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Marchini T, Abogunloko T, Wolf D. Modulating Autoimmunity against LDL: Development of a Vaccine against Atherosclerosis. Hamostaseologie 2021; 41:447-457. [PMID: 34942658 PMCID: PMC8702296 DOI: 10.1055/a-1661-1908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AbstractAtherosclerosis is a chronic inflammatory disease of the arterial wall that leads to the build-up of occluding atherosclerotic plaques. Its clinical sequelae, myocardial infarction and stroke, represent the most frequent causes of death worldwide. Atherosclerosis is a multifactorial pathology that involves traditional risk factors and chronic low-grade inflammation in the atherosclerotic plaque and systemically. This process is accompanied by a strong autoimmune response that involves autoreactive T cells in lymph nodes and atherosclerotic plaques, as well as autoantibodies that recognize low-density lipoprotein (LDL) and its main protein component apolipoprotein B (ApoB). In the past 60 years, numerous preclinical observations have suggested that immunomodulatory vaccination with LDL, ApoB, or its peptides has the potential to specifically dampen autoimmunity, enhance tolerance to atherosclerosis-specific antigens, and protect from experimental atherosclerosis in mouse models. Here, we summarize and discuss mechanisms, challenges, and therapeutic opportunities of immunomodulatory vaccination and other strategies to enhance protective immunity in atherosclerosis.
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Affiliation(s)
- Timoteo Marchini
- Cardiology and Angiology I, University Heart Center and Medical Center – University of Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Facultad de Farmacia y Bioquímica, Instituto de Bioquímica y Medicina Molecular (IBIMOL), Universidad de Buenos Aires, CONICET, Buenos Aires, Argentina
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Germany
| | - Tijani Abogunloko
- Cardiology and Angiology I, University Heart Center and Medical Center – University of Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Germany
| | - Dennis Wolf
- Cardiology and Angiology I, University Heart Center and Medical Center – University of Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
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2
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ApoB-Specific CD4 + T Cells in Mouse and Human Atherosclerosis. Cells 2021; 10:cells10020446. [PMID: 33669769 PMCID: PMC7922692 DOI: 10.3390/cells10020446] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/11/2022] Open
Abstract
Atherosclerosis is a chronic inflammatory condition of the arterial wall that leads to the formation of vessel-occluding plaques within the subintimal space of middle-sized and larger arteries. While traditionally understood as a myeloid-driven lipid-storage disease, growing evidence suggests that the accumulation of low-density lipoprotein cholesterol (LDL-C) ignites an autoimmune response with CD4+ T-helper (TH) cells that recognize self-peptides from Apolipoprotein B (ApoB), the core protein of LDL-C. These autoreactive CD4+ T cells home to the atherosclerotic plaque, clonally expand, instruct other cells in the plaque, and induce clinical plaque instability. Recent developments in detecting antigen-specific cells at the single cell level have demonstrated that ApoB-reactive CD4+ T cells exist in humans and mice. Their phenotypes and functions deviate from classical immunological concepts of distinct and terminally differentiated TH immunity. Instead, ApoB-specific CD4+ T cells have a highly plastic phenotype, can acquire several, partially opposing and mixed transcriptional programs simultaneously, and transit from one TH subset into another over time. In this review, we highlight adaptive immune mechanisms in atherosclerosis with a focus on CD4+ T cells, introduce novel technologies to detect ApoB-specific CD4+ T cells at the single cell level, and discuss the potential impact of ApoB-driven autoimmunity in atherosclerosis.
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3
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Dong Q, Yu J, Ding Y, Ji QW, Zhu RR, Wei YZ, Xu WB, Zhong YC, Zhu ZF, Meng K, Peng YD, Sun HT, Wang Y, Pan CL, Zeng QT, Yu KW. Phosphorylcholine-Primed Dendritic Cells Aggravate the Development of Atherosclerosis in ApoE -/- Mice. Circ Rep 2021; 3:86-94. [PMID: 33693294 PMCID: PMC7939956 DOI: 10.1253/circrep.cr-20-0118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background:
Atherosclerosis is an inflammatory disease involving activation of adaptive and innate immune responses to antigens, including oxidized low-density lipoprotein (oxLDL) and phosphorylcholine (PC). Dendritic cells (DCs), which are antigen-presenting cells that activate T cells, are present in atherosclerotic lesions and are activated in immune organs. However, the mechanism by which PC promotes atherosclerosis is unclear. Methods and Results:
To evaluate whether PC promotes atherosclerosis via DCs, 2×105
DCs activated by PC-keyhole limpet hemocyanin (DCs+PC-KLH) were injected into ApoE−/−
mice and the features of the plaques and the effects of the DCs on cellular and humoral immunity against PC-KLH were determined. Mice injected with DCs+PC-KLH had significantly larger atherosclerotic lesions than controls, with increased inflammation in the lesions and plaque instability. Furthermore, DCs+PC-KLH were characterized using flow cytometry after coculture of bone marrow-derived DCs and naïve T cells. DCs+PC-KLH showed an inflammatory phenotype, with increased CD86, CD40, and major histocompatibility complex Class II molecules (MHC-II), which promoted PC-specific T helper (Th) 1 and Th17 cell differentiation in vivo and in vitro. Moreover, 2 weeks after the administration of DCs+PC-KLH to mice, these mice produced PC- and oxLDL-specific IgG2a, compared with no production in the controls. Conclusions:
These findings suggest that DCs presenting PC promote specific immunity to PC, increase lesion inflammation, and accelerate atherosclerosis, which may explain how PC promotes atherosclerosis.
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Affiliation(s)
- Qian Dong
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Jian Yu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Yan Ding
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Qing-Wei Ji
- Department of Cardiology, the People's Hospital of Guangxi Zhuang Autonomous Region Nanning China
| | - Rui-Rui Zhu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Yu-Zhen Wei
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University Zhengzhou China
| | - Wen-Bing Xu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Yu-Cheng Zhong
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Zheng-Feng Zhu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Kai Meng
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Yu-Dong Peng
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Hai-Tao Sun
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Yue Wang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Cheng-Liang Pan
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Qiu-Tang Zeng
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Kun-Wu Yu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
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4
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Mohmmad‐Rezaei M, Arefnezhad R, Ahmadi R, Abdollahpour‐Alitappeh M, Mirzaei Y, Arjmand M, Ferns GA, Bashash D, Bagheri N. An overview of the innate and adaptive immune system in atherosclerosis. IUBMB Life 2020. [DOI: 10.1002/iub.2425] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Mina Mohmmad‐Rezaei
- Cellular and Molecular Research Center, Basic Health Sciences Institute Shahrekord University of Medical Sciences Shahrekord Iran
| | - Reza Arefnezhad
- Halal Research Center of IRI, FDA Tehran Iran
- Department of Anatomy, School of Medicine Shiraz University of Medical Sciences Shiraz Iran
| | - Reza Ahmadi
- Clinical Biochemistry Research Center, Basic Health Sciences Institute Shahrekord University of Medical Sciences Shahrekord Iran
| | | | - Yousef Mirzaei
- Department of Biogeosciences, Scientific Research Center Soran University Soran Iraq
| | - Mohammad‐Hassan Arjmand
- Cellular and Molecular Research Center, Basic Health Sciences Institute Shahrekord University of Medical Sciences Shahrekord Iran
- Cancer Research Center Shahrekord University of Medical Sciences Shahrekord Iran
| | - Gordon A. Ferns
- Brighton & Sussex Medical School, Division of Medical Education Sussex United Kingdom
| | - Davood Bashash
- Department of Hematology and Blood Banking, School of Allied Medical Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Nader Bagheri
- Cellular and Molecular Research Center, Basic Health Sciences Institute Shahrekord University of Medical Sciences Shahrekord Iran
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5
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Yi X, Wang Y, Jia Z, Hiller S, Nakamura J, Luft JC, Tian S, DeSimone JM. Retinoic Acid-Loaded Poly(lactic- co-glycolic acid) Nanoparticle Formulation of ApoB-100-Derived Peptide 210 Attenuates Atherosclerosis. J Biomed Nanotechnol 2020; 16:467-480. [PMID: 32970979 DOI: 10.1166/jbn.2020.2905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We developed a vaccine formulation containing ApoB derived P210 peptides as autoantigens, retinoic acid (RA) as an immune enhancer, both of which were delivered using PLGA nanoparticles. The formula was used to induce an immune response in 12-week-old male Apoe-/- mice with pre-existing atherosclerotic lesions. The nanotechnology platform PRINT® was used to fabricate PLGA nanoparticles that encapsulated RA inside and adsorbed the P210 onto the particle surface. In this study, we demonstrated that immunization of Apoe-/- mice with the formulation was able to considerably attenuate atherosclerotic lesions, accompanied by increased P210 specific IgM and another oxidized lipid derived autoantigen, M2AA, specific IgG autoantibodies, and decreased the inflammatory response, as compared to the P210 group with Freund's adjuvant. Our formulation represents an exciting technology to enhance the efficacy of the P210 vaccine.
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6
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Affiliation(s)
- Göran K Hansson
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
| | - Jan Nilsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
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7
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Abstract
Adaptive as well as innate immune responses contribute to the development of atherosclerosis. Studies performed in experimental animals have revealed that some of these immune responses are protective while others contribute to the progression of disease. These observations suggest that it may be possible to develop novel therapies for cardiovascular disease by selectively modulating such atheroprotective and proatherogenic immunity. Recent advances in cancer treatment using immune check inhibitors and CAR (chimeric antigen receptor) T-cell therapy serve as excellent examples of the possibilities of targeting the immune system to combat disease. LDL (low-density lipoprotein) that has accumulated in the artery wall is a key autoantigen in atherosclerosis, and activation of antigen-specific T helper 1–type T cells is thought to fuel plaque inflammation. Studies aiming to prove this concept by immunizing experimental animals with oxidized LDL particles unexpectedly resulted in activation of atheroprotective immunity involving regulatory T cells. This prompted several research groups to try to develop vaccines against atherosclerosis. In this review, we will discuss the experimental and clinical data supporting the possibility of developing immune-based therapies for lowering cardiovascular risk. We will also summarize ongoing clinical studies and discuss the challenges associated with developing an effective and safe atherosclerosis vaccine.
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Affiliation(s)
- Jan Nilsson
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (J.N.)
| | - Göran K. Hansson
- Department of Medicine, Karolinska University Hospital Solna, Karolinska Institute, Sweden (G.K.H.)
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8
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Ospina-Quintero L, Jaramillo JC, Tabares-Guevara JH, Ramírez-Pineda JR. Reformulating Small Molecules for Cardiovascular Disease Immune Intervention: Low-Dose Combined Vitamin D/Dexamethasone Promotes IL-10 Production and Atheroprotection in Dyslipidemic Mice. Front Immunol 2020; 11:743. [PMID: 32395119 PMCID: PMC7197409 DOI: 10.3389/fimmu.2020.00743] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/01/2020] [Indexed: 12/15/2022] Open
Abstract
The targeting of proinflammatory pathways has a prophylactic and therapeutic potential on atherosclerotic cardiovascular diseases (CVD). An alternative/complementary strategy is the promotion of endogenous atheroprotective mechanisms that are impaired during atherosclerosis progression, such as the activity of tolerogenic dendritic cells (tolDC) and regulatory T cells (Treg). There is a need to develop novel low cost, safe and effective tolDC/Treg-inducing formulations that are atheroprotective and that can be of easy translation into clinical settings. We found that apolipoprotein E-deficient (ApoE–/–) mice treated with a low-dose combined formulation of Vitamin D and Dexamethasone (VitD/Dexa), delivered repetitively and subcutaneously (sc) promoted interleukin-10 (IL-10) production by dendritic cells and other antigen presenting cells in the lymph nodes draining the site of injection and the spleens. Expectedly, the treatment also increased the numbers of IL-10-producing CD4+ T cells. Concomitantly, the frequency of IFNγ-producing CD4+ and CD8+ T cells in the spleen, and the IFNγ response of splenocytes to polyclonal stimulation ex vivo were lower after VitD/Dexa treatment, indicating a reduced proatherogenic Th1 response. Interestingly, VitD/Dexa-treated mice had smaller atherosclerotic lesions, with reduced lipid content and lower inflammatory infiltrate of macrophages and T cells in the aortic root. No hypolipidemic or antioxidant effect could be detected, suggesting that a dominantly immunomodulatory mechanism of atheroprotection was engaged under the low-dose sc VitD/Dexa conditions used. Finally, no evidence of clinical, biochemical or immune toxicity was observed in treated ApoE–/– mice and, most importantly, C57BL/6 mice latently infected with Leishmania parasites and treated with an identical VitD/Dexa dose/scheme showed no clinical or microbiological signs of disease reactivation, suggesting the absence of general immunosuppression. Altogether, these results indicate that a non-toxic, non-immunosuppressive, low-dose of VitD/Dexa, administered subcutaneously and repetitively, exerts atheroprotective effects in dyslipidemic mice, apparently due to the induction of an IL-10-producing network of lymphoid and myeloid immune cells. These well known, widely available, and inexpensive small molecules can be easily co-formulated into a simple and accessible agent with a potential use as a prophylactic or therapeutic immune intervention for CVD and other chronic inflammatory diseases.
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Affiliation(s)
- Laura Ospina-Quintero
- Grupo Inmunomodulación (GIM), Instituto de Investigaciones Médicas, Facultad de Medicina, Corporación Académica para el Estudio de Patologías Tropicales (CAEPT), Universidad de Antioquia, Medellin, Colombia
| | - Julio C Jaramillo
- Grupo Inmunomodulación (GIM), Instituto de Investigaciones Médicas, Facultad de Medicina, Corporación Académica para el Estudio de Patologías Tropicales (CAEPT), Universidad de Antioquia, Medellin, Colombia
| | - Jorge H Tabares-Guevara
- Grupo Inmunomodulación (GIM), Instituto de Investigaciones Médicas, Facultad de Medicina, Corporación Académica para el Estudio de Patologías Tropicales (CAEPT), Universidad de Antioquia, Medellin, Colombia
| | - José R Ramírez-Pineda
- Grupo Inmunomodulación (GIM), Instituto de Investigaciones Médicas, Facultad de Medicina, Corporación Académica para el Estudio de Patologías Tropicales (CAEPT), Universidad de Antioquia, Medellin, Colombia
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9
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Steinmetz M, Laurans L, Nordsiek S, Weiß L, van der Veken B, Ponnuswamy P, Esposito B, Vandestienne M, Giraud A, Göbbel C, Steffen E, Radecke T, Potteaux S, Nickenig G, Rassaf T, Tedgui A, Mallat Z. Thymic stromal lymphopoietin is a key cytokine for the immunomodulation of atherogenesis with Freund's adjuvant. J Cell Mol Med 2020; 24:5731-5739. [PMID: 32285594 PMCID: PMC7214169 DOI: 10.1111/jcmm.15235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 02/04/2020] [Accepted: 02/15/2020] [Indexed: 01/06/2023] Open
Abstract
Adaptive immune responses regulate the development of atherosclerosis, with a detrimental effect of type 1 but a protective role of type 2 immune responses. Immunization of Apolipoprotein E‐deficient (ApoE−/−) mice with Freund's adjuvant inhibits the development of atherosclerosis. However, the underlying mechanisms are not fully understood. Thymic stromal lymphopoietin (TSLP) is an IL7‐like cytokine with essential impact on type 2 immune responses (Th2). Thymic stromal lymphopoietin is strongly expressed in epithelial cells of the skin, but also in various immune cells following appropriate stimulation. In this study, we investigated whether TSLP may be crucial for the anti‐atherogenic effect of Freund's adjuvant. Subcutaneous injection of complete Freund's adjuvant (CFA) rapidly led to the expression of TSLP and IL1β at the site of injection. In male mice, CFA‐induced TSLP occurred in immigrated monocytes—and not epithelial cells—and was dependent on NLRP3 inflammasome activation and IL1β‐signalling. In females, CFA‐induced TSLP was independent of IL1β and upon ovariectomy. CFA/OVA led to a more pronounced imbalance of the T cell response in TSLPR−/− mice, with increased INFγ/IL4 ratio compared with wild‐type controls. To test whether TSLP contributes to the anti‐atherogenic effects of Freund's adjuvant, we treated ApoE−/− and ApoE−/−/TSLPR−/− mice with either CFA/IFA or PBS. ApoE−/− mice showed less atherogenesis upon CFA/IFA compared with PBS injections. ApoE−/−/TSLPR−/− mice had no attenuation of atherogenesis upon CFA/IFA treatment. Freund's adjuvant executes significant immune‐modulating effects via TSLP induction. TSLP‐TSLPR signalling is critical for CFA/IFA‐mediated attenuation of atherosclerosis.
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Affiliation(s)
- Martin Steinmetz
- Klinik für Kardiologie und Angiologie, Westdeutsches Herz- und Gefäßzentrum, Universitätsklinikum Essen, Essen, Germany.,Paris Cardiovascular Research Center, INSERM U970, Paris, France.,Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Ludivine Laurans
- Paris Cardiovascular Research Center, INSERM U970, Paris, France
| | - Sarah Nordsiek
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Lena Weiß
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | | | | | - Bruno Esposito
- Paris Cardiovascular Research Center, INSERM U970, Paris, France
| | | | - Andreas Giraud
- Paris Cardiovascular Research Center, INSERM U970, Paris, France
| | - Cristina Göbbel
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Eva Steffen
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Tobias Radecke
- Klinik für Kardiologie und Angiologie, Westdeutsches Herz- und Gefäßzentrum, Universitätsklinikum Essen, Essen, Germany
| | | | - Georg Nickenig
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Tienush Rassaf
- Klinik für Kardiologie und Angiologie, Westdeutsches Herz- und Gefäßzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Alain Tedgui
- Paris Cardiovascular Research Center, INSERM U970, Paris, France
| | - Ziad Mallat
- Paris Cardiovascular Research Center, INSERM U970, Paris, France.,Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
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10
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Abstract
There is now overwhelming experimental and clinical evidence that atherosclerosis is a chronic inflammatory disease. Lessons from genome-wide association studies, advanced in vivo imaging techniques, transgenic lineage tracing mice, and clinical interventional studies have shown that both innate and adaptive immune mechanisms can accelerate or curb atherosclerosis. Here, we summarize and discuss the pathogenesis of atherosclerosis with a focus on adaptive immunity. We discuss some limitations of animal models and the need for models that are tailored to better translate to human atherosclerosis and ultimately progress in prevention and treatment.
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Affiliation(s)
- Dennis Wolf
- From the Department of Cardiology and Angiology I, University Heart Center Freiburg, Germany (D.W.).,Faculty of Medicine, University of Freiburg, Germany (D.W.)
| | - Klaus Ley
- Division of Inflammation Biology, La Jolla Institute for Immunology, CA (K.L.).,Department of Bioengineering, University of California San Diego, La Jolla (K.L.)
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11
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Tsilingiri K, de la Fuente H, Relaño M, Sánchez-Díaz R, Rodríguez C, Crespo J, Sánchez-Cabo F, Dopazo A, Alonso-Lebrero JL, Vara A, Vázquez J, Casasnovas JM, Alfonso F, Ibáñez B, Fuster V, Martínez-González J, Martín P, Sánchez-Madrid F. Oxidized Low-Density Lipoprotein Receptor in Lymphocytes Prevents Atherosclerosis and Predicts Subclinical Disease. Circulation 2019; 139:243-255. [PMID: 30586697 DOI: 10.1161/circulationaha.118.034326] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although the role of Th17 and regulatory T cells in the progression of atherosclerosis has been highlighted in recent years, their molecular mediators remain elusive. We aimed to evaluate the association between the CD69 receptor, a regulator of Th17/regulatory T cell immunity, and atherosclerosis development in animal models and in patients with subclinical disease. METHODS Low-density lipoprotein receptor-deficient chimeric mice expressing or not expressing CD69 on either myeloid or lymphoid cells were subjected to a high fat diet. In vitro functional assays with human T cells were performed to decipher the mechanism of the observed phenotypes. Expression of CD69 and NR4A nuclear receptors was evaluated by reverse transcription-polymerase chain reaction in 305 male participants of the PESA study (Progression of Early Subclinical Atherosclerosis) with extensive (n=128) or focal (n=55) subclinical atherosclerosis and without disease (n=122). RESULTS After a high fat diet, mice lacking CD69 on lymphoid cells developed large atheroma plaque along with an increased Th17/regulatory T cell ratio in blood. Oxidized low-density lipoprotein was shown to bind specifically and functionally to CD69 on human T lymphocytes, inhibiting the development of Th17 cells through the activation of NR4A nuclear receptors. Participants of the PESA study with evidence of subclinical atherosclerosis displayed a significant CD69 and NR4A1 mRNA downregulation in peripheral blood leukocytes compared with participants without disease. The expression of CD69 remained associated with the risk of subclinical atherosclerosis in an adjusted multivariable logistic regression model (odds ratio, 0.62; 95% CI, 0.40-0.94; P=0.006) after adjustment for traditional risk factors, the expression of NR4A1, the level of oxidized low-density lipoprotein, and the counts of different leucocyte subsets. CONCLUSIONS CD69 depletion from the lymphoid compartment promotes a Th17/regulatory T cell imbalance and exacerbates the development of atherosclerosis. CD69 binding to oxidized low-density lipoprotein on T cells induces the expression of anti-inflammatory transcription factors. Data from a cohort of the PESA study with subclinical atherosclerosis indicate that CD69 expression in PBLs inversely correlates with the presence of disease. The expression of CD69 remained an independent predictor of subclinical atherosclerosis after adjustment for traditional risk factors.
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Affiliation(s)
- Katerina Tsilingiri
- Vascular Pathophysiology Area (K.T., M.R., R.S.-D., V.F., P.M., F.S.-M.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Hortensia de la Fuente
- Department of Immunology (H.d.L.F., J.L.A.-L., A.V., F.S.-M.), Instituto de Investigación Sanitaria Hospital de la Princesa, IIS-IP, Madrid, Spain.,CIBER de Enfermedades Cardiovasculares, Madrid, Spain (H.d.L.F., R.S.-D., C.R., J.V., B.I., J.M.-G, P.M., F.S.-M.)
| | - Marta Relaño
- Vascular Pathophysiology Area (K.T., M.R., R.S.-D., V.F., P.M., F.S.-M.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Raquel Sánchez-Díaz
- Vascular Pathophysiology Area (K.T., M.R., R.S.-D., V.F., P.M., F.S.-M.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain.,CIBER de Enfermedades Cardiovasculares, Madrid, Spain (H.d.L.F., R.S.-D., C.R., J.V., B.I., J.M.-G, P.M., F.S.-M.)
| | - Cristina Rodríguez
- Institut de Recerca del Hospital de la Santa Creu i Sant Pau-Programa ICCC, IIB-Sant Pau, Barcelona, Spain (C.R., J.C.).,CIBER de Enfermedades Cardiovasculares, Madrid, Spain (H.d.L.F., R.S.-D., C.R., J.V., B.I., J.M.-G, P.M., F.S.-M.)
| | - Javier Crespo
- Institut de Recerca del Hospital de la Santa Creu i Sant Pau-Programa ICCC, IIB-Sant Pau, Barcelona, Spain (C.R., J.C.).,CIBER de Enfermedades Cardiovasculares, Madrid, Spain (H.d.L.F., R.S.-D., C.R., J.V., B.I., J.M.-G, P.M., F.S.-M.)
| | - Fátima Sánchez-Cabo
- Bioinformatics Unit (F.S.-C.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Ana Dopazo
- Genomics Unit (A.D.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - José L Alonso-Lebrero
- Department of Immunology (H.d.L.F., J.L.A.-L., A.V., F.S.-M.), Instituto de Investigación Sanitaria Hospital de la Princesa, IIS-IP, Madrid, Spain
| | - Alicia Vara
- Department of Immunology (H.d.L.F., J.L.A.-L., A.V., F.S.-M.), Instituto de Investigación Sanitaria Hospital de la Princesa, IIS-IP, Madrid, Spain
| | - Jesús Vázquez
- Proteomics Unit (J.V.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | | | - Fernando Alfonso
- Department of Cardiology (F.A.), Instituto de Investigación Sanitaria Hospital de la Princesa, IIS-IP, Madrid, Spain
| | - Borja Ibáñez
- Myocardial Pathophysiology Area (B.I.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain.,IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain (B.I.).,CIBER de Enfermedades Cardiovasculares, Madrid, Spain (H.d.L.F., R.S.-D., C.R., J.V., B.I., J.M.-G, P.M., F.S.-M.)
| | - Valentín Fuster
- Vascular Pathophysiology Area (K.T., M.R., R.S.-D., V.F., P.M., F.S.-M.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain.,Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (V.F.)
| | - José Martínez-González
- Instituto de Investigaciones Biomédicas de Barcelona, IIB-Sant Pau, Spain (J.M.-G.).,CIBER de Enfermedades Cardiovasculares, Madrid, Spain (H.d.L.F., R.S.-D., C.R., J.V., B.I., J.M.-G, P.M., F.S.-M.)
| | - Pilar Martín
- Vascular Pathophysiology Area (K.T., M.R., R.S.-D., V.F., P.M., F.S.-M.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain.,CIBER de Enfermedades Cardiovasculares, Madrid, Spain (H.d.L.F., R.S.-D., C.R., J.V., B.I., J.M.-G, P.M., F.S.-M.)
| | - Francisco Sánchez-Madrid
- Vascular Pathophysiology Area (K.T., M.R., R.S.-D., V.F., P.M., F.S.-M.), Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain.,Department of Immunology (H.d.L.F., J.L.A.-L., A.V., F.S.-M.), Instituto de Investigación Sanitaria Hospital de la Princesa, IIS-IP, Madrid, Spain.,CIBER de Enfermedades Cardiovasculares, Madrid, Spain (H.d.L.F., R.S.-D., C.R., J.V., B.I., J.M.-G, P.M., F.S.-M.)
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12
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Wigren M, Rattik S, Yao Mattisson I, Tomas L, Grönberg C, Söderberg I, Alm R, Sundius L, Ljungcrantz I, Björkbacka H, Fredrikson GN, Nilsson J. Lack of Ability to Present Antigens on Major Histocompatibility Complex Class II Molecules Aggravates Atherosclerosis in ApoE
−/−
Mice. Circulation 2019; 139:2554-2566. [DOI: 10.1161/circulationaha.118.039288] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Maria Wigren
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Sara Rattik
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Ingrid Yao Mattisson
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Lukas Tomas
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Caitriona Grönberg
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Ingrid Söderberg
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Ragnar Alm
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Lena Sundius
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Irena Ljungcrantz
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Harry Björkbacka
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | | | - Jan Nilsson
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
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13
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Activation of immune responses against the basement membrane component collagen type IV does not affect the development of atherosclerosis in ApoE-deficient mice. Sci Rep 2019; 9:5964. [PMID: 30979943 PMCID: PMC6461614 DOI: 10.1038/s41598-019-42375-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 03/27/2019] [Indexed: 12/15/2022] Open
Abstract
Oxidation of low-density lipoprotein (LDL) in the arterial extracellular matrix results in malondialdehyde (MDA)-modifications of surrounding matrix proteins. We have recently demonstrated an association between high levels of autoantibodies against MDA-modified collagen type IV and risk for development of myocardial infarction. Collagen type IV is an important component of the endothelial basement membrane and influences smooth muscle cell function. We hypothesized that immune responses against collagen type IV could contribute to vascular injury affecting the development of atherosclerosis. To investigate this possibility, we induced an antibody-response against collagen type IV in apolipoprotein E (Apo E)-deficient mice. Female ApoE−/− mice on C57BL/6 background were immunized with α1α2 type IV collagen chain peptides linked to the immune-enhancer PADRE, PADRE alone or PBS at 12 weeks of age with three subsequent booster injections before the mice were killed at 23 weeks of age. Immunization of PADRE alone induced autoantibodies against PADRE, increased IL-4 secretion from splenocytes and reduced SMC content in the subvalvular plaques. Immunization with peptides of α1α2 type IV collagen chains induced a strong IgG1antibody response against collagen type IV peptides without affecting the distribution of T cell populations, plasma cytokine or lipid levels. There were no differences in atherosclerotic plaque development between collagen α1α2(IV)-PADRE immunized mice and control mice. Our findings demonstrate that the presence of antibodies against the basement membrane component collagen type IV does not affect atherosclerosis development in ApoE−/− mice. This suggests that the association between autoantibodies against collagen type IV and risk for myocardial infarction found in humans does not reflect a pathogenic role of these autoantibodies.
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14
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Abstract
There is now overwhelming experimental and clinical evidence that arteriosclerosis is a chronic inflammatory disease. Lessons learned from genome-wide association studies, advanced in vivo imaging techniques, transgenic lineage tracing mice models and clinical interventional studies have shown that both innate and adaptive immune mechanisms can accelerate or curb arteriosclerosis. This article summarizes and discusses the pathogenesis of arteriosclerosis with a focus on the role of the adaptive immune system. Some limitations of animal models are discussed and the need for models that are tailored to better translate to human atherosclerosis and ultimately progress in prevention and treatment are emphasized.
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Affiliation(s)
- D Wolf
- Abteilung für Kardiologie und Angiologie I, Universitäts-Herzzentrum Freiburg, Freiburg, Deutschland
- Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland
| | - K Ley
- Division of Inflammation Biology, La Jolla Institute for Immunology, 9420 Athena Cir, 92037, La Jolla, CA, USA.
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA.
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15
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Kobiyama K, Vassallo M, Mitzi J, Winkels H, Pei H, Kimura T, Miller J, Wolf D, Ley K. A clinically applicable adjuvant for an atherosclerosis vaccine in mice. Eur J Immunol 2018; 48:1580-1587. [PMID: 29932463 DOI: 10.1002/eji.201847584] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/11/2018] [Accepted: 06/20/2018] [Indexed: 12/25/2022]
Abstract
Vaccination with MHC-II-restricted peptides from Apolipoprotein B (ApoB) with complete and incomplete Freund's adjuvant (CFA/IFA) is known to protect mice from atherosclerosis. This vaccination induces antigen-specific IgG1 and IgG2c antibody responses and a robust CD4 T cell response in lymph nodes. However, CFA/IFA cannot be used in humans. To find a clinically applicable adjuvant, we tested the effect of vaccinating Apoe-deficient mice with ApoB peptide P6 (TGAYSNASSTESASY). In a broad screening experiment, Addavax, a squalene-based oil-in-water adjuvant similar to MF59, was the only adjuvant that showed similar efficacy as CFA/IFA. This was confirmed in a confirmation experiment for both the aortic arch and whole aorta analyzed by en face analysis after atherosclerotic lesion staining. Mechanistically, restimulated peritoneal cells from mice immunized with P6 in Addavax released significant amounts of IL-10. Unlike P6 in CFA/IFA, vaccination with P6 in Addavax did not induce any detectable IgG1 or IgG2c antibodies to P6. These data suggest that squalene-based adjuvants such as MF59 are good candidate adjuvants for developing a clinically effective atherosclerosis vaccine.
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Affiliation(s)
- Kouji Kobiyama
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Melanie Vassallo
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Jessica Mitzi
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Holger Winkels
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Hong Pei
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Takayuki Kimura
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Jacqueline Miller
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Dennis Wolf
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Klaus Ley
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA.,Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
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16
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Aghebati T, Mohammadpour AH, Afshar M, Jaafari MR, Abnous K, Nazemi S, Issazadeh S, Hashemzadeh S, Zare M, Badiee A. A novel atheroprotective role of MF59-like adjuvant when co-administered with CETP vaccine in rabbit model of atherosclerosis. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2017; 19:1345-1352. [PMID: 28096968 PMCID: PMC5220241 DOI: 10.22038/ijbms.2016.7922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES In this study, for the first time, MF59 adjuvant was used to develop a cholesteryl ester transfer protein (CETP) vaccine. The efficacy of the vaccine was compared with the efficacy of CETP vaccine formulated with Alum/CpG, the formulation that its immunogenicity has been already demonstrated in rabbit and mice. MATERIALS AND METHODS Tetanus toxoid- CETP peptide (TT-CETP) was mixed with Alum/CpG or MF59-like and administered subcutaneously for total five times in rabbit model of atherosclerosis. Anti-TT-CETP specific antibody, CETP activity in sera and mRNA level of cytokine IL-4 and IFN-γ in peripheral mononuclear cells were determined. Therapeutic response was also examined by tracking serum lipoprotein levels and pathologic observation of atherosclerotic lesions at aortic site. RESULTS More anti-TT-CETP antibody was found in Alum/CpG vaccinated rabbits compared to buffer (P<0.001). Antibody induced by MF59-like formulation was not significantly higher than buffer. CETP activity and lipoprotein levels were not significantly different between vaccinated and control rabbits. The mRNA level of IL-4 was significantly lower than buffer while, IFN-γ gene expression was significantly higher in both vaccinated groups. Atherosclerosis thickness grade of aorta was dramatically lower than buffer (P<0.01) in both vaccinated groups. CONCLUSION It is concluded that MF59-adjuvanted CETP vaccine showed anti-atherosclerosis properties, but the protective effect could not be directly attributed to the immune response induced by anti TT-CETP antibody and CETP inhibition. Further studies are needed to explain the anti-atherosclerosis properties of MF59 in the presence of TT-CETP peptide.
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Affiliation(s)
- Tamara Aghebati
- Nanotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Afshar
- Department of Anatomy, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran; Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Reza Jaafari
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Khalil Abnous
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Nazemi
- Research and Education Department, Razavi Hospital, Mashhad, Iran
| | - Sobhan Issazadeh
- Research and Education Department, Razavi Hospital, Mashhad, Iran
| | | | | | - Ali Badiee
- Nanotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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17
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Wick C. Tolerization against atherosclerosis using heat shock protein 60. Cell Stress Chaperones 2016; 21:201-11. [PMID: 26577462 PMCID: PMC4786533 DOI: 10.1007/s12192-015-0659-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 01/06/2023] Open
Abstract
Atherosclerosis is a chronic inflammatory disease of the artery wall, and both innate and adaptive immunity play important roles in the pathogenesis of this disease. In several experimental and human experiments of early atherosclerotic lesions, it has been shown that the first pathogenic event in atherogenesis is intimal infiltration of T cells at predilection sites. These T cells react to heat shock protein 60 (HSP60), which is a ubiquitous self-antigen expressed on the surface of endothelial cells (ECs) together with adhesion molecules in response to classical risk factors for atherosclerosis. When HSP60 is expressed on the EC surface, it can act as a "danger-signal" for both cellular and humoral immune reactions. Acquired by infection or vaccination, beneficial protective immunity to microbial HSP60 and bona fide autoimmunity to biochemically altered autologous HSP60 is present in all humans. Thus, the development of atherosclerosis during aging is paid by the price for lifelong protective preexisting anti-HSP60 immunity by harmful (auto)immune cross-reactive attack on arterial ECs maltreated by atherosclerosis risk factors. This is supported by experiments, which shows that bacterial HSP60 immunization can lead and accelerate experimental atherosclerosis. This review article presents accumulating proof that supports the idea that tolerization with antigenic HSP60 protein or its peptides may arrest or even prevent atherosclerosis by increased production of regulatory T cells and/or anti-inflammatory cytokines. Recent data indicates that HSP60, or more likely some of its derivative peptides, has immunoregulatory functions. Therefore, these peptides may have important potential for being used as diagnostic agents or therapeutic targets.
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Affiliation(s)
- Cecilia Wick
- Department of Medicine, Rheumatology Unit, Karolinska Institutet, Center for Molecular Medicine (CMM) L8:04, Karolinska University Hospital Solna, S-17176, Stockholm, Sweden.
- Laboratory of Autoimmunity, Division for Experimental Pathophysiology and Immunology, Biocenter, Innsbruck Medical University, Innsbruck, A-6020, Austria.
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18
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Abstract
Atherosclerosis is a chronic inflammatory disease of the artery wall. Adaptive immunity plays a key role in the pathogenesis of atherosclerosis. Recently, modulation of the immune response against atherosclerotic plaque antigen(s) has attracted attention as a potentially preventive and therapeutic approach. Here, we review a series of studies on immunization with various antigens targeting treatment and prevention of atherosclerosis. Atherosclerosis-related antigens include oxidized low-density lipoprotein (LDL), apolipoprotein B-100 (ApoB-100) and heat shock protein (HSP) 60/65. Accumulating evidence supports the idea that immunization with these antigenic proteins or peptides may reduce atherosclerosis. In this review, we discuss the current status of immunization studies and possible associated mechanisms of atheroprotection.
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19
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Zhu L, He Z, Wu F, Ding R, Jiang Q, Zhang J, Fan M, Wang X, Eva B, Jan N, Liang C, Wu Z. Immunization with advanced glycation end products modified low density lipoprotein inhibits atherosclerosis progression in diabetic apoE and LDLR null mice. Cardiovasc Diabetol 2014; 13:151. [PMID: 25391642 PMCID: PMC4234834 DOI: 10.1186/s12933-014-0151-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 10/22/2014] [Indexed: 01/10/2023] Open
Abstract
Background Diabetes accelerates atherosclerosis through undefined molecular mechanisms. Hyperglycemia induces formation of advanced glycation end product (AGE)-modified low-density lipoprotein (LDL). Anti-AGE-LDL autoantibodies favor atherosclerosis (AS) progression in humans, while anti oxidized LDL immunization inhibits AS in hypercholesterolemic, non-diabetic mice. We here investigated if AGE-LDL immunization protects against AS in diabetic mice. Methods After diabetes induction with streptozotocin and high fat diet, both low density lipoprotein receptor (LDLR)−/− and apoE female mice were randomized to: AGE-LDL immunization with aluminum hydroxide (Alum) adjuvant; Alum alone; or PBS. Results AGE-LDL immunization: significantly reduced AS; induced specific plasma IgM and IgG antibodies; upregulated splenic Th2, Treg and IL-10 levels, without altering Th1 or Th17 cells; and increased serum high density lipoprotein(HDL) while numerically lowering HbA1c levels. Conclusions Subcutaneous immunization with AGE-LDL significantly inhibits atherosclerosis progression in hyperlipidemic diabetic mice possibly through activation of specific humoral and cell mediated immune responses and metabolic control improvement. Electronic supplementary material The online version of this article (doi:10.1186/s12933-014-0151-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lin Zhu
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China. .,457th hospital of PLA, Wuhan, People's Republic of China.
| | - Zhiqing He
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
| | - Feng Wu
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China. .,Department of Research, Center for Stem Cell Biology, Roger Williams Medical Center, Boston University School of Medicine, Providence, RI, USA.
| | - Ru Ding
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
| | - Qixia Jiang
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
| | - Jiayou Zhang
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
| | - Min Fan
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
| | - Xing Wang
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
| | - Bengtsson Eva
- Experimental Cardiovascular Research, CRC 91:12, Lund University, Entrance 72, Skåne University Hospital Malmö, SE-205 02, Malmö, Sweden.
| | - Nilsson Jan
- Experimental Cardiovascular Research, CRC 91:12, Lund University, Entrance 72, Skåne University Hospital Malmö, SE-205 02, Malmö, Sweden.
| | - Chun Liang
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
| | - Zonggui Wu
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
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20
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A role for impaired regulatory T cell function in adverse responses to aluminum adjuvant-containing vaccines in genetically susceptible individuals. Vaccine 2014; 32:5149-55. [PMID: 25066736 DOI: 10.1016/j.vaccine.2014.07.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 06/28/2014] [Accepted: 07/15/2014] [Indexed: 12/14/2022]
Abstract
Regulatory T cells play a critical role in the immune response to vaccination, but there is only a limited understanding of the response of regulatory T cells to aluminum adjuvants and the vaccines that contain them. Available studies in animal models show that although induced T regulatory cells may be induced concomitantly with effector T cells following aluminum-adjuvanted vaccination, they are unable to protect against sensitization, suggesting that under the Th2 immune-stimulating effects of aluminum adjuvants, Treg cells may be functionally compromised. Allergic diseases are characterized by immune dysregulation, with increases in IL-4 and IL-6, both of which exert negative effects on Treg function. For individuals with a genetic predisposition, the beneficial influence of adjuvants on immune responsiveness may be accompanied by immune dysregulation, leading to allergic diseases. This review examines aspects of the regulatory T cell response to aluminum-adjuvanted immunization and possible genetic susceptibility factors related to that response.
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21
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Engelbertsen D, Rattik S, Knutsson A, Björkbacka H, Bengtsson E, Nilsson J. Induction of T helper 2 responses against human apolipoprotein B100 does not affect atherosclerosis in ApoE−/− mice. Cardiovasc Res 2014; 103:304-12. [DOI: 10.1093/cvr/cvu131] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Abstract
Atherosclerosis is the primary cause of acute myocardial infarction and stroke. It is well established that arterial inflammation in response to accumulation and oxidation of lipoproteins in the vascular wall is the major factor responsible for the development of atherosclerosis. During recent years, it has become apparent that this vascular inflammation is modulated by a complex array of autoimmune responses against modified self-antigens in the atherosclerotic plaque and that both protective and pathogenic immune responses become activated as part of the disease process. Studies of hypercholesterolemia-induced immune activation in mouse models of atherosclerosis have demonstrated that Th1 cells contribute to disease progression while regulatory T cells are protective. It has been suggested that antigen presentation of modified self-antigens in the inflammatory environment of atherosclerotic plaques favors generation of antigen-specific Th1 cells over that of regulatory T cells, resulting in a local loss of tolerance. This concept has stimulated the development of plaque-antigen tolerogenic vaccines to dampen plaque inflammation and disease progression. A first generation of atherosclerosis vaccines based on peptides derived from apoB100 and heat shock proteins have demonstrated promising results in animal studies and are now approaching clinical testing.
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Affiliation(s)
- Jan Nilsson
- Department of Clinical Sciences, Malmö University Hospital, Lund University, SE-205 02 Malmö, Sweden.
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23
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Libby P, Lichtman AH, Hansson GK. Immune effector mechanisms implicated in atherosclerosis: from mice to humans. Immunity 2013; 38:1092-104. [PMID: 23809160 DOI: 10.1016/j.immuni.2013.06.009] [Citation(s) in RCA: 481] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/12/2013] [Indexed: 02/06/2023]
Abstract
According to the traditional view, atherosclerosis results from a passive buildup of cholesterol in the artery wall. Yet, burgeoning evidence implicates inflammation and immune effector mechanisms in the pathogenesis of this disease. Both innate and adaptive immunity operate during atherogenesis and link many traditional risk factors to altered arterial functions. Inflammatory pathways have become targets in the quest for novel preventive and therapeutic strategies against cardiovascular disease, a growing contributor to morbidity and mortality worldwide. Here we review current experimental and clinical knowledge of the pathogenesis of atherosclerosis through an immunological lens and how host defense mechanisms essential for survival of the species actually contribute to this chronic disease but also present new opportunities for its mitigation.
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Affiliation(s)
- Peter Libby
- Brigham and Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, NRB7, Boston, MA 02115, USA.
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24
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Keijzer C, van der Zee R, van Eden W, Broere F. Treg inducing adjuvants for therapeutic vaccination against chronic inflammatory diseases. Front Immunol 2013; 4:245. [PMID: 23970886 PMCID: PMC3747555 DOI: 10.3389/fimmu.2013.00245] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 08/06/2013] [Indexed: 01/21/2023] Open
Abstract
Many existing therapies in autoimmune diseases are based on systemic suppression of inflammation and the observed side effects of these therapies illustrate the pressing need for more specific interventions. Regulatory T-cells (Treg) are pivotal controllers of (auto-aggressive) immune responses and inflammation, and decreased Treg numbers and/or functioning have been associated with autoimmune disease. Therefore, Treg became frequently studied targets for more specific immunotherapy. Especially antigen-specific targeting of Treg would enable local and tailor made interventions, while obviating the negative side effect of general immuno-suppression. Self-antigens that participate in inflammation, irrespective of the etiology of the different autoimmune diseases, are held to be candidate antigens for antigen-specific interventions. Rather than tolerance induction to disease inciting self-antigens, which are frequently unknown, general self-antigens expressed at sites of inflammation would allow targeting of disease independent, but inflammatory-site specific, regulatory mechanisms. Preferably, such self-antigens should be abundantly expressed and up-regulated at the inflammatory-site. In this perspective heat shock proteins (Hsp) have several characteristics that make them highly attractive targets for antigen-specific Treg inducing therapy. The development of an antigen-specific Treg inducing vaccine is a major novel goal in the field of immunotherapy in autoimmune diseases. However, progress is hampered not only by the lack of effective antigens, but also by the fact that other factors such as dose, route, and the presence or absence of an adjuvant, turned out to be critical unknowns, with respect to the effective induction of Treg. In addition, the use of a Treg inducing adjuvant might be required to achieve an effective regulatory response, in the case of ongoing inflammation. Future goals in clinical trials will be the optimization of natural Treg expansion (or the induction of adaptive Treg) without loss of their suppressive function or the concomitant induction of non-regulatory T-cells. Here, we will discuss the potential use of protein/peptide-based vaccines combined with Treg inducing adjuvants for the development of therapeutic vaccines against chronic inflammatory conditions.
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Affiliation(s)
- Chantal Keijzer
- Immunology, Infectious Diseases and Immunology, Faculty Veterinary Medicine, University Utrecht , Utrecht , Netherlands
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25
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Affiliation(s)
- Hiroshi Iwata
- From the Center for Interdisciplinary Cardiovascular Sciences, Harvard Medical School, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts (H.I.); Department of Cardiovascular Medicine, The University of Tokyo Graduate School of Medicine, Bunkyo, Tokyo, Japan (H.I., I.M., R.N.); and Jichi Medical University, Yakushiji, Shimotsuke-shi, Tochigi Prefecture, Japan (R.N.)
| | - Ichiro Manabe
- From the Center for Interdisciplinary Cardiovascular Sciences, Harvard Medical School, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts (H.I.); Department of Cardiovascular Medicine, The University of Tokyo Graduate School of Medicine, Bunkyo, Tokyo, Japan (H.I., I.M., R.N.); and Jichi Medical University, Yakushiji, Shimotsuke-shi, Tochigi Prefecture, Japan (R.N.)
| | - Ryozo Nagai
- From the Center for Interdisciplinary Cardiovascular Sciences, Harvard Medical School, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts (H.I.); Department of Cardiovascular Medicine, The University of Tokyo Graduate School of Medicine, Bunkyo, Tokyo, Japan (H.I., I.M., R.N.); and Jichi Medical University, Yakushiji, Shimotsuke-shi, Tochigi Prefecture, Japan (R.N.)
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26
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Zetterqvist AV, Berglund LM, Blanco F, Garcia-Vaz E, Wigren M, Dunér P, Andersson AMD, To F, Spegel P, Nilsson J, Bengtsson E, Gomez MF. Inhibition of nuclear factor of activated T-cells (NFAT) suppresses accelerated atherosclerosis in diabetic mice. PLoS One 2013; 8:e65020. [PMID: 23755169 PMCID: PMC3670844 DOI: 10.1371/journal.pone.0065020] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 04/21/2013] [Indexed: 01/13/2023] Open
Abstract
Objective of the Study Diabetic patients have a much more widespread and aggressive form of atherosclerosis and therefore, higher risk for myocardial infarction, peripheral vascular disease and stroke, but the molecular mechanisms leading to accelerated damage are still unclear. Recently, we showed that hyperglycemia activates the transcription factor NFAT in the arterial wall, inducing the expression of the pro-atherosclerotic protein osteopontin. Here we investigate whether NFAT activation may be a link between diabetes and atherogenesis. Methodology and Principal Findings Streptozotocin (STZ)-induced diabetes in apolipoprotein E−/− mice resulted in 2.2 fold increased aortic atherosclerosis and enhanced pro-inflammatory burden, as evidenced by elevated blood monocytes, endothelial activation- and inflammatory markers in aorta, and pro-inflammatory cytokines in plasma. In vivo treatment with the NFAT blocker A-285222 for 4 weeks completely inhibited the diabetes-induced aggravation of atherosclerosis, having no effect in non-diabetic mice. STZ-treated mice exhibited hyperglycemia and higher plasma cholesterol and triglycerides, but these were unaffected by A-285222. NFAT-dependent transcriptional activity was examined in aorta, spleen, thymus, brain, heart, liver and kidney, but only augmented in the aorta of diabetic mice. A-285222 completely blocked this diabetes-driven NFAT activation, but had no impact on the other organs or on splenocyte proliferation or cytokine secretion, ruling out systemic immunosuppression as the mechanism behind reduced atherosclerosis. Instead, NFAT inhibition effectively reduced IL-6, osteopontin, monocyte chemotactic protein 1, intercellular adhesion molecule 1, CD68 and tissue factor expression in the arterial wall and lowered plasma IL-6 in diabetic mice. Conclusions Targeting NFAT signaling may be a novel and attractive approach for the treatment of diabetic macrovascular complications.
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MESH Headings
- Animals
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/pathology
- Apolipoproteins E/deficiency
- Apolipoproteins E/metabolism
- Atherosclerosis/blood
- Atherosclerosis/complications
- Atherosclerosis/pathology
- Biomarkers/metabolism
- Blood Glucose/metabolism
- Body Weight/drug effects
- Cholesterol/blood
- Diabetes Mellitus, Experimental/blood
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Disease Progression
- Inflammation/pathology
- Interleukin-6/blood
- Mice, Inbred C57BL
- Monocytes/metabolism
- NFATC Transcription Factors/antagonists & inhibitors
- NFATC Transcription Factors/metabolism
- Plaque, Atherosclerotic/metabolism
- Plaque, Atherosclerotic/pathology
- Pyrazoles/pharmacokinetics
- Pyrazoles/pharmacology
- Signal Transduction/drug effects
- Transcription, Genetic/drug effects
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Affiliation(s)
| | - Lisa M. Berglund
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Fabiana Blanco
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Eliana Garcia-Vaz
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Maria Wigren
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Pontus Dunér
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | | | - Fong To
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Peter Spegel
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Jan Nilsson
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Eva Bengtsson
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Maria F. Gomez
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
- * E-mail:
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27
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Increased inflammation in atherosclerotic lesions of diabetic Akita-LDLr⁻/⁻ mice compared to nondiabetic LDLr⁻/⁻ mice. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:176162. [PMID: 23243415 PMCID: PMC3515907 DOI: 10.1155/2012/176162] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 10/09/2012] [Accepted: 10/12/2012] [Indexed: 12/19/2022]
Abstract
Background. Diabetes is associated with increased cardiovascular disease, but the underlying cellular and molecular mechanisms are poorly understood. One proposed mechanism is that diabetes aggravates atherosclerosis by enhancing plaque inflammation. The Akita mouse has recently been adopted as a relevant model for microvascular complications of diabetes. Here we investigate the development of atherosclerosis and inflammation in vessels of Akita mice on LDLr−/− background. Methods and Results. Akita-LDLr−/− and LDLr−/− mice were fed high-fat diet from 6 to 24 weeks of age. Blood glucose levels were higher in both male and female Akita-LDLr−/− mice (137% and 70%, resp.). Male Akita-LDLr−/− mice had markedly increased plasma cholesterol and triglyceride levels, a three-fold increase in atherosclerosis, and enhanced accumulation of macrophages and T-cells in plaques. In contrast, female Akita-LDLr−/− mice demonstrated a modest 29% increase in plasma cholesterol and no significant increase in triglycerides, atherosclerosis, or inflammatory cells in lesions. Male Akita-LDLr−/− mice had increased levels of plasma IL-1β compared to nondiabetic mice, whereas no such difference was seen between female diabetic and nondiabetic mice. Conclusion. Akita-LDLr−/− mice display considerable gender differences in the development of diabetic atherosclerosis. In addition, the increased atherosclerosis in male Akita-LDLr−/− mice is associated with an increase in inflammatory cells in lesions.
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28
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Emerging biomarkers and intervention targets for immune-modulation of atherosclerosis - a review of the experimental evidence. Atherosclerosis 2012. [PMID: 23177975 DOI: 10.1016/j.atherosclerosis.2012.10.074] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The role of inflammation in atherosclerosis and plaque vulnerability is well recognized. However, it is only during recent years it has become evident that this inflammation is modulated by immune responses against plaque antigens such as oxidized LDL. Interestingly, both protective and pathogenic immune responses exist and experimental data from animal studies suggest that modulation of these immune responses represents a promising new target for treatment of cardiovascular disease. It has been proposed that during early stages of the disease, autoimmune responses against plaque antigens are controlled by regulatory T cells that inhibit the activity of auto-reactive Th1 effector T cells by release of anti-inflammatory cytokines such as IL-10 and TGF-β. As the disease progresses this control is gradually lost and immune responses towards plaque antigens switch towards activation of Th1 effector T cells and release of pro-inflammatory cytokines such as interferon-γ, TNF-α and IL-1β. Several novel immune-modulatory therapies that promote or mimic tolerogenic immune responses against plaque antigens have demonstrated athero-protective effects in experimental models and a first generation of such immune-modulatory therapies are now in early or about to enter into clinical testing. A challenge in the clinical development of these therapies is that our knowledge of the role of the immune system in atherosclerosis largely rests on data from animal models of the disease. It is therefore critical that more attention is given to the characterization and evaluation of immune biomarkers for cardiovascular risk.
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29
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Pasterkamp G. Lipid-immunity cross-talk: a role for adipocyte fatty acid binding protein? Arterioscler Thromb Vasc Biol 2012; 32:2043-4. [PMID: 22895664 DOI: 10.1161/atvbaha.112.254797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Nilsson J, Björkbacka H, Fredrikson GN. Apolipoprotein B100 autoimmunity and atherosclerosis - disease mechanisms and therapeutic potential. Curr Opin Lipidol 2012; 23:422-8. [PMID: 22814703 DOI: 10.1097/mol.0b013e328356ec7c] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW Adaptive immune responses have been shown to play an important role in the atherosclerotic disease process and both pathogenic and protective immunity has been identified. Apolipoprotein (apo) B100 appears to be a key antigen and novel therapies modulating immune responses against apo B100 have shown promising results in experimental models. This review will discuss recent developments in the mechanistic understanding of apo B100 autoimmunity and approaches taken to use this knowledge for development of novel therapies. RECENT FINDINGS It has recently been shown that not only apo B100 modified by oxidation but also nonmodified apo B100 is targeted by autoimmune responses. This implies that a corresponding set of regulatory T cells with the same antigen specificity must exist and that these cells under normal circumstances are able to prevent autoimmunity against LDL. Recent studies also suggest that the atheroprotective effect of apo B100 peptide immunization acts by re-enforcing the activity of such cells. SUMMARY These novel findings suggest that aggravation of plaque inflammation may occur as a result of a local loss of tolerance against LDL in the plaque due to insufficient activity of regulatory T cells. Restoration of lost tolerance represents an interesting novel approach for treatment of cardiovascular disease.
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Affiliation(s)
- Jan Nilsson
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Sweden.
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31
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Wigren M, Björkbacka H, Andersson L, Ljungcrantz I, Fredrikson GN, Persson M, Bryngelsson C, Hedblad B, Nilsson J. Low levels of circulating CD4+FoxP3+ T cells are associated with an increased risk for development of myocardial infarction but not for stroke. Arterioscler Thromb Vasc Biol 2012; 32:2000-4. [PMID: 22628434 DOI: 10.1161/atvbaha.112.251579] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Regulatory T cells (Tregs) protect against atherosclerosis in experimental models, but their association with cardiovascular disease in humans remains to be elucidated. The aim of the present study was to determine whether circulating Tregs predict the development of acute cardiovascular events in humans. METHODS AND RESULTS The study cohort consisted of a random sample of participants (n=700), aged 68 to 73 years, from the Malmö Diet and Cancer Study. Mononuclear leukocytes, stored at -140 degrees C at the baseline investigation in 1991-1994, were thawed and Tregs, defined by the expression of FoxP3 in CD4+ T cells, were analyzed by flow cytometry. There was no detectable loss of cells during storage, and the viability of thawed leukocytes was 95%. A low fraction of both CD4+FoxP3+ and CD4+CD25+FoxP3+ T cells was associated with a higher release of proinflammatory cytokines from activated mononuclear leukocytes, and this association was strongest for CD4+FoxP3+ cells. Eighty-four coronary events and 66 strokes were registered during follow-up until December 31, 2008. In a Cox proportional hazard regression model adjusting for major risk factors, low levels of baseline CD4+FoxP3+ T cells were associated with an increased risk for the development of acute coronary events but not stroke. There were no associations between CD4+CD25+FoxP3+ T cells and development of an acute coronary event or stroke. CONCLUSIONS This study provides prospective evidence for the role of Tregs in the development of myocardial infarction. The findings are in accordance with previous experimental studies and provide clinical support for a protective role of Tregs in atherosclerosis. The lack of association between Tregs and stroke may reflect the more heterogeneous cause of this disease.
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Affiliation(s)
- Maria Wigren
- Department of Clinical Sciences, Entrance 72, 60:13, Malmö University Hospital, 20502 Malmö, Sweden
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32
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Wigren M, Nilsson J, Kolbus D. Lymphocytes in atherosclerosis. Clin Chim Acta 2012; 413:1562-8. [PMID: 22565046 DOI: 10.1016/j.cca.2012.04.031] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 04/29/2012] [Accepted: 04/29/2012] [Indexed: 02/08/2023]
Abstract
It is well established that atherosclerosis is caused by an inflammatory process in the arterial intima. However, it is only in recent years that it has become clear that this inflammation is modulated by immune responses against plaque antigens. These antigens are primarily believed to be modified self-antigens such as oxidized LDL. The immune system is challenged to determine whether these antigens should be regarded self and tolerated or non-self and eliminated. The latter will result in plaque development while the first will be protective. T cells are key effectors of both types of responses. An activation of regulatory T cells inhibits auto-reactive T effector cells and is anti-inflammatory. In contrast, if Th1 cells become activated in the plaque this is associated with increased inflammation and disease progression. The role of B cells in atherosclerosis remains to be clarified but some species of athero-protective antibodies have been identified. The elucidation of role of immune system in atherosclerosis has revealed new targets for intervention and both vaccines and antibody-based therapies are presently in or due to enter clinical testing.
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Affiliation(s)
- Maria Wigren
- Department of Clinical Sciences Malmö, Lund University, Sweden
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33
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Humoral and cellular immune responses in atherosclerosis: Spotlight on B- and T-cells. Vascul Pharmacol 2012; 56:193-203. [DOI: 10.1016/j.vph.2012.01.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 01/17/2012] [Accepted: 01/28/2012] [Indexed: 01/20/2023]
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34
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Klingenberg R, Ketelhuth DF, Strodthoff D, Gregori S, Hansson GK. Subcutaneous immunization with heat shock protein-65 reduces atherosclerosis in Apoe−/− mice. Immunobiology 2012; 217:540-7. [DOI: 10.1016/j.imbio.2011.06.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 06/19/2011] [Indexed: 10/18/2022]
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35
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Herbin O, Ait-Oufella H, Yu W, Fredrikson GN, Aubier B, Perez N, Barateau V, Nilsson J, Tedgui A, Mallat Z. Regulatory T-Cell Response to Apolipoprotein B100–Derived Peptides Reduces the Development and Progression of Atherosclerosis in Mice. Arterioscler Thromb Vasc Biol 2012; 32:605-12. [DOI: 10.1161/atvbaha.111.242800] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Olivier Herbin
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Hafid Ait-Oufella
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Wang Yu
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Gunilla Nordin Fredrikson
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Benjamin Aubier
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Nicolas Perez
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Véronique Barateau
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Jan Nilsson
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Alain Tedgui
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
| | - Ziad Mallat
- From the Institut National de la Santé et de la Recherche Médicale, Unit 970, Paris Cardiovascular Research Center, Paris, France (O.H., H.A.-O., W.Y., B.A., N.P., V.B., A.T., Z.M.); Assistance Publique-Hopitaux de Paris (H.A.-O.); Department of Clinical Sciences, Scania University Hospital Malmö, Lund University, Malmö, Sweden (G.N.F., J.N.); Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (Z.M.)
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de Jager SCA, Kuiper J. Vaccination strategies in atherosclerosis. Thromb Haemost 2011; 106:796-803. [PMID: 22012002 DOI: 10.1160/th11-05-0369] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Accepted: 10/03/2011] [Indexed: 12/16/2022]
Abstract
The treatment of atherosclerosis is currently based on lipid lowering in combination with anti-inflammatory therapies that slow the progression of atherosclerosis. Still, we are not able to fully inhibit the formation or progression of atherosclerotic lesions. A very effective strategy in other disease pathologies is vaccination, in which the body is challenged with the culprit protein or micro-organism in order to create a highly specific humoral immune-response. Immunisation can typically be divided into active or passive immunisation. Active immunisation occurs naturally when the body is exposed to certain microbes or antigens, but also artificially in the case of vaccination. Exposure to a microbe or antigen will result in the production of (antigen specific) antibodies. Passive immunisation is defined as the transfer of humoral immunity (as a result of antibody transfer). Another mechanism to ensure immune-protection is tolerance induction. Immune tolerance occurs naturally to prevent immune responses to 'self-antigens', but can also be induced to non-self antigens. Acquired tolerance to foreign antigens is accompanied by suppression of cellular and/or humoral immune response to the introduced antigen. In its most effective way, vaccination can result in a lifelong protection against the targeted pathology, and therefore the development of an atherosclerosis-specific vaccination is of high importance in the future prevention of atherosclerosis. One of the difficulties in developing effective vaccination strategies for atherosclerosis is the selection of a specific antigen to target. So far vaccination strategies have been based on targeting of lipid-antigens, inflammation-derived antigens, and recently cell-based vaccination strategies have been employed; but also the cardiovascular 'side-effects' of infection-based vaccines are worthy of our attention. This review describes the current status-quo on classical antibody associated vaccination strategies but also includes promising immune-modulation approaches that may lead to a clinical application.
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Affiliation(s)
- S C A de Jager
- Dept. of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research, Leiden University, Leiden, The Netherlands.
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37
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Cipolletta D, Kolodin D, Benoist C, Mathis D. Tissular T(regs): a unique population of adipose-tissue-resident Foxp3+CD4+ T cells that impacts organismal metabolism. Semin Immunol 2011; 23:431-7. [PMID: 21724410 DOI: 10.1016/j.smim.2011.06.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 06/07/2011] [Indexed: 10/18/2022]
Abstract
Foxp3+CD4+ regulatory T (T(reg)) cells are a key population in controlling the immune response. Recently, their roles have been expanded to broader, non-immune, contexts, in particular the metabolic consequences downstream of obesity-induced inflammation, e.g. type-2 diabetes and cardiovascular disease. This review highlights the major innate and adaptive immune cell subsets contributing to adipose-tissue inflammation, the key role played by fat-resident T(regs), and the potential of T(reg)-based therapies for treatment of the metabolic syndrome.
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Affiliation(s)
- Daniela Cipolletta
- Department of Pathology, Harvard Medical School, Boston, MA 02115, United States
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38
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Wigren M, Kolbus D, Dunér P, Ljungcrantz I, Söderberg I, Björkbacka H, Fredrikson GN, Nilsson J. Evidence for a role of regulatory T cells in mediating the atheroprotective effect of apolipoprotein B peptide vaccine. J Intern Med 2011; 269:546-56. [PMID: 21114693 DOI: 10.1111/j.1365-2796.2010.02311.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Autoimmune responses against oxidized low-density lipoprotein are considered to play an important pro-inflammatory role in atherosclerosis and to promote disease progression. T-regulatory cells (Tregs) are immunosuppressive cells that have an important part in maintaining self-tolerance and protection against autoimmunity. We investigated whether aBp210, a prototype atherosclerosis vaccine based on a peptide sequence derived from apolipoprotein B, inhibits atherosclerosis through the activation of Tregs. DESIGN Six-week-old Apoe(-/-) mice were immunized with aBp210 and received booster immunizations 3 and 5 weeks later, as well as 1 week before being killed at 25 weeks of age. RESULTS At 12 weeks, immunized mice had increased expression of the Treg marker CD25 on circulating CD4 cells, and concanavalin A (Con A)-induced interferon-γ, interleukin (IL)-4, and IL-10 release from splenocytes was markedly depressed. At 25 weeks, there was a fivefold expansion of splenic CD4+ CD25+ Foxp3 Tregs, a 65% decrease in Con A-induced splenic T-cell proliferation and a 37% reduction in the development of atherosclerosis in immunized mice. Administration of blocking antibodies against CD25 neutralized aBp210-induced Treg activation as well as the reduction of atherosclerosis. CONCLUSIONS The present findings demonstrate that immunization of Apoe(-/-) mice with the apolipoprotein B peptide vaccine aBp210 is associated with activation of Tregs. Administration of antibodies against CD25 results in depletion of Tregs and blocking of the atheroprotective effect of the vaccine. Modulation in atherosclerosis-related autoimmunity by antigen-specific activation of Tregs represents a novel approach for treatment of atherosclerosis.
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Affiliation(s)
- M Wigren
- Department of Clinical Sciences, Malmö University Hospital, Lund University, Sweden.
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39
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Lahoute C, Herbin O, Mallat Z, Tedgui A. Adaptive immunity in atherosclerosis: mechanisms and future therapeutic targets. Nat Rev Cardiol 2011; 8:348-58. [PMID: 21502963 DOI: 10.1038/nrcardio.2011.62] [Citation(s) in RCA: 177] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chronic inflammation drives the development of atherosclerosis, and adaptive immunity is deeply involved in this process. Initial studies attributed a pathogenic role to T cells in atherosclerosis, mainly owing to the proatherogenic role of the T-helper (T(H))-1 cell subset, whereas the influence of T(H)2 and T(H)17 subsets is still debated. Today we know that T regulatory cells play a critical role in the protection against atherosclerotic lesion development and inflammation. In contrast to T cells, B cells were initially considered to be protective in atherosclerosis, assumingly through the production of protective antibodies against oxidized LDL. This concept has now been refined and proatherogenic roles of certain mature B cell subsets have been identified. We review the current knowledge about the role of various lymphocyte subsets in the development and progression of atherosclerosis and highlight future targets for immunomodulatory therapy.
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Affiliation(s)
- Charlotte Lahoute
- French National Institute of Health and Medical Research, Paris Cardiovascular Research Center, Université Paris Descartes, 56 rue Leblanc, Paris, France
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40
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Dunér P, To F, Beckmann K, Björkbacka H, Fredrikson GN, Nilsson J, Bengtsson E. Immunization of apoE–/– mice with aldehyde-modified fibronectin inhibits the development of atherosclerosis. Cardiovasc Res 2011; 91:528-36. [DOI: 10.1093/cvr/cvr101] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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41
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Kolbus D, Wigren M, Ljungcrantz I, Söderberg I, Alm R, Björkbacka H, Nilsson J, Fredrikson GN. Immunization with cationized BSA inhibits progression of disease in ApoBec-1/LDL receptor deficient mice with manifest atherosclerosis. Immunobiology 2010; 216:663-9. [PMID: 21247654 DOI: 10.1016/j.imbio.2010.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 11/09/2010] [Accepted: 11/10/2010] [Indexed: 12/22/2022]
Abstract
Immune responses against modified self-antigens generated by hypercholesterolemia play an important role in atherosclerosis identifying the immune system as a possible novel target for prevention and treatment of cardiovascular disease. It has recently been shown that these immune responses can be modulated by subcutaneous injection of adjuvant. In the present study we immunized 25-week old ApoBec-1/LDL receptor deficient mice with manifest atherosclerosis with adjuvant and two different concentrations of the carrier molecule cationized BSA (cBSA). Plasma levels of Th2-induced apolipoprotein B (apoB)/IgG1 immune complexes were increased in the cBSA immunized groups verifying induction of immunity against a self-antigen. Mice were sacrificed at 36 weeks of age and atherosclerosis was monitored by en face Oil red O staining of the aorta. Immunization with 100 μg cBSA inhibited plaque progression, whereas the lower dose (50 μg) did not. In addition, the higher dose induced a more stable plaque phenotype, indicated by a higher content of collagen and less macrophages and T cells in the plaques. Moreover, there was an increased ratio of Foxp3+/Foxp3⁻ T cells in the circulation suggesting activation of a regulatory T cell response. In conclusion, we show that immunization with cBSA induces an immune response against apoB as well as an activation of Treg cells. This was associated with development of a more stable plaque phenotype and reduced atherosclerosis progression.
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Affiliation(s)
- Daniel Kolbus
- Department of Clinical Sciences, Skane University Hospital in Malmö, Lund University, Sweden
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42
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Dunér P, To F, Berg K, Alm R, Björkbacka H, Engelbertsen D, Fredrikson GN, Nilsson J, Bengtsson E. Immune responses against aldehyde-modified laminin accelerate atherosclerosis in Apoe−/− mice. Atherosclerosis 2010; 212:457-65. [DOI: 10.1016/j.atherosclerosis.2010.07.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 07/13/2010] [Accepted: 07/15/2010] [Indexed: 10/19/2022]
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43
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Ammirati E, Cianflone D, Banfi M, Vecchio V, Palini A, De Metrio M, Marenzi G, Panciroli C, Tumminello G, Anzuini A, Palloshi A, Grigore L, Garlaschelli K, Tramontana S, Tavano D, Airoldi F, Manfredi AA, Catapano AL, Norata GD. Circulating CD4+CD25hiCD127lo regulatory T-Cell levels do not reflect the extent or severity of carotid and coronary atherosclerosis. Arterioscler Thromb Vasc Biol 2010; 30:1832-41. [PMID: 20539016 DOI: 10.1161/atvbaha.110.206813] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Regulatory T (Treg) cells play a protective role in experimental atherosclerosis. In the present study, we investigated whether the levels of circulating Treg cells relate to the degree of atherosclerosis in carotid and coronary arteries. METHODS AND RESULTS We studied 2 distinct populations: (1) 113 subjects, selected from a free-living population (carotid study), in which we measured the intima-media thickness of the common carotid artery, as a surrogate marker of initial atherosclerosis; and (2) 75 controls and 125 patients with coronary artery disease (coronary study): 36 with chronic stable angina, 50 with non-ST-elevation acute coronary syndrome, 39 with ST-elevation acute myocardial infarction. Treg-cell levels were evaluated by flow cytometry (Treg cells identified as CD3(+)CD4(+)CD25(high)CD127(low)) and by mRNA expression of forkhead box P3 or of Treg-associated cytokine interleukin 10. In the carotid study, no correlation was observed between Treg-cell levels and intima-media thickness. No differences in Treg-cell levels were observed comparing rapid versus slow intima-media thickness progressors from a subgroup of patients (n=65), in which prospective data on 6-year intima-media thickness progression were available. In the coronary group, Treg-cell levels were not altered in chronic stable angina patients. In contrast, nonunivocal variations were observed in patients suffering an acute coronary syndrome (with a Treg-cell increase in ST-elevation acute myocardial infarction and a Treg-cell decrease in non-ST-elevation acute coronary syndrome patients). CONCLUSIONS The results suggest that determination of circulating Treg-cell levels based on flow cytometry or mRNA assessment is not a useful indicator of the extent or severity of atherosclerosis.
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Affiliation(s)
- Enrico Ammirati
- Clinical Cardiovascular Biology Research Centre, San Raffaele Scientific Institute and the Università Vita-Salute San Raffaele, Via Olgettina 58, 20132 Milan, Italy.
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44
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Matarese G, Procaccini C, De Rosa V, Horvath TL, La Cava A. Regulatory T cells in obesity: the leptin connection. Trends Mol Med 2010; 16:247-56. [PMID: 20493774 DOI: 10.1016/j.molmed.2010.04.002] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Revised: 04/06/2010] [Accepted: 04/08/2010] [Indexed: 01/15/2023]
Abstract
Studies to understand the pathogenesis of obesity have revealed mediators that are responsible for the control of food intake and metabolism at the hypothalamic level. However, molecular insight explaining the link between obesity and low-degree chronic inflammation remains elusive. The adipocyte-derived hormone leptin, and thereby the nutritional status, could control immune self-tolerance by affecting regulatory T (Treg) cell responsiveness and function. Furthermore, resident Treg cells, which are capable of modulating metabolism and glucose homeostasis, are abundant in adipose tissue. Here, we provide an update on recent findings relating Treg cells to obesity and discuss how the intricate network of interactions among leptin, Treg cells and adipose tissue might provide new strategies for therapeutic interventions.
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Affiliation(s)
- Giuseppe Matarese
- Laboratorio di Immunologia, Istituto di Endocrinologia e Oncologia Sperimentale, Consiglio Nazionale delle Ricerche (IEOS-CNR), Napoli, Italy.
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Hermansson A, Ketelhuth DF, Strodthoff D, Wurm M, Hansson EM, Nicoletti A, Paulsson-Berne G, Hansson GK. Inhibition of T cell response to native low-density lipoprotein reduces atherosclerosis. J Exp Med 2010; 207:1081-93. [PMID: 20439543 PMCID: PMC2867279 DOI: 10.1084/jem.20092243] [Citation(s) in RCA: 175] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Accepted: 03/11/2010] [Indexed: 12/25/2022] Open
Abstract
Immune responses to oxidized low-density lipoprotein (oxLDL) are proposed to be important in atherosclerosis. To identify the mechanisms of recognition that govern T cell responses to LDL particles, we generated T cell hybridomas from human ApoB100 transgenic (huB100(tg)) mice that were immunized with human oxLDL. Surprisingly, none of the hybridomas responded to oxidized LDL, only to native LDL and the purified LDL apolipoprotein ApoB100. However, sera from immunized mice contained IgG antibodies to oxLDL, suggesting that T cell responses to native ApoB100 help B cells making antibodies to oxLDL. ApoB100 responding CD4(+) T cell hybridomas were MHC class II-restricted and expressed a single T cell receptor (TCR) variable (V) beta chain, TRBV31, with different Valpha chains. Immunization of huB100(tg)xLdlr(-/-) mice with a TRBV31-derived peptide induced anti-TRBV31 antibodies that blocked T cell recognition of ApoB100. This treatment significantly reduced atherosclerosis by 65%, with a concomitant reduction of macrophage infiltration and MHC class II expression in lesions. In conclusion, CD4(+) T cells recognize epitopes on native ApoB100 protein, this response is associated with a limited set of clonotypic TCRs, and blocking TCR-dependent antigen recognition by these T cells protects against atherosclerosis.
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Affiliation(s)
- Andreas Hermansson
- Department of Medicine, Center for Molecular Medicine, Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm SE-17176, Sweden
| | - Daniel F.J. Ketelhuth
- Department of Medicine, Center for Molecular Medicine, Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm SE-17176, Sweden
| | - Daniela Strodthoff
- Department of Medicine, Center for Molecular Medicine, Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm SE-17176, Sweden
| | - Marion Wurm
- Department of Medicine, Center for Molecular Medicine, Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm SE-17176, Sweden
| | - Emil M. Hansson
- Department of Medicine, Center for Molecular Medicine, Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm SE-17176, Sweden
| | - Antonino Nicoletti
- Institut National de la Santé et de la Recherche Médicale U698, Université Denis Diderot, Paris 75006, France
| | - Gabrielle Paulsson-Berne
- Department of Medicine, Center for Molecular Medicine, Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm SE-17176, Sweden
| | - Göran K. Hansson
- Department of Medicine, Center for Molecular Medicine, Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm SE-17176, Sweden
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Klingenberg R, Lebens M, Hermansson A, Fredrikson GN, Strodthoff D, Rudling M, Ketelhuth DF, Gerdes N, Holmgren J, Nilsson J, Hansson GK. Intranasal Immunization With an Apolipoprotein B-100 Fusion Protein Induces Antigen-Specific Regulatory T Cells and Reduces Atherosclerosis. Arterioscler Thromb Vasc Biol 2010; 30:946-52. [DOI: 10.1161/atvbaha.109.202671] [Citation(s) in RCA: 161] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective—
Atherosclerosis is an inflammatory disease. Autoimmune responses to low-density lipoproteins (LDL) contribute to its progression, whereas immunization with LDL may induce atheroprotective or proatherogenic responses. The objective of this study was to develop an atheroprotective vaccine by targeting a peptide of the LDL protein constituent apolipoprotein B-100 (apoB-100) to the nasal mucosa to induce a protective mucosal immune response.
Methods and Results—
A peptide comprising amino acids 3136 to 3155 of apoB-100 (p210) was fused to the B subunit of cholera toxin (CTB), which binds to a ganglioside on mucosal epithelia. The effect of nasal administration of the p210-CTB fusion protein on atherogenesis was compared with that of an ovalbumin peptide fused to CTB and with untreated controls. Immunization with p210-CTB for 12 weeks caused a 35% reduction in aortic lesion size in
Apoe
−/−
mice. This effect was accompanied by induction of regulatory T cells that markedly suppressed effector T cells rechallenged with apoB-100 and increased numbers of interleukin (IL)-10
+
CD4
+
T cells. Furthermore, a peptide-specific antibody response was observed. Atheroprotection was also documented in
apoe
−/−
mice lacking functional transforming growth factor-β receptors on T cells.
Conclusion—
Nasal administration of an apoB-100 peptide fused to CTB attenuates atherosclerosis and induces regulatory Tr1 cells that inhibit T effector responses to apoB-100.
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Affiliation(s)
- Roland Klingenberg
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Michael Lebens
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Andreas Hermansson
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Gunilla Nordin Fredrikson
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Daniela Strodthoff
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Mats Rudling
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Daniel F.J. Ketelhuth
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Norbert Gerdes
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Jan Holmgren
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Jan Nilsson
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
| | - Göran K. Hansson
- From Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital Solna (R.K., A.H., D.S., D.F.J.K., N.G., G.K.H.) and Departments of Medicine and Biosciences and Nutrition, Karolinska University Hospital Huddinge (M.R.), Karolinska Institutet, Stockholm, Sweden; Department of Microbiology & Immunology and University of Gothenburg Vaccine Research Institute (GUVAX), Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (M.L., J.H.); and Department of
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Inflammatory and autoimmune reactions in atherosclerosis and vaccine design informatics. J Biomed Biotechnol 2010; 2010:459798. [PMID: 20414374 PMCID: PMC2858284 DOI: 10.1155/2010/459798] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 01/15/2010] [Accepted: 01/28/2010] [Indexed: 12/14/2022] Open
Abstract
Atherosclerosis is the leading pathological contributor to cardiovascular morbidity and mortality worldwide. As its complex pathogenesis has been gradually unwoven, the regime of treatments and therapies has increased with still much ground to cover. Active research in the past decade has attempted to develop antiatherosclerosis vaccines with some positive results. Nevertheless, it remains to develop a vaccine against atherosclerosis with high affinity, specificity, efficiency, and minimal undesirable pathology. In this review, we explore vaccine development against atherosclerosis by interpolating a number of novel findings in the fields of vascular biology, immunology, and bioinformatics. With recent technological breakthroughs, vaccine development affords precision in specifying the nature of the desired immune response—useful when addressing a disease as complex as atherosclerosis with a manifold of inflammatory and autoimmune components. Moreover, our exploration of available bioinformatic tools for epitope-based vaccine design provides a method to avoid expenditure of excess time or resources.
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48
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Shi GP. Immunomodulation of vascular diseases: atherosclerosis and autoimmunity. Eur J Vasc Endovasc Surg 2010; 39:485-94. [PMID: 20188603 DOI: 10.1016/j.ejvs.2010.01.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Accepted: 01/30/2010] [Indexed: 01/05/2023]
Abstract
The autoimmune disease atherosclerosis contributes to several vascular complications. Besides vascular cells, inflammatory cells occur prominently in atherosclerotic lesions; lymphocytes play a detrimental role in the initiation and progression of this common vascular disease. Recent discoveries have led to the identification of several important lymphocyte types within the atherosclerotic lesions. However, peripheral lymphocytes and those in the lymphoid organs both figure critically in the regulation of atherosclerotic lesion growth. Although the concept of atherosclerosis as an autoimmune disease is well known, the ways in which autoantigens and autoantibodies contribute to atherogenesis in human or even in animal models remains largely unknown. For example, autoantigen immunisation can either promote or attenuate atherogenesis in animals, depending on the antigen types and the routes and carriers of immunisation. This article summarises recent findings regarding lesion inflammatory cell types, autoantigens and autoantibody isotypes that can affect the initiation and progression of atherosclerosis from both human and animal studies.
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Affiliation(s)
- G-P Shi
- Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Exley C, Siesjö P, Eriksson H. The immunobiology of aluminium adjuvants: how do they really work? Trends Immunol 2010; 31:103-9. [PMID: 20153253 DOI: 10.1016/j.it.2009.12.009] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 12/23/2009] [Accepted: 12/23/2009] [Indexed: 12/31/2022]
Abstract
Aluminium adjuvants potentiate the immune response, thereby ensuring the potency and efficacy of typically sparingly available antigen. Their concomitant critical importance in mass vaccination programmes may have prompted recent intense interest in understanding how they work and their safety. Progress in these areas is stymied, however, by a lack of accessible knowledge pertaining to the bioinorganic chemistry of aluminium adjuvants, and, consequently, the inappropriate application and interpretation of experimental models of their mode of action. The objective herein is, therefore, to identify the many ways that aluminium chemistry contributes to the wide and versatile armoury of its adjuvants, such that future research might be guided towards a fuller understanding of their role in human vaccinations.
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Affiliation(s)
- Christopher Exley
- The Birchall Centre, Lennard-Jones Laboratories, Keele University, Staffordshire, ST5 5BG, UK.
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50
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Abstract
The initial event in atherogenesis is the increased transcytosis of low density lipoprotein, and its subsequent deposition, retention and modification in the subendothelium. It is followed by the infiltration of activated inflammatory cells from the coronary circulation into the arterial wall. There they secrete reactive oxygen species (ROS) and produce oxidized lipoproteins capable of inducing endothelial cell apoptosis, and thereby plaque erosion. Activated T lymphocytes, macrophages and mast cells, accumulate in the eroded plaque where they secrete a variety of proteases capable of inducing degradation of extracellular proteins, thereby rendering the plaques more prone to rupture. This review summarizes the recent advancements in the understanding of the roles of ROS and oxidized lipoproteins in the activation of inflammatory cells and inducing signalling pathways related to cell death and apoptosis. In addition, it presents evidence that this vicious circle between oxidative stress and inflammation does not only occur in the diseased arterial wall, but also in adipose tissues. There, oxidative stress and inflammation impair adipocyte maturation resulting in defective insulin action and adipocytokine signalling. The latter is associated with increased infiltration of inflammatory cells, loss of anti-oxidant protection and cell death in the arterial wall.
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Affiliation(s)
- Maarten Hulsmans
- Atherosclerosis and Metabolism Unit, Department of Cardiovascular Diseases, Katholieke Universiteit Leuven, Belgium
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