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Cheng A, Holland SM. Anti-cytokine autoantibodies: mechanistic insights and disease associations. Nat Rev Immunol 2024; 24:161-177. [PMID: 37726402 DOI: 10.1038/s41577-023-00933-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/21/2023]
Abstract
Anti-cytokine autoantibodies (ACAAs) are increasingly recognized as modulating disease severity in infection, inflammation and autoimmunity. By reducing or augmenting cytokine signalling pathways or by altering the half-life of cytokines in the circulation, ACAAs can be either pathogenic or disease ameliorating. The origins of ACAAs remain unclear. Here, we focus on the most common ACAAs in the context of disease groups with similar characteristics. We review the emerging genetic and environmental factors that are thought to drive their production. We also describe how the profiling of ACAAs should be considered for the early diagnosis, active monitoring, treatment or sub-phenotyping of diseases. Finally, we discuss how understanding the biology of naturally occurring ACAAs can guide therapeutic strategies.
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Affiliation(s)
- Aristine Cheng
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Division of Infectious Diseases, Department of Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Steven M Holland
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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2
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Abstract
The majority of rheumatic diseases are chronic and require long-term use of disease-modifying agents to confer the best chance of controlling the disease. A significant proportion of these drugs have a risk, albeit small, of potentially serious side effects, such as neutropenia; therefore, there has been an understandable concern over the use of potentially toxic rheumatic drugs in the elderly. Factors that may contribute to this concern include age, pre-existing co-morbidities, polypharmacy, difficulty in monitoring side effects, and patient perception. The risk of using such medication needs to be balanced with their benefits in controlling chronic disease. This review discusses how rheumatic disease and anti-rheumatic medication are associated with neutropenia in an older age group. Of the rheumatic diseases, we give special focus to rheumatoid arthritis and the use of methotrexate, as well as touching on management considerations in neutropenia.
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Vincent T, Plawecki M, Goulabchand R, Guilpain P, Eliaou JF. Emerging clinical phenotypes associated with anti-cytokine autoantibodies. Autoimmun Rev 2015; 14:528-35. [PMID: 25633324 DOI: 10.1016/j.autrev.2015.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 01/21/2015] [Indexed: 01/23/2023]
Abstract
Anti-cytokine autoantibodies (AAbs) are frequent and involve a very large panel of cytokines both in healthy subjects and in patients with various pathological conditions. In healthy individuals, anti-cytokine AAbs are described as a part of the natural AAb repertoire and are thought to contribute to the fine regulation of cytokine homeostasis. In some patients, neutralizing AAbs targeting cytokines required for the immune protection against specific microbes may induce acquired immunodeficiency leading to very specific infectious phenotypes. For instance, anti-IFNγ AAbs may induce disseminated non-tuberculous mycobacterial infections; anti-IL-17 AAbs are associated with the development of chronic mucosal candidiasis, and anti-IL-6 AAbs with severe staphylococcal or streptococcal infections. In patients with autoimmune diseases, AAbs directed against pathogenic cytokines are able to influence the course of the diseases. In lupus patients, neutralizing anti-IFNα and anti-TNFα AAbs are associated with a decreased bioactivity of the corresponding cytokine and a lower disease severity. Similarly, anti-IL-1α AAbs are associated with nondestructive forms of chronic polyarthritis. More surprisingly, neutralizing anti-BAFF AAbs are observed in the serum of lupus patients with elevated IFNα signature and higher disease activity. In this review, we summarize the current literature describing the different phenotypes and the main mechanisms associated with the occurrence of anti-cytokine AAbs.
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Affiliation(s)
- Thierry Vincent
- St Eloi Hospital, Department of Immunology, Montpellier University, CHRU de Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France; The Neuroscience Institute of Montpellier, INM, INSERM UMR1051, Saint Eloi Hospital, Montpellier, France.
| | - Maëlle Plawecki
- St Eloi Hospital, Department of Immunology, Montpellier University, CHRU de Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France
| | - Radjiv Goulabchand
- St Eloi Hospital, Department of Internal Medicine, Montpellier University, CHRU de Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France
| | - Philippe Guilpain
- St Eloi Hospital, Department of Internal Medicine, Montpellier University, CHRU de Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France
| | - Jean François Eliaou
- St Eloi Hospital, Department of Immunology, Montpellier University, CHRU de Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France; INSERM U1194, Institut de Recherche en Cancérologie de Montpellier (IRCM), Université de Montpellier, Montpellier, France
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Cappellano G, Orilieri E, Woldetsadik AD, Boggio E, Soluri MF, Comi C, Sblattero D, Chiocchetti A, Dianzani U. Anti-cytokine autoantibodies in autoimmune diseases. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL IMMUNOLOGY 2012; 1:136-46. [PMID: 23885320 PMCID: PMC3714194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 10/30/2012] [Indexed: 06/02/2023]
Abstract
An overview of the current literature is showing that autoantibodies (AutoAbs) against cytokines are produced in several pathological conditions, including autoimmune diseases, but can also be detected in healthy individuals. In autoimmune diseases, these AutoAbs may also be prognostic markers, either negative (such as AutoAbs to IL-8 and IL-1α in rheumatoid arthritis) or positive (such as AutoAbs to IL-6 in systemic sclerosis and those to osteopontin in rheumatoid arthritis). They may have neutralizing activity and influence the course of the physiological and pathological immune responses. High levels of AutoAbs against cytokines may even lead to immunodeficiency, such as those to IL-17 in autoimmune polyendocrine syndrome type I or those to IFN-γ in mycobacterial infections. Their role in human therapy may be exploited not only through passive immunization but also through vaccination, which may improve the costs for long lasting treatments of autoimmune diseases. Detection and quantification of these AutoAbs can be profoundly influenced by the technique used and standardization of these methods is needed to increase the value of their analysis.
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Affiliation(s)
- Giuseppe Cappellano
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Health Sciences, “A. Avogadro” University of Eastern PiedmontNovara, Italy
| | - Elisabetta Orilieri
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Health Sciences, “A. Avogadro” University of Eastern PiedmontNovara, Italy
| | - Abiy D Woldetsadik
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Health Sciences, “A. Avogadro” University of Eastern PiedmontNovara, Italy
| | - Elena Boggio
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Health Sciences, “A. Avogadro” University of Eastern PiedmontNovara, Italy
| | - Maria F Soluri
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Health Sciences, “A. Avogadro” University of Eastern PiedmontNovara, Italy
| | - Cristoforo Comi
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Translational Medicine, “A. Avogadro” University of Eastern PiedmontNovara, Italy
| | - Daniele Sblattero
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Health Sciences, “A. Avogadro” University of Eastern PiedmontNovara, Italy
| | - Annalisa Chiocchetti
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Health Sciences, “A. Avogadro” University of Eastern PiedmontNovara, Italy
| | - Umberto Dianzani
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), “A. Avogadro” University of Eastern PiedmontNovara, Italy
- Department of Health Sciences, “A. Avogadro” University of Eastern PiedmontNovara, Italy
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de Lemos Rieper C, Galle P, Hansen MB. Characterization and potential clinical applications of autoantibodies against cytokines. Cytokine Growth Factor Rev 2009; 20:61-75. [DOI: 10.1016/j.cytogfr.2009.01.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Youssef LA, Schuyler M, Gilmartin L, Pickett G, Bard JDJ, Tarleton CA, Archibeque T, Qualls C, Wilson BS, Oliver JM. Histamine release from the basophils of control and asthmatic subjects and a comparison of gene expression between "releaser" and "nonreleaser" basophils. THE JOURNAL OF IMMUNOLOGY 2007; 178:4584-94. [PMID: 17372017 DOI: 10.4049/jimmunol.178.7.4584] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Most human blood basophils respond to FcepsilonRI cross-linking by releasing histamine and other inflammatory mediators. Basophils that do not degranulate after anti-IgE challenge, known as "nonreleaser" basophils, characteristically have no or barely detectable levels of the Syk tyrosine kinase. The true incidence of the nonreleaser phenotype, its relationship (if any) to allergic asthma, and its molecular mechanism are not well understood. In this study, we report statistical analyses of degranulation assays performed in 68 control and 61 asthmatic subjects that establish higher basal and anti-IgE-stimulated basophil degranulation among the asthmatics. Remarkably, 28% of the control group and 13% of the asthmatic group were nonreleasers for all or part of our 4-year long study and cycling between the releaser and nonreleaser phenotypes occurred at least once in blood basophils from 8 (of 8) asthmatic and 16 (of 23) control donors. Microarray analysis showed that basal gene expression was generally lower in nonreleaser than releaser basophils. In releaser cells, FcepsilonRI cross-linking up-regulated >200 genes, including genes encoding receptors (the FcepsilonRI alpha and beta subunits, the histamine 4 receptor, the chemokine (C-C motif) receptor 1), signaling proteins (Lyn), chemokines (IL-8, RANTES, MIP-1alpha, and MIP-1beta) and transcription factors (early growth response-1, early growth response-3, and AP-1). FcepsilonRI cross-linking induced fewer, and quite distinct, transcriptional responses in nonreleaser cells. We conclude that "nonreleaser" and "cycler" basophils represent a distinct and reversible natural phenotype. Although histamine is more readily released from basophils isolated from asthmatics than controls, the presence of nonreleaser basophils does not rule out the diagnosis of asthma.
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Affiliation(s)
- Lama A Youssef
- Department of Pathology, University of New Mexico Health Sciences Center, School of Medicine, 2325 Camino de Salud, NM 87131, USA
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Hellmich B, Pinals RS, Loughran TP, Sullivan KE. New clues to accrue on neutropenia in rheumatoid arthritis. Clin Immunol 2005; 117:1-5. [PMID: 16000259 DOI: 10.1016/j.clim.2005.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2005] [Accepted: 06/01/2005] [Indexed: 11/21/2022]
Affiliation(s)
- Bernhard Hellmich
- Poliklinik für Rheumatologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Germany
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Hellmich B, Merkel F, Weber M, Gross WL. [Early diagnosis of chronic systemic inflammatory disorders]. Internist (Berl) 2005; 46:421-32. [PMID: 15717185 DOI: 10.1007/s00108-005-1371-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Functionally relevant damage caused by chronic systemic inflammatory disorders of autoimmune and/or unknown origin can be reduced or sometimes avoided by early initiation of treatment. This requires a correct diagnosis which makes treatment as early as possible. Due to the often uncharacteristic symptoms at the onset of disease, early diagnosis in systemic inflammatory disorders represents a diagnostic challenge. This review outlines current standards and limitations in the early diagnosis of rheumatoid arthritis, collagen vascular diseases and primary systemic vasculitides. Recent advances especially in serology and imaging techniques have improved early diagnosis of systemic inflammatory disorders.
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