Dissociation of autoaggression and self-superantigen reactivity

The role of atorvastatin in regulating the immune response leading to vascular damage in a model of Kawasaki disease

Superantigens have been implicated in a number of diseases including Kawasaki disease (KD), a multi-system vasculitis resulting in coronary artery aneurysms. We have characterized a murine disease model in which coronary arteritis is induced by a novel superantigen found in Lactobacillus casei cell wall extract (LCWE). Using this animal model of KD, we have identified three pathogenic steps leading to coronary artery aneurysm formation. These steps include T cell activation and proliferation, production of the proinflammatory cytokine tumour necrosis factor (TNF)-α and up-regulation of matrix metalloproteinase 9 (MMP-9), an elastolytic protease. In addition to their cholesterol-lowering effects, 3-hydroxy-3-methylglutaryl (HMG) coenzyme A (CoA) reductase inhibitors (statins) have pleotropic immunomodulatory properties. Thus, we examined the effect of atorvastatin in modulating each of these three critical pathogenic processes leading to aneurysm formation in the disease model. Atorvastatin inhibited lymphocyte proliferation in response to superantigen stimulation in a dose-dependent manner. This inhibition was also observed for production of soluble mediators of inflammation including interleukin (IL)-2 and TNF-α. The inhibitory effect on proliferation was rescued completely by mevalonic acid, confirming that the mechanism responsible for this inhibitory activity on immune activation was inhibition of HMG-CoA reductase. Similarly, TNF-α-induced MMP-9 production was reduced in a dose-dependent manner in response to atorvastatin. Inhibition of extracellular-regulated kinase (ERK) phosphorylation appears to be the mechanism responsible for inhibition of MMP-9 production. In conclusion, atorvastatin is able to inhibit critical steps known to be important in the development of coronary aneurysms, suggesting that statins may have therapeutic benefit in patients with KD.

Immunogenicity in peptide-immunotherapy: from self/nonself to similar/dissimilar sequences

The nature of the relationship between an antigenic amino acid sequence and its capability to evoke an immune response is still an unsolved problem. Although experiments indicate that specific (dis)continuous amino acid sequences may determine specific immune responses, how immunogenic properties and recognition informations are mapped onto a non-linear sequence is not understood. Immunology has invoked the concept of self/nonself discrimination in order to explain the capability of the organism to selectively immunoreact. However, no clear, logical and rational pathway has emerged to relate a structure and its immuno-nonreactivity. It cannot yet be dismissed what Koshland wrote in 1990: "Of all the mysteries of modern science, the mechanism of self versus nonself recognition in the immune system ranks at or near the top". This chapter reviews the concept of self/nonself discrimination in the immune system starting from the historical perspective and the conceptual framework that underlie immune reaction pattern. It also introduces future research directions based on a proteomic dissection of the immune unit, qualitatively defined as a low-similarity sequence and quantitatively delimitated by the minimum amino acid requisite able to evoke an immune response, independently ofany, microbial or viral, "foreignness".

Sjögren's syndrome: immunologic and neuroendocrine mechanisms

SS patients are characterized by decreased volume of lacrimal and salivary secretions. The dryness results from a combination of destroyed glandular elements as well as by interference with the neuro-endocrine innervation of the residual glands. Specific genetic factors (i.e. HLA class II alleles) have been associated with increased risk of SS in Caucasian (US), Chinese and Japanese populations. However, different class II MHC alleles are risk factors in each population. The environmental factors that precipitate SS remain unknown. Future understanding of the mechanisms of destruction of the salivary and lacrimal glands may provide a more rationale approach to therapy.

Do endogenous retroviruses have etiological implications in inflammatory and degenerative nervous system diseases?

Vertebrates carry large numbers of endogenous retroviruses (ERVs) and related sequences in their genomes. These retroviral elements are inherited as Mendelian traits. Generally, ERVs are defective without the ability of being expressed as viral particles. However, ERV sequences often have a potential for expression of at least some proteins. So far, the possible biological significance of ERVs is not clear. Nonetheless, there are observations suggesting a connection between ERVs and various diseases. This is the case with murine lupus and a spinal cord disease of certain mouse strains. In the present review, we discuss possible mechanisms by which ERVs could contribute to the development of human degenerative and inflammatory nervous system diseases, including direct effects on nervous system cells and immune cells. Interactions between ERVs and infectious viruses are also discussed. Finally, we review a possible retroviral etiology of multiple sclerosis.