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Affiliation(s)
- Sonia Berrih-Aknin
- INSERM U974; Paris France
- CNRS FRE3617; Paris France
- Sorbonne University; UPMC Univ Paris 06; Paris France
- AIM; Institute of Myology; Paris France
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Effect of Polygoni Cuspidati Rhizoma et Radix and Its Ingredient Resveratrol on Experimental Autoimmune Myasthenia Gravis by Suppressing Immune Response. CHINESE HERBAL MEDICINES 2016. [DOI: 10.1016/s1674-6384(16)60047-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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3
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Wu B, Goluszko E, Huda R, Tüzün E, Christadoss P. Experimental Autoimmune Myasthenia Gravis in the Mouse. ACTA ACUST UNITED AC 2013; Chapter 15:Unit 15.8.. [DOI: 10.1002/0471142735.im1508s100] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Bo Wu
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Elzbieta Goluszko
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Ruksana Huda
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Premkumar Christadoss
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
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Chae CS, Kwon HK, Hwang JS, Kim JE, Im SH. Prophylactic effect of probiotics on the development of experimental autoimmune myasthenia gravis. PLoS One 2012; 7:e52119. [PMID: 23284891 PMCID: PMC3527378 DOI: 10.1371/journal.pone.0052119] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 11/12/2012] [Indexed: 12/03/2022] Open
Abstract
Probiotics are live bacteria that confer health benefits to the host physiology. Although protective role of probiotics have been reported in diverse diseases, no information is available whether probiotics can modulate neuromuscular immune disorders. We have recently demonstrated that IRT5 probiotics, a mixture of 5 probiotics, could suppress diverse experimental disorders in mice model. In this study we further investigated whether IRT5 probiotics could modulate the progression of experimental autoimmune myasthenia gravis (EAMG). Myasthenia gravis (MG) is a T cell dependent antibody mediated autoimmune disorder in which acetylcholine receptor (AChR) at the neuromuscular junction is the major auto-antigen. Oral administration of IRT5 probiotics significantly reduced clinical symptoms of EAMG such as weight loss, body trembling and grip strength. Prophylactic effect of IRT5 probiotics on EMAG is mediated by down-regulation of effector function of AChR-reactive T cells and B cells. Administration of IRT5 probiotics decreased AChR-reactive lymphocyte proliferation, anti-AChR reactive IgG levels and inflammatory cytokine levels such as IFN-γ, TNF-α, IL-6 and IL-17. Down-regulation of inflammatory mediators in AChR-reactive lymphocytes by IRT5 probiotics is mediated by the generation of regulatory dendritic cells (rDCs) that express increased levels of IL-10, TGF-β, arginase 1 and aldh1a2. Furthermore, DCs isolated from IRT5 probiotics-fed group effectively converted CD4+ T cells into CD4+Foxp3+ regulatory T cells compared with control DCs. Our data suggest that IRT5 probiotics could be applicable to modulate antibody mediated autoimmune diseases including myasthenia gravis.
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Affiliation(s)
- Chang-Suk Chae
- School of Life Sciences and Immune Synapse Research Center, Gwangju Institute of Science and Technology (GIST), Buk-gu, Gwangju, Korea
| | - Ho-Keun Kwon
- School of Life Sciences and Immune Synapse Research Center, Gwangju Institute of Science and Technology (GIST), Buk-gu, Gwangju, Korea
| | - Ji-Sun Hwang
- School of Life Sciences and Immune Synapse Research Center, Gwangju Institute of Science and Technology (GIST), Buk-gu, Gwangju, Korea
| | - Jung-Eun Kim
- School of Life Sciences and Immune Synapse Research Center, Gwangju Institute of Science and Technology (GIST), Buk-gu, Gwangju, Korea
| | - Sin-Hyeog Im
- School of Life Sciences and Immune Synapse Research Center, Gwangju Institute of Science and Technology (GIST), Buk-gu, Gwangju, Korea
- * E-mail:
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5
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Baggi F, Antozzi C, Toscani C, Cordiglieri C. Acetylcholine Receptor-Induced Experimental Myasthenia Gravis: What Have We Learned from Animal Models After Three Decades? Arch Immunol Ther Exp (Warsz) 2011; 60:19-30. [DOI: 10.1007/s00005-011-0158-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 09/28/2011] [Indexed: 01/23/2023]
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6
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Wu B, Goluszko E, Huda R, Tüzün E, Christadoss P. Experimental Autoimmune Myasthenia Gravis in the Mouse. ACTA ACUST UNITED AC 2011; Chapter 15:Unit 15.23. [PMID: 22048803 DOI: 10.1002/0471142735.im1523s95] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bo Wu
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Elzbieta Goluszko
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Ruksana Huda
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
| | - Premkumar Christadoss
- Department of Microbiology and Immunology, University of Texas Medical Branch Galveston Texas
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Activation of the receptor for advanced glycation end products (RAGE) exacerbates experimental autoimmune myasthenia gravis symptoms. Clin Immunol 2011; 141:36-48. [DOI: 10.1016/j.clim.2011.04.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 04/20/2011] [Accepted: 04/21/2011] [Indexed: 12/20/2022]
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8
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Tüzün E, Huda R, Christadoss P. Complement and cytokine based therapeutic strategies in myasthenia gravis. J Autoimmun 2011; 37:136-43. [PMID: 21636248 DOI: 10.1016/j.jaut.2011.05.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 05/02/2011] [Indexed: 01/17/2023]
Abstract
Myasthenia gravis (MG) is a T cell-dependent and antibody-mediated disease in which the target antigen is the skeletal muscle acetylcholine receptor (AChR). In the last few decades, several immunological factors involved in MG pathogenesis have been discovered mostly by studies utilizing the experimental autoimmune myasthenia gravis (EAMG) model. Nevertheless, MG patients are still treated with non-specific global immunosuppression that is associated with severe chronic side effects. Due to the high heterogeneity of AChR epitopes and antibody responses involved in MG pathogenesis, the specific treatment of MG symptoms have to be achieved by inhibiting the complement factors and cytokines involved in anti-AChR immunity. EAMG studies have clearly shown that inhibition of the classical and common complement pathways effectively and specifically diminish the neuromuscular junction destruction induced by anti-AChR antibodies. The inborn or acquired deficiencies of IL-6, TNF-α and TNF receptor functions are associated with the lowest EAMG incidences. Th17-type immunity has recently emerged as an important contributor of EAMG pathogenesis. Overall, these results suggest that inhibition of the complement cascade and the cytokine networks alone or in combination might aid in development of future treatment models that would reduce MG symptoms with highest efficacy and lowest side effect profile.
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Affiliation(s)
- Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA
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9
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Pal J, Rozsa C, Komoly S, Illes Z. Clinical and biological heterogeneity of autoimmune myasthenia gravis. J Neuroimmunol 2011; 231:43-54. [DOI: 10.1016/j.jneuroim.2010.10.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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10
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YAPICI Z, TÜZÜN E, ALTUNAYOĞLU V, ERDOĞAN A, ERAKSOY M. HIGH INTERLEUKIN-10 PRODUCTION IS ASSOCIATED WITH ANTI-ACETYLCHOLINE RECEPTOR ANTIBODY PRODUCTION AND TREATMENT RESPONSE IN JUVENILE MYASTHENIA GRAVIS. Int J Neurosci 2009; 117:1505-12. [DOI: 10.1080/00207450601125840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Fee DB, Kasarskis EJ. Myasthenia gravis associated with etanercept therapy. Muscle Nerve 2009; 39:866-70. [DOI: 10.1002/mus.21280] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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12
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Soliven B, Rezania K, Gundogdu B, Harding-Clay B, Oger J, Arnason BG. Terbutaline in myasthenia gravis: A pilot study. J Neurol Sci 2009; 277:150-4. [DOI: 10.1016/j.jns.2008.09.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Revised: 09/18/2008] [Accepted: 09/23/2008] [Indexed: 10/21/2022]
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13
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Wu B, Goluszko E, Christadoss P. Experimental autoimmune myasthenia gravis in the mouse. CURRENT PROTOCOLS IN IMMUNOLOGY 2008; Chapter 15:Unit 15.8. [PMID: 18432738 DOI: 10.1002/0471142735.im1508s21] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Myasthenia gravis (MG) is a T cell-dependent antibody-mediated autoimmune neuromuscular disease. Antibodies to the nicotinic acetylcholine receptor (AChR) destroy the AChR, thus leading to defective neuromuscular transmission of electrical impulse and to muscle weakness. This unit is a practical guide to the induction and evaluation of experimental autoimmune myasthenia gravis (EAMG) in the mouse, the animal model for MG. Protocols are provided for the extraction and purification of AChR from the electric organs of Torpedo californica, or eel. The purified receptor is used as an immunogen to induce autoimmunity to AChR, thus causing EAMG. The defect in neuromuscular transmission can also be measured quantitatively by electromyography, as described here. In addition, EAMG is frequently characterized by the presence of antibodies to AChR, which are measured by radioimmunoassay and by a marked antibody-mediated reduction in the number of muscle AChRs. AChR extracted from mouse muscle is used in measuring serum antibody levels and for quantifying muscle AChR content.
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Affiliation(s)
- B Wu
- University of Texas Medical Branch, Galveston, Texas, USA
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Conti-Fine BM, Milani M, Wang W. CD4+T Cells and Cytokines in the Pathogenesis of Acquired Myasthenia Gravis. Ann N Y Acad Sci 2008; 1132:193-209. [DOI: 10.1196/annals.1405.042] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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15
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Sommer N, Tackenberg B, Hohlfeld R. The immunopathogenesis of myasthenia gravis. HANDBOOK OF CLINICAL NEUROLOGY 2008; 91:169-212. [PMID: 18631843 DOI: 10.1016/s0072-9752(07)01505-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Norbert Sommer
- Clinical Neuroimmunology Group, Philipps-University, Marburg, Germany
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16
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Fuchs S, Feferman T, Zhu KY, Meidler R, Margalit R, Wang N, Laub O, Souroujon MC. Suppression of Experimental Autoimmune Myasthenia Gravis by Intravenous Immunoglobulin and Isolation of a Disease-Specific IgG Fraction. Ann N Y Acad Sci 2007; 1110:550-8. [PMID: 17911471 DOI: 10.1196/annals.1423.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Intravenous immunoglobulin (IVIG) administration has been beneficially used for the treatment of a variety of autoimmune diseases including myasthenia gravis (MG). We have demonstrated that IVIG administration in experimental autoimmune MG (EAMG) results in suppression of disease that is accompanied by decreased Th1 cell and B cell proliferation. Chromatography of pooled human immunoglobulins (IVIGs) on immobilized IgG, isolated from rats with EAMG, results in a complete depletion of the suppressive activity of the IVIG. Moreover, the eluate from this EAMG-specific antibody column retains the immunosuppressive activity of IVIG. This study supports the notion that the therapeutic effect of IVIGs is mediated by an antigen-specific anti-immunoglobulin (anti-idiotypic) activity that is essential for its suppressive activity.
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Affiliation(s)
- Sara Fuchs
- Department of Immunology, The Weizmann Institute of Science, Rehovot 76100, Israel.
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Kakoulidou M, Bjelak S, Pirskanen R, Lefvert AK. A clinical and immunological study of a myasthenia gravis patient treated with infliximab. Acta Neurol Scand 2007; 115:279-83. [PMID: 17376128 DOI: 10.1111/j.1600-0404.2006.00778.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To measure clinical and immunological parameters in a patient with myasthenia gravis (MG) treated with antibodies against tumour necrosis factor-alpha (infliximab, Remicade). PATIENT AND METHODS A patient with severe MG received repeated injections of infliximab. His muscle function score was monitored and the immunological parameters were followed using enzyme-linked immunosorbent assay, flow cytometry and radioimmunoassay. RESULTS The patient improved in muscle fatigability tests and the levels of antibodies against the acetylcholine receptor decreased during treatment. The activation marker human leucocyte antigen-DR on CD4(+) T cells also decreased. CONCLUSION Treatment with infliximab might be beneficial for patients with severe MG but demands careful monitoring of possible serious side-effects.
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Affiliation(s)
- M Kakoulidou
- Immunological Research Unit, Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
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Le Panse R, Cizeron-Clairac G, Bismuth J, Berrih-Aknin S. Microarrays reveal distinct gene signatures in the thymus of seropositive and seronegative myasthenia gravis patients and the role of CC chemokine ligand 21 in thymic hyperplasia. THE JOURNAL OF IMMUNOLOGY 2007; 177:7868-79. [PMID: 17114458 PMCID: PMC1892191 DOI: 10.4049/jimmunol.177.11.7868] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Myasthenia gravis (MG) is an autoimmune disease mainly caused by antiacetylcholine receptor autoantibodies (seropositive (SP) disease) or by Abs against unknown autoantigenic target(s) (seronegative (SN) disease). Thymectomy is usually beneficial although thymic hyperplasia with ectopic germinal centers is mainly observed in SP MG. To understand the role of thymus in the disease process, we compared the thymic transcriptome of non-MG adults to those of SP patients with a low or high degree of hyperplasia or SN patients. Surprisingly, an overexpression of MHC class II, Ig, and B cell marker genes is observed in SP but also SN MG patients. Moreover, we demonstrate an overexpression of CXCL13 in all MG thymuses leading probably to the generalized B cell infiltration. However, we find different chemotactic properties for MG subgroups and, especially, a specific overexpression of CCL21 in hyperplastic thymuses triggering most likely ectopic germinal center development. Besides, SN patients present a peculiar signature with an abnormal expression of genes involved in muscle development and synaptic transmission, but also genes implicated in host response, suggesting that viral infection might be related to SN MG. Altogether, these results underline differential pathogenic mechanisms in the thymus of SP and SN MG and propose new research areas.
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Affiliation(s)
- Rozen Le Panse
- Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8162, Institut Paris-Sud Cytokines, Université Paris XI, Hôpital Marie Lannelongue, 133 avenue de la résistance, 92350 Le Plessis-Robinson, France
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The Use of Biologics and Other Immunosuppressants in the Treatment of Common Inflammatory Diseases in Neuro-ophthalmology. Clin Ophthalmol 2007; 47:151-60, x. [DOI: 10.1097/iio.0b013e31815723ad] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
Myasthenia gravis (MG) is an autoimmune syndrome caused by the failure of neuromuscular transmission, which results from the binding of autoantibodies to proteins involved in signaling at the neuromuscular junction (NMJ). These proteins include the nicotinic AChR or, less frequently, a muscle-specific tyrosine kinase (MuSK) involved in AChR clustering. Much is known about the mechanisms that maintain self tolerance and modulate anti-AChR Ab synthesis, AChR clustering, and AChR function as well as those that cause neuromuscular transmission failure upon Ab binding. This insight has led to the development of improved diagnostic methods and to the design of specific immunosuppressive or immunomodulatory treatments.
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Affiliation(s)
- Bianca M Conti-Fine
- Department of Biochemistry, University of Minnesota, Minneapolis, Minnesota 55455, USA.
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Fostieri E, Kostelidou K, Poulas K, Tzartos SJ. Recent advances in the understanding and therapy of myasthenia gravis. FUTURE NEUROLOGY 2006. [DOI: 10.2217/14796708.1.6.799] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Myasthenia gravis (MG) is a T-cell dependent autoimmune disease mediated by autoantibodies, which mainly target muscle nicotinic acetylcholine receptors (AChR) and cause loss of functional AChRs in the neuromuscular junction. Both MG and its major autoantigen are studied extensively, yet the etiology of the disease remains unclear, although it is known to be associated with the thymus. A genetic predisposition, combined with several unidentified environmental stimuli, likely creates a favorable milieu in which the disease can appear. Current research focusses on elucidating the cellular and molecular pathways of immune dysregulation, which underly MG outburst and progression. Considerable progress has been made concerning the involvement of the thymus, the identification of impaired mechanisms of immune control and the B–T-cell interaction in MG pathogenesis, while the role of chemokines arises as an intriguing new puzzle. Recent findings fueled the development of novel therapeutic approaches with some encouraging, although preliminary, results. This review summarizes recent achievements in the fields of both basic research and therapeutics.
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Affiliation(s)
- Efrosini Fostieri
- Hellenic Pasteur Institute, Department of Biochemistry, 127 Vas. Sofias Avenue, 11521 Athens, Greece
| | - Kalliopi Kostelidou
- Hellenic Pasteur Institute, Department of Biochemistry, 127 Vas. Sofias Avenue 11521 Athens, Greece
| | | | - Socrates J Tzartos
- Hellenic Pasteur Institute, Department of Biochemistry, 127 Vas. Sofias Avenue, 11521 Athens, Greece and, Department of Pharmacy, University of Patras, 26504 Patras, Greece
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22
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Aimbire F, Lopes-Martins RAB, Castro-Faria-Neto HC, Albertini R, Chavantes MC, Pacheco MTT, Leonardo PSLM, Iversen VV, Bjordal JM. Low-level laser therapy can reduce lipopolysaccharide-induced contractile force dysfunction and TNF-alpha levels in rat diaphragm muscle. Lasers Med Sci 2006; 21:238-44. [PMID: 17033742 DOI: 10.1007/s10103-006-0405-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Revised: 03/27/2006] [Accepted: 08/10/2006] [Indexed: 10/24/2022]
Abstract
Our objective was to investigate if low-level laser therapy (LLLT) could improve respiratory function and inhibit tumor necrosis factor (TNF-alpha) release into the diaphragm muscle of rats after an intravenous injection of lipopolysaccharide (LPS) (5 mg/kg). We randomly divided Wistar rats in a control group without LPS injection, and LPS groups receiving either (a) no therapy, (b) four sessions in 24 h with diode Ga-AsI-Al laser of 650 nm and a total dose of 5.2 J/cm2, or (c) an intravenous injection (1.25 mg/kg) of the TNF-alpha inhibitor chlorpromazine (CPZ). LPS injection reduced maximal force by electrical stimulation of diaphragm muscle from 24.15+/-0.87 N in controls, but the addition of LLLT partly inhibited this reduction (LPS only: 15.01+/-1.1 N vs LPS+LLLT: 18.84+/-0.73 N, P<0.05). In addition, this dose of LLLT and CPZ significantly (P<0.05 and P<0.01, respectively) reduced TNF-alpha concentrations in diaphragm muscle when compared to the untreated control group.
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Affiliation(s)
- F Aimbire
- Research Group of Animal Experimental, IP & D UNIVAP R. Shishima Hifumi, 2911, 12240-000, São José dos Campos, SP, Brazil
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Milani M, Ostlie N, Wu H, Wang W, Conti-Fine BM. CD4+ T and B cells cooperate in the immunoregulation of Experimental Autoimmune Myasthenia Gravis. J Neuroimmunol 2006; 179:152-62. [PMID: 16945426 DOI: 10.1016/j.jneuroim.2006.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2006] [Revised: 06/28/2006] [Accepted: 07/03/2006] [Indexed: 11/20/2022]
Abstract
C57Bl6 mice (B6 mice) immunized with Torpedo acetylcholine receptor (TAChR) in Freund's adjuvants (FA) develop Experimental Autoimmune Myasthenia Gravis (EAMG). In mouse EAMG Th2 cytokines may be protective. Aluminum hydroxide (Alum) was used to immunize B6 mice to the TAChR and prime CD4+ T and B cells secreting Th2 cytokines. Mice immunized with TAChR/Alum developed anti-AChR CD4+ T cells response, but minimal antibody levels and symptoms. TAChR/Alum treatments prior immunization with TAChR/FA protected mice from EAMG. Cell transfer experiments demonstrated that B and CD4+ T cells mediated the protective effect by causing intense reduction of complement-fixing anti-TAChR IgG subclasses.
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Affiliation(s)
- Monica Milani
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN, USA.
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Zhu KY, Feferman T, Maiti PK, Souroujon MC, Fuchs S. Intravenous immunoglobulin suppresses experimental myasthenia gravis: Immunological mechanisms. J Neuroimmunol 2006; 176:187-97. [PMID: 16730380 DOI: 10.1016/j.jneuroim.2006.04.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Revised: 03/21/2006] [Accepted: 04/10/2006] [Indexed: 11/16/2022]
Abstract
Intravenous immunoglobulin (IVIG) administration has been beneficially used in the treatment of several autoimmune disorders including myasthenia gravis (MG), although its mechanism of action is still not clear. To study the optimal conditions of IVIG treatment and delineate its mechanism of action we established a suitable model in rat experimental autoimmune MG (EAMG). We show that IVIG has a suppressive effect on the clinical symptoms of ongoing EAMG that is associated with decreased AChR-specific cellular and humoral immune reactivity. Costimulatory factors and cytokine profile analyses suggest that IVIG immunomodulation in EAMG involves suppression of B and Th1-type T cell responses with no generation of T-regulatory cells. Our data contribute to the understanding of the immunological mechanisms underlying IVIG treatment in MG and in other autoimmune disorders.
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Affiliation(s)
- Kai-Yun Zhu
- Department of Immunology, Weizmann Institute of Science, Rehovot 76100, Israel
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Tüzün E, Li J, Wanasen N, Soong L, Christadoss P. Immunization of mice with T cell-dependent antigens promotes IL-6 and TNF-α production in muscle cells. Cytokine 2006; 35:100-6. [PMID: 16919469 DOI: 10.1016/j.cyto.2006.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2006] [Revised: 04/19/2006] [Accepted: 05/19/2006] [Indexed: 11/21/2022]
Abstract
IL-6 and TNF-alpha are proinflammatory cytokines involved in various inflammatory or non-inflammatory disorders characterized by muscle wasting. While infiltrating leukocytes are known to be the major source of these cytokines, it is unclear whether muscle cells also contribute to local inflammation. In this study, we first showed that cultured muscle cells and naive mouse muscle tissue were capable of producing IL-6 and TNF-alpha. We demonstrated an increased expression of IL-6 and TNF-alpha on muscle sections of C57BL/6J mice immunized with acetylcholine receptor (AChR) in the complete Freund's adjuvant (CFA) or with CFA only. In the presence of IL-6 or TNF-alpha, cultured AChR-expressing mouse (G-8) and human (TE671) skeletal muscle cells showed significantly decreased alpha-bungarotoxin-binding sites as measured by cellular ELISA. Moreover, IL-6- or TNF-alpha-treated muscle cells displayed a considerable increase in apoptotic cell ratios. Collectively, this study suggests a direct role for these two cytokines in muscle cell destruction and a possibility of muscle cell damage via an autocrine fashion.
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Affiliation(s)
- Erdem Tüzün
- Department of Microbiology and Immunology, The University of Texas Medical Branch, Galveston, TX 77555-1070, USA.
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Yang H, Tüzün E, Alagappan D, Yu X, Scott BG, Ischenko A, Christadoss P. IL-1 receptor antagonist-mediated therapeutic effect in murine myasthenia gravis is associated with suppressed serum proinflammatory cytokines, C3, and anti-acetylcholine receptor IgG1. THE JOURNAL OF IMMUNOLOGY 2005; 175:2018-25. [PMID: 16034147 DOI: 10.4049/jimmunol.175.3.2018] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In myasthenia gravis (MG), TNF and IL-1beta polymorphisms and high serum levels of these proinflammatory cytokines have been observed. Likewise, TNF and IL-1beta are critical for the activation of acetylcholine receptor (AChR)-specific T and B cells and for the development of experimental autoimmune myasthenia gravis (EAMG) induced by AChR immunization. We tested the therapeutic effect of human recombinant IL-1 receptor antagonist (IL-1ra) in C57BL/6 mice with EAMG. Multiple daily injections of 0.01 mg of IL-1ra administered for 2 wk following two AChR immunizations decreased the incidence and severity of clinical EAMG. Furthermore, IL-1ra treatment of mice with ongoing clinical EAMG reduced the clinical symptoms of disease. The IL-1ra-mediated suppression of clinical disease was associated with suppressed serum IFN-gamma, TNF-alpha, IL-1beta, IL-2, IL-6, C3, and anti-AChR IgG1 without influencing total serum IgG. Therefore, IL-1ra could be used as a nonsteroidal drug for the treatment of MG.
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MESH Headings
- Animals
- Cells, Cultured
- Complement C3/antagonists & inhibitors
- Complement C3/physiology
- Cytokines/antagonists & inhibitors
- Cytokines/blood
- Immunity, Cellular
- Immunodominant Epitopes/administration & dosage
- Immunodominant Epitopes/immunology
- Immunoglobulin G/biosynthesis
- Immunoglobulin G/blood
- Immunosuppressive Agents/administration & dosage
- Immunosuppressive Agents/therapeutic use
- Inflammation Mediators/antagonists & inhibitors
- Inflammation Mediators/blood
- Interleukin 1 Receptor Antagonist Protein
- Male
- Mice
- Mice, Inbred C57BL
- Myasthenia Gravis, Autoimmune, Experimental/immunology
- Myasthenia Gravis, Autoimmune, Experimental/prevention & control
- Peptide Fragments/administration & dosage
- Peptide Fragments/immunology
- Protein Subunits/administration & dosage
- Protein Subunits/immunology
- Receptors, Cholinergic/administration & dosage
- Receptors, Cholinergic/immunology
- Receptors, Interleukin-1/antagonists & inhibitors
- Severity of Illness Index
- Sialoglycoproteins/administration & dosage
- Sialoglycoproteins/physiology
- Sialoglycoproteins/therapeutic use
- Torpedo/immunology
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Affiliation(s)
- Huan Yang
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA
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27
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Rowin J, Meriggioli MN, Tüzün E, Leurgans S, Christadoss P. Etanercept treatment in corticosteroid-dependent myasthenia gravis. Neurology 2004; 63:2390-2. [PMID: 15623708 DOI: 10.1212/01.wnl.0000147242.92691.71] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors report a prospective pilot trial of etanercept in corticosteroid-dependent autoimmune myasthenia gravis. Eleven patients were enrolled, with eight completing the 6-month trial. Two patients were withdrawn owing to disease worsening, and one patient was withdrawn because of an erythematous skin rash. Six of the eight patients who completed the trial improved, based on quantitative measures of muscle strength and lowering of corticosteroid requirement.
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Affiliation(s)
- J Rowin
- Section of Neuromuscular Disease, Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL 60612-7330, USA
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28
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Tüzün E, Scott BG, Yang H, Wu B, Goluszko E, Guigneaux M, Higgs S, Christadoss P. Circulating Immune Complexes Augment Severity of Antibody-Mediated Myasthenia Gravis in Hypogammaglobulinemic RIIIS/J Mice. THE JOURNAL OF IMMUNOLOGY 2004; 172:5743-52. [PMID: 15100321 DOI: 10.4049/jimmunol.172.9.5743] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Experimental autoimmune myasthenia gravis (EAMG) is severe in RIIIS/J mice, despite a significant B cell immunodeficiency and a massive TCR V beta gene deletion. Severity of EAMG in RIIIS/J mice is greater than MHC-identical (H-2(r)) B10.RIII mice, suggesting the influence of non-MHC genes as an EAMG-potentiating factor in this strain. To delineate the role of deleted TCR V beta genes in RIIIS/J mice, we obtained (RIIIS/J x B10.RIII)F(1) (V beta(b/c)) x RIIIS/J (V beta(c)) backcross mice using Mendelian genetic methods and immunized them with acetylcholine receptor. EAMG susceptibility was not elevated in mice with V beta(c) genotype having 70% V beta gene deletion. Next, we performed microarray analysis on 12,488 spleen cDNAs obtained from spleens of naive RIIIS/J and B10.RIII mice. In RIIIS/J mice, 263 cDNAs were overexpressed and 303 cDNAs were underexpressed greater than 2-fold, compared with B10.RIII mice. TCR gene expression was augmented, whereas NK receptor, C1q, and C3 gene expressions were diminished in RIIIS/J mice. RIIIS/J mice also had increased lymph node T cell counts, elevated serum anti-AChR Ab levels, and serum C3 and C1q-conjugated circulating immune complex levels. A direct correlation between increased serum C1q-conjugated circulating immune complex levels and disease severity was observed in RIIIS/J mice.
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MESH Headings
- Adjuvants, Immunologic/biosynthesis
- Adjuvants, Immunologic/blood
- Adjuvants, Immunologic/physiology
- Agammaglobulinemia/genetics
- Agammaglobulinemia/immunology
- Agammaglobulinemia/pathology
- Animals
- Antigen-Antibody Complex/biosynthesis
- Antigen-Antibody Complex/blood
- Antigen-Antibody Complex/physiology
- Antigens, Surface/analysis
- Autoantibodies/biosynthesis
- Autoantibodies/physiology
- B-Lymphocyte Subsets/pathology
- Complement C1q/biosynthesis
- Complement C3/biosynthesis
- Gene Deletion
- Germinal Center/pathology
- H-2 Antigens/genetics
- Histocompatibility Testing
- Immunoglobulin G/blood
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- Lymphocyte Count
- Lymphopenia/genetics
- Lymphopenia/immunology
- Lymphopenia/pathology
- Mice
- Mice, Inbred C57BL
- Mice, Mutant Strains
- Myasthenia Gravis, Autoimmune, Experimental/epidemiology
- Myasthenia Gravis, Autoimmune, Experimental/genetics
- Myasthenia Gravis, Autoimmune, Experimental/immunology
- Myasthenia Gravis, Autoimmune, Experimental/pathology
- Oligonucleotide Array Sequence Analysis
- Receptors, Antigen, T-Cell, alpha-beta/biosynthesis
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Cholinergic/administration & dosage
- Receptors, Cholinergic/immunology
- Receptors, Immunologic/biosynthesis
- Receptors, Immunologic/genetics
- Receptors, KIR
- Severity of Illness Index
- Spleen/immunology
- Spleen/metabolism
- Spleen/pathology
- T-Lymphocyte Subsets/pathology
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Affiliation(s)
- Erdem Tüzün
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
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29
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Poussin MA, Tüzün E, Goluszko E, Scott BG, Yang H, Franco JU, Christadoss P. B7-1 costimulatory molecule is critical for the development of experimental autoimmune myasthenia gravis. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2003; 170:4389-96. [PMID: 12682276 DOI: 10.4049/jimmunol.170.8.4389] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Following immunization with acetylcholine receptor (AChR), MHC class II-restricted, AChR-specific CD4 cell activation is critical for the development of experimental autoimmune myasthenia gravis (EAMG) in C57BL/6 mice. To study the contributions of B7-1 and B7-2 costimulatory molecules in EAMG, B7-1, B7-2, and B7-1/B7-2 gene knockout (KO) mice were immunized with Torpedo AChR in CFA. Compared with wild-type C57BL6 mice, B7-1 and B7-1/2 KO mice were resistant to EAMG development. B7-1 KO mice had reduced anti-AChR Ab compared with C57BL/6 mice. However, neither B7-1 nor B7-2 gene disruption impaired AChR-induced or dominant alpha(146-162) peptide-induced in vitro lymphoproliferative responses. Blocking of the B7-1 or B7-2 molecule by specific mAbs in vivo led to a reduction in the AChR-specific lymphocyte response, and the reduction was more pronounced in mice treated with anti-B7-2 Ab. The findings implicate B7-1 molecules as having a critical role in the induction of EAMG, and the resistance of B7-1 KO mice is associated with suppressed humoral, rather than suppressed AChR-specific, T cell responses. The data also point to B7-2 molecules as being the dominant costimulatory molecules required for AChR-induced lymphocyte proliferation.
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MESH Headings
- Animals
- Antibodies, Blocking/administration & dosage
- Antigens, CD/genetics
- Antigens, CD/immunology
- Autoantibodies/biosynthesis
- B-Lymphocyte Subsets/cytology
- B-Lymphocyte Subsets/immunology
- B7-1 Antigen/genetics
- B7-1 Antigen/immunology
- B7-1 Antigen/physiology
- B7-2 Antigen
- CD4-Positive T-Lymphocytes/cytology
- CD4-Positive T-Lymphocytes/immunology
- Cells, Cultured
- Cytokines/biosynthesis
- Growth Inhibitors/administration & dosage
- H-2 Antigens/immunology
- Histocompatibility Antigen H-2D
- Injections, Intraperitoneal
- Injections, Subcutaneous
- Lymph Nodes/cytology
- Lymph Nodes/immunology
- Lymphocyte Activation/genetics
- Lymphocyte Activation/immunology
- Membrane Glycoproteins/antagonists & inhibitors
- Membrane Glycoproteins/genetics
- Membrane Glycoproteins/immunology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Mice, Transgenic
- Mitosis/genetics
- Mitosis/immunology
- Mutagenesis, Site-Directed
- Myasthenia Gravis, Autoimmune, Experimental/genetics
- Myasthenia Gravis, Autoimmune, Experimental/immunology
- Myasthenia Gravis, Autoimmune, Experimental/prevention & control
- Peptide Fragments/immunology
- Receptors, Nicotinic/administration & dosage
- Receptors, Nicotinic/immunology
- Receptors, Nicotinic/physiology
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Affiliation(s)
- Mathilde A Poussin
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
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30
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Hoffman EP, Rao D, Pachman LM. Clarifying the boundaries between the inflammatory and dystrophic myopathies: insights from molecular diagnostics and microarrays. Rheum Dis Clin North Am 2002; 28:743-57. [PMID: 12506770 DOI: 10.1016/s0889-857x(02)00031-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Clinical and histopathologic overlaps between the muscular dystrophies and inflammatory myopathies are being increasingly recognized. Most patients with a muscular dystrophy show improvement with prednisone treatment, although they will not be cured; many patients with idiopathic inflammatory myopathies are cured. Dysferlin-deficiency was recently recognized as a cause of late-onset dystrophy with substantial inflammation in muscle. Corticosteroid usage by these patients may result in nonrecoverable loss of strength. Therefore, it is important to rule out dysferlin-deficiency before initiating a course of corticosteroids. Newly emerging, genome-wide transcriptional profiling technology allows the identification of the interacting pathways that are active in the muscle of patients with inflammatory myopathies or dystrophies. There are several, complex molecular pathways; however, the comparison of expression profiles in patients with different muscle disorders permits the delineation of disease-specific patterns. It is hoped that novel approaches for treating the inflammatory myopathies and dystrophies can be derived from intimate knowledge of the pathways involved in each disease, and the key molecules that provide cross-talk between pathways.
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Affiliation(s)
- Eric P Hoffman
- Center for Genetic Medicine, Children's National Medical Center, Washington, DC 20010, USA.
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31
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Deng C, Goluszko E, Tüzün E, Yang H, Christadoss P. Resistance to experimental autoimmune myasthenia gravis in IL-6-deficient mice is associated with reduced germinal center formation and C3 production. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2002; 169:1077-83. [PMID: 12097416 DOI: 10.4049/jimmunol.169.2.1077] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
To provide direct genetic evidence for a role of IL-6 in experimental autoimmune myasthenia gravis (EAMG), IL-6 gene KO (IL-6(-/-)) mice in the C57BL/6 background were immunized with Torpedo californica acetylcholine receptor (AChR) and evaluated for EAMG. Only 25% of AChR-immunized IL-6(-/-) mice developed clinical EAMG compared to 83% of C57BL/6 (wild-type) mice. A significant reduction in the secondary anti-AChR Ab of IgG, IgG(2b), and IgG(2c), but not the primary or secondary IgM response was observed in AChR-immunized IL-6(-/-) mice, suggesting a possible defect in T cell help and class switching to anti-AChR IgG(2) isotype. The AChR-specific lymphocyte proliferative response, IFN-gamma, and IL-10 production were suppressed in AChR-immunized IL-6(-/-) mice. EAMG resistance in IL-6(-/-) mice was associated with a significant reduction in germinal center formation and decreased serum complement C3 levels. The data provide the first direct genetic evidence for a key role of IL-6 in the autoimmune response to AChR and in EAMG pathogenesis.
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Affiliation(s)
- Caishu Deng
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA
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32
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Christadoss P, Goluszko E. Treatment of experimental autoimmune myasthenia gravis with recombinant human tumor necrosis factor receptor Fc protein. J Neuroimmunol 2002; 122:186-90. [PMID: 11777558 DOI: 10.1016/s0165-5728(01)00473-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Lymphotoxin-alpha (TNF-beta) and TNF receptor p55 gene knockout mice are resistant to the development of antibody and complement mediated experimental autoimmune myasthenia gravis (EAMG), suggesting a possible role of TNF in mediating EAMG. Therefore, we tested the hypothesis that blocking the functional interaction of TNF with their receptors by soluble recombinant human TNFR:Fc would suppress the ongoing clinical EAMG. Recombinant human TNFR:Fc administered daily for 2 weeks to C57BL6 mice with ongoing clinical EAMG significantly improved clinical EAMG when compared with placebo-treated mice. A clinical trial of selected myasthenia gravis patients with recombinant human TNFR:Fc could be attempted.
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Affiliation(s)
- Premkumar Christadoss
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Boulevard, 3.142 MRB, Galveston, TX 77555-1070, USA.
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