | | | | - Robert G Nagele
- Biomarker Discovery Center, New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA; Durin Technologies, Inc., New Brunswick, NJ, USA.
| | | |
Collapse
|
24
|
Ntatsaki E, Isenberg D. Risk factors for renal disease in systemic lupus erythematosus and their clinical implications. Expert Rev Clin Immunol 2015; 11:837-48. [DOI: 10.1586/1744666x.2015.1045418] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
25
|
Shahani L. Steroid unresponsive anti-NMDA receptor encephalitis during pregnancy successfully treated with plasmapheresis. BMJ Case Rep 2015; 2015:bcr-2014-208823. [PMID: 25926583 DOI: 10.1136/bcr-2014-208823] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is an autoimmune disorder resulting in neurological and psychiatric symptoms. It is rare during pregnancy and treatment is extremely challenging as little data exist to guide management. A 26-year-old woman presented at 22 weeks of gestation with intermittent headache and an acute episode of bizarre behaviour and grandiose delusions resulting in hospitalisation. The patient was worked up for encephalitis and was found to have anti-NMDA receptor antibody in cerebrospinal fluid as well as in serum. She was initially treated with high-dose steroids but failed to improve clinically and serologically. She was then treated with plasmapheresis and showed clinical and serological response. She had a successful delivery at 37 weeks and the baby did not show serological evidence of disease. This case adds to the sparse literature of anti-NMDA receptor encephalitis during pregnancy and adds to the differential diagnosis of new onset psychiatric symptoms during pregnancy.
Collapse
Affiliation(s)
- Lokesh Shahani
- Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
26
|
Ramos-Casals M, Brito-Zerón P, Kostov B, Sisó-Almirall A, Bosch X, Buss D, Trilla A, Stone JH, Khamashta MA, Shoenfeld Y. Google-driven search for big data in autoimmune geoepidemiology: analysis of 394,827 patients with systemic autoimmune diseases. Autoimmun Rev 2015; 14:670-9. [PMID: 25842074 DOI: 10.1016/j.autrev.2015.03.008] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 03/30/2015] [Indexed: 01/08/2023]
Abstract
Systemic autoimmune diseases (SADs) are a significant cause of morbidity and mortality worldwide, although their epidemiological profile varies significantly country by country. We explored the potential of the Google search engine to collect and merge large series (>1000 patients) of SADs reported in the Pubmed library, with the aim of obtaining a high-definition geoepidemiological picture of each disease. We collected data from 394,827 patients with SADs. Analysis showed a predominance of medical vs. administrative databases (74% vs. 26%), public health system vs. health insurance resources (88% vs. 12%) and patient-based vs. population-based designs (82% vs. 18%). The most unbalanced gender ratio was found in primary Sjögren syndrome (pSS), with nearly 10 females affected per 1 male, followed by systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and antiphospholipid syndrome (APS) (ratio of nearly 5:1). Each disease predominantly affects a specific age group: children (Kawasaki disease, primary immunodeficiencies and Schonlein-Henoch disease), young people (SLE Behçet disease and sarcoidosis), middle-aged people (SSc, vasculitis and pSS) and the elderly (amyloidosis, polymyalgia rheumatica, and giant cell arteritis). We found significant differences in the geographical distribution of studies for each disease, and a higher frequency of the three SADs with available data (SLE, inflammatory myopathies and Kawasaki disease) in African-American patients. Using a "big data" approach enabled hitherto unseen connections in SADs to emerge.
Collapse
Affiliation(s)
- Manuel Ramos-Casals
- Josep Font Laboratory of Autoimmune Diseases, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.
| | - Pilar Brito-Zerón
- Josep Font Laboratory of Autoimmune Diseases, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain
| | - Belchin Kostov
- Primary Care Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Primary Care Centre Les Corts, CAPSE, Barcelona, Spain
| | - Antoni Sisó-Almirall
- Primary Care Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Primary Care Centre Les Corts, CAPSE, Barcelona, Spain
| | - Xavier Bosch
- Department of Internal Medicine, ICMiD, Hospital Clínic, Barcelona, Spain
| | - David Buss
- Josep Font Laboratory of Autoimmune Diseases, CELLEX, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain
| | - Antoni Trilla
- Preventive Medicine and Epidemiology Unit, Hospital Clínic-Universitat de Barcelona, Barcelona Centre for International Health Research, Barcelona, Catalonia, Spain
| | - John H Stone
- Harvard Medical School, Boston, MA 02114, USA; Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Munther A Khamashta
- Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, King's College University, London, UK
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
27
|
Lyme disease: A rigorous review of diagnostic criteria and treatment. J Autoimmun 2015; 57:82-115. [DOI: 10.1016/j.jaut.2014.09.004] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 01/07/2023]
|
28
|
Discovering the pathogenesis of autoimmune diseases at the 9th International Congress of Autoimmunity, Nice, France, 2014. Immunol Res 2014; 60:253-6. [DOI: 10.1007/s12026-014-8608-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
29
|
Dar L, Shalev V, Weitzman D, Chodick G, Arnson Y, Amital H. No male predominance in offspring of women with rheumatoid arthritis or systemic lupus erythematosus. Immunol Res 2014; 60:361-5. [DOI: 10.1007/s12026-014-8603-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
30
|
Pathogenesis and potential therapeutic targets in systemic lupus erythematosus: from bench to bedside. AUTOIMMUNITY HIGHLIGHTS 2014; 5:33-45. [PMID: 26000154 PMCID: PMC4389042 DOI: 10.1007/s13317-014-0058-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 06/12/2014] [Indexed: 12/18/2022]
Abstract
Systemic lupus erythematosus (SLE) is considered an autoimmune disease with multiorgan involvement. Many advances have been made during the last decade regarding inflammatory pathways, genetic and epigenetic alterations, adaptive and innate immune system mechanisms specifically involved in SLE pathogenesis. Apoptosis has been proposed as an important player in SLE pathogenesis more than a decade ago. However, only recently new key apoptotic pathways have been investigated and the link between apoptotic debris containing autoantigens, innate immunity and ongoing inflammation has been further elucidated. Better understanding of cellular mechanisms and involved cytokines contributed to the development of new biological drugs specifically addressed for SLE therapy.
Collapse
|
31
|
Berrih-Aknin S. Myasthenia Gravis: paradox versus paradigm in autoimmunity. J Autoimmun 2014; 52:1-28. [PMID: 24934596 DOI: 10.1016/j.jaut.2014.05.001] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 05/07/2014] [Indexed: 12/12/2022]
Abstract
Myasthenia Gravis (MG) is a paradigm of organ-specific autoimmune disease (AID). It is mediated by antibodies that target the neuromuscular junction. The purpose of this review is to place MG in the general context of autoimmunity, to summarize the common mechanisms between MG and other AIDs, and to describe the specific mechanisms of MG. We have chosen the most common organ-specific AIDs to compare with MG: type 1 diabetes mellitus (T1DM), autoimmune thyroid diseases (AITD), multiple sclerosis (MS), some systemic AIDs (systemic lupus erythematous (SLE), rheumatoid arthritis (RA), Sjogren's syndrome (SS)), as well as inflammatory diseases of the gut and liver (celiac disease (CeD), Crohn's disease (CD), and primary biliary cirrhosis (PBC)). Several features are similar between all AIDs, suggesting that common pathogenic mechanisms lead to their development. In this review, we address the predisposing factors (genetic, epigenetic, hormones, vitamin D, microbiota), the triggering components (infections, drugs) and their interactions with the immune system [1,2]. The dysregulation of the immune system is detailed and includes the role of B cells, Treg cells, Th17 and cytokines. We particularly focused on the role of TNF-α and interferon type I whose role in MG is very analogous to that in several other AIDS. The implication of AIRE, a key factor in central tolerance is also discussed. Finally, if MG is a prototype of AIDS, it has a clear specificity compared to the other AIDS, by the fact that the target organ, the muscle, is not the site of immune infiltration and B cell expansion, but exclusively that of antibody-mediated pathogenic mechanisms. By contrast, the thymus in the early onset subtype frequently undergoes tissue remodeling, resulting in the development of ectopic germinal centers surrounded by high endothelial venules (HEV), as observed in the target organs of many other AIDs.
Collapse
Affiliation(s)
- Sonia Berrih-Aknin
- Sorbonne Universités, UPMC Univ Paris 06, Myology Research Center UM76, F-75013 Paris, France; INSERM U974, F-75013 Paris, France; CNRS FRE 3617, F-75013 Paris, France; Institute of Myology, F-75013 Paris, France.
| |
Collapse
|
32
|
Abstract
It is astounding to consider that virtually, every textbook of physiology in every medical school in the world does not include a chapter on immunology. On the other hand, virtually, in every textbook in internal medicine, immunology and immune response overlaps with every tissue and every organ. Indeed, historically, the concept of the immune response was recognized primarily in the setting of allergy and/or anaphylaxis. Indeed, the very concepts of infection, microbiology and host protection are relatively new sciences. In fact, it was little more than 100 years ago when washing hands became what is now coined "standard of care." How different it is in 2013, where one finds Handi Wipes for shoppers to use at grocery stores to protect themselves from the flora on shopping cart handles. Autoimmunity is even a newer concept without going into the well-known history of Paul Ehrlich and hemolytic anemias, the LE cell, and the beginning field of serology (and rheumatoid factor discovery). It is apparent that our understanding of autoimmunity has become linked hand-in-glove with new tools and investigational probes into serology and, more recently, the cellular immune response. With such discoveries, a number of key observations stand out. Firstly, there are a great deal more autoantibodies than there are autoimmune diseases. Second, there are a great deal more of autoimmune diseases than was believed in 1963 on the occasion of the publication of the first textbook of autoimmune diseases. Third, autoimmune diseases are, for the most part, orphan diseases, with many entities afflicting too few patients to excite the financial limb of pharmaceutical companies. In this special issue, we have grouped a number of papers, many of which were presented at the recent Congress of Autoimmunity that focus on issues that are not commonly discussed in autoimmunity. It reminds us that due to the ubiquitous nature of the innate and adaptive response, that there are a large number of diseases that have either an inflammatory and/or specific autoimmune response, we have to keep an open eye because everything is potentially autoimmune until proven otherwise.
Collapse
Affiliation(s)
- Yehuda Shoenfeld
- Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,
| |
Collapse
|
33
|
Abstract
The initiation and perpetuation of autoimmunity recognize numerous checkpoints, from the genomic susceptibility to the breakdown of tolerance. This latter phenomenon includes the loss of B cell anergy and T regulatory cell failure, as well as the production of autoantibodies and autoreactive T cells. These mechanisms ultimately lead to tissue injury via different mechanisms that span from the production of proinflammatory cytokines to the chemotaxis of immune cells to the target sites. The pathways to autoimmunity have been widely investigated over the past year and resulted in a number of articles in peer-reviewed journals that has increased by nearly 10 % compared to 2011. We herein follow on the attempt to provide a brief discussion of the majority of articles on autoimmune diseases that were published in the major immunology journals in the previous solar year. The selection is necessarily arbitrary and may thus not be seen as comprehensive but reflects current research trends. Indeed, 2012 articles were mostly dedicated to define new and old mechanisms with potential therapeutic implications in autoimmunity in general, though based on specific clinical conditions or animal models. As paradigmatic examples, the environmental influence on autoimmunity, Th17 changes modulating the autoimmune response, serum autoantibodies and B cell changes as biomarkers and therapeutic targets were major issues addressed by experimental articles in 2012. Further, a growing number of studies investigated the sex bias of autoimmunity and supported different working hypotheses to explain the female predominance, including sex chromosome changes and reproductive life factors. In conclusion, the resulting scenario illustrates that common factors may underlie different autoimmune diseases and this is well represented by the observed alterations in interferon-α and TGFβ or by the shared signaling pathways.
Collapse
Affiliation(s)
- Carlo Selmi
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy,
| |
Collapse
|
34
|
Tsuneyama K, Baba H, Kikuchi K, Nishida T, Nomoto K, Hayashi S, Miwa S, Nakajima T, Nakanishi Y, Masuda S, Terada M, Imura J, Selmi C. Autoimmune features in metabolic liver disease: a single-center experience and review of the literature. Clin Rev Allergy Immunol 2014; 45:143-8. [PMID: 23842720 DOI: 10.1007/s12016-013-8383-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Non-alcoholic steatohepatitis (NASH) is the progressive phenotype of non-alcoholic fatty liver disease associated with the metabolic syndrome. The existence of autoimmune features in NASH has been reported, but its significance remains unclear. We herein report the autoantibody profile of 54 patients with histologically proven NASH and further determined the development of autoimmunity in three different murine NASH models (monosodium glutamate, CDAA (choline-deficient L-amino acid-defined), and TSOD (Tsumura Suzuki, Obese Diabetes)) at 48 weeks of age. Forty-eight percent (26/54) of NASH cases were positive for antinuclear (ANA) or antimitochondrial antibody and manifested histological signs of overlap with autoimmune hepatitis and primary biliary cirrhosis, respectively. These patients were significantly older (60 ± 10 versus 50 ± 16 years), more frequently women (81 % versus 43 %), and with more severe portal inflammatory infiltrate compared with patients without autoimmunity. In one third of mice, regardless of the model, we observed a marked lymphoid infiltrate with non-suppurative cholangitis, and several cases were ANA-positive, but none AMA-positive. Our data suggest that autoimmunity may share some pathogenetic traits with the chronic inflammation of NASH, possibly related to advanced age.
Collapse
Affiliation(s)
- Koichi Tsuneyama
- Department of Diagnostic Pathology, Graduate School of Medical and Pharmaceutical Sciences, University of Toyama, Toyama, 930-0194, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Perricone C, Shoenfeld N, Agmon-Levin N, de Carolis C, Perricone R, Shoenfeld Y. Smell and autoimmunity: a comprehensive review. Clin Rev Allergy Immunol 2014; 45:87-96. [PMID: 23233263 DOI: 10.1007/s12016-012-8343-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The sense of smell is an ancient sensory modality vital for sampling and perceiving the chemical composition of surrounding environments. Olfaction involves a pathway of biochemical and electrophysiological processes, which allows the conversion of molecular information into sensations. Disturbances in the olfactory function have been investigated mainly in neurological/neurodegenerative disorders such as Alzheimer's and Parkinson's diseases; impaired sense of smell has been associated with depressed mood. Only recently, smell capability was tested in other diseases, particularly autoimmune diseases. Shoenfeld and colleagues opened this chapter showing that patients affected with systemic lupus erythematosus (SLE) have disturbances in their olfactory functions and revealed its association with neuropsychiatric manifestations of the disease. This evidence was confirmed in experimental models and replicated in other SLE populations. The connection between autoimmunity and the sense of smell was lately emphasized by studies on patients with Sjögren's syndrome and in patients with other autoimmune/immune-mediated diseases, such as polydermatomyositis, recurrent spontaneous abortion, and hereditary angioedema. Genetic susceptibility and hormonal and environmental factors may play a role in these conditions. Olfactory receptor gene clusters are located in proximity to key locus of susceptibility for autoimmune diseases such as the major histocompatibility complex, suggesting not only a physic linkage, but a functional association. Nonetheless, gender- and hormone-mediated effects are fundamental in the development of autoimmune diseases. The different connections between smell and autoimmunity, genes and hormones may suggest that this is another tessera of a mosaic which is waiting the answer of Oedipus.
Collapse
Affiliation(s)
- Carlo Perricone
- Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | | | | | | | | | | |
Collapse
|
36
|
Autoimmunity: from black water fever to regulatory function. J Autoimmun 2014; 48-49:1-9. [PMID: 24491820 DOI: 10.1016/j.jaut.2013.12.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 12/31/2013] [Indexed: 12/15/2022]
Abstract
Autoimmunity is a field that has only been around for a little over a century. Initially, it was thought that autoimmunity could not happen, that the body would never turn on itself (i.e. "horror autotoxicus"). It was only around the First World War that autoimmunity was recognized as the pathogenesis of various diseases, including rheumatoid arthritis. The discovery of Compound E led to successful treatment of patients with autoimmune diseases, but it was not till later that the adverse effects of this class of drugs were elucidated. The "modern" age of autoimmunity began around 1945 with the description of blackwater fever, and most of the subsequent research on hemolytic anemia and the role of an autoantibody in its pathogenesis led to a description of the anti-globulin reaction. The lupus erythematous (LE) cell was recognized in the mid-1940s by Hargreaves. His research carried on into the 1960s. Rheumatoid factor was also first described in the 1940s as yet another serum factor with activity against globulin-coated sheep red blood cells. The concept of autoimmunity really gained a foothold in the 1950s, when autoimmune thyroid disease and idiopathic thrombocytopenia were first described. Much has happened since then, and our understanding of autoimmunity has evolved now to include mechanisms of apoptosis, signaling pathway derangements, and the discovery of subsets of T cells with regulatory activity. The modern day study of autoimmunity is a fascinating area of research, and full understanding of the pathogenesis of autoimmune diseases is far from being completely elucidated.
Collapse
|
37
|
Fischer S, Agmon-Levin N, Shapira Y, Porat Katz BS, Graell E, Cervera R, Stojanovich L, Gómez Puerta JA, Sanmartí R, Shoenfeld Y. Toxoplasma gondii: bystander or cofactor in rheumatoid arthritis. Immunol Res 2014; 56:287-92. [PMID: 23553228 DOI: 10.1007/s12026-013-8402-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Parasitic infections may induce variable immunomodulatory effects and control of autoimmune disease. Toxoplasma gondii (T. gondii) is a ubiquitous intracellular protozoan that was recently associated with autoimmunity. This study was undertaken to investigate the seroprevalence and clinical correlation of anti-T. gondii antibodies in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We evaluated sera from European patients with RA (n = 125) and SLE (n = 164) for the prevalence of anti-T. gondii IgG antibodies (ATXAb), as well as other common infections such as Cytomegalovirus, Epstein-Barr, and Rubella virus. The rates of seropositivity were determined utilizing the LIAISON chemiluminescent immunoassays (DiaSorin, Italy). Our results showed a higher seroprevalence of ATXAb in RA patients, as compared with SLE patients [63 vs. 36 %, respectively (p = 0.01)]. The rates of seropositivity of IgG against other infectious agents were comparable between RA and SLE patients. ATXAb-seropositivity was associated with older age of RA patients, although it did not correlate with RA disease activity and other manifestations of the disease. In conclusion, our data suggest a possible link between exposure to T. gondii infection and RA.
Collapse
Affiliation(s)
- Svetlana Fischer
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 52621, Tel HaShomer, Israel
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Chang C. Unmet needs in the treatment of autoimmunity: from aspirin to stem cells. Autoimmun Rev 2014; 13:331-46. [PMID: 24462645 DOI: 10.1016/j.autrev.2014.01.052] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2013] [Indexed: 12/26/2022]
Abstract
As rheumatologic diseases became understood to be autoimmune in nature, the drugs used to treat this group of conditions has evolved from herbal or plant derived anti-inflammatory agents, such as salicylates, quinine and colchicine to the many recently approved biological response modifiers. These new drugs, especially the anti-tumor necrosis factor agents, have shown remarkable efficacy in autoimmune diseases, and there are new agents under investigation that will provide additional treatment options. In between, the world was introduced to cortisone and all of its derivatives, as chemical synthesis led to better, more efficacious drugs with lesser side effects. Disease modifying anti-rheumatic agents have actually been around since the first half of the 20th century, but only began to be used in the treatment of autoimmune diseases in the 1970s and 1980s. One advantage is that they have been invaluable in their ability to offer "steroid sparing" to decrease the adverse effects of steroids. Research over the past decade has resulted in a new class of drugs that influence cytokine regulatory pathways such as the Janus associated kinase inhibitors. The promise of personalized medicine now permeates current research into new pharmacological agents for the treatment of autoimmune disease. The new appreciation for the gene-environment interaction in the pathogenesis of most diseases especially those as heterogeneous as autoimmune diseases, has led to our focus on targeted therapies. Add to that the new knowledge of epigenetics and how changes in DNA and histone structure affect expression of genes that can play a role in immune signaling, and we now have a new exciting frontier for cutting edge drug development. The history of treatment of autoimmune diseases is really only a little over a century, but so much has changed, leading to increasing lifespans and improved quality of life of those who suffer from these ailments.
Collapse
Affiliation(s)
- Christopher Chang
- Division of Allergy and Immunology, Thomas Jefferson University, Nemours/A.I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, USA.
| |
Collapse
|
39
|
Koh KM, Kim US. Characteristics of pupillo-accommodative functions according to time of onset, gender and age in tonic pupil. Int J Ophthalmol 2013; 6:659-61. [PMID: 24195044 DOI: 10.3980/j.issn.2222-3959.2013.05.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 07/16/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the characteristics of pupillo-accommodative functions in patients with idiopathic tonic pupil according to the time of onset, gender, and age. METHODS Totally, 15 males and 19 females were divided into 2 groups depending on the time of disease onset: group I (onset <2 months, n=20) and group II (onset >2 months, n=14). A supersensivity test was conducted by applying diluted pilocarpine 0.125% to the eye and accommodative functions were evaluated using the near-point of accommodation (NPA) as the cutoff point, at which the patient experienced blurred vision. Pupil size and the ratio of decrease in the affected pupil after instillation of 0.125% pilocarpine were investigated. RESULTS There was no significant difference between the 2 groups regarding the various pupillary reflex results, including data on the affected pupil size before and after 0.125% pilocarpine, anisocoria, and ratio of pupil decrease. No significant difference in NPA was found between the 2 groups. However, female patients were noted to have greater anisocoria and a faster constriction ratio than those of the male patients (P=0.02 and P=0.04). On subgroup analysis, female patients from group II had larger affected-pupil sizes before 0.125% pilocarpine instillation and longer NPAs than those of the male patients. CONCLUSION No relationship was found between time of onset and dysfunction of pupillo-accommodative functions. Pupillo-accommodative functions and age were not related, except for the NPA.
Collapse
Affiliation(s)
- Kyung-Min Koh
- Department of Ophthalmology, Kim's Eye Hospital, Seoul 150-034, Korea
| | | |
Collapse
|
40
|
Tanaka A, Takikawa H. Geoepidemiology of primary sclerosing cholangitis: A critical review. J Autoimmun 2013; 46:35-40. [DOI: 10.1016/j.jaut.2013.07.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 07/11/2013] [Indexed: 12/20/2022]
|
41
|
Podda M, Selmi C, Lleo A, Moroni L, Invernizzi P. The limitations and hidden gems of the epidemiology of primary biliary cirrhosis. J Autoimmun 2013; 46:81-7. [PMID: 23871640 DOI: 10.1016/j.jaut.2013.06.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 06/23/2013] [Indexed: 12/28/2022]
|
42
|
Beccastrini E, D'Elios MM, Emmi G, Silvestri E, Squatrito D, Prisco D, Emmi L. Systemic lupus erythematosus: immunopathogenesis and novel therapeutic targets. Int J Immunopathol Pharmacol 2013; 26:585-96. [PMID: 24067455 DOI: 10.1177/039463201302600302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is the prototype of autoimmune diseases with multiorgan involvement. SLE presents many genetic and epigenetic associations and the pathogenesis is characterized by a complex network of alterations affecting both adaptative and innate immunity. The disclosure of novel mechanisms of SLE pathogenesis suggested new therapeutic targets, based on interference with the cytokine pathways or on depletion of the immune cells.
Collapse
Affiliation(s)
- E Beccastrini
- SOD Medical Pathology, Center for Autoimmune Systemic Diseases, Behcet Center and Lupus Clinic, AOU Careggi, Florence, Italy
| | | | | | | | | | | | | |
Collapse
|
43
|
Gey A, Diallo A, Seneschal J, Léauté-Labrèze C, Boralevi F, Jouary T, Taieb A, Ezzedine K. Autoimmune thyroid disease in vitiligo: multivariate analysis indicates intricate pathomechanisms. Br J Dermatol 2013; 168:756-61. [PMID: 23253044 DOI: 10.1111/bjd.12166] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Vitiligo/nonsegmental vitiligo (NSV) is often associated with thyroid dysimmunity although very few reports have studied this association using multivariate logistic regression. OBJECTIVE To identify weighted factors associated with the presence of autoimmune thyroid disease (AITD) in a large cohort of patients with vitiligo/NSV. METHODS This was a prospective observational study in 626 patients with a confirmed diagnosis of vitiligo/NSV attending the vitiligo clinic of the University Hospital Department of Dermatology, Bordeaux, France, from 1 January 2006 to 1 May 2012. The Vitiligo European Task Force (VETF) questionnaire was completed for each consecutive patient. AITD was defined as the presence of significant levels of serum antithyroperoxidase antibodies or evidence of autoimmune thyroiditis. Univariate and multivariate logistic regression procedures were conducted to identify factors associated with AITD in this cohort of patients with vitiligo/NSV. RESULTS A total of 626 patients with vitiligo/NSV were included, of whom 131 had AITD (AITD-vitiligo). Stress as an onset factor, familial history of AITD, body surface involvement and duration of the disease were positively associated with AITD-vitiligo using univariate analysis, whereas female sex, age at onset of vitiligo, personal history of autoimmune disease and localization on the trunk were found to be independently associated with AITD-vitiligo. CONCLUSION Vitiligo associated with AITD has clinical features distinct from vitiligo without AITD. In particular, female patients, and patients with longer duration of disease and greater body surface involvement are more likely to present with AITD and should thus be monitored for thyroid function and antithyroid antibodies on a regular basis.
Collapse
Affiliation(s)
- A Gey
- Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Pellegrin, place Amélie Raba-Léon, 33076, Bordeaux, France
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Maraschin JDF, Weinert LS, Murussi N, Witter V, Rodrigues TDC, Rossato ER, Silveiro SP. Influence of age at diagnosis and duration of diabetes on the positivity of glutamic acid decarboxylase antibody in South-Brazilian type 1 diabetes mellitus. Ann Clin Biochem 2013; 50:262-6. [DOI: 10.1177/0004563212474560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aim To evaluate the influence of age of onset and duration of diabetes on the positivity of glutamic acid decarboxylase antibody (GADA) in South-Brazilian type 1 diabetes mellitus (DM) patients. Methods GADA was evaluated in 92 patients with type 1 diabetes, in 147 gestational DM patients, and in 59 subjects with normal glucose tolerance. Results Type 1 patients with positive GADA ( N = 44, 48%) were older at the onset of diabetes (22 ± 9 versus 18 ± 10 y, P = 0.043) and had a shorter DM duration (12 ± 8 versus 19 ± 9 y, P < 0.001), as compared with negative GADA patients. A logistic regression with antibody positivity as the dependent variable and diabetes duration as the independent variable, showed that the shorter diabetes duration was related to the presence of the antibody with an odds ratio (OR) = 5.6; (CI 95% = 2.1–14.6); P < 0.001. Another model, with age at diagnosis as the independent variable, did not show any association with antibody positivity. However, analysing only men, a shorter DM duration (OR = 6.5; CI = 1.7–24.0; P = 0.006), and also a higher age at diagnosis (OR = 5.5; CI = 1.5–21.0; P = 0.01) were significantly related to the antibody positivity. The performance of GADA was similar in up to 15 y of duration of DM ( P = 0.78), but significantly diminished with higher duration ( P = 0.001). Conclusion GADA testing is a helpful tool in the diagnosis of type 1 DM starting in young adults and older individuals. Even though the positivity rate declines along the course of disease, it still provides useful information up to 15 y after the diabetes diagnosis.
Collapse
Affiliation(s)
- Jorge de Faria Maraschin
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia da Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Rua Ramiro Barcelos, 2400, 2 andar, 90035-003, Porto Alegre, RS, Brazil
| | - Letícia Schwerz Weinert
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia da Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Rua Ramiro Barcelos, 2400, 2 andar, 90035-003, Porto Alegre, RS, Brazil
| | - Nádia Murussi
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia da Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Rua Ramiro Barcelos, 2400, 2 andar, 90035-003, Porto Alegre, RS, Brazil
| | - Vanessa Witter
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia da Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Rua Ramiro Barcelos, 2400, 2 andar, 90035-003, Porto Alegre, RS, Brazil
| | - Ticiana da Costa Rodrigues
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia da Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Rua Ramiro Barcelos, 2400, 2 andar, 90035-003, Porto Alegre, RS, Brazil
| | - Egna Regina Rossato
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia da Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Rua Ramiro Barcelos, 2400, 2 andar, 90035-003, Porto Alegre, RS, Brazil
| | - Sandra Pinho Silveiro
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia da Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Rua Ramiro Barcelos, 2400, 2 andar, 90035-003, Porto Alegre, RS, Brazil
| |
Collapse
|
45
|
Natural IgG autoantibodies are abundant and ubiquitous in human sera, and their number is influenced by age, gender, and disease. PLoS One 2013; 8:e60726. [PMID: 23589757 PMCID: PMC3617628 DOI: 10.1371/journal.pone.0060726] [Citation(s) in RCA: 217] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 03/01/2013] [Indexed: 11/20/2022] Open
Abstract
The presence of self-reactive IgG autoantibodies in human sera is largely thought to represent a breakdown in central tolerance and is typically regarded as a harbinger of autoimmune pathology. In the present study, immune-response profiling of human serum from 166 individuals via human protein microarrays demonstrates that IgG autoantibodies are abundant in all human serum, usually numbering in the thousands. These IgG autoantibodies bind to human antigens from organs and tissues all over the body and their serum diversity is strongly influenced by age, gender, and the presence of specific diseases. We also found that serum IgG autoantibody profiles are unique to an individual and remarkably stable over time. Similar profiles exist in rat and swine, suggesting conservation of this immunological feature among mammals. The number, diversity, and apparent evolutionary conservation of autoantibody profiles suggest that IgG autoantibodies have some important, as yet unrecognized, physiological function. We propose that IgG autoantibodies have evolved as an adaptive mechanism for debris-clearance, a function consistent with their apparent utility as diagnostic indicators of disease as already established for Alzheimer’s and Parkinson’s diseases.
Collapse
|
46
|
The critical importance of epigenetics in autoimmunity. J Autoimmun 2013; 41:1-5. [PMID: 23375849 DOI: 10.1016/j.jaut.2013.01.010] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 01/13/2013] [Indexed: 11/21/2022]
Abstract
Autoimmune diseases are characterized by aberrant immune responses against healthy cells and tissues, in which a given individual's genetic susceptibilities play a central role; however, the exact mechanisms underlying the development of these conditions remain for the most part unknown. In recent years, accumulating evidence has demonstrated that, in addition to genetics, other complementary mechanisms are involved in the pathogenesis of autoimmunity, in particular, epigenetics. Epigenetics is defined as stable and heritable patterns of gene expression that do not entail any alterations to the original DNA sequence. Epigenetic mechanisms primarily consist of DNA methylation, histone modifications and small non-coding RNA transcripts. Epigenetic marks can be affected by age and other environmental triggers, providing a plausible link between environmental factors and the onset and development of various human diseases. Because of their primary function in regulating timely gene expression, epigenetic mechanisms offer potential advantages in terms of interpreting the molecular basis of complicated diseases and providing new promising therapeutic avenues for their treatment. The present review focuses on recent progress made in elucidating the relationship between epigenetics and the pathogenesis of autoimmune diseases, including systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, primary Sjögren's syndrome, primary biliary cirrhosis, psoriasis and type 1 diabetes.
Collapse
|
47
|
Diagnostic value of labial minor salivary gland biopsy for Sjögren's syndrome: A systematic review. Autoimmun Rev 2013; 12:416-20. [DOI: 10.1016/j.autrev.2012.08.001] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 08/01/2012] [Indexed: 11/23/2022]
|
48
|
Mavropoulos A, Orfanidou T, Liaskos C, Smyk DS, Billinis C, Blank M, Rigopoulou EI, Bogdanos DP. p38 mitogen-activated protein kinase (p38 MAPK)-mediated autoimmunity: lessons to learn from ANCA vasculitis and pemphigus vulgaris. Autoimmun Rev 2012. [PMID: 23207287 DOI: 10.1016/j.autrev.2012.10.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Evidence is beginning to accumulate that p38 mitogen activated protein kinase (p38 MAPK) signaling pathway plays an important role in the regulation of cellular and humoral autoimmune responses. The exact mechanisms and the degree by which the p38 MAPK pathway participates in the immune-mediated induction of diseases have started to emerge. This review discusses the recent advances in the molecular dissection of the p38 MAPK pathway and the findings generated by reports investigating its role in the pathogenesis of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and autoimmune hepatitis. Application of newly-developed protocols based on sensitive flow cytometric detection has proven to be a useful tool in the investigation of the phosphorylation of p38 MAPK within different peripheral blood mononuclear cell populations and may help us to better understand the enigmatic role of this signaling cascade in the induction of autoimmunity as well as its role in immunosuppressive-induced remission. Special attention is paid to reported data proposing a specific role for autoantibody-induced activation of p38 MAPK-mediated immunopathology in the pathogenesis of autoimmune blistering diseases and anti-neutrophilic antibody-mediated vasculitides.
Collapse
Affiliation(s)
- Athanasios Mavropoulos
- Institute of Liver Studies, King's College London School of Medicine at King's College Hospital, Denmark Hill Campus, London SE5 9RS, UK
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Di Pietro F, Dato S, Carpi FM, Corneveaux JJ, Serfaustini S, Maoloni S, Mignini F, Huentelman MJ, Passarino G, Napolioni V. TP53*P72 allele influences negatively female life expectancy in a population of central Italy: cross-sectional study and genetic-demographic approach analysis. J Gerontol A Biol Sci Med Sci 2012; 68:539-45. [PMID: 23125046 DOI: 10.1093/gerona/gls223] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The association of TP53 P72R (rs1042522) with longevity remains uncertain and varies with ethnicity. Here, we tested its association with longevity in a cross-sectional population of Central Italy (18-106 years, N = 1,072), by integrating demographic information and frequency data to account for the different survival rates between sexes through the application of a genetic-demographic approach. rs1042522 affects females longevity, showing significant associations in Comparison 2 (Age Class 3 [>91 years] vs Age Class 2 [73-91 years]) under both additive (odds ratio [OR] 0.574; p = .006) and dominant (OR 0.513; p = .006) models. The TP53*P72 allele is significantly underrepresented in Age Class 3 only in women (OR 0.575; p = .008). The genetic-demographic approach demonstrated that the frequency of female TP53*P72 carriers underwent a significant reduction after 82 years (OR 0.586; p = .002). The same analyses gave nonsignificant results in men. The discrepancies among the results obtained on rs1042522 for longevity could result from the pleiotropic effects of p53 and the potential ethnic variation of its functional variants.
Collapse
Affiliation(s)
- Fabio Di Pietro
- School of Biosciences and Biotechnologies, University of Camerino, Camerino, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
You Z, Wang Q, Bian Z, Liu Y, Han X, Peng Y, Shen L, Chen X, Qiu D, Selmi CF, Gershwin ME, Ma X. The immunopathology of liver granulomas in primary biliary cirrhosis. J Autoimmun 2012; 39:216-21. [PMID: 22727562 PMCID: PMC3558985 DOI: 10.1016/j.jaut.2012.05.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 05/24/2012] [Accepted: 05/24/2012] [Indexed: 02/07/2023]
Abstract
Liver granulomas and elevated serum IgM are commonly observed in patients with primary biliary cirrhosis (PBC) but their pathogenetic significance remains largely unknown. To address this issue we performed an extensive immunostaining and colocalization study of markers associated with dendritic cells and IgM in a large cohort of tissue samples from PBC and control livers as well as from non-hepatic granulomatous diseases. First, the classical dendritic cell CD11c marker is highly expressed and more sensitive than classical hematoxylin-eosin staining in detecting granulomas associated with PBC and other conditions. Second, PBC cases with CD11c-positive granulomas have significantly higher serum IgM levels and earlier disease stages. Third, granulomas from PBC and other diseases demonstrate markers of dendritic cell immaturity, i.e. CD11b, reduced MHC II, IL-23, CCR7 and CD83 expression, and elevated C1q expression. Lastly, B cells and IgM-positive plasma cells are largely represented around PBC granulomas along with macrophages. In conclusion, our comprehensive immunohistochemical study suggests that dendritic cells are key to the pathogenesis of granulomas, regardless of their origin. More specifically, PBC liver granulomas may result from the interaction between immature dendritic cells and IgM.
Collapse
Affiliation(s)
- Zhengrui You
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Qixia Wang
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Zhaolian Bian
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Yuan Liu
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Xiaofeng Han
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Yanshen Peng
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Lei Shen
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Xiaoyu Chen
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Dekai Qiu
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Carlo F. Selmi
- Division of Rheumatology, Allergy, and Clinical Immunology, University of California at Davis, Davis, CA, USA
| | - M. Eric Gershwin
- Division of Rheumatology, Allergy, and Clinical Immunology, University of California at Davis, Davis, CA, USA
| | - Xiong Ma
- Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China
| |
Collapse
|