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Lokhandwala S, Townsend J, Ciurtin C. Existing and Emerging Targeted Therapies in Juvenile Psoriatic Arthritis: Challenges and Unmet Needs. Paediatr Drugs 2024; 26:217-228. [PMID: 38310623 DOI: 10.1007/s40272-023-00618-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 02/06/2024]
Abstract
Juvenile psoriatic arthritis (JPsA) is a heterogeneous type of non-systemic chronic inflammatory arthritis affecting children and young people. This review focuses on highlighting challenges in harmonising recommendations for the use of available therapies in JPsA, according to its distinct clinical phenotypes, and explores the similarities and differences between the disease classification and management across age. We further explore the emerging therapeutic landscape, summarising the recently completed clinical trials in JPsA, and ongoing studies in both JPsA and adults with psoriatic arthritis, highlighting unmet needs and barriers for translational research in JPsA. The novel therapeutic agents in clinical development in JPsA range from monoclonal antibodies targeting interleukin (IL)-17, IL-12/23 and IL-23 blockades to synthetic small molecules targeting Janus kinase and tyrosine kinase and phosphodiesterase-4 inhibition. In addition, there are head-to-head clinical trials comparing tumour necrosis factor-α blockade with both IL-17 and IL-23 inhibition. Most of these new therapies have been tested in adults with psoriatic arthritis and have advanced to the phase III stage of drug development or received license for use, suggesting promising signals for efficacy and potentially acceptable safety and tolerability for JPsA. Further translational research in JPsA is required to improve our understanding of the impact of age at onset on treatment efficacy, as well as to provide opportunities for better management of refractory disease and improved long-term outcomes in JPsA, for ultimate patient benefit.
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Affiliation(s)
- Sarrah Lokhandwala
- Department of Biomedical Sciences, University College London, London, UK
| | | | - Coziana Ciurtin
- Centre for Adolescent Rheumatology, Division of Medicine, University College London, London, UK.
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2
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Naveen R, Guleria S, Aggarwal A. Recent updates in enthesitis-related arthritis. Rheumatol Int 2023; 43:409-420. [PMID: 36629936 DOI: 10.1007/s00296-023-05274-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023]
Abstract
Enthesitis-related arthritis (ERA) is a category of juvenile idiopathic arthritis which belongs to the spectrum of diseases that are included in juvenile spondyloarthropathy. In recent years, there have been significant advances in understanding pathogenesis, tools to assess disease activity, early recognition of the axial disease, and targeted therapy using IL-17 inhibitors and small molecule inhibitors. The current narrative review highlights these new advances. Among many hypotheses linking HLA B27 to ERA, one of them is the effect of HLA B27 on gut dysbiosis. However, recent data suggest that gut dysbiosis is probably not determined by HLA B27. Though children present with arthritis and enthesitis, axial disease is present in 50-60% on MRI. Using data-driven approach, discriminative MRI finding for active and chronic diseases has been defined for children. This will help in the early recognition of disease. An abridged version of juvenile spondyloarthropathy disease activity (JSpADA) score without the need for acute phase reactants and Schober test performed as well as the original score may increase its acceptance in routine practice. Secukinumab (anti-IL-17 antibody) has shown a more than 75% response rate in children with ERA and may be a good alternative to anti-TNF therapy. Initial data with tofacitinib also look promising. All these will translate into better outcomes for children with ERA.
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Affiliation(s)
- R Naveen
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India
| | - Shivika Guleria
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India
| | - Amita Aggarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
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3
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Morissette F, Mongeau-Pérusse V, Rizkallah E, Thébault P, Lepage S, Brissette S, Bruneau J, Dubreucq S, Stip E, Cailhier JF, Jutras-Aswad D. Exploring cannabidiol effects on inflammatory markers in individuals with cocaine use disorder: a randomized controlled trial. Neuropsychopharmacology 2021; 46:2101-2111. [PMID: 34331010 PMCID: PMC8505631 DOI: 10.1038/s41386-021-01098-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 01/29/2023]
Abstract
Cocaine use disorder (CUD) is a major public health issue associated with physical, social, and psychological problems. Excessive and repeated cocaine use induces oxidative stress leading to a systemic inflammatory response. Cannabidiol (CBD) has gained substantial interest for its anti-inflammatory properties, safety, and tolerability profile. However, CBD anti-inflammatory properties have yet to be confirmed in humans. This exploratory study is based on a single-site randomized controlled trial that enrolled participants with CUD between 18 and 65 years, randomized (1:1) to daily receive either CBD (800 mg) or placebo for 92 days. The trial was divided into a 10-day detoxification (phase I) followed by a 12-week outpatient follow-up (phase II). Blood samples were collected from 48 participants at baseline, day 8, week 4, and week 12 and were analyzed to determine monocytes and lymphocytes phenotypes, and concentrations of various inflammatory markers such as cytokines. We used generalized estimating equations to detect group differences. Participants treated with CBD had lower levels of interleukin-6 (p = 0.017), vascular endothelial growth factor (p = 0.032), intermediate monocytes CD14+CD16+ (p = 0.024), and natural killer CD56negCD16hi (p = 0.000) compared with participants receiving placebo. CD25+CD4+T cells were higher in the CBD group (p = 0.007). No significant group difference was observed for B lymphocytes. This study suggests that CBD may exert anti-inflammatory effects in individuals with CUD.
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Affiliation(s)
- Florence Morissette
- grid.14848.310000 0001 2292 3357Faculty of Medicine, Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC Canada ,grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada
| | - Violaine Mongeau-Pérusse
- grid.14848.310000 0001 2292 3357Faculty of Medicine, Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC Canada ,grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada
| | - Elie Rizkallah
- grid.14848.310000 0001 2292 3357Faculty of Medicine, Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC Canada ,grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada
| | - Paméla Thébault
- grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada ,Montreal Cancer Institute, Montreal, QC Canada
| | - Stéphanie Lepage
- grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada ,Montreal Cancer Institute, Montreal, QC Canada
| | - Suzanne Brissette
- grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada ,grid.14848.310000 0001 2292 3357Faculty of Medicine, Department of Family and Emergency Medicine, Université de Montréal, Montreal, QC Canada
| | - Julie Bruneau
- grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada ,grid.14848.310000 0001 2292 3357Faculty of Medicine, Department of Family and Emergency Medicine, Université de Montréal, Montreal, QC Canada
| | - Simon Dubreucq
- grid.14848.310000 0001 2292 3357Faculty of Medicine, Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC Canada ,grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada
| | - Emmanuel Stip
- grid.14848.310000 0001 2292 3357Faculty of Medicine, Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC Canada ,grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada ,grid.43519.3a0000 0001 2193 6666Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Jean-François Cailhier
- grid.410559.c0000 0001 0743 2111Research Centre of Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC Canada ,Montreal Cancer Institute, Montreal, QC Canada ,grid.14848.310000 0001 2292 3357Division of Nephrology, Department of Medicine, Université de Montréal, Montreal, QC Canada
| | - Didier Jutras-Aswad
- Faculty of Medicine, Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC, Canada. .,Research Centre of Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada. .,University Institute on Addictions, Montreal, QC, Canada.
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4
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Reiff DD, Stoll ML, Cron RQ. Precision medicine in juvenile idiopathic arthritis-has the time arrived? THE LANCET. RHEUMATOLOGY 2021; 3:e808-e817. [PMID: 38297525 DOI: 10.1016/s2665-9913(21)00252-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/07/2021] [Accepted: 07/28/2021] [Indexed: 12/14/2022]
Abstract
The introduction of disease-modifying anti-rheumatic drug therapies for treating children and adolescents with chronic arthritis (ie, juvenile idiopathic arthritis [JIA]) has revolutionised care and outcomes. The biologic revolution continues to expand, with ever-changing immunological targets coming to market after basic research and clinical trials. The first class of biologics that was beneficial for children with JIA was tumour necrosis factor (TNF) inhibitors. If used early and aggressively, TNF inhibitors are capable of inducing disease remission for most of the seven subtypes of JIA, with the exception of systemic JIA (which more frequently responds to interleukin [IL]-1 or IL-6 inhibition). Nevertheless, there are still subsets of patients with JIA with disease that is difficult to treat or who develop extra-articular features that require a different therapeutic approach. Although finding an effective biological therapy for individual children with JIA can be trial and error, ongoing research and clinical trials are providing insight into a more personalised approach to care. In addition, redefining the JIA classification, in part based on shared similarities with various adult arthritides, could allow for extrapolation of knowledge from studies in adults with chronic arthritis.
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Affiliation(s)
- Daniel D Reiff
- Department of Pediatrics, Division of Rheumatology, University of Alabama, Birmingham, AL, USA
| | - Matthew L Stoll
- Department of Pediatrics, Division of Rheumatology, University of Alabama, Birmingham, AL, USA
| | - Randy Q Cron
- Department of Pediatrics, Division of Rheumatology, University of Alabama, Birmingham, AL, USA.
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5
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Wu CY, Yang HY, Huang JL, Lai JH. Signals and Mechanisms Regulating Monocyte and Macrophage Activation in the Pathogenesis of Juvenile Idiopathic Arthritis. Int J Mol Sci 2021; 22:ijms22157960. [PMID: 34360720 PMCID: PMC8347893 DOI: 10.3390/ijms22157960] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 12/13/2022] Open
Abstract
Monocytes (Mos) and macrophages (Mφs) are key players in the innate immune system and are critical in coordinating the initiation, expansion, and regression of many autoimmune diseases. In addition, they display immunoregulatory effects that impact inflammation and are essential in tissue repair and regeneration. Juvenile idiopathic arthritis (JIA) is an umbrella term describing inflammatory joint diseases in children. Accumulated evidence suggests a link between Mo and Mφ activation and JIA pathogenesis. Accordingly, topics regarding the signals and mechanisms regulating Mo and Mφ activation leading to pathologies in patients with JIA are of great interest. In this review, we critically summarize recent advances in the understanding of how Mo and Mφ activation is involved in JIA pathogenesis and focus on the signaling pathways and mechanisms participating in the related cell activation processes.
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Affiliation(s)
- Chao-Yi Wu
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (C.-Y.W.); (J.-L.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Huang-Yu Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Jing-Long Huang
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (C.-Y.W.); (J.-L.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Pediatrics, New Taipei Municipal TuCheng Hospital, New Taipei City 236, Taiwan
| | - Jenn-Haung Lai
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan
- National Defense Medical Center, Graduate Institute of Medical Science, Taipei 114, Taiwan
- Correspondence: ; Tel./Fax: +886-2-8791-8382
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6
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Fisher C, Ciurtin C, Leandro M, Sen D, Wedderburn LR. Similarities and Differences Between Juvenile and Adult Spondyloarthropathies. Front Med (Lausanne) 2021; 8:681621. [PMID: 34136509 PMCID: PMC8200411 DOI: 10.3389/fmed.2021.681621] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/26/2021] [Indexed: 12/17/2022] Open
Abstract
Spondyloarthritis (SpA) encompasses a broad spectrum of conditions occurring from childhood to middle age. Key features of SpA include axial and peripheral arthritis, enthesitis, extra-articular manifestations, and a strong association with HLA-B27. These features are common across the ages but there are important differences between juvenile and adult onset disease. Juvenile SpA predominantly affects the peripheral joints and the incidence of axial arthritis increases with age. Enthesitis is important in early disease. This review article highlights the similarities and differences between juvenile and adult SpA including classification, pathogenesis, clinical features, imaging, therapeutic strategies, and disease outcomes. In addition, the impact of the biological transition from childhood to adulthood is explored including the importance of musculoskeletal and immunological maturation. We discuss how the changes associated with adolescence may be important in explaining age-related differences in the clinical phenotype between juvenile and adult SpA and their implications for the treatment of juvenile SpA.
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Affiliation(s)
- Corinne Fisher
- Centre for Adolescent Rheumatology Versus Arthritis at University College London, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom.,Department of Adolescent Rheumatology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.,National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology Versus Arthritis at University College London, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom.,Department of Adolescent Rheumatology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.,Division of Medicine, Department of Rheumatology (Bloomsbury), University College London, London, United Kingdom
| | - Maria Leandro
- Centre for Adolescent Rheumatology Versus Arthritis at University College London, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom.,Department of Adolescent Rheumatology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.,Division of Medicine, Department of Rheumatology (Bloomsbury), University College London, London, United Kingdom
| | - Debajit Sen
- Centre for Adolescent Rheumatology Versus Arthritis at University College London, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom.,Department of Adolescent Rheumatology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.,National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Lucy R Wedderburn
- Centre for Adolescent Rheumatology Versus Arthritis at University College London, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom.,National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children, London, United Kingdom.,Infection, Immunity & Inflammation Teaching and Research Department University College London Great Ormond Street Institute of Child Health, London, United Kingdom
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7
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Mendez ME, Sebastian A, Murugesh DK, Hum NR, McCool JL, Hsia AW, Christiansen BA, Loots GG. LPS-Induced Inflammation Prior to Injury Exacerbates the Development of Post-Traumatic Osteoarthritis in Mice. J Bone Miner Res 2020; 35:2229-2241. [PMID: 32564401 PMCID: PMC7689775 DOI: 10.1002/jbmr.4117] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/08/2020] [Accepted: 06/17/2020] [Indexed: 12/11/2022]
Abstract
Osteoarthritis (OA) is a debilitating and painful disease characterized by the progressive loss of articular cartilage. Post-traumatic osteoarthritis (PTOA) is an injury-induced type of OA that persists in an asymptomatic phase for years before it becomes diagnosed in ~50% of injured individuals. Although PTOA is not classified as an inflammatory disease, it has been suggested that inflammation could be a major driver of PTOA development. Here we examined whether a state of systemic inflammation induced by lipopolysaccharide (LPS) administration 5-days before injury would modulate PTOA outcomes. RNA-seq analysis at 1-day post-injury followed by micro-computed tomography (μCT) and histology characterization at 6 weeks post-injury revealed that LPS administration causes more severe PTOA phenotypes. These phenotypes included significantly higher loss of cartilage and subchondral bone volume. Gene expression analysis showed that LPS alone induced a large cohort of inflammatory genes previously shown to be elevated in synovial M1 macrophages of rheumatoid arthritis (RA) patients, suggesting that systemic LPS produces synovitis. This synovitis was sufficient to promote PTOA in MRL/MpJ mice, a strain previously shown to be resistant to PTOA. The synovium of LPS-treated injured joints displayed an increase in cellularity, and immunohistological examination confirmed that this increase was in part attributable to an elevation in type 1 macrophages. LPS induced the expression of Tlr7 and Tlr8 in both injured and uninjured joints, genes known to be elevated in RA. We conclude that inflammation before injury is an important risk factor for the development of PTOA and that correlating patient serum endotoxin levels or their state of systemic inflammation with PTOA progression may help develop new, effective treatments to lower the rate of PTOA in injured individuals. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
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Affiliation(s)
- Melanie E Mendez
- Physical and Life Science Directorate, Lawrence Livermore National Laboratory, Livermore, CA, USA.,School of Natural Sciences, University of California Merced, Merced, CA, USA
| | - Aimy Sebastian
- Physical and Life Science Directorate, Lawrence Livermore National Laboratory, Livermore, CA, USA
| | - Deepa K Murugesh
- Physical and Life Science Directorate, Lawrence Livermore National Laboratory, Livermore, CA, USA
| | - Nicholas R Hum
- Physical and Life Science Directorate, Lawrence Livermore National Laboratory, Livermore, CA, USA.,School of Natural Sciences, University of California Merced, Merced, CA, USA
| | - Jillian L McCool
- Physical and Life Science Directorate, Lawrence Livermore National Laboratory, Livermore, CA, USA.,School of Natural Sciences, University of California Merced, Merced, CA, USA
| | - Allison W Hsia
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA
| | - Blaine A Christiansen
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA
| | - Gabriela G Loots
- Physical and Life Science Directorate, Lawrence Livermore National Laboratory, Livermore, CA, USA.,School of Natural Sciences, University of California Merced, Merced, CA, USA
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8
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Prada-Medina CA, Peron JPS, Nakaya HI. Immature neutrophil signature associated with the sexual dimorphism of systemic juvenile idiopathic arthritis. J Leukoc Biol 2020; 108:1319-1327. [PMID: 32794262 DOI: 10.1002/jlb.6ma0720-015rr] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/08/2020] [Accepted: 01/13/2020] [Indexed: 12/30/2022] Open
Abstract
Juvenile idiopathic arthritis (JIA) is a group of inflammatory conditions of unknown etiology whose incidence is sex dependent. Although several studies have attempted to identify JIA-related gene signatures, none have systematically assessed the impact of sex on the whole blood transcriptomes of JIA patients. By analyzing over 400 unique pediatric gene expression profiles, we characterized the sexual differences in leukocyte composition of systemic JIA patients and identified sex-specific gene signatures that were related to immature neutrophils. Female systemic JIA patients presented higher activation of immature neutrophil-related genes compared to males, and these genes were associated with the response to IL-1 receptor blockade treatment. Also, we found that this immature neutrophil signature is sexually dimorphic across human lifespan and in adults with rheumatoid arthritis and asthma. These results suggest that neutrophil maturation is sexually dimorphic in rheumatic inflammation, and that this may impact disease progression and treatment.
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Affiliation(s)
- Cesar Augusto Prada-Medina
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Jean Pierre Schatzmann Peron
- Department of Immunology, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur-USP, University of São Paulo, São Paulo, Brazil
| | - Helder I Nakaya
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur-USP, University of São Paulo, São Paulo, Brazil
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9
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Schmidt T, Berthold E, Arve-Butler S, Gullstrand B, Mossberg A, Kahn F, Bengtsson AA, Månsson B, Kahn R. Children with oligoarticular juvenile idiopathic arthritis have skewed synovial monocyte polarization pattern with functional impairment-a distinct inflammatory pattern for oligoarticular juvenile arthritis. Arthritis Res Ther 2020; 22:186. [PMID: 32787920 PMCID: PMC7425414 DOI: 10.1186/s13075-020-02279-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/28/2020] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) is an umbrella term of inflammatory joint diseases in children. Oligoarthritis is the most common form in the Western world, representing roughly 60% of all patients. Monocytes and macrophages play an important role in adult arthritides, but their role in oligoarticular JIA is less studied. Polarization highly influences monocytes' and macrophages' effector functions, broadly separated into pro-inflammatory M1 or anti-inflammatory M2 phenotypes. Here, we set out to investigate the polarization pattern and functional aspects of synovial monocytes in oligoarticular juvenile idiopathic arthritis (JIA). METHODS Paired synovial fluid, blood samples (n = 13), and synovial biopsies (n = 3) were collected from patients with untreated oligoarticular JIA. Monocytes were analyzed for polarization markers by flow cytometry and qPCR. Effector function was analyzed by a phagocytosis assay. Polarization of healthy monocytes was investigated by stimulation with synovial fluid in vitro. Monocyte/macrophage distribution, polarization, and mRNA expression were investigated in biopsies by immunohistochemistry, immunofluorescence, and in situ hybridization. RESULTS Children with oligoarticular JIA have polarized synovial fluid monocytes of a specific M1(IFNγ)/M2(IL-4)-like pattern. This was evidenced by increased surface expression of CD40 (p < 0.001), CD86 (p < 0.001), and CD206 (p < 0.001), but not CD163, as compared to paired circulating monocytes. Additionally, polarization was extensively explored at the mRNA level and synovial fluid monocytes differentially expressed classical markers of M1(IFNγ)/M2(IL-4) polarization compared to circulating monocytes. Synovial fluid monocytes were functionally affected, as assessed by reduced capacity to phagocytose (p < 0.01). Synovial fluid induced M2 markers (CD16 and CD206), but not M1 (CD40) or CD86 in healthy monocytes and did not induce cytokine production. Single and co-expression of surface CD40 and CD206, as well as mRNA expression of IL-10 and TNF, was observed in monocytes/macrophages in synovial biopsies. CONCLUSION Children with untreated oligoarticular JIA have similar and distinct synovial fluid monocyte polarization pattern of mixed pro- and anti-inflammatory features. This pattern was not exclusively a result of the synovial fluid milieu as monocytes/macrophages in the synovial membrane show similar patterns. Our study highlights a distinct polarization pattern in oligoarticular JIA, which could be utilized for future treatment strategies.
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Affiliation(s)
- Tobias Schmidt
- Department of Pediatrics, Clinical Sciences Lund, Lund University, BMC B13, Klinikgatan 26, 22185, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, BMC B13, Klinikgatan 26, 22185, Lund, Sweden
| | - Elisabet Berthold
- Wallenberg Center for Molecular Medicine, Lund University, BMC B13, Klinikgatan 26, 22185, Lund, Sweden.,Department of Rheumatology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Sabine Arve-Butler
- Wallenberg Center for Molecular Medicine, Lund University, BMC B13, Klinikgatan 26, 22185, Lund, Sweden.,Department of Rheumatology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Birgitta Gullstrand
- Department of Rheumatology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Anki Mossberg
- Department of Pediatrics, Clinical Sciences Lund, Lund University, BMC B13, Klinikgatan 26, 22185, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, BMC B13, Klinikgatan 26, 22185, Lund, Sweden
| | - Fredrik Kahn
- Department of Infection Medicine, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Anders A Bengtsson
- Department of Rheumatology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Bengt Månsson
- Department of Rheumatology, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Robin Kahn
- Department of Pediatrics, Clinical Sciences Lund, Lund University, BMC B13, Klinikgatan 26, 22185, Lund, Sweden. .,Wallenberg Center for Molecular Medicine, Lund University, BMC B13, Klinikgatan 26, 22185, Lund, Sweden.
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10
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Cren M, Nziza N, Carbasse A, Mahe P, Dufourcq-Lopez E, Delpont M, Chevassus H, Khalil M, Mura T, Duroux-Richard I, Apparailly F, Jeziorski E, Louis-Plence P. Differential Accumulation and Activation of Monocyte and Dendritic Cell Subsets in Inflamed Synovial Fluid Discriminates Between Juvenile Idiopathic Arthritis and Septic Arthritis. Front Immunol 2020; 11:1716. [PMID: 32849606 PMCID: PMC7411147 DOI: 10.3389/fimmu.2020.01716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/29/2020] [Indexed: 12/20/2022] Open
Abstract
Despite their distinct etiology, several lines of evidence suggest that innate immunity plays a pivotal role in both juvenile idiopathic arthritis (JIA) and septic arthritis (SA) pathophysiology. Indeed, monocytes and dendritic cells (DC) are involved in the first line of defense against pathogens and play a critical role in initiating and orchestrating the immune response. The aim of this study was to compare the number and phenotype of monocytes and DCs in peripheral blood (PB) and synovial fluid (SF) from patients with JIA and SA to identify specific cell subsets and activation markers associated with pathophysiological mechanisms and that could be used as biomarkers to discriminate both diseases. The proportion of intermediate and non-classical monocytes in the SF and PB, respectively, were significantly higher in JIA than in SA patients. In contrast the proportion of classical monocytes and their absolute numbers were higher in the SF from SA compared with JIA patients. Higher expression of CD64 on non-classical monocyte was observed in PB from SA compared with JIA patients. In SF, higher expression of CD64 on classical and intermediate monocyte as well as higher CD163 expression on intermediate monocytes was observed in SA compared with JIA patients. Moreover, whereas the number of conventional (cDC), plasmacytoid (pDC) and inflammatory (infDC) DCs was comparable between groups in PB, the number of CD141+ cDCs and CD123+ pDCs in the SF was significantly higher in JIA than in SA patients. CD14+ infDCs represented the major DC subset in the SF of both groups with potent activation assessed by high expression of HLA-DR and CD86 and significant up-regulation of HLA-DR expression in SA compared with JIA patients. Finally, higher activation of SF DC subsets was monitored in SA compared with JIA with significant up-regulation of CD86 and PDL2 expression on several DC subsets. Our results show the differential accumulation and activation of innate immune cells between septic and inflammatory arthritis. They strongly indicate that the relative high numbers of CD141+ cDC and CD123+ pDCs in SF are specific for JIA while the over-activation of DC and monocyte subsets is specific for SA.
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Affiliation(s)
- Maïlys Cren
- IRMB, INSERM, Université Montpellier, Montpellier, France
| | - Nadège Nziza
- IRMB, INSERM, Université Montpellier, Montpellier, France.,Arthritis R&D, Neuilly sur Seine, France
| | - Aurélia Carbasse
- CHU Montpellier, Pediatric Department, Université Montpellier, Montpellier, France
| | - Perrine Mahe
- CHU Montpellier, Pediatric Department, Université Montpellier, Montpellier, France
| | | | - Marion Delpont
- CHU Montpellier, Pediatric Orthopedic Surgery Unit, Université Montpellier, Montpellier, France
| | - Hugues Chevassus
- CHU Montpellier, Centre d'Investigation Clinique, Université Montpellier, Montpellier, France.,Inserm, CIC1411, Montpellier, France
| | - Mirna Khalil
- CHU Montpellier, Centre d'Investigation Clinique, Université Montpellier, Montpellier, France.,Inserm, CIC1411, Montpellier, France
| | - Thibault Mura
- CHU Montpellier, Clinical Research and Epidemiology Unit, Université Montpellier, Montpellier, France
| | | | - Florence Apparailly
- IRMB, INSERM, Université Montpellier, Montpellier, France.,CHU Montpellier, Clinical Department for Osteoarticular Diseases, Université Montpellier, Montpellier, France
| | - Eric Jeziorski
- CHU Montpellier, Pediatric Department, Université Montpellier, Montpellier, France.,PCCI, INSERM, University of Montpellier, Montpellier, France
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11
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Wang Z, Bao H, Liu Y, Wang Y, Qin J, Yang L. Interleukin-23 derived from CD16 + monocytes drives IL-17 secretion by TLR4 pathway in children with mycoplasma pneumoniae pneumonia. Life Sci 2020; 258:118149. [PMID: 32726660 DOI: 10.1016/j.lfs.2020.118149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/10/2020] [Accepted: 07/22/2020] [Indexed: 02/07/2023]
Abstract
AIMS The study aimed to investigate whether IL-23 is amplified in monocyte subsets of MP pneumonia and to determine its relevant pathway. MATERIALS AND METHODS We firstly analyze the IL-23p19 expression in monocyte subgroups in MP pneumonia patients and healthy controls subjects by using flow cytometry. Then, we also analyzed the percentage of IL-17+γδT cells and Th17 cells in patients with MP pneumonia and controls subjects. At the same time, the relation between IL-23 and IL-17 were also assessed. Furthermore, we constructed the recombinant community-acquired respiratory distress syndrome (CARDS) toxin and intend to stimulate peripheral blood mononuclear cells and RAW264.7 cells in vitro. IL-23p19 was detected by flow cytometry and the mRNA levels were measured by real-time PCR. Finally, TLR4 pathway was also investigated by TAK242 inhibitor. KEY FINDINGS It turned out that the expression of IL-23p19 was increased in CD14brightCD16+ monocyte of MP pneumonia patients than controls subjects. The patients with MP pneumonia had significantly higher the percentage of IL-17+γδT cells and Th17 cells than controls subjects. Interestingly, the levels of IL-23 were positively related to IL-17 in MP pneumonia patients. CD16+ monocytes and RAW264.7 cells, respectively can be induced by CARDS toxin to secrete IL-23 by TLR4 pathway in vitro. SIGNIFICANCE These results indicated that IL-23-IL-17+γδT/Th17 axis may play a role in the pathogenesis of MP pneumonia, whereas IL-23 derived from CD16+ monocytes was expanded in MP pneumonia by TLR4 pathway.
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Affiliation(s)
- Zhihua Wang
- Department of Pediatrics, Tianjin Nankai Hospital, Tianjin, China; Nankai Clinical School, Tianjin Medical University, Tianjin, China
| | - Huijing Bao
- Integrative Medical Diagnosis Laboratory, Tianjin Nankai Hospital, Tianjin, China
| | - Yan Liu
- Department of Pediatrics, Tianjin Nankai Hospital, Tianjin, China; Nankai Clinical School, Tianjin Medical University, Tianjin, China
| | - Yushui Wang
- Department of Pediatrics, Tianjin Nankai Hospital, Tianjin, China; Nankai Clinical School, Tianjin Medical University, Tianjin, China
| | - Junfang Qin
- Medical School of Nankai University, Nankai University, Tianjin, China
| | - Lei Yang
- Institute of Acute Abdominal Diseases, Tianjin Nankai Hospital, Tianjin, China.
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12
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Torres-Ruiz J, Carrillo-Vazquez DA, Padilla-Ortiz DM, Vazquez-Rodriguez R, Nuñez-Alvarez C, Juarez-Vega G, Gomez-Martin D. TLR expression in peripheral monocyte subsets of patients with idiopathic inflammatory myopathies: association with clinical and immunological features. J Transl Med 2020; 18:125. [PMID: 32164729 PMCID: PMC7066841 DOI: 10.1186/s12967-020-02290-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/04/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Monocytes and toll-like receptors (TLR) have been found in the inflammatory infiltrate of muscle biopsies in patients with idiopathic inflammatory myopathies (IIM), suggesting an important role of these cells in the pathogenesis of myositis. The monocyte subsets, their TLR expression in peripheral blood and their relationship with the clinical characteristics of patients with IIM has not been addressed. METHODS We recruited 45 patients with IIM diagnosis and 15 age and sex-adjusted healthy controls. We assessed the disease activity and damage, performed a nailfold capillaroscopy and registered the cardio-pulmonary parameters from the medical charts. Monocyte subsets, their expression of TLR2 and TLR4 and the serum Th1/Th2/Th17 cytokines levels were evaluated by flow cytometry. We expressed quantitative variables as medians and interquartile ranges (IQR) or minimum and maximum (min-max). Differences between groups were assessed with Mann-Whitney U and the Kruskal-Wallis tests. Correlation between quantitative variables was assessed with Spearman Rho. RESULTS Twenty-nine patients were women (64.4%) and 32 (71.1%) had dermatomyositis. In comparison to healthy controls, patients with active IIM had a higher percentage of intermediate monocytes and lower amounts of classical monocytes. Patients with IIM had a higher expression of TLR4 in all their monocyte subsets, regardless of disease activity and prednisone treatment. Serum IL-6 correlated with the TLR2 expression in every monocyte subset and the expression of TLR2 in intermediate monocytes was higher among patients with dysphagia. Subjects with nailfold capillaroscopy abnormalities had a higher amount of TLR2+ classical and non-classical monocytes and those with interstitial lung disease (ILD) had a higher percentage of TLR4+ non-classical monocytes. The classical and intermediate monocytes from patients with anti Mi2 antibodies had a higher expression of TLR4. The percentage of intermediate monocytes and the expression of TLR4 in all monocyte subsets showed a good diagnostic capacity in patients with IIM. CONCLUSION Patients with IIM have a differential pool of monocyte subsets with an enhanced expression of TLR2 and TLR4, which correlates with disease activity and distinctive clinical features including dysphagia, ILD, vasculopathy, and pro-inflammatory cytokines. These immunological features might be useful as a potential diagnostic tool as well as novel disease activity biomarkers in IIM.
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Affiliation(s)
- Jiram Torres-Ruiz
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,Emergency Medicine Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Daniel Alberto Carrillo-Vazquez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Diana Marcela Padilla-Ortiz
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,Universidad de La Sabana, Hospital Militar Central, Bogotá, DC, Colombia
| | - Ricardo Vazquez-Rodriguez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Carlos Nuñez-Alvarez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Guillermo Juarez-Vega
- Flow Cytometry Unit, Red de Apoyo a la Investigación, Coordinación de Investigación Científica, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Diana Gomez-Martin
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave Morones Prieto 3000, 64710, Monterrey, Nuevo Leon, Mexico.
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13
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Whole blood RNA signatures in leprosy patients identify reversal reactions before clinical onset: a prospective, multicenter study. Sci Rep 2019; 9:17931. [PMID: 31784594 PMCID: PMC6884598 DOI: 10.1038/s41598-019-54213-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 11/07/2019] [Indexed: 11/30/2022] Open
Abstract
Early diagnosis of leprosy is challenging, particularly its inflammatory reactions, the major cause of irreversible neuropathy in leprosy. Current diagnostics cannot identify which patients are at risk of developing reactions. This study assessed blood RNA expression levels as potential biomarkers for leprosy. Prospective cohorts of newly diagnosed leprosy patients, including reactions, and healthy controls were recruited in Bangladesh, Brazil, Ethiopia and Nepal. RNA expression in 1,090 whole blood samples was determined for 103 target genes for innate and adaptive immune profiling by dual color Reverse-Transcription Multiplex Ligation-dependent Probe Amplification (dcRT-MLPA) followed by cluster analysis. We identified transcriptomic biomarkers associated with leprosy disease, different leprosy phenotypes as well as high exposure to Mycobacterium leprae which respectively allow improved diagnosis and classification of leprosy patients and detection of infection. Importantly, a transcriptomic signature of risk for reversal reactions consisting of five genes (CCL2, CD8A, IL2, IL15 and MARCO) was identified based on cross-sectional comparison of RNA expression. In addition, intra-individual longitudinal analyses of leprosy patients before, during and after treatment of reversal reactions, indicated that several IFN-induced genes increased significantly at onset of reaction whereas IL15 decreased. This multi-site study, situated in four leprosy endemic areas, demonstrates the potential of host transcriptomic biomarkers as correlates of risk for leprosy. Importantly, a prospective five-gene signature for reversal reactions could predict reversal reactions at least 2 weeks before onset. Thus, transcriptomic biomarkers provide promise for early detection of these acute inflammatory episodes and thereby help prevent permanent neuropathy and disability in leprosy patients.
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14
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Shah NM, Edey LF, Imami N, Johnson MR. Human labour is associated with altered regulatory T cell function and maternal immune activation. Clin Exp Immunol 2019; 199:182-200. [PMID: 31617583 DOI: 10.1111/cei.13384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/14/2022] Open
Abstract
During human pregnancy, regulatory T cell (Treg ) function is enhanced and immune activation is repressed allowing the growth and development of the feto-placental unit. Here, we have investigated whether human labour is associated with a reversal of the pregnancy-induced changes in the maternal immune system. We tested the hypothesis that human labour is associated with a decline in Treg function, specifically their ability to modulate Toll-like receptor (TLR)-induced immune responses. We studied the changes in cell number, activation status and functional behaviour of peripheral blood, myometrial (myoMC) and cord blood mononuclear cells (CBMC) with the onset of labour. We found that Treg function declines and that Treg cellular targets change with labour onset. The changes in Treg function were associated with increased activation of myoMC, assessed by their expression of major histocompatibility complex (MHC) class II molecules and CBMC inflammatory cells. The innate immune system showed increased activation, as shown by altered monocyte and neutrophil cell phenotypes, possibly to be ready to respond to microbial invasion after birth or to contribute to tissue remodelling. Our results highlight changes in the function of the adaptive and innate immune systems that may have important roles in the onset of human labour.
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Affiliation(s)
- N M Shah
- Department of Surgery and Cancer, Imperial College London, Chelsea and Westminster Hospital, London, UK
| | - L F Edey
- Department of Surgery and Cancer, Imperial College London, Chelsea and Westminster Hospital, London, UK
| | - N Imami
- Department of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK
| | - M R Johnson
- Department of Surgery and Cancer, Imperial College London, Chelsea and Westminster Hospital, London, UK
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15
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Natarajan G, Perriotte-Olson C, Casey CA, Donohue TM, Talmon GA, Harris EN, Kabanov AV, Saraswathi V. Effect of nanoformulated copper/zinc superoxide dismutase on chronic ethanol-induced alterations in liver and adipose tissue. Alcohol 2019; 79:71-79. [PMID: 30611703 DOI: 10.1016/j.alcohol.2018.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/22/2018] [Accepted: 12/28/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND We previously reported that nanoformulated copper/zinc superoxide dismutase (Nano) attenuates non-alcoholic fatty liver disease and adipose tissue (AT) inflammation in obese animals. Here, we sought to determine whether Nano treatment attenuates alcohol-associated liver disease (AALD) and AT inflammation in alcohol-fed mice. METHODS We pre-treated E-47 cells (HepG2 cells that over-express CYP2E1) with native- or nano-superoxide dismutase (SOD) for 6 h, followed by treatment with ethanol and/or linoleic acid (LA), a free fatty acid. For in vivo studies, male C57BL/6 mice were fed the Lieber-DeCarli control or ethanol liquid diet for 4 weeks. The mice received Nano once every 2 days during the last 2 weeks of ethanol feeding. RESULTS Our in vitro studies revealed that Nano pretreatment reduced LA + ethanol-induced oxidative stress in E-47 cells. Our in vivo experiments showed that ethanol-fed Nano-treated mice had 22% lower hepatic triglyceride levels than mice fed ethanol alone. Nano-treated ethanol-fed mice also had 2-fold lower levels of Cd68 and similarly reduced levels of Ccl2 and Mmp12 mRNAs, than in untreated ethanol-fed mice. We also noted that ethanol feeding caused a remarkable increase in hepatic and/or plasma MCP-1 and CCR2 protein, which was blunted in ethanol + Nano-treated animals. The hepatic content of SREBP-1c, a transcription factor that promotes lipogenesis, was higher in ethanol-fed mice than controls but was attenuated in ethanol + Nano-treated animals. Further, livers of ethanol + Nano-treated mice had significantly higher levels of phosphorylated adenosine monophosphate-activated protein kinase (AMPK) than both control and ethanol-fed mice. In AT, the levels of Il6 mRNA, a hepatoprotective cytokine, and that of Arg1, a marker of anti-inflammatory macrophages, were significantly increased in ethanol + Nano-treated mice compared with control mice. CONCLUSION Our data indicate that Nano treatment attenuates ethanol-induced steatohepatitis and that this effect is associated with an apparent activation of AMPK signaling. Our data also suggest that Nano induces Arg1 and Il6 expression in AT, suggesting anti-inflammatory effects in this tissue.
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Affiliation(s)
- Gopalakrishnan Natarajan
- Department of Internal Medicine, Divisions of Diabetes, Endocrinology, and Metabolism, University of Nebraska Medical Center, Omaha, NE, United States
| | - Curtis Perriotte-Olson
- Department of Internal Medicine, Divisions of Diabetes, Endocrinology, and Metabolism, University of Nebraska Medical Center, Omaha, NE, United States
| | - Carol A Casey
- Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE, United States; VA Nebraska-Western Iowa Health Care System, Omaha, NE, United States
| | - Terrence M Donohue
- Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE, United States; VA Nebraska-Western Iowa Health Care System, Omaha, NE, United States
| | - Geoffrey A Talmon
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Edward N Harris
- Department of Biochemistry, University of Nebraska at Lincoln, Lincoln, NE, United States
| | - Alexander V Kabanov
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Viswanathan Saraswathi
- Department of Internal Medicine, Divisions of Diabetes, Endocrinology, and Metabolism, University of Nebraska Medical Center, Omaha, NE, United States; VA Nebraska-Western Iowa Health Care System, Omaha, NE, United States.
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16
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Nziza N, Duroux-Richard I, Apparailly F. MicroRNAs in juvenile idiopathic arthritis: Can we learn more about pathophysiological mechanisms? Autoimmun Rev 2019; 18:796-804. [DOI: 10.1016/j.autrev.2019.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/03/2019] [Indexed: 01/05/2023]
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17
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Bhattacharya S, Yadav A, Aggarwal A. Evidence for M2 macrophage activation in patients with enthesitis-related arthritis category of juvenile idiopathic arthritis. Clin Rheumatol 2019; 38:1715-1719. [PMID: 30734215 DOI: 10.1007/s10067-018-04408-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 11/28/2022]
Abstract
Recently, an increase in CD163+ macrophages in ileal biopsies from ankylosing spondylitis patients and an increase in intermediate monocytes in enthesitis-related arthritis (ERA) have been reported. Thus, we studied sCD163 levels as M2 macrophage marker in serum and synovial fluid (SF) of ERA children and CD163 expression on monocyte subsets. Serum samples from ERA patients and healthy controls (HC) were assayed for sCD163 (ELISA). Serum and SF from ERA patients were analyzed when available from same patient (paired samples). In 10 patients, the CD163 expression level was analyzed on monocyte subsets by flow cytometry. Results are expressed as median (interquartile range (IQR)). Sera from 85 patients, SF from 32 ERA patients, and serum from 46 HC were analyzed. The average age at inclusion was 16 ± 3.24 years and age at onset was 11.2 ± 2.79 years. Seventy-nine of them were boys and HLA-B27 was positive in 64/80 patients. The median serum sCD163 levels were higher in patients [1080 (1305.2) ng/ml] than HC [780 (812.5) ng/ml; p < 0.001]. The SF levels [9000 (1250) ng/ml] were much higher than serum [3800 (3287.66) ng/ml; p < 0.001]. Disease activity data was available in 56 patients. Mean tender joint count was 2 (3), swollen joint count was 2 (2), ESR was 70 (65) mm and CRP was 7.1 (8.9) mg/dl. Serum sCD163 levels correlated with SF but not with disease activity. Intermediate monocytes (CD14+CD16+) from ERA patients had higher CD163 expression than HC. Elevated sCD163 levels in ERA patient's sera and even higher levels in paired SF suggest towards activation of alternatively activated macrophages in ERA. Lack of correlation with activity may suggest that they have an immune-regulatory role in ERA.
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Affiliation(s)
- Shruti Bhattacharya
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India
| | - Akhilesh Yadav
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India
| | - Amita Aggarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
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18
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Gómez-Aristizábal A, Gandhi R, Mahomed NN, Marshall KW, Viswanathan S. Synovial fluid monocyte/macrophage subsets and their correlation to patient-reported outcomes in osteoarthritic patients: a cohort study. Arthritis Res Ther 2019; 21:26. [PMID: 30658702 PMCID: PMC6339358 DOI: 10.1186/s13075-018-1798-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 12/17/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Chronic, low-grade inflammation of the synovium (synovitis) is a hallmark of osteoarthritis (OA), thus understanding of OA immunobiology, mediated by immune effectors, is of importance. Specifically, monocytes/macrophages (MΦs) are known to be abundantly present in OA joints and involved in OA progression. However, different subsets of OA MΦs have not been investigated in detail, especially in terms of their relationship with patient-reported outcome measures (PROMs). We hypothesized that levels of synovial fluid (SF) MΦ subsets are indicative of joint function and quality of life in patients with OA, and can therefore serve as biomarkers and therapeutic targets for OA. METHODS In this cohort study, synovial fluid leukocytes (SFLs, N = 86) and peripheral blood mononuclear cells (n = 53) from patients with knee OA were characterized. Soluble MΦ receptors and chemokine (sCD14, sCD163, CCL2, CX3CL1) levels were detected in SF using immunoassays. Linear models, adjusted for sex, age and body mass index, were used to determine associations between SF MΦs and soluble factors with PROMs (N = 83). Pearson correlation was calculated to determine correlation between MΦ subsets, T cells and soluble factors. RESULTS SF MΦs were the most abundant SFLs. Within these, the double-positive CD14+CD16+-MΦ subset is enriched in knee OA SF compared to the circulation. Importantly, MΦ subset ratios correlated with PROMs, specially stiffness, function and quality of life. Interestingly, the SF CD14+CD16+-MΦ subset ratio correlated with SF chemokine (C-C motif) ligand 2 (CCL2) levels but not with levels of sCD163 or sCD14; we found no association between PROMs and either SF CCL2, sCD163, sCD14 or CX3CL1 (which was below detection levels). All SF MΦs displayed high levels of HLA-DR, suggesting an activated phenotype. Correlation between OA SF MΦ subsets and activated CD4+ T cell subsets suggests modulation of CD4+ T cell activation by MΦs. CONCLUSION SF MΦ subsets are associated with knee OA PROMs and display an activated phenotype, which may lead to modulation of CD4+ T cell activation. Knee OA SF MΦ subsets could serve as knee OA function biomarkers and as targets of novel therapeutics.
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Affiliation(s)
- Alejandro Gómez-Aristizábal
- Arthritis Program, University Health Network, Toronto, ON Canada
- Krembil Research Institute, University Health Network, Toronto, ON Canada
- Cell Therapy Program, University Health Network, Toronto, ON Canada
| | - Rajiv Gandhi
- Arthritis Program, University Health Network, Toronto, ON Canada
- Krembil Research Institute, University Health Network, Toronto, ON Canada
- Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, ON Canada
| | - Nizar N. Mahomed
- Arthritis Program, University Health Network, Toronto, ON Canada
- Krembil Research Institute, University Health Network, Toronto, ON Canada
- Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, ON Canada
| | - K. Wayne Marshall
- Arthritis Program, University Health Network, Toronto, ON Canada
- Krembil Research Institute, University Health Network, Toronto, ON Canada
- Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, ON Canada
| | - Sowmya Viswanathan
- Arthritis Program, University Health Network, Toronto, ON Canada
- Krembil Research Institute, University Health Network, Toronto, ON Canada
- Cell Therapy Program, University Health Network, Toronto, ON Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON Canada
- Division of Hematology, Department of Medicine, University of Toronto, Toronto, ON Canada
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19
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Mattos RT, Medeiros NI, Menezes CA, Fares RCG, Franco EP, Dutra WO, Rios-Santos F, Correa-Oliveira R, Gomes JAS. Chronic Low-Grade Inflammation in Childhood Obesity Is Associated with Decreased IL-10 Expression by Monocyte Subsets. PLoS One 2016; 11:e0168610. [PMID: 27977792 PMCID: PMC5158089 DOI: 10.1371/journal.pone.0168610] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/03/2016] [Indexed: 12/19/2022] Open
Abstract
Chronic low-grade inflammation is related to the development of comorbidities and poor prognosis in obesity. Monocytes are main sources of cytokines and play a pivotal role in inflammation. We evaluated monocyte frequency, phenotype and cytokine profile of monocyte subsets, to determine their association with the pathogenesis of childhood obesity. Children with obesity were evaluated for biochemical and anthropometric parameters. Monocyte subsets were characterized by flow cytometry, considering cytokine production and activation/recognition molecules. Correlation analysis between clinical parameters and immunological data delineated the monocytes contribution for low-grade inflammation. We observed a higher frequency of non-classical monocytes in the childhood obesity group (CO) than normal-weight group (NW). All subsets displayed higher TLR4 expression in CO, but their recognition and antigen presentation functions seem to be diminished due to lower expression of CD40, CD80/86 and HLA-DR. All subsets showed a lower expression of IL-10 in CO and correlation analyses showed changes in IL-10 expression profile. The lower expression of IL-10 may be decisive for the maintenance of the low-grade inflammation status in CO, especially for alterations in non-classical monocytes profile. These cells may contribute to supporting inflammation and loss of regulation in the immune response of children with obesity.
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Affiliation(s)
- Rafael T. Mattos
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Nayara I. Medeiros
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
- Laboratório de Imunologia Celular e Molecular, Centro de Pesquisa René Rachou, FIOCRUZ, Belo Horizonte, MG, Brasil
| | - Carlos A. Menezes
- Departamento de Genética, Universidade Estadual de Santa Cruz, Ilhéus, BA, Brasil
- Serviço de Medicina Preventiva da Unimed, Aracaju, SE, Brasil
| | - Rafaelle C. G. Fares
- Laboratório de Imunologia Celular e Molecular, Centro de Pesquisa René Rachou, FIOCRUZ, Belo Horizonte, MG, Brasil
| | - Eliza P. Franco
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Walderez O. Dutra
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
- Instituto Nacional de Ciência e Tecnologia em Doenças Topicais—INCT-DT
| | - Fabrício Rios-Santos
- Faculdade de Medicina, Departamento de Ciências Básicas da Saúde, Universidade Federal de Mato Grasso, Cuiabá, MT, Brasil
| | - Rodrigo Correa-Oliveira
- Laboratório de Imunologia Celular e Molecular, Centro de Pesquisa René Rachou, FIOCRUZ, Belo Horizonte, MG, Brasil
- Instituto Nacional de Ciência e Tecnologia em Doenças Topicais—INCT-DT
| | - Juliana A. S. Gomes
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
- * E-mail:
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