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Chen S, Qian H, Dai F, Fan G, Lu H, Deng C, Shi Y, He Y, Zhang X, Shi G, Liu Y. Detection of anti-calreticulin antibody in the sera of Chinese patients with primary Sjögren syndrome. Semin Arthritis Rheum 2024; 68:152488. [PMID: 38896912 DOI: 10.1016/j.semarthrit.2024.152488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Primary Sjögren syndrome (pSjS) is one of the most prevalent systemic autoimmune diseases and characterized with hyperactivation of B cell and the abundant presence of autoantibodies in sera. The salivary gland epithelial cells (SGECs) release autoantigens to evoke autoimmunity through releasing elevated apoptosis or secreting autoantigen-containing exosomes, thus identifying autoantibodies directly to SGECs might provide insights into disease related biomarkers as well as further elucidating pathogenesis mechanisms. The present study was undertaken to identify autoantibodies to SGECs and to evaluate its clinical values in Chinese pSjS. METHODS Cell-based indirect immunofluorescence and immunostaining, two-dimensional electrophoresis and liquid chromatograph-tandem mass spectrometry were conducted to identify the autoantibodies to human salivary gland cell line A253 in pSjS sera. Enzyme-linked immunosorbent assay (ELISA) was applied to identify autoantibody titer in pSjS cohort and healthy controls. The prevalence and clinical significance of the identified autoantibodies was further assessed in pSjS population. RESULTS Anti-calreticulin (CALR) antibody was identified as a new autoantibody directly to SGECs in sera from pSjS patients. Anti-CALR antibody were detected in 37 of 120 pSjS patients (30.83 %) and 1 of 54 healthy controls (1.85 %). It was found in 40.85 % pSjS with anti-SSA positive, 53.85 % with anti-SSB positive, and 14.7 % in sero-negative pSjS. Anti-CALR antibody was associated with clinical manifestations including weight loss(p = 0.045), vasculitis (p = 0.031), and laboratory parameters including erythrocyte sedimentation rate (ESR) (r = 0.056, p = 0.021), Krebs von den Lungen-6 (KL-6) (r = 0.121, p = 0.035), IgG (r = 0.097, p < 0.001), IgG2 (r = 0.142, p = 0.022), IgG3 (r = 0.287, p < 0.001), fibrinogen (r = 0.084, p = 0.016), D-Dimer (r = 0.086, p = 0.012) and fibrinogen degradation production (r = 0.150, p = 0.002). The expression of CALR in salivary glands was related to lymphocytes infiltration into salivary glands in pSjS patients (r = 0.7076, p = 0.0034). CONCLUSION To our knowledge, this was the first study to investigate the prevalence and clinical significance of anti-CALR antibody in Chinses pSjS patients. The present study identified an autoimmune antibody, anti-CALR antibody, as a good autoimmune biomarker for sero-negative pSjS.
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Affiliation(s)
- Shiju Chen
- Department of Rheumatology and Clinical Immunology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, XM, 361000, China; Xiamen Municipal Clinical Research Center for Immune Diseases, Xiamen, XM, 361000, China; Xiamen Key Laboratory of Rheumatology and Clinical Immunology, Xiamen, XM, 361000, China
| | - Hongyan Qian
- Department of Rheumatology and Clinical Immunology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, XM, 361000, China; Xiamen Municipal Clinical Research Center for Immune Diseases, Xiamen, XM, 361000, China; Xiamen Key Laboratory of Rheumatology and Clinical Immunology, Xiamen, XM, 361000, China
| | - Fan Dai
- School of Medicine, Xiamen University, Xiamen, XM, 361000, China
| | - Guihua Fan
- School of Medicine, Xiamen University, Xiamen, XM, 361000, China
| | - Huiqin Lu
- School of Medicine, Xiamen University, Xiamen, XM, 361000, China
| | - Chaoqiong Deng
- School of Medicine, Xiamen University, Xiamen, XM, 361000, China
| | - Yingying Shi
- School of Medicine, Xiamen University, Xiamen, XM, 361000, China
| | - Yan He
- Department of Rheumatology and Clinical Immunology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, XM, 361000, China; Xiamen Municipal Clinical Research Center for Immune Diseases, Xiamen, XM, 361000, China; Xiamen Key Laboratory of Rheumatology and Clinical Immunology, Xiamen, XM, 361000, China
| | - Xinwei Zhang
- Department of Rheumatology and Clinical Immunology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, XM, 361000, China; Xiamen Municipal Clinical Research Center for Immune Diseases, Xiamen, XM, 361000, China; Xiamen Key Laboratory of Rheumatology and Clinical Immunology, Xiamen, XM, 361000, China
| | - Guixiu Shi
- Department of Rheumatology and Clinical Immunology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, XM, 361000, China; Xiamen Municipal Clinical Research Center for Immune Diseases, Xiamen, XM, 361000, China; Xiamen Key Laboratory of Rheumatology and Clinical Immunology, Xiamen, XM, 361000, China.
| | - Yuan Liu
- Department of Rheumatology and Clinical Immunology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, XM, 361000, China; Xiamen Municipal Clinical Research Center for Immune Diseases, Xiamen, XM, 361000, China; Xiamen Key Laboratory of Rheumatology and Clinical Immunology, Xiamen, XM, 361000, China.
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Eggleton P, De Alba J, Weinreich M, Calias P, Foulkes R, Corrigall VM. The therapeutic mavericks: Potent immunomodulating chaperones capable of treating human diseases. J Cell Mol Med 2023; 27:322-339. [PMID: 36651415 PMCID: PMC9889696 DOI: 10.1111/jcmm.17669] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/16/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Two major chaperones, calreticulin (CRT) and binding immunoglobulin protein (GRP78/BiP) dependent on their location, have immunoregulatory or anti-inflammatory functions respectively. CRT induces pro-inflammatory cytokines, dendritic cell (DC) maturation and activates cytotoxic T cells against tumours. By contrast, GRP78/BiP induces anti-inflammatory cytokines, inhibits DC maturation and heightens T-regulatory cell responses. These latter functions rebalance immune homeostasis in inflammatory diseases, such as rheumatoid arthritis. Both chaperones are therapeutically relevant agents acting primarily on monocytes/DCs. Endogenous exposure of CRT on cancer cell surfaces acts as an 'eat-me' signal and facilitates improved elimination of stressed and dying tumour cells by DCs. Therefore, therapeutics that promote endogenous CRT translocation to the cell surface can improve the removal of cancer cells. However, infused recombinant CRT dampens this cancer cell eradication by binding directly to the DCs. Low levels of endogenous BiP appear as a surface biomarker of endoplasmic reticulum (ER) stress in some types of tumour cells, a reflection of cells undergoing proliferation, in which resulting hypoxia and nutrient deprivation perturb ER homeostasis triggering the unfolded protein response, leading to increased expression of GRP78/BiP and altered cellular location. Conversely, infusion of an analogue of GRP78/BiP (IRL201805) can lead to long-term immune resetting and restoration of immune homeostasis. The therapeutic potential of both chaperones relies on them being relocated from their intracellular ER environment. Ongoing clinical trials are employing therapeutic interventions to either enhance endogenous cell surface CRT or infuse IRL201805, thereby triggering several disease-relevant immune responses leading to a beneficial clinical outcome.
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Affiliation(s)
- Paul Eggleton
- Revolo BiotherapeuticsNew OrleansLouisianaUSA,University of Exeter Medical SchoolExeterUK
| | | | | | | | | | - Valerie M. Corrigall
- Revolo BiotherapeuticsNew OrleansLouisianaUSA,Centre for Inflammation Biology and Cancer Immunology, King's College London, New Hunts HouseGuy' HospitalLondonUK
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3
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Contribution of Infectious Agents to the Development of Celiac Disease. Microorganisms 2021; 9:microorganisms9030547. [PMID: 33800833 PMCID: PMC8001938 DOI: 10.3390/microorganisms9030547] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
The ingestion of wheat gliadin (alcohol-soluble proteins, an integral part of wheat gluten) and related proteins induce, in genetically predisposed individuals, celiac disease (CD), which is characterized by immune-mediated impairment of the small intestinal mucosa. The lifelong omission of gluten and related grain proteins, i.e., a gluten-free diet (GFD), is at present the only therapy for CD. Although a GFD usually reduces CD symptoms, it does not entirely restore the small intestinal mucosa to a fully healthy state. Recently, the participation of microbial components in pathogenetic mechanisms of celiac disease was suggested. The present review provides information on infectious diseases associated with CD and the putative role of infections in CD development. Moreover, the involvement of the microbiota as a factor contributing to pathological changes in the intestine is discussed. Attention is paid to the mechanisms by which microbes and their components affect mucosal immunity, including tolerance to food antigens. Modulation of microbiota composition and function and the potential beneficial effects of probiotics in celiac disease are discussed.
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Chen H, Yang H, Cheng QX, Ge YP, Peng QL, Zhang YM, Cheng GH, Wang GC, Lu X. A novel autoantibody targeting calreticulin is associated with cancer in patients with idiopathic inflammatory myopathies. Clin Transl Immunology 2020; 9:e1195. [PMID: 33082955 PMCID: PMC7558046 DOI: 10.1002/cti2.1195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/15/2020] [Accepted: 09/22/2020] [Indexed: 12/22/2022] Open
Abstract
Objectives To investigate the prevalence and clinical significance of anti‐calreticulin autoantibodies (anti‐CRT Ab) in a large cohort of idiopathic inflammatory myopathy (IIM) patients. Methods Sera from 469 patients with IIM, 196 patients with other connective tissue diseases, 28 patients with solid tumors and 81 healthy controls were screened for anti‐CRT Ab by enzyme‐linked immunosorbent assay using human recombinant CRT protein. Sera from 35 IIM patients were tested using an immunoprecipitation assay to confirm the presence of anti‐CRT Ab. Subsequently, IIM–cancer patients were identified and divided into new‐onset, remission and recurrent groups based on their cancer status. The relationships between anti‐CRT Ab levels and IIM disease activity were also investigated. Results Serum anti‐CRT Ab was detected positive in 81 of the 469 (17.3%) IIM patients. Immunoprecipitated bands were observed at a molecular weight of 60 kDa corresponding to the CRT protein. The IIM patients with anti‐CRT Ab more frequently had cancers compared to the patients without anti‐CRT Ab. Moreover, the prevalence of anti‐CRT Ab differed according to the cancer status. The IIM patients with recurrent cancers had a much higher prevalence of anti‐CRT Ab than those with cancers in remission. Also, serum anti‐CRT Ab levels positively correlated with disease activity at baseline and at follow‐up visits. Conclusion We report the existence of serum anti‐CRT Ab in IIM patients and demonstrate the possible association of anti‐CRT Ab with malignancy in IIM patients. Serum anti‐CRT Ab could serve as a novel candidate marker of cancer in IIM patients.
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Affiliation(s)
- He Chen
- Department of Rheumatology China-Japan Friendship Hospital Beijing 100029 China
| | - Heng Yang
- Center for Systems Medicine Institute of Basic Medical Sciences Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100005 China.,Suzhou Institute of Systems Medicine Suzhou Jiangsu 215123 China
| | - Qiu-Xiang Cheng
- Center for Systems Medicine Institute of Basic Medical Sciences Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100005 China.,Suzhou Institute of Systems Medicine Suzhou Jiangsu 215123 China
| | - Yong-Peng Ge
- Department of Rheumatology China-Japan Friendship Hospital Beijing 100029 China
| | - Qing-Lin Peng
- Department of Rheumatology China-Japan Friendship Hospital Beijing 100029 China
| | - Ya-Mei Zhang
- Department of Rheumatology China-Japan Friendship Hospital Beijing 100029 China
| | - Gen-Hong Cheng
- Department of Microbiology, Immunology and Molecular Genetics University of California Los Angeles CA 90095 USA
| | - Guo-Chun Wang
- Department of Rheumatology China-Japan Friendship Hospital Beijing 100029 China
| | - Xin Lu
- Department of Rheumatology China-Japan Friendship Hospital Beijing 100029 China
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Pan J, Yu L, Wu Q, Lin X, Liu S, Hu S, Rosa C, Eichinger D, Pino I, Zhu H, Qian J, Huang Y. Integration of IgA and IgG Autoantigens Improves Performance of Biomarker Panels for Early Diagnosis of Lung Cancer. Mol Cell Proteomics 2020; 19:490-500. [PMID: 31924693 PMCID: PMC7050113 DOI: 10.1074/mcp.ra119.001905] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Indexed: 01/01/2023] Open
Abstract
Lung cancer (LC) remains the leading cause of mortality from malignant tumors worldwide. In our previous study, we surveyed both IgG and IgM-bound serological biomarkers and validated a panel of IgG-bound autoantigens for early LC diagnosis with 50% sensitivity at 90% specificity. To further improve the performance of these serological biomarkers, we surveyed HuProt arrays, comprised of 20,240 human proteins, for IgA-bound autoantigens because IgAs are a major immunoglobulin isotype in the lung. Integrating with IgG-bound autoantigens, we discovered and validated a combined biomarker panel using ELISA-format tests. Specifically, in Phase I, we obtained IgA-based autoimmune profiles of 69 early stage LC patients, 30 healthy subjects and 25 patients with lung benign lesions (LBL) on HuProt arrays and identified 28 proteins as candidate autoantigens that were significantly associated with early stage LC. In Phase II, we re-purified the autoantigens and converted them into an ELISA-format testing to profile an additional large cohort, comprised of 136 early stage LC patients, 58 healthy individuals, and 29 LBL patients. Integration of IgG autoimmune profiles allowed us to identify and validate a biomarker panel of three IgA autoantigens (i.e. BCL7A, and TRIM33 and MTERF4) and three IgG autoantigens (i.e. CTAG1A, DDX4 and MAGEC2) for diagnosis of early stage LC with 73.5% sensitivity at >85% specificity. In Phase III, the performance of this biomarker panel was confirmed with an independent cohort, comprised of 88 early stage LC patients, 18 LBL patients, and 36 healthy subjects. Finally, a blind test on 178 serum samples was conducted to confirm the performance of the biomarker panel. In summary, this study demonstrates for the first time that an integrated panel of IgA/IgG autoantigens can serve as valuable biomarkers to further improve the performance of early diagnosis of LC.
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Affiliation(s)
- Jianbo Pan
- Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland 21205
| | - Lili Yu
- Provincial Clinical College, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou 350001, Fujian, China
| | - Qingwei Wu
- Provincial Clinical College, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou 350001, Fujian, China
| | - Xiaoqing Lin
- Provincial Clinical College, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou 350001, Fujian, China
| | - Shuang Liu
- Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland 21205
| | - Shaohui Hu
- CDI Laboratories, Inc., Mayagüez, PR 00681
| | | | | | | | - Heng Zhu
- Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland 21205; The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD 21205
| | - Jiang Qian
- Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland 21205; The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD 21205
| | - Yi Huang
- Provincial Clinical College, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou 350001, Fujian, China; Center for Experimental Research in Clinical Medicine, Fujian Provincial Hospital, Fuzhou 350001, Fujian, China.
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Clarke A, Perry E, Kelly C, De Soyza A, Heesom K, Gold LI, Ollier W, Hutchinson D, Eggleton P. Heightened autoantibody immune response to citrullinated calreticulin in bronchiectasis: Implications for rheumatoid arthritis. Int J Biochem Cell Biol 2017; 89:199-206. [PMID: 28652209 DOI: 10.1016/j.biocel.2017.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 06/15/2017] [Accepted: 06/22/2017] [Indexed: 01/08/2023]
Abstract
Calreticulin (CRT) and citrullinated (citCRT) are implicated in rheumatoid arthritis (RA) pathology. citCRT binds to RA shared epitopes (SE) on HLA-DR molecules with high affinity and triggers pro-inflammatory events in adjacent cells. The aim of the study was to detect the presence of citCRT prior to developing RA and evaluate if citCT is a target for autoantibodies in RA cohorts with and without lung disease. Antibodies were assessed by ELISA against native CRT, citCRT and general protein citrullination, in sera from 50 RA patients without lung disease, 122 bronchiectasis (BR) patients, 52 bronchiectasis patients with RA (BRRA), 87 asthma patients and 77 healthy controls (HC). Serum citCRT was detected by immunoblotting and mass spectrometry. Genomic DNA was genotyped for HLA-DRB1 alleles. Patients were assessed for DAS28, rheumatoid factor, and anti-cyclic citrullinated peptide antibodies. Extracellular citCRT was detected in BR patients sera prior to them developing RA. A citCRT SE binding peptide GEWKPR261citQIDNPDYK was identified. Anti-CRT antibodies were observed in 18% of BR patients with or without RA. Anti-citCRT antibodies were observed in ∼35% of BR or RA patients, increasing to 58% in BRRA patients. In the RA alone patients 7/20 (35%) who were negative for RF and anti-CCP were anti-CRT antibody positive and had higher DAS28 scores than triple negative RA alone patients. Three of the four BR patients who developed RA over 18 months were anti-citCRT+ve SE+ve. The detection of citCRT in BR and development of anti-citCRT in BR patients suggests citCRT antigens are early targets of antigenicity in these patients, especially in SE+ve patients prior to the onset of RA.
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Affiliation(s)
- Alex Clarke
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Elizabeth Perry
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK; Rheumatology Department,Musgrove Park Hospital, Taunton, Somerset, UK
| | - Clive Kelly
- Rheumatology Department, Queen Elizabeth Hospital, Gateshead, UK
| | - Anthony De Soyza
- Institute for Cellular Medicine, Newcastle University & Sir William Leech Centre, Adult Bronchiectasis Service, The Freeman Hospital, Newcastle, UK
| | - Kate Heesom
- Proteomics Facility, University of Bristol, Bristol BS8 1TD, UK
| | - Leslie I Gold
- Division of Translational Medicine, New York University School of Medicine, New York, United States
| | - William Ollier
- Centre for Integrated Genomic Medical Research, The University of Manchester, Manchester, UK
| | - David Hutchinson
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK; Rheumatology Department, Royal Cornwall Hospital, Truro, UK
| | - P Eggleton
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK.
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Sánchez D, Gregor P, Čurila K, Hoffmanová I, Hábová V, Tučková L, Tlaskalová-Hogenová H. Anti-calreticulin antibodies and calreticulin in sera of patients diagnosed with dilated or hypertrophic cardiomyopathy. Autoimmunity 2016; 49:554-562. [PMID: 27689957 DOI: 10.1080/08916934.2016.1214822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Distinct cellular level of the Ca2+-binding chaperone calreticulin (CRT) is essential for correct embryonal cardiac development and postnatal function. However, CRT is also a potential autoantigen eliciting formation of antibodies (Ab), whose role is not yet clarified. Immunization with CRT leads to cardiac injury, while overexpression of CRT in cardiomyocytes induces dilated cardiomyopathy (DCM) in animals. Hence, we analysed levels of anti-CRT Ab and calreticulin in the sera of patients with idiopatic DCM and hypertrophic cardiomyopathy (HCM). ELISA and immunoblot using human recombinant CRT and Pepscan with synthetic, overlapping decapeptides of CRT were used to detect anti-CRT Ab. Serum CRT concentration was tested by ELISA. Significantly increased levels of anti-CRT Ab of isotypes IgA (p < 0.001) and IgG (p < 0.05) were found in patients with both DCM (12/34 seropositive for IgA, 7/34 for IgG) and HCM (13/38 seropositive for IgA, 11/38 for IgG) against healthy controls (2/79 for IgA, 1/79 for IgG). Titration analysis in seropositive DCM and HCM patients documented anti-CRT Ab detected at 1/1600 dilution for IgG and 1/800 for IgA (and IgA1) and at least at 1/200 dilution for IgA2, IgG1, IgG2 and IgG3. Pepscan identified immunogenic CRT epitopes recognized by IgA and IgG Ab of these patients. Significantly increased levels of CRT relative to healthy controls were found in sera of patients with HCM (p < 0.01, 5/19). These data extend the knowledge of seroprevalence of anti-CRT Ab and CRT, and suggest possible involvement of autoimmune mechanisms directed to CRT in some forms of cardiomyopathies, which are clinically heterogeneous.
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Affiliation(s)
- Daniel Sánchez
- a Laboratory of Cellular and Molecular Immunology , Institute of Microbiology v.v.i, Czech Academy of Sciences , Prague , Czech Republic
| | - Pavel Gregor
- b Cardiocenter, Department of Cardiology, Third Faculty of Medicine, Charles University in Prague and University Hospital Královské Vinohrady , Prague , Czech Republic , and
| | - Karol Čurila
- b Cardiocenter, Department of Cardiology, Third Faculty of Medicine, Charles University in Prague and University Hospital Královské Vinohrady , Prague , Czech Republic , and
| | - Iva Hoffmanová
- c Second Department of Internal Medicine, Third Faculty of Medicine, Charles University in Prague and University Hospital Královské Vinohrady , Prague , Czech Republic
| | - Věra Hábová
- a Laboratory of Cellular and Molecular Immunology , Institute of Microbiology v.v.i, Czech Academy of Sciences , Prague , Czech Republic
| | - Ludmila Tučková
- a Laboratory of Cellular and Molecular Immunology , Institute of Microbiology v.v.i, Czech Academy of Sciences , Prague , Czech Republic
| | - Helena Tlaskalová-Hogenová
- a Laboratory of Cellular and Molecular Immunology , Institute of Microbiology v.v.i, Czech Academy of Sciences , Prague , Czech Republic
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Woodward J. Improving outcomes of refractory celiac disease - current and emerging treatment strategies. Clin Exp Gastroenterol 2016; 9:225-36. [PMID: 27536154 PMCID: PMC4976763 DOI: 10.2147/ceg.s87200] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Intestinal inflammation and symptoms of celiac disease (CD) usually respond well to gluten withdrawal, but rare cases are refractory to diet. Two types of refractory CD are discriminated on the basis of the presence or absence of an atypical population of mucosal lymphocytes that may progress to enteropathy-associated T-cell lymphoma. Challenges remain in the secure diagnosis of both types of refractory disease, and evidence on which to base treatment recommendations is flawed by the small numbers of reported patients and the use of different diagnostic strategies. Recent advances in our understanding of the mechanisms of the condition in conjunction with the development of immunomodulatory agents for managing other inflammatory diseases are helping to shape future approaches to targeted therapy. Progression will depend on collaboration and recruitment to trials. In the meantime, there is evidence to suggest that earlier diagnosis and better follow-up and management of CD may prevent the development of refractoriness.
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Affiliation(s)
- Jeremy Woodward
- Department of Gastroenterology and Clinical Nutrition, Addenbrooke’s Hospital, Cambridge, UK
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Wiersma VR, Michalak M, Abdullah TM, Bremer E, Eggleton P. Mechanisms of Translocation of ER Chaperones to the Cell Surface and Immunomodulatory Roles in Cancer and Autoimmunity. Front Oncol 2015; 5:7. [PMID: 25688334 PMCID: PMC4310273 DOI: 10.3389/fonc.2015.00007] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/10/2015] [Indexed: 01/12/2023] Open
Abstract
Endoplasmic reticulum (ER) chaperones (e.g., calreticulin, heat shock proteins, and isomerases) perform a multitude of functions within the ER. However, many of these chaperones can translocate to the cytosol and eventually the surface of cells, particularly during ER stress induced by e.g., drugs, UV irradiation, and microbial stimuli. Once on the cell surface or in the extracellular space, the ER chaperones can take on immunogenic characteristics, as mostly described in the context of cancer, appearing as damage-associated molecular patterns recognized by the immune system. How ER chaperones relocate to the cell surface and interact with other intracellular proteins appears to influence whether a tumor cell is targeted for cell death. The relocation of ER proteins to the cell surface can be exploited to target cancer cells for elimination by immune mechanism. Here we evaluate the evidence for the different mechanisms of ER protein translocation and binding to the cell surface and how ER protein translocation can act as a signal for cancer cells to undergo killing by immunogenic cell death and other cell death pathways. The release of chaperones can also exacerbate underlying autoimmune conditions, such as rheumatoid arthritis and multiple sclerosis, and the immunomodulatory role of extracellular chaperones as potential cancer immunotherapies requires cautious monitoring, particularly in cancer patients with underlying autoimmune disease.
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Affiliation(s)
- Valerie R. Wiersma
- Department of Surgery, Translational Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marek Michalak
- University of Exeter Medical School, Exeter Devon, UK
- Department of Biochemistry, University of Alberta, Edmonton, AB, Canada
| | | | - Edwin Bremer
- Department of Surgery, Translational Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- University of Exeter Medical School, Exeter Devon, UK
| | - Paul Eggleton
- University of Exeter Medical School, Exeter Devon, UK
- Department of Biochemistry, University of Alberta, Edmonton, AB, Canada
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Samasca G, Lupan I, Deleanu D, Cristea V, Makovicky P. Immunological approach of the challenges of the XXI century in celiac disease. Int Rev Immunol 2013; 33:3-8. [PMID: 23768156 DOI: 10.3109/08830185.2013.797414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Gabriel Samasca
- 1Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Contribution of humoral immune responses to the antitumor effects mediated by anthracyclines. Cell Death Differ 2013; 21:50-8. [PMID: 23744294 DOI: 10.1038/cdd.2013.60] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/24/2013] [Accepted: 04/26/2013] [Indexed: 12/29/2022] Open
Abstract
Immunogenic cell death induced by cytotoxic compounds contributes to the success of selected chemotherapies by eliciting a protective anticancer immune response, which is mediated by CD4(+) and CD8(+) T cells producing interferon-γ. In many instances, cancer progression is associated with high titers of tumor-specific antibodies, which become detectable in the serum, but whose functional relevance is elusive. Here, we explored the role of humoral immune responses in the anticancer efficacy of anthracyclines. Chemotherapy reduced the number of tumor-infiltrating B cells, and failed to promote humoral responses against immunodominant tumor antigens. Although anthracycline-based anticancer chemotherapies failed in T cell-deficient mice, they successfully reduced the growth of cancers developing in mice lacking B lymphocytes (due to the injection of a B-cell-depleting anti-CD20 antibody), immunoglobulins (Igs) or Ig receptors (Fc receptor) due to genetic manipulations. These results suggest that the humoral arm of antitumor immunity is dispensable for the immune-dependent therapeutic effect of anthracyclines against mouse sarcoma. In addition, we show here that the titers of IgA and IgG antibodies directed against an autoantigen appearing at the cell surface of tumor cells post chemotherapy (calreticulin, CRT) did not significantly increase in patients treated with anthracyclines, and that anti-CRT antibodies had no prognostic or predictive significance. Collectively, our data indicate that humoral anticancer immune responses differ from cellular responses in, thus far, that they do not contribute to the success of anthracycline-mediated anticancer therapies in human breast cancers and mouse sarcomas.
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Erić-Nikolić A, Milovanović Z, Sánchez D, Pekáriková A, Džodić R, Matić IZ, Tučková L, Jevrić M, Buta M, Rašković S, Juranić Z. Overexpression of calreticulin in malignant and benign breast tumors: relationship with humoral immunity. Oncology 2012; 82:48-55. [PMID: 22310016 DOI: 10.1159/000335267] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 11/16/2011] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Calreticulin is a multicompartmental protein which regulates many important cellular responses. The aim of this study was to elucidate whether the intensity and location of calreticulin overexpression in tumor cells are related to the elevated humoral immunity to calreticulin in patients with benign or malignant breast disease. METHODS This study involved 27 patients with benign and 58 patients with malignant breast tumors before surgical resection and 38 healthy volunteers. Cytoplasmatic or membranous calreticulin overexpression in malignant or benign cells in paraffin-embedded tissues was determined using immunohistochemistry. Levels of the serum anti-calreticulin autoantibodies were detected by ELISA. RESULTS Statistically significant differences between serum levels of IgA of anti-calreticulin antibodies in controls and patients with breast tumors, and between controls and patients with nonmalignant breast diseases were found, but no statistically significant differences were found between levels of serum IgG anti-calreticulin antibodies. Humoral immunity to calreticulin developed against cytoplasmatic and co-localized membranous calreticulin was not correlated to the intensity of its overexpression and was present even in the absence of its membranous localization. CONCLUSIONS The degree of calreticulin overexpression in lobular breast carcinoma is lower than in ductal breast carcinoma. Elevated concentrations of anti-calreticulin IgA antibodies were present more frequently in patients with metastasis in locoregional lymph nodes in comparison to anti-calreticulin IgG antibodies.
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Pekáriková A, Sánchez D, Palová-Jelínková L, Simsová M, Benes Z, Hoffmanová I, Drastich P, Janatková I, Mothes T, Tlaskalová-Hogenová H, Tucková L. Calreticulin is a B cell molecular target in some gastrointestinal malignancies. Clin Exp Immunol 2009; 160:215-22. [PMID: 20030668 DOI: 10.1111/j.1365-2249.2009.04085.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Calreticulin, upon translocation to the cell surface, plays a critical role in the recognition of tumour cells and in experimentally induced cellular anti-tumour immunity. However, less is known about anti-calreticulin antibodies and their role in malignancies. Using enzyme-linked immunosorbent assay (ELISA), we found immunoglobulin (Ig)A and/or IgG anti-calreticulin antibodies in sera of approximately 63% of patients with hepatocellular carcinoma (HCC), 57% of patients with colorectal adenocarcinoma (CRA) and 47% of patients with pancreatic adenocarcinoma (PACA), while healthy controls, patients with viral hepatitis C and with chronic pancreatitis reached only 2%, 20% and 31% seropositivity, respectively. We found significantly elevated mean levels of IgA anti-calreticulin antibodies (P < 0.001) in patients with HCC (78.7 +/- 52.3 AU, mean +/- standard deviation), PACA (66.5 +/- 30.9 AU) and CRA (61.8 +/- 25.8 AU) when compared to healthy controls (41.4 +/- 19.2 AU). Significantly elevated mean levels of IgG anti-calreticulin antibodies (P < 0.001) were detected in patients with HCC (121.9 +/- 94.2 AU), gall bladder adenocarcinoma (118.4 +/- 80.0 AU) and PACA (88.7 +/- 55.6 AU) when compared to healthy controls (56.7 +/- 22.9 AU). Pepscan analysis revealed a large number of antigenic epitopes of calreticulin recognized by both IgA and IgG antibodies of patients with HCC and PACA, indicating robust systemic immune response. Moreover, significantly elevated levels of antibodies against peptide KGEWKPRQIDNP (P < 0.001) in these patients, tested by ELISA, confirmed the distinct character of antibody reactivity against calreticulin. The high occurrence and specificity of serum anti-calreticulin autoantibodies in the majority of patients with some gastrointestinal malignancies provide the evidence for their possible clinical relevance.
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Affiliation(s)
- A Pekáriková
- Department of Immunology, Institute of Microbiology, v.v.i., Academy of Sciences of the Czech Republic, Prague, Czech Republic
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Gold LI, Eggleton P, Sweetwyne MT, Van Duyn LB, Greives MR, Naylor SM, Michalak M, Murphy-Ullrich JE. Calreticulin: non-endoplasmic reticulum functions in physiology and disease. FASEB J 2009; 24:665-83. [PMID: 19940256 DOI: 10.1096/fj.09-145482] [Citation(s) in RCA: 299] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Calreticulin (CRT), when localized to the endoplasmic reticulum (ER), has important functions in directing proper conformation of proteins and glycoproteins, as well as in homeostatic control of cytosolic and ER calcium levels. There is also steadily accumulating evidence for diverse roles for CRT localized outside the ER, including data suggesting important roles for CRT localized to the outer cell surface of a variety of cell types, in the cytosol, and in the extracellular matrix (ECM). Furthermore, the addition of exogenous CRT rescues numerous CRT-driven functions, such as adhesion, migration, phagocytosis, and immunoregulatory functions of CRT-null cells. Recent studies show that topically applied CRT has diverse and profound biological effects that enhance cutaneous wound healing in animal models. This evidence for extracellular bioactivities of CRT has provided new insights into this classically ER-resident protein, despite a lack of knowledge of how CRT exits from the ER to the cell surface or how it is released into the extracellular milieu. Nonetheless, it has become clear that CRT is a multicompartmental protein that regulates a wide array of cellular responses important in physiological and pathological processes, such as wound healing, the immune response, fibrosis, and cancer.-Gold, L. I., Eggleton, P., Sweetwyne, M. T., Van Duyn, L. B., Greives, M. R., Naylor, S.-M., Michalak, M., Murphy-Ullrich, J. E. Calreticulin: non-endoplamic reticulum functions in physiology and disease.
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Affiliation(s)
- Leslie I Gold
- Departments of Medicine and Pathology, New York, University School of Medicine, 550 First Ave., NB16S13 New York, NY 10016 USA.
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