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Kokori E, Olatunji G, Ogieuhi IJ, Aboje JE, Olatunji D, Aremu SA, Igwe SC, Moradeyo A, Ajayi YI, Aderinto N. Teplizumab's immunomodulatory effects on pancreatic β-cell function in type 1 diabetes mellitus. Clin Diabetes Endocrinol 2024; 10:23. [PMID: 39123252 PMCID: PMC11316332 DOI: 10.1186/s40842-024-00181-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/09/2024] [Indexed: 08/12/2024] Open
Abstract
This review explores the immunomodulatory potential of Teplizumab and its impact on pancreatic β-cell function in T1D. Characterized by the autoimmune destruction of insulin-producing beta cells, T1D's management involves maintaining glycemic control through exogenous insulin. Teplizumab, a humanized monoclonal antibody targeting the CD3 antigen, has shown promise in delaying T1D onset and preserving residual β-cell function. The review employs a narrative approach, synthesizing evidence from diverse clinical trials and studies gathered through a meticulous literature search. It scrutinizes Teplizumab's mechanisms of action, including its influence on autoreactive CD8 + T cells and regulatory T cells, offering insights into its immunological pathways. The synthesis of findings from various trials demonstrates Teplizumab's efficacy in preserving C-peptide levels and reducing exogenous insulin requirements, particularly in recent-onset T1D. Considering Teplizumab's real-world implications, the paper addresses potential obstacles, including side effects, patient selection criteria, and logistical challenges. It also emphasizes exploring combination therapies and personalized treatment strategies to maximize Teplizumab's benefits. The review contributes a nuanced perspective on Teplizumab's clinical implications and future directions in T1D management, bridging theoretical understanding with practical considerations.
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Affiliation(s)
- Emmanuel Kokori
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | | | - John Ehi Aboje
- Department of Medicine, College of Health Sciences, Benue State University, Benue, Nigeria
| | - Doyin Olatunji
- Department of Health Sciences, Western Illinois University, Macomb, USA
| | | | | | - Abdulrahmon Moradeyo
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Yusuf Ismaila Ajayi
- Department of Medicine and Surgery, Obafemi Awolowo University, Ife, Nigeria
| | - Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
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Zhang L, Xia Q, Li W, Liu Q, Zhang L, Tian X, Ye L, Wang G, Peng Q. Immunoproteasome subunit β5i promotes perifascicular muscle atrophy in dermatomyositis by upregulating RIG-I. RMD Open 2023; 9:rmdopen-2022-002818. [PMID: 36854567 PMCID: PMC9980316 DOI: 10.1136/rmdopen-2022-002818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/04/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Perifascicular atrophy is a unique pathological hallmark in dermatomyositis (DM)-affected muscles; however, the mechanism underlying this process remains unclear. In this study, we aimed to investigate the potential role of the immunoproteasome subunit β5i and retinoic acid-inducible gene-I (RIG-I) in DM-associated muscle atrophy. METHODS The expression of β5i and RIG-I in the muscles of 16 patients with DM was examined by PCR, western blotting and immunohistochemistry. The associations between β5i and RIG-I expression levels and muscle disease severity were evaluated. Lentivirus transduction was used to overexpress β5i in human skeletal muscle myoblasts (HSMMs) and consequent cell functional changes were studied in vitro. RESULTS β5i and RIG-I expression in the muscle of patients with DM was significantly increased and closely associated with muscle disease severity. Immunohistochemistry and immunofluorescence analyses showed the marked colocalised expression of β5i and RIG-I in perifascicular myofibres. β5i overexpression in HSMMs significantly upregulated RIG-I, the muscle atrophy marker MuRF1, type I IFN-related proteins (MxA and IFNβ) and NF-κB pathway-related proteins (pIκBα, pIRF3 and pNF-κBp65). In addition, the viability of HSMMs decreased significantly after β5i overexpression and was partly recovered by treatment with a β5i inhibitor (PR957). Moreover, activation of RIG-I by pppRNA upregulated IFNβ and MuRF1 and reduced the cell viability of HSMMs. CONCLUSION The immunoproteasome subunit β5i promotes perifascicular muscle atrophy in DM via RIG-I upregulation; our findings suggest a pathomechanistic role of β5i and RIG-I in DM-associated muscle damage, highlighting these components as potential therapeutic targets for the treatment of DM.
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Affiliation(s)
- Lu Zhang
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Qisheng Xia
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Wenli Li
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Qingyan Liu
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Lining Zhang
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Xiaolan Tian
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Lifang Ye
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Guochun Wang
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
| | - Qinglin Peng
- Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, China
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Zhou M, Cheng X, Zhu W, Jiang J, Zhu S, Wu X, Liu M, Fang Q. Activation of
cGAS‐STING
pathway – A possible cause of myofiber atrophy/necrosis in dermatomyositis and immune‐mediated necrotizing myopathy. J Clin Lab Anal 2022; 36:e24631. [PMID: 36030554 PMCID: PMC9550984 DOI: 10.1002/jcla.24631] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/08/2019] [Accepted: 06/22/2022] [Indexed: 11/09/2022] Open
Abstract
Objective The objective was to investigate the expression of the cGAS‐STING pathway‐associated protein in idiopathic inflammatory myopathy (IIM) and to investigate whether it is related to myofiber atrophy/necrosis in patients with dermatomyositis and immune‐mediated necrotizing myopathy. Material and Methods Muscle specimens obtained by open biopsy from 26 IIM patients (14 with dermatomyositis (DM), 8 with immune‐mediated necrotizing myopathy (IMNM), and 4 with other types of IIM), 4 dystrophinopathy, and 9 control patients were assessed for expression of cGAS‐STING pathway members via Western blot, quantitative real‐time PCR analysis (qRT‐PCR), and immunochemistry. Meanwhile, analysis its location distribution througn immunochemistry. Results Compared to the control group, the expression of cGAS, STING, and related molecules was obviously increased in muscle samples of IIM patients. Upregulated cGAS and STING were mainly located in the vascular structure, inflammatory infiltrates, and atrophic and necrotic fibers. While comparing to the Dys patients, the mRNA level of cGAS, STING, and TNF‐a was upregulated, meanwhile, the protein of the TBK1, P‐TBK1, and P‐IRF3 associated with interferon upregulation was overexpressed through Western blot in IMNM and DM. Considering that cGAS and STING are located in necrotic and Mx1‐positive atrophic fibers, it is really possible that the cGAS‐STING pathway may lead to fibers atrophy/necrosis by producing IFNs. Conclusion The cGAS‐STING pathway was activated in the muscle samples of IIM patients and its activation may be the reason of myofiber atrophy and necrosis in DM and IMNM patients.
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Affiliation(s)
- Meichen Zhou
- Department of Neurology First Affiliated Hospital of Soochow University Suzhou China
| | - Xiaoxiao Cheng
- Department of Neurology First Affiliated Hospital of Soochow University Suzhou China
| | - Wenhua Zhu
- Department of Neurology Huashan hospital Shanghai China
| | - Jianhua Jiang
- Department of Neurology First Affiliated Hospital of Soochow University Suzhou China
| | - Sijia Zhu
- Department of Neurology First Affiliated Hospital of Soochow University Suzhou China
| | - Xuan Wu
- Department of Neurology Affiliated Hospital of Yangzhou University Yangzhou China
| | - Meirong Liu
- Department of Neurology First Affiliated Hospital of Soochow University Suzhou China
| | - Qi Fang
- Department of Neurology First Affiliated Hospital of Soochow University Suzhou China
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Song J, Li M, Li C, Liu K, Zhu Y, Zhang H. Friend or foe: RIG- I like receptors and diseases. Autoimmun Rev 2022; 21:103161. [PMID: 35926770 PMCID: PMC9343065 DOI: 10.1016/j.autrev.2022.103161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 07/29/2022] [Indexed: 12/22/2022]
Abstract
Retinoic acid-inducible gene I (RIG-I)-like receptors (RLRs), which are pivotal sensors of RNA virus invasions, mediate the transcriptional induction of genes encoding type I interferons (IFNs) and proinflammatory cytokines, successfully establishing host antiviral immune response. A few excellent reviews have elaborated on the structural biology of RLRs and the antiviral mechanisms of RLR activation. In this review, we give a basic understanding of RLR biology and summarize recent findings of how RLR signaling cascade is strictly controlled by host regulatory mechanisms, which include RLR-interacting proteins, post-translational modifications and microRNAs (miRNAs). Furthermore, we pay particular attention to the relationship between RLRs and diseases, especially how RLRs participate in SARS-CoV-2, malaria or bacterial infections, how single-nucleotide polymorphisms (SNPs) or mutations in RLRs and antibodies against RLRs lead to autoinflammatory diseases and autoimmune diseases, and how RLRs are involved in anti-tumor immunity. These findings will provide insights and guidance for antiviral and immunomodulatory therapies targeting RLRs.
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Affiliation(s)
- Jie Song
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha City, Hunan Province, China; Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha City, Hunan Province, China; Sepsis Translational Medicine Key Lab of Hunan Province, Central South University, Changsha City, Hunan Province, China
| | - Muyuan Li
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha City, Hunan Province, China; Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha City, Hunan Province, China; Sepsis Translational Medicine Key Lab of Hunan Province, Central South University, Changsha City, Hunan Province, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha City, Hunan Province, China
| | - Caiyan Li
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha City, Hunan Province, China; Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha City, Hunan Province, China; Sepsis Translational Medicine Key Lab of Hunan Province, Central South University, Changsha City, Hunan Province, China
| | - Ke Liu
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha City, Hunan Province, China; Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha City, Hunan Province, China; Sepsis Translational Medicine Key Lab of Hunan Province, Central South University, Changsha City, Hunan Province, China
| | - Yaxi Zhu
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha City, Hunan Province, China; Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha City, Hunan Province, China; Sepsis Translational Medicine Key Lab of Hunan Province, Central South University, Changsha City, Hunan Province, China.
| | - Huali Zhang
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha City, Hunan Province, China; Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha City, Hunan Province, China; Sepsis Translational Medicine Key Lab of Hunan Province, Central South University, Changsha City, Hunan Province, China.
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Abstract
PURPOSE OF REVIEW This review provides updates regarding the role of interferon (IFN) in juvenile dermatomyositis (JDM), including comparison to interferonopathies and therapeutic implications. RECENT FINDINGS Transcriptomic and protein-based studies in different tissues and peripheral IFN-α assessment have demonstrated the importance of the dysregulated IFN pathway in JDM. Additional studies have validated IFN-regulated gene and protein expression correlation with disease activity in blood and muscle, with potential to predict flares. Type I and II IFN both are dysregulated in peripheral blood and muscle, with more type I IFN in skin. Muscle studies connects hypoxia to IFN production and IFN to vascular dysfunction and muscle atrophy. JDM overlaps with interferonopathy phenotype and IFN signature. There are multiple case reports and case series noting decreased IFN markers and clinical improvement in refractory JDM with Janus kinase (JAK) inhibitors. SUMMARY Studies confirm IFN, particularly type I and II IFN, is an important part of JDM pathogenesis by the level of dysregulation and correlation with disease activity, as well as IFN recapitulating key JDM muscle pathology. Smaller studies indicate there may be differences by myositis-specific autoantibody group, but validation is needed. JAK inhibitors are a promising therapy as they can inhibit IFN signaling, but further study is needed regarding which patients will benefit, dosing, and safety monitoring.
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Affiliation(s)
- Hanna Kim
- Juvenile Myositis Pathogenesis and Therapeutics Unit, National Institute of Arthritis Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland, USA
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Ricci E, Roselletti E, Gentili M, Sabbatini S, Perito S, Riccardi C, Migliorati G, Monari C, Ronchetti S. Glucocorticoid-Induced Leucine Zipper-Mediated TLR2 Downregulation Accounts for Reduced Neutrophil Activity Following Acute DEX Treatment. Cells 2021; 10:2228. [PMID: 34571877 PMCID: PMC8472062 DOI: 10.3390/cells10092228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 12/03/2022] Open
Abstract
Glucocorticoids are the most powerful anti-inflammatory and immunosuppressive pharmacological drugs available, despite their adverse effects. Glucocorticoid-induced leucine zipper (GILZ) is a glucocorticoid-induced gene that shares several anti-inflammatory properties with glucocorticoids. Although immunosuppressive effects of glucocorticoids on neutrophils remain poorly understood, we previously demonstrated that GILZ suppresses neutrophil activation under glucocorticoid treatment. Here, we sought to explore the regulation of Toll-like receptor 2 (TLR2) by the synthetic glucocorticoid dexamethasone (DEX) on neutrophils and the associated GILZ involvement. Peripheral blood neutrophils were isolated from wild type and GILZ-knock-out (KO) mice. TLR2 was found to be downregulated by the in vivo administration of glucocorticoids in wild type but not in GILZ-KO neutrophils, suggesting the involvement of GILZ in TLR2 downregulation. Accordingly, the TLR2-associated anti-fungal activity of neutrophils was reduced by DEX treatment in wild type but not GILZ-KO neutrophils. Furthermore, GILZ did not interact with NF-κB but was found to bind with STAT5, a pivotal factor in the regulation of TLR2 expression. A similar modulation of TLR2 expression, impaired phagocytosis, and killing activity was observed in circulating human neutrophils treated in vitro with DEX. These results demonstrate that glucocorticoids reduce the ability of neutrophils to respond to infections by downregulating TLR2 via GILZ, thereby reducing critical functions.
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Affiliation(s)
- Erika Ricci
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
| | - Elena Roselletti
- Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (S.S.); (S.P.); (C.M.)
| | - Marco Gentili
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (S.S.); (S.P.); (C.M.)
| | - Stefano Perito
- Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (S.S.); (S.P.); (C.M.)
| | - Carlo Riccardi
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
| | - Graziella Migliorati
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
| | - Claudia Monari
- Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (S.S.); (S.P.); (C.M.)
| | - Simona Ronchetti
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
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Zhang L, Xia Q, Li W, Peng Q, Yang H, Lu X, Wang G. The RIG-I pathway is involved in peripheral T cell lymphopenia in patients with dermatomyositis. Arthritis Res Ther 2019; 21:131. [PMID: 31142372 PMCID: PMC6542107 DOI: 10.1186/s13075-019-1905-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/03/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Peripheral T cell lymphopenia is a clinical phenomenon in some patients with dermatomyositis (DM). Patients with T cell lymphopenia are more susceptible to life-threatening infections. However, the pathogenesis of T cell lymphopenia remains unclear. In this study, we aimed to determine retinoic acid-inducible gene I (RIG-I) expression in peripheral T lymphocytes and explore the correlation between RIG-I and T cell lymphopenia in DM. METHODS The mRNA and protein expression levels of RIG-I were determined in peripheral T lymphocytes of 26 treatment-naive DM patients by q-PCR and Western blot. The apoptosis of peripheral T lymphocytes was detected by flow cytometry. The associations between RIG-I expression levels and clinical characteristics were investigated. In Jurkat cell, we examined the relationship between RIG-I and cell apoptosis following RIG-I overexpression or activation by specific ligand (pppRNA). The CRISPR/Cas9 gene editing system was used for RIG-I knockout. Fas and caspase 3 were identified by Western blot. CCK8 colorimeter was performed to monitor cell proliferation. RESULTS In DM patients, we observed the peripheral T lymphocyte count decreased notably while the apoptosis of T lymphocytes increased significantly compared with healthy control. RIG-I expression levels in peripheral T cell correlated negatively with T cell count in DM patients. RIG-I protein expression decreased significantly, and the number of T cell increased when disease was improved. In Jurkat cells, increased apoptosis and elevated expression of Fas and cleaved-caspase 3 protein were observed following RIG-I overexpression or RIG-I-specific ligand (pppRNA) activation. Meanwhile, the proliferation of Jurkat cells was markedly reduced. Whereas, neither cell apoptosis nor the cell viability of the RIG-I knockout clones exhibited significant changes following pppRNA activation. CONCLUSION Our study showed for the first time that negative correlation between the increased RIG-I expression in peripheral T lymphocyte and T cell count in some patients with DM. We demonstrated that highly expressed RIG-I played a critical role in inducing apoptosis and inhibiting proliferation of T lymphocyte in vitro. Therefore, RIG-I-mediated apoptosis may be one of the possible mechanisms of T cell lymphopenia in some patients with DM. These findings expand our existing knowledge on the mechanisms of innate immunity in pathogenesis and provide new therapeutic avenues for DM.
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Affiliation(s)
- Lu Zhang
- Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, 2 Yinhua Road, Chaoyang District, Beijing, 100029 China
| | - Qisheng Xia
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, 100029 China
| | - Wenli Li
- Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, 2 Yinhua Road, Chaoyang District, Beijing, 100029 China
| | - Qinglin Peng
- Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, 2 Yinhua Road, Chaoyang District, Beijing, 100029 China
| | - Hanbo Yang
- Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, 2 Yinhua Road, Chaoyang District, Beijing, 100029 China
| | - Xin Lu
- Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, 2 Yinhua Road, Chaoyang District, Beijing, 100029 China
| | - Guochun Wang
- Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, 2 Yinhua Road, Chaoyang District, Beijing, 100029 China
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The clinical and histopathological features of idiopathic inflammatory myopathies with asymmetric muscle involvement. J Clin Neurosci 2019; 65:46-53. [PMID: 31060889 DOI: 10.1016/j.jocn.2019.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 02/01/2019] [Accepted: 04/12/2019] [Indexed: 12/25/2022]
Abstract
The objective is to determine the frequency of idiopathic inflammatory myopathies (IIMs) with asymmetric muscle involvement (IIMs-A) as initial manifestations in total IIMs and to compare the demographic, clinical, histopathological and radiological characteristics of IIMs-A with classical IIMs (IIMs-C). We retrospectively reviewed the clinical, laboratory, muscle images, histopathological features and treatment response of patients at the Qilu hospital who were diagnosed as IIMs from April 2005 to August 2017. We found among 134 IIMs patients, 13(9.2%) patients with IIMs-A were identified, of which 7 patients were diagnosed as dermatomyositis (DM), 2 as polymyositis (PM), 4 as immune-mediated necrotizing myopathy (IMNM) using the European Neuromuscular Centre (ENMC) criteria. The mean age of our group was 59.1 years old. The duration from the initial symptoms to the first examination was less than 12 months in 12 patients (92.3%). 46.2% patients accompanied with weakness of distal limbs and bulbar symptoms. Finger flexion involvement was found in 5 patients (38.5%). There was no patient that finger flexion was weaker than shoulder abduction. The creatine kinase (CK) level in the serum ranged from 41 IU/L to 9125 IU/L (average: 3192.7 ± 2769.9 IU/L). Serum positive anti-mitochondrial antibodies (AMAs) were found in four patients (30.8%). Endomysial fibrosis and inflammatory cell infiltration were detected in 92.3%, 84.6% patients respectively. Mitochondrial abnormalities in histopathological finding of muscle biopsy were seen in 100% cases. The major histocompatibility complex class I (MHC-I) (84.6%) and class II (MHC-II) (92.3%) expressed on muscle biopsies from almost all cases of our patients. MAC antibody, however, was detected in only 20-40% patients. Eight patients (61.5%) had favorable outcomes. The conclusion was that IIMs-A presented mainly in DM, generally with mitochondrial abnormality and highly positive AMAs. The relationship between the presence of AMAs and the asymmetric muscle involvement in DM needs to be further clarified. We should also consider the diagnosis of IIMs when the patient has features of positive AMAs and asymmetric muscle involvement.
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Ladislau L, Suárez-Calvet X, Toquet S, Landon-Cardinal O, Amelin D, Depp M, Rodero MP, Hathazi D, Duffy D, Bondet V, Preusse C, Bienvenu B, Rozenberg F, Roos A, Benjamim CF, Gallardo E, Illa I, Mouly V, Stenzel W, Butler-Browne G, Benveniste O, Allenbach Y. JAK inhibitor improves type I interferon induced damage: proof of concept in dermatomyositis. Brain 2018; 141:1609-1621. [DOI: 10.1093/brain/awy105] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/17/2018] [Indexed: 12/17/2022] Open
Affiliation(s)
- Leandro Ladislau
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Xavier Suárez-Calvet
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
- Neuromuscular Diseases Unit, Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona and Institut de Recerca Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Ségolène Toquet
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
| | - Océane Landon-Cardinal
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
| | - Damien Amelin
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
| | - Marine Depp
- Laboratory of Neurogenetics and Neuroinflammation, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1163 and Université Paris Descartes, Université Sorbonne Paris Cité, Institut Imagine, 75015 Paris, France
| | - Mathieu P Rodero
- Laboratory of Neurogenetics and Neuroinflammation, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1163 and Université Paris Descartes, Université Sorbonne Paris Cité, Institut Imagine, 75015 Paris, France
| | - Denisa Hathazi
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V, Biomedical Research Department, Tissue Omics group, Otto-Hahn-Str. 6b, 44227, Dortmund, Germany
| | - Darragh Duffy
- INSERM UMR 1223 and Laboratory of Dendritic Cell Immunobiology, Institut Pasteur, Paris, France
| | - Vincent Bondet
- INSERM UMR 1223 and Laboratory of Dendritic Cell Immunobiology, Institut Pasteur, Paris, France
| | - Corinna Preusse
- Department of Neuropathology, Charité University, Berlin, Germany
| | - Boris Bienvenu
- Department of Internal Medicine, Saint Joseph Hospital, Marseille, France
| | - Flore Rozenberg
- Departement de Virologie, Hôpital Cochin, Paris Descartes Universités, Paris, France
| | - Andreas Roos
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V, Biomedical Research Department, Tissue Omics group, Otto-Hahn-Str. 6b, 44227, Dortmund, Germany
- Institute of Genetic Medicine, John Walton Muscular Dystrophy Research Centre, International Centre for Life, Central Parkway, Newcastle upon Tyne, England, UK
| | - Claudia F Benjamim
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduard Gallardo
- Neuromuscular Diseases Unit, Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona and Institut de Recerca Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Isabel Illa
- Neuromuscular Diseases Unit, Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona and Institut de Recerca Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Vincent Mouly
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
| | - Werner Stenzel
- Department of Neuropathology, Charité University, Berlin, Germany
| | - Gillian Butler-Browne
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
| | - Olivier Benveniste
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
| | - Yves Allenbach
- Sorbonne Université, INSERM, Association Institut de Myologie, Center of Research in Myology, UMRS 974, AP-HP, Department of Internal Medicine and Clinical Immunology, DHU I2B, Pitié-Salpêtrière Hospital, F-75013, Paris, France
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10
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Abstract
The type I interferon pathway has been implicated in the pathogenesis of a number of rheumatic diseases, including systemic lupus erythematosus, Sjögren syndrome, myositis, systemic sclerosis, and rheumatoid arthritis. In normal immune responses, type I interferons have a critical role in the defence against viruses, yet in many rheumatic diseases, large subgroups of patients demonstrate persistent activation of the type I interferon pathway. Genetic variations in type I interferon-related genes are risk factors for some rheumatic diseases, and can explain some of the heterogeneity in type I interferon responses seen between patients within a given disease. Inappropriate activation of the immune response via Toll-like receptors and other nucleic acid sensors also contributes to the dysregulation of the type I interferon pathway in a number of rheumatic diseases. Theoretically, differences in type I interferon activity between patients might predict response to immune-based therapies, as has been demonstrated for rheumatoid arthritis. A number of type I interferon and type I interferon pathway blocking therapies are currently in clinical trials, the results of which are promising thus far. This Review provides an overview of the many ways in which the type I interferon system affects rheumatic diseases.
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Affiliation(s)
- Theresa L. Wampler Muskardin
- Colton Center for Autoimmunity, Department of Medicine, New York University School of Medicine, New York, NY, USA
- Department of Pathology, New York University School of Medicine, New York, NY, USA
| | - Timothy B. Niewold
- Colton Center for Autoimmunity, Department of Medicine, New York University School of Medicine, New York, NY, USA
- Division of Rheumatology, Department of Medicine and Pediatrics, New York University School of Medicine, New York, NY, USA
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11
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Role of the chemokine receptors CXCR3, CXCR4 and CCR7 in the intramuscular recruitment of plasmacytoid dendritic cells in dermatomyositis. J Neuroimmunol 2018; 319:142-148. [PMID: 29366593 DOI: 10.1016/j.jneuroim.2018.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 10/13/2017] [Accepted: 01/08/2018] [Indexed: 12/18/2022]
Abstract
To explore the possible mechanism implicated in the recruitment of plasmacytoid dendritic cells (pDCs), we investigated the expression of the chemokine receptors CXCR3, CXCR4, and CCR7 on intramuscular and circulating pDCs from patients with dermatomyositis (DM). Using immunohistochemistry, preferential expression of CXCR3, CXCR4 and CCR7 was identified in the perivascular inflammatory infiltrates within the perimysium in DM muscle. Western-blot analysis showed marked up-regulation of expression of CXCR3, CXCR4 and CCR7 in muscle homogenate from patients with DM compared with that in non-diseased controls. Co-localization of CD303+ pDCs with these chemokine receptors was further examined by double immunofluorescence staining, which showed extensive co-localization of CD303 with CXCR3/CXCR4/CCR7 in DM biopsies. Flow cytometry was then used to investigate the proportion of pDCs among the total PBMCs and the expression of CXCR3, CXCR4 and CCR7 on circulating pDCs. The proportion of CD123+CD303+ pDCs in peripheral blood from DM patients was markedly decreased compared to that from polymyositis (PM) patients and normal controls. Significantly increased expression of CXCR3, but not CXCR4 or CCR7, was further identified on circulating pDCs in DM. Correlation analysis showed that the expression of CXCR3 correlated inversely with the frequency of pDCs in peripheral blood. Our findings indicate that the chemokine receptors, CXCR3, CXCR4 and CCR7 may be involved in the recruitment of pDCs from peripheral blood to muscle tissues in DM via different mechanisms, and in which CXCR3 may play an important role under DM conditions.
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12
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13
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Meyer A, Lannes B, Goetz J, Echaniz-Laguna A, Lipsker D, Arnaud L, Martin T, Gottenberg JE, Geny B, Sibilia J. Inflammatory myopathies: A new landscape. Joint Bone Spine 2017; 85:23-33. [PMID: 28343013 DOI: 10.1016/j.jbspin.2017.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2017] [Indexed: 02/07/2023]
Abstract
Greater accuracy in clinical descriptions combined with advances in muscle histology and immunology have established that inflammatory myopathies (IMs), similarly to inflammatory rheumatic diseases, constitute a highly heterogeneous group of conditions. The topographic distribution, severity, and tempo of onset of the myopathy vary widely, and the histological findings distinguish at least five different profiles, which may reflect different pathophysiological processes. Most IMs are connective tissue diseases that can affect multiple organs, among which the most common targets are the skin, joints, and lungs. The extramuscular manifestations may antedate the muscular involvement and should therefore suggest a diagnosis of IM even in the absence of obvious muscle disease. About 20 different autoantibodies have been identified in patients with IM. Some are mutually exclusive and associated with specific combinations of clinical manifestations. Following the model of antisynthetase syndrome, about 10 syndromes associated with autoantibodies specific of IM have been identified. Thus, polymyositis is now emerging as a rare entity that is often mistaken for more recently described patterns of IM. No consensus exists to date about the classification of IMs. Nevertheless, the clinical manifestations, autoantibody profile, and muscle histology can be used to distinguish patient subgroups with fairly homogeneous patterns of complications, treatment responses, and outcomes. These subgroups are also characterized by specific genetic and environmental factors. The advances made in the nosology of IMs have benefited the diagnosis, personalization of treatment strategies, and understanding of pathophysiological mechanisms. They can be expected to assist in the development of specific treatments.
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Affiliation(s)
- Alain Meyer
- Service de physiologie et d'explorations fonctionnelles, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Service de rhumatologie, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Centre de référence des maladies auto-immunes rares, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France.
| | - Béatrice Lannes
- Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France; Département de pathologie, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - Joëlle Goetz
- Laboratoire d'immunologie, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - Andoni Echaniz-Laguna
- Service de neurologie, centre de référence des maladies neuromusculaires, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - Dan Lipsker
- Clinique dermatologique, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - Laurent Arnaud
- Service de rhumatologie, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Centre de référence des maladies auto-immunes rares, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France
| | - Thierry Martin
- Centre de référence des maladies auto-immunes rares, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France; Service d'immunologie clinique, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - Jacques Eric Gottenberg
- Service de rhumatologie, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Centre de référence des maladies auto-immunes rares, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France
| | - Bernard Geny
- Service de physiologie et d'explorations fonctionnelles, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Centre de référence des maladies auto-immunes rares, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France
| | - Jean Sibilia
- Service de rhumatologie, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Centre de référence des maladies auto-immunes rares, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France
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14
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Li L, Dai T, Yan C. Response to comments in The Journal of Neuroimmunology (December 16th, 2015). J Neuroimmunol 2016; 299:79-80. [PMID: 27725126 DOI: 10.1016/j.jneuroim.2016.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 07/29/2016] [Accepted: 07/30/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Ling Li
- Department of Neurology and Neuromuscular Center, Qilu Hospital of Shandong University, Jinan, China; Department of Neurology, Qilu Hospital of Shandong University, Qingdao, China
| | - Tingjun Dai
- Department of Neurology, Qilu Hospital of Shandong University, Qingdao, China
| | - Chuanzhu Yan
- Department of Neurology and Neuromuscular Center, Qilu Hospital of Shandong University, Jinan, China; Department of Neurology, Qilu Hospital of Shandong University, Qingdao, China; Brain Science Research Institute, Shandong University, Jinan, China.
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15
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Chen LY, Cui ZL, Hua FC, Yang WJ, Bai Y, Lan FH. Bioinformatics analysis of gene expression profiles of dermatomyositis. Mol Med Rep 2016; 14:3785-90. [PMID: 27599581 DOI: 10.3892/mmr.2016.5703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 08/17/2016] [Indexed: 11/05/2022] Open
Abstract
Dermatomyositis (DM) is a type of autoimmune inflammatory myopathy, which primarily affects the skin and muscle. The underlying mechanisms of DM remain poorly understood. The present study aimed to explore gene expression profile alterations, investigate the underlying mechanisms, and identify novel targets for DM. The GSE48280 dataset, which includes data from five DM and five normal muscle tissue samples, was obtained from the Gene Expression Omnibus. Firstly, differentially expressed genes (DEGs) were screened by limma package in R. Subsequently, functional and pathway enrichment analyses were performed using ClueGO from Cytoscape. Finally, protein‑protein interaction (PPI) networks were constructed using STRING and Cytoscape, in order to identify hub genes. As a result, 180 upregulated and 21 downregulated genes were identified in the DM samples. The Gene Ontology enrichment analysis revealed that the type I interferon (IFN) signaling pathway was the most significantly enriched term within the DEGs. The Kyoto Encyclopedia of Genes and Genomes pathway analysis identified 27 significant pathways, the majority of which can be divided into the infectious diseases and immune system categories. Following construction of PPI networks, 24 hub genes were selected, all of which were associated with the type I IFN signaling pathway in DM. The findings of the present study indicated that type I IFNs may have a central role in the induction of DM. In addition, other DEGs, including chemokine (C‑C motif) ligand 5, C‑X‑C motif chemokine 10, Toll‑like receptor 3, DEXD/H‑Box helicase 58, interferon induced with helicase C domain 1, interferon‑stimulated gene 15 and MX dynamin‑like GTPase 1, may be potential targets for DM diagnosis and treatment.
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Affiliation(s)
- Liang-Yuan Chen
- Department of Clinical Genetics and Experimental Medicine, Fuzong Clinical School, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Zhao-Lei Cui
- Department of Clinical Laboratory, Fujian Provincial Tumor Hospital, Fuzhou, Fujian 350014, P.R. China
| | - Fan-Cui Hua
- Department of Clinical Genetics and Experimental Medicine, Fuzong Clinical School, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Weng-Jing Yang
- Department of Clinical Genetics and Experimental Medicine, Fuzong Clinical School, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Ye Bai
- Department of Clinical Genetics and Experimental Medicine, Fuzong Clinical School, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Feng-Hua Lan
- Department of Clinical Genetics and Experimental Medicine, Fuzong Clinical School, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
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16
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Duffy L, O'Reilly SC. Toll-like receptors in the pathogenesis of autoimmune diseases: recent and emerging translational developments. Immunotargets Ther 2016; 5:69-80. [PMID: 27579291 PMCID: PMC5001654 DOI: 10.2147/itt.s89795] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Autoinflammatory diseases are defined as the loss of self-tolerance in which an inflammatory response to self-antigens occurs, which are a significant global burden. Toll-like receptors are key pattern recognition receptors, which integrate signals leading to the activation of transcription factors and ultimately proinflammatory cytokines. Recently, it has become apparent that these are at the nexus of autoinflammatory diseases making them viable and attractive drug targets. The aim of this review was to evaluate the role of innate immunity in autoinflammatory conditions alongside the role of negative regulation while suggesting possible therapeutic targets.
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Affiliation(s)
- Laura Duffy
- Immunology and Cell Biology Group, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Steven C O'Reilly
- Immunology and Cell Biology Group, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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17
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Comment to "Role of Toll-like receptors and retinoic acid inducible gene I in endogenous production of type I interferon in dermatomyositis". J Neuroimmunol 2016; 291:125. [PMID: 26723487 DOI: 10.1016/j.jneuroim.2015.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 12/17/2015] [Indexed: 11/24/2022]
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