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Ziegler L, Fuehner S, Kessel C, Hinze C, Klotsche J, Niewerth M, Minden K, Foell D. Soluble interleukin-2 receptor serum levels facilitate prediction of relapses in subgroups of patients with juvenile idiopathic arthritis. Rheumatology (Oxford) 2022; 61:4975-4984. [PMID: 35325053 DOI: 10.1093/rheumatology/keac178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/15/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES JIA is characterised by a chronic disease course. Once patients achieve a state of inactive disease, there are no established biomarkers to predict the further course of inflammation for these patients. Therefore, the purpose of this study was to quantify serum biomarkers during quiescent disease to evaluate their use in identifying JIA patients at risk for future disease flare. METHODS Patients with non-systemic JIA reaching inactive disease status were divided into two groups: 92 patients with future active disease after a median period of 6 months (range 3-9) and 80 patients with persistent inactive disease for the following period (median 11 months, range 7-16) according to the juvenile arthritis DAS (JADAS). Clinical parameters and serum levels of various biomarkers were measured in the state of inactive disease using immunoassays in both groups and were analysed for their potential to predict the further course of disease. RESULTS Soluble interleukin-2 receptor (sIL-2R) serum levels were significantly higher in patients with future active disease (P = 0.021), which especially applied to patients with RF-negative polyarticular and extended oligoarticular JIA (P < 0.001). Higher sIL-2R serum levels during inactive disease were associated with a greater number of active joints at future active disease. CONCLUSION Patients without clinical signs of disease activity already presented with increased sIL-2R serum levels several months before disease relapses, whereas conventional inflammation parameters were not elevated. Determination of sIL-2R serum levels during inactive disease may facilitate identifying patients with subclinical disease activity at risk for future active disease.
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Affiliation(s)
- Linda Ziegler
- Department of Pediatric Rheumatology and Immunology, University Hospital Muenster, Muenster
| | - Sabrina Fuehner
- Department of Pediatric Rheumatology and Immunology, University Hospital Muenster, Muenster
| | - Christoph Kessel
- Department of Pediatric Rheumatology and Immunology, University Hospital Muenster, Muenster
| | - Claas Hinze
- Department of Pediatric Rheumatology and Immunology, University Hospital Muenster, Muenster
| | - Jens Klotsche
- Epidemiology Unit, German Rheumatism Research Center, Berlin, Germany
| | - Martina Niewerth
- Epidemiology Unit, German Rheumatism Research Center, Berlin, Germany
| | - Kirsten Minden
- Epidemiology Unit, German Rheumatism Research Center, Berlin, Germany
| | - Dirk Foell
- Department of Pediatric Rheumatology and Immunology, University Hospital Muenster, Muenster
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The role of A Disintegrin and Metalloproteinase (ADAM)-10 in T helper cell biology. BIOCHIMICA ET BIOPHYSICA ACTA. MOLECULAR CELL RESEARCH 2022; 1869:119192. [PMID: 34982961 DOI: 10.1016/j.bbamcr.2021.119192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022]
Abstract
A Disintegrin and Metalloproteinases (ADAM)-10 is a member of a family of membrane-anchored proteinases that regulate a broad range of cellular functions with central roles within the immune system. This has spurred the interest to modulate ADAM activity therapeutically in immunological diseases. CD4 T helper (Th) cells are the key regulators of adaptive immune responses. Their development and function is strongly dependent on Notch, a key ADAM-10 substrate. However, Th cells rely on a variety of additional ADAM-10 substrates regulating their functional activity at multiple levels. The complexity of both, the ADAM substrate expression as well as the functional consequences of ADAM-mediated cleavage of the various substrates complicates the analysis of cell type specific effects. Here we provide an overview on the major ADAM-10 substrates relevant for CD4 T cell biology and discuss the potential effects of ADAM-mediated cleavage exemplified for a selection of important substrates.
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Malengier-Devlies B, Metzemaekers M, Wouters C, Proost P, Matthys P. Neutrophil Homeostasis and Emergency Granulopoiesis: The Example of Systemic Juvenile Idiopathic Arthritis. Front Immunol 2021; 12:766620. [PMID: 34966386 PMCID: PMC8710701 DOI: 10.3389/fimmu.2021.766620] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/23/2021] [Indexed: 12/21/2022] Open
Abstract
Neutrophils are key pathogen exterminators of the innate immune system endowed with oxidative and non-oxidative defense mechanisms. More recently, a more complex role for neutrophils as decision shaping cells that instruct other leukocytes to fine-tune innate and adaptive immune responses has come into view. Under homeostatic conditions, neutrophils are short-lived cells that are continuously released from the bone marrow. Their development starts with undifferentiated hematopoietic stem cells that pass through different immature subtypes to eventually become fully equipped, mature neutrophils capable of launching fast and robust immune responses. During severe (systemic) inflammation, there is an increased need for neutrophils. The hematopoietic system rapidly adapts to this increased demand by switching from steady-state blood cell production to emergency granulopoiesis. During emergency granulopoiesis, the de novo production of neutrophils by the bone marrow and at extramedullary sites is augmented, while additional mature neutrophils are rapidly released from the marginated pools. Although neutrophils are indispensable for host protection against microorganisms, excessive activation causes tissue damage in neutrophil-rich diseases. Therefore, tight regulation of neutrophil homeostasis is imperative. In this review, we discuss the kinetics of neutrophil ontogenesis in homeostatic conditions and during emergency myelopoiesis and provide an overview of the different molecular players involved in this regulation. We substantiate this review with the example of an autoinflammatory disease, i.e. systemic juvenile idiopathic arthritis.
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Affiliation(s)
- Bert Malengier-Devlies
- Department of Microbiology, Immunology and Transplantation, Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Mieke Metzemaekers
- Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Carine Wouters
- Department of Microbiology, Immunology and Transplantation, Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.,Division of Pediatric Rheumatology, University Hospitals Leuven, Leuven, Belgium.,European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) at University Hospital Leuven, Leuven, Belgium
| | - Paul Proost
- Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Patrick Matthys
- Department of Microbiology, Immunology and Transplantation, Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
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Sweis IE, Cressey BC. Potential role of the common food additive manufactured citric acid in eliciting significant inflammatory reactions contributing to serious disease states: A series of four case reports. Toxicol Rep 2018; 5:808-812. [PMID: 30128297 PMCID: PMC6097542 DOI: 10.1016/j.toxrep.2018.08.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 07/30/2018] [Accepted: 08/02/2018] [Indexed: 12/19/2022] Open
Abstract
Citric acid naturally exists in fruits and vegetables. However, it is not the naturally occurring citric acid, but the manufactured citric acid (MCA) that is used extensively as a food and beverage additive. Approximately 99% of the world's production of MCA is carried out using the fungus Aspergillus niger since 1919. Aspergilus niger is a known allergen. The FDA placed MCA under the category of GRAS without any research to substantiate this claim. In 2016, 2.3 million tons of MCA were produced, predominantly in China, and approximately 70% is used as a food or beverage additive. There have been no scientific studies performed to evaluate the safety of MCA when ingested in substantial amounts and with chronic exposure. We present four case reports of patients with a history of significant and repetitive inflammatory reactions including respiratory symptoms, joint pain, irritable bowel symptoms, muscular pain and enervation following ingestion of foods, beverages or vitamins containing MCA. We believe that ingestion of the MCA may lead to a harmful inflammatory cascade which manifests differently in different individuals based on their genetic predisposition and susceptibility, and that the use of MCA as an additive in consumable products warrants further studies to document its safety.
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Affiliation(s)
- Iliana E. Sweis
- Department of Surgery, University of Illinois at Chicago, USA
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Brescia AC, Simonds MM, Sullivan KE, Rose CD. Secretion of pro-inflammatory cytokines and chemokines and loss of regulatory signals by fibroblast-like synoviocytes in juvenile idiopathic arthritis. Proteomics Clin Appl 2017; 11:1600088. [PMID: 28012239 PMCID: PMC6084365 DOI: 10.1002/prca.201600088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 06/28/2016] [Accepted: 12/19/2016] [Indexed: 11/08/2022]
Abstract
PURPOSE The goal is to investigate the specific contribution of fibroblast-like synoviocytes (FLS) to the inflammatory milieu of the synovium in juvenile idiopathic arthritis (JIA) through detection of secreted proteins. EXPERIMENTAL DESIGN Expression of 89 cytokines and chemokines is determined on unprocessed synovial fluid from controls and JIA patients using antibody arrays. Supernatants from pure cell cultures of FLS grown from synovial fluids or tissues from JIA and controls are also examined for protein expression. Ingenuity Pathway Analysis (IPA) is revealed top pathways and upstream regulators of significant proteins. RESULTS Protein studies is revealed that JIA FLS release pro-inflammatory cytokines and chemokines, including IL-4, IL-6, IL-17, CXCL1, and CXCL6, and lose expression of important regulator signals, such as IL-10 and TIMP2. Of the 84 proteins differentially expressed between controls and JIA in the synovial fluid, 1/3 (29 proteins) are differentially expressed in the cell culture supernatants of JIA and control FLS. ELISA of cell culture supernatants and synovial fluid confirmed seven key proteins. CONCLUSION AND CLINICAL RELEVANCE JIA FLS are central to perpetuation of inflammation in JIA, including trafficking of inflammatory cells and effects on the extracellular matrix. These cells express key disease-specific chemokines that, with further refinement, may allow us to tailor therapy appropriately.
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Gorczyca D, Postępski J, Czajkowska A, Paściak M, Prescha A, Olesińska E, Gruenpeter A, Lachór-Motyka I, Szponar B. The profile of polyunsaturated fatty acids in juvenile idiopathic arthritis and association with disease activity. Clin Rheumatol 2017; 36:1269-1279. [PMID: 28247163 PMCID: PMC5486496 DOI: 10.1007/s10067-017-3586-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 02/16/2017] [Accepted: 02/20/2017] [Indexed: 01/10/2023]
Abstract
We investigated the association between dietary intake of n-3 and n-6 polyunsaturated fatty acids (PUFAs), serum profiles, and immune and inflammatory markers in juvenile idiopathic arthritis (JIA) in relation to onset, activity, and duration. A total of 66 JIA patients and 42 controls were included. Serum PUFA levels were assessed by gas-liquid chromatography-mass spectrometry, a dietary intake by 7-day dietary record method, and IL-6, IL-10, and IL-17A levels using ELISA. Dietary PUFA intake did not differ between the JIA group and controls. Intakes of n-6 and n-3 PUFA and serum levels were not associated. Levels of total n-6 PUFA and linoleic acid (LA) were higher in inactive JIA than in active JIA. Patients with active and short-lasting disease (less than 3 months from diagnosis) had significantly lower levels of arachidonic acid (AA) and docosahexaenoic acid (DHA) than the control. Serum α-linolenic acid (ALA) levels were significantly higher in poly-JIA than in oligo-JIA and in controls. We found significantly higher serum IL-10 levels in JIA than in controls. Serum n-6 and n-3 levels were significantly negatively correlated with active joint count, erythrocyte sedimentation rate, and C-reactive protein and positively with platelet count. Our study presents the low levels of AA and DHA in the active phase of short-lasting JIA, particularly poly-JIA, and the relationship between n-6 and n-3 PUFA and classic markers of inflammation. PUFAs may contribute to the pathogenesis of JIA and support a necessity to identify new targets suitable for successful interventional studies in JIA patients.
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Affiliation(s)
- Daiva Gorczyca
- Third Department and Clinic of Paediatrics, Immunology and Rheumatology of Developmental Age, Wroclaw Medical University, Wroclaw, Poland.
| | - Jacek Postępski
- First Department of Paediatrics Pulmonology and Rheumatology, University of Medicine in Lublin, Lublin, Poland
| | - Aleksandra Czajkowska
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Mariola Paściak
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Anna Prescha
- Department of Food Science and Dietetics, Wroclaw Medical University, Wroclaw, Poland
| | - Edyta Olesińska
- First Department of Paediatrics Pulmonology and Rheumatology, University of Medicine in Lublin, Lublin, Poland
| | - Anna Gruenpeter
- Department of Paediatric Rheumatology, John Paul II Paediatric Centre, Sosnowiec, Poland
| | - Iwona Lachór-Motyka
- Department of Paediatric Rheumatology, John Paul II Paediatric Centre, Sosnowiec, Poland
| | - Bogumiła Szponar
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Fathy MM, Elsaadany HF, Ali YF, Farghaly MAA, Hamed ME, Ibrahim HE, Noah MA, Allah MAN, Elashkar SSA, Abdelsalam NI, Abdelrahman HM, Ahmed AR, Anany HG, Ismail SM, Ibrahim BR, Al Azizi NM, Gawish HH, Al-Akad GM, Nabil RM, Fahmy DS, Alsayed SF. Association of IL-10 gene polymorphisms and susceptibility to Juvenile Idiopathic Arthritis in Egyptian children and adolescents: a case-control study. Ital J Pediatr 2017; 43:9. [PMID: 28257625 PMCID: PMC5347812 DOI: 10.1186/s13052-017-0328-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/11/2017] [Indexed: 11/10/2022] Open
Abstract
Background Juvenile Idiopathic Arthritis (JIA) is the most common chronic arthritis in children worldwide. Among anti-inflammatory cytokines, interleukin-10 (IL-10) is a key immunosuppressive cytokine involved in the pathogenesis of JIA. To date, only a few studies concerned the association of interleukin-10 gene polymorphisms with JIA. In this study, we aimed to investigate 3 cytokine single-nucleotide polymorphisms situated at positions -1082(G/A), −819(C/T), and −592(C/A) in the promoter region of the IL-10 gene to determine whether this polymorphism could be a marker of susceptibility to JIA in Egyptian children and adolescents. We also measured the serum level of IL-10 to assess its relation to such polymorphism. Methods This was a case-control study included 100 patients diagnosed with JIA, and matched with age, gender, ethnicity 100 healthy control subjects. Interleukin-10 −1082(G/A), −819(C/T), and −592(C/A) polymorphisms were genotyped by amplification refractory mutation system- polymerase chain reaction (ARMS)-PCR methodology, while the serum IL10 levels were measured by ELISA method. Results Compared to the controls subjects, the frequency of IL-10- AA genotype and A allele at the –1082 position were overrepresented in patients with JIA (OR = 2.7; 95% CI: 1.1–6.4 for the AA genotype; P <0.05 and OR: 1.5; 95% CI: 1.03–2.3 for the A allele; P <0.05 respectively). On the other hand, no significant differences were found between the 2 groups in the genotype or allele frequencies for the –819 and –592 positions. Of note, we found a significant positive association between the IL-10 (-1082) AA genotype and susceptibility to polyarticular JIA (OR: 4.3; 95% CI: 1.5–12.7; P <0.01). We observed that patients with the IL-10 (-1082) AA genotype had significantly lower serum IL-10 levels (2.3 ± 0.9 pg/ml) compared to those with AG genotype (7.6 ± 1.5 pg/ml) and GG genotype (9.5 ± 1.2 pg/ml); P < 0.01, respectively. Conclusion We demonstrate for the first time, to the best of our knowledge, that the presence of an A allele or AA gene variant at the –1082 position of the promoter region of the interleukin-10 gene may constitute risk factors for developing JIA in Egyptian children and adolescents. Moreover, we observed a significant positive association between the IL10 –1082 AA gene variant and susceptibility to polyarticular JIA.
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Affiliation(s)
- Manar M Fathy
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt.
| | - Hosam F Elsaadany
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Yasser F Ali
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Mohsen A A Farghaly
- Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Mohammed E Hamed
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Hany E Ibrahim
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Maha A Noah
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Mayy A N Allah
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Shaimaa S A Elashkar
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Nasser I Abdelsalam
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Hind M Abdelrahman
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Ahmed R Ahmed
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Heba G Anany
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Sanaa M Ismail
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Boshra R Ibrahim
- Department of Pediatrics, Faculty of Medicine, Zagazig University, 13 Omar Bin Elkhattab St, Al Qawmia, Zagazig City, AlSharqia Governorate, Egypt
| | - Nashwa M Al Azizi
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Heba H Gawish
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ghada M Al-Akad
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rehab M Nabil
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dalia S Fahmy
- Department of Rheumatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Salah F Alsayed
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Wagner DH. Overlooked Mechanisms in Type 1 Diabetes Etiology: How Unique Costimulatory Molecules Contribute to Diabetogenesis. Front Endocrinol (Lausanne) 2017; 8:208. [PMID: 28878738 PMCID: PMC5572340 DOI: 10.3389/fendo.2017.00208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 08/08/2017] [Indexed: 01/16/2023] Open
Abstract
Type 1 Diabetes (T1D) develops when immune cells invade the pancreatic islets resulting in loss of insulin production in beta cells. T cells have been proven to be central players in that process. What is surprising, however, is that classic mechanisms of tolerance cannot explain diabetogenesis; alternate mechanisms must now be considered. T cell receptor (TCR) revision is the process whereby T cells in the periphery alter TCR expression, outside the safety-net of thymic selection pressures. This process results in an expanded T cell repertoire, capable of responding to a universe of pathogens, but limitations are that increased risk for autoimmune disease development occurs. Classic T cell costimulators including the CD28 family have long been thought to be the major drivers for full T cell activation. In actuality, CD28 and its family member counterparts, ICOS and CTLA-4, all drive regulatory responses. Inflammation is driven by CD40, not CD28. CD40 as a costimulus has been largely overlooked. When naïve T cells interact with antigen presenting cell CD154, the major ligand for CD40, is induced. This creates a milieu for T cell (CD40)-T cell (CD154) interaction, leading to inflammation. Finally, defined pathogenic effector cells including TH40 (CD4+CD40+) cells can express FOXP3 but are not Tregs. The cells loose FOXP3 to become pathogenic effector cells. Each of these mechanisms creates novel options to better understand diabetogenesis and create new therapeutic targets for T1D.
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Affiliation(s)
- David H. Wagner
- The Program in Integrated Immunology, Department of Medicine, Webb-Waring Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- *Correspondence: David H. Wagner Jr.,
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Evensen K, Aulie HA, Rønning OM, Flatø B, Russell D. Carotid Atherosclerosis in Adult Patients with Persistently Active Juvenile Idiopathic Arthritis Compared with Healthy Controls. J Rheumatol 2016; 43:810-5. [DOI: 10.3899/jrheum.150499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2015] [Indexed: 11/22/2022]
Abstract
Objective.Juvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatic disease in childhood. It is regarded as a systemic inflammatory disease with possible increased risk of cardiovascular disease (CVD). The aim of this study was to assess carotid intima-media thickness (IMT) and carotid stenosis as surrogate measures for CVD in adults with longterm active JIA and healthy age- and sex-matched controls.Methods.Seventy-five patients with JIA (age 28–45 yrs) with persistently active disease at least 15 years after disease onset were reexamined after a median of 29 years and compared with 75 matched controls. Patients and controls were examined by color duplex ultrasound of the carotid arteries to compare carotid IMT and carotid stenosis in the 2 groups.Results.Patients with JIA did not have increased carotid IMT values compared with the controls (mean ± SD: 0.56 mm ± 0.09 vs 0.58 mm ± 0.07, p = 0.289). Patients with a higher disease activity indicated by the Juvenile Arthritis Disease Activity Score value above the median value had increased carotid IMT compared with the patients with a lower value, but not statistically different compared with controls. No carotid stenoses were detected in patients or controls.Conclusion.We found similar carotid IMT values in adult patients with JIA and controls.
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Gariup M, Gonzalez A, Lázaro L, Torres F, Serra-Pagès C, Morer A. IL-8 and the innate immunity as biomarkers in acute child and adolescent psychopathology. Psychoneuroendocrinology 2015; 62:233-42. [PMID: 26325024 DOI: 10.1016/j.psyneuen.2015.08.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The role of inflammation in psychopathology has received great attention over the past decades. Immune system dysfunction and altered cytokine levels have been reported in most psychiatric disorders in adults. Few data are available regarding children and adolescents (C&A), or regarding the relationship between cytokine levels and psychosocial stress. This study investigates the profile of the most described cytokines in a sample of C&A inpatients affected by an acute psychiatric condition requiring hospitalization, in comparison with healthy subjects, as well as possible associations between psychosocial stressors and psychopathology and/or cytokine concentrations. METHODS Patients with a diagnosis of Affective, Anxiety, Adjustment, Psychotic, Obsessive-Compulsive, Tic or Tourette Disorders were consecutively recruited from our clinic between June 2010 and February 2012. Controls were recruited from the same geographic area. All subjects were between 8 and 17 years old. Twelve cytokines are compared: interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL_10, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IFN-γ-induced protein-10 (IP-10), monocyte chemoattractant protein (MCP)-1. Psychosocial stress was measured through the Stressful Life Events Scale, Child and Parents versions (SLES-C and SLES-P) and the evaluation of the family integrity. RESULTS One hundred and eleven subjects (77C&A inpatients and 34 healthy controls), of which 54 were males (49%), with a median (interquartile range) age of 16 (13.7-17.3) years, were included in this study. IL-1β, IL6, IL8, IP-10, MCP-1 and monocytes were found to be significantly higher in the patient group (p<0.05). Differences were confirmed when adjusting by BMI, age, gender and drug intake at admission for all cytokines except MCP-1. IL-8 and IL-1β were also higher throughout the different diagnostic categories, than in control group (p<0.05). Stress measures were higher in patients. A significant correlation was found between stress measured by the SLES and some inflammatory markers: SLES_C with IL-1β, IL-8, MCP-1, and SLES_P with IL-1β and monocytes absolute and relative counts (Spearman's r between 0.219 and 0.297, p<0.05). Logistic regression identified the following variables as independent predictors of the patient condition, (odds ratio per quartile, p-value): IL8 (1, 0.9, 12.1, 32.0, p=0.044), IP10 (1, 14.1, 2.5, 3.7, p=0.044), monocyte absolute count (1, 1.1, 6.0, 19.4, p=0.030). CONCLUSIONS Results show elevated inflammation markers from the innate immune system across C&A acute psychiatric diagnosis, and suggest a link between psychopathology, inflammation and stress. Inflammatory markers resulted predictors of patient status. These exploratory results are coherent with current psychoneuroimmunology and neurodevelopmental investigations.
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Affiliation(s)
- Maria Gariup
- Psychiatry Department, Kolding Hospital, Skovvejen, Kolding 6000, Denmark; Medicine Faculty, Barcelona University, C/ Villarroel 170, Barcelona 08036, Spain.
| | - Azucena Gonzalez
- Immunonlogy Dept., Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain.
| | - Luisa Lázaro
- Medicine Faculty, Barcelona University, C/ Villarroel 170, Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Child and Adolescent Psychiatry, Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Group G04, Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain.
| | - Ferran Torres
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Carles Serra-Pagès
- Medicine Faculty, Barcelona University, C/ Villarroel 170, Barcelona 08036, Spain; Immunonlogy Dept., Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - Astrid Morer
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Child and Adolescent Psychiatry, Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Group G04, Hospital Clínic, C/ Villarroel 170, Barcelona 08036, Spain.
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Habets KLL, Trouw LA, Levarht EWN, Korporaal SJA, Habets PAM, de Groot P, Huizinga TWJ, Toes REM. Anti-citrullinated protein antibodies contribute to platelet activation in rheumatoid arthritis. Arthritis Res Ther 2015; 17:209. [PMID: 26268317 PMCID: PMC4548712 DOI: 10.1186/s13075-015-0665-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/29/2015] [Indexed: 01/11/2023] Open
Abstract
Introduction Although the role of platelets in rheumatoid arthritis (RA) is relatively unexplored, recent studies point towards a contribution of platelets in arthritis. We set out to determine platelet phenotype in RA and studied whether this could be influenced by the presence of anti-citrullinated protein antibodies (ACPA). Methods Platelets from healthy controls were incubated in the presence of plasma of patients with RA or age- and sex-matched healthy controls and plasma from ACPAneg or ACPApos patients or in the presence of plate-bound ACPA. Characteristics of platelets isolated from patients with RA were correlated to disease activity. Results Platelets isolated from healthy controls displayed markers of platelet activation in the presence of plasma derived from RA patients, as determined by P-selectin expression, formation of aggregates and secretion of soluble CD40 ligand (sCD40L). Furthermore, levels of P-selectin expression and sCD40L release correlated with high ACPA titres. In accordance with these findings, enhanced platelet activation was observed after incubation with ACPApos plasma versus ACPAneg plasma. Pre-incubation of platelets with blocking antibodies directed against low-affinity immunoglobulin G receptor (FcγRIIa) completely inhibited the ACPA-mediated activation. In addition, expression of P-selectin measured as number of platelets correlated with Disease Activity Score in 44 joints, C-reactive protein level, ACPA status and ACPA level. Conclusions We show for the first time that ACPA can mediate an FcγRIIa-dependent activation of platelets. As ACPA can be detected several years before RA disease onset and activated platelets contribute to vascular permeability, these data implicate a possible role for ACPA-mediated activation of platelets in arthritis onset. Electronic supplementary material The online version of this article (doi:10.1186/s13075-015-0665-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kim L L Habets
- Department of Rheumatology, Leiden University Medical Centre, C1-R, PO Box 9600, 2300, RC, Leiden, the Netherlands.
| | - Leendert A Trouw
- Department of Rheumatology, Leiden University Medical Centre, C1-R, PO Box 9600, 2300, RC, Leiden, the Netherlands.
| | - E W Nivine Levarht
- Department of Rheumatology, Leiden University Medical Centre, C1-R, PO Box 9600, 2300, RC, Leiden, the Netherlands.
| | - Suzanne J A Korporaal
- Department of Clinical Chemistry and Haematology, University Medical Centre, Utrecht, the Netherlands. .,Division of Biopharmaceutics, Leiden Amsterdam Centre for Drug Research, University of Leiden, Leiden, the Netherlands.
| | - Petra A M Habets
- Knowledge Centre Forensic Psychiatric Care, Rekem Psychiatric Hospital, Rekem, Belgium.
| | - Philip de Groot
- Department of Clinical Chemistry and Haematology, University Medical Centre, Utrecht, the Netherlands.
| | - Tom W J Huizinga
- Department of Rheumatology, Leiden University Medical Centre, C1-R, PO Box 9600, 2300, RC, Leiden, the Netherlands.
| | - René E M Toes
- Department of Rheumatology, Leiden University Medical Centre, C1-R, PO Box 9600, 2300, RC, Leiden, the Netherlands.
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12
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Cytokine balance and cytokine-driven natural killer cell dysfunction in systemic juvenile idiopathic arthritis. Cytokine Growth Factor Rev 2015; 26:35-45. [DOI: 10.1016/j.cytogfr.2014.05.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 05/13/2014] [Accepted: 05/15/2014] [Indexed: 01/14/2023]
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13
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Strathmann FG, Schulte S, Goerl K, Petron DJ. Blood-based biomarkers for traumatic brain injury: Evaluation of research approaches, available methods and potential utility from the clinician and clinical laboratory perspectives. Clin Biochem 2014; 47:876-88. [DOI: 10.1016/j.clinbiochem.2014.01.028] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/05/2014] [Accepted: 01/23/2014] [Indexed: 01/06/2023]
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14
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Imbalance of Th17 and T-regulatory cells in peripheral blood and synovial fluid in treatment naïve children with juvenile idiopathic arthritis. Cent Eur J Immunol 2014; 39:71-6. [PMID: 26155103 PMCID: PMC4439971 DOI: 10.5114/ceji.2014.42128] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/18/2013] [Indexed: 01/18/2023] Open
Abstract
Objectives The imbalance between Th17 and T regulatory cells (Tregs) may be a key event in development of autoimmunity. The problem is poorly explored in juvenile idiopathic arthritis (JIA) so far. In this study, peripheral blood (PB) and synovial fluid (SF) Tregs and Th17 cells from were assessed in untreated JIA children. Material and methods In 50 children with JIA the PB or SF percentages of Tregs and Th17 cells were assessed by flow cytometry, in comparison with PB Tregs and Th17 cells from 28 healthy controls. Additionally, in both groups the levels of proinfammatory cytokines, such as interleukin (IL)-1β, IL -6, IL -17, IL -21, IL -23 and tumor necrosis factor α (TN F-α) were assessed using ELI SA method. Results The proportion of JIA PB Th17 cells was significantly higher than in the controls (p = 0.01). Serum levels of IL -1β, IL -6, IL -17, IL -23 were also significantly higher in JIA (p = 0.011, p = 0.007, p = 0.008 and p = 0.023, respectively). The highest serum IL -6 levels were observed in oligoarthritis JIA (p = 0.031). Synovial fluid IL -21 concentration was distinctly higher in polyarticular JIA. Synovial fluid levels of TN F-α, IL -1β and IL -6 were significantly higher than in JIA PB (p = 0.038, p = 0.013 and p < 0.001, respectively). There was a significant correlation between IL -6 and PB Tregs (p = 0.02). Conclusions The results of this comprehensive analysis indicate a role of Th17 cell activation in the pathogenesis of JIA.
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Xie JH, Yamniuk AP, Borowski V, Kuhn R, Susulic V, Rex-Rabe S, Yang X, Zhou X, Zhang Y, Gillooly K, Brosius R, Ravishankar R, Waggie K, Mink K, Price L, Rehfuss R, Tamura J, An Y, Cheng L, Abramczyk B, Ignatovich O, Drew P, Grant S, Bryson JW, Suchard S, Salter-Cid L, Nadler S, Suri A. Engineering of a Novel Anti-CD40L Domain Antibody for Treatment of Autoimmune Diseases. THE JOURNAL OF IMMUNOLOGY 2014; 192:4083-92. [DOI: 10.4049/jimmunol.1303239] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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16
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Ceeraz S, Nowak EC, Burns CM, Noelle RJ. Immune checkpoint receptors in regulating immune reactivity in rheumatic disease. Arthritis Res Ther 2014; 16:469. [PMID: 25606596 PMCID: PMC4289356 DOI: 10.1186/s13075-014-0469-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Immune checkpoint regulators are critical modulators of the immune system, allowing the initiation of a productive immune response and preventing the onset of autoimmunity. Co-inhibitory and co-stimulatory immune checkpoint receptors are required for full T-cell activation and effector functions such as the production of cytokines. In autoimmune rheumatic diseases, impaired tolerance leads to the development of diseases such as rheumatoid arthritis, systemic lupus erythematosus, and Sjogren's syndrome. Targeting the pathways of the inhibitory immune checkpoint molecules CD152 (cytotoxic T lymphocyte antigen-4) and CD279 (programmed death-1) in cancer shows robust anti-tumor responses and tumor regression. This observation suggests that, in autoimmune diseases, the converse strategy of engaging these molecules may alleviate inflammation owing to the success of abatacept (CD152-Ig) in rheumatoid arthritis patients. We review the preclinical and clinical developments in targeting immune checkpoint regulators in rheumatic disease.
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Affiliation(s)
- Sabrina Ceeraz
- />Department of Microbiology and Immunology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH 03756 USA
| | - Elizabeth C Nowak
- />Department of Microbiology and Immunology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH 03756 USA
| | - Christopher M Burns
- />Department of Medicine, Section of Rheumatology, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH 03756 USA
| | - Randolph J Noelle
- />Department of Microbiology and Immunology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH 03756 USA
- />Medical Research Council Centre of Transplantation, Guy’s Hospital, King’s College London, London, SE1 9RT UK
- />Department of Immune Regulation and Intervention, King’s College London, King’s Health Partners, London, SE1 9RT UK
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Habets KLL, Huizinga TWJ, Toes REM. Platelets and autoimmunity. Eur J Clin Invest 2013; 43:746-57. [PMID: 23617819 DOI: 10.1111/eci.12101] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 04/01/2013] [Indexed: 12/12/2022]
Abstract
Vascular injury is the initial manifestation of inflammation resulting in the recruitment and activation of various cell types. The integrity of the vascular wall is monitored by platelets that become activated in the presence of exposed subendothelium. Besides their well-established role in haemostasis, ample data are now emerging on the many immunoregulatory functions of platelets. Platelets store and release a large plethora of cytokines, chemokines and growth factors. They also represent the largest circulating pool of many inflammatory mediators like P-selectin, CD40L and non-neuronal serotonin. Furthermore, complement activation occurs on the platelet surface and deposition of complement results in platelet activation. Overall, platelets have multiple functions in both innate and adaptive immunity. Further insight into the multifaceted role of platelets could therefore provide important clues into how we could implement current platelet therapy to reduce both platelet-induced thrombosis and inflammation. In this review, we discuss the current perceptions of platelet involvement in various autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis and multiple sclerosis.
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Affiliation(s)
- Kim L L Habets
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
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18
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Jednacz E, Rutkowska-Sak L. Atherosclerosis in juvenile idiopathic arthritis. Mediators Inflamm 2012; 2012:714732. [PMID: 22933832 PMCID: PMC3425868 DOI: 10.1155/2012/714732] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 07/17/2012] [Accepted: 07/17/2012] [Indexed: 12/24/2022] Open
Abstract
Atherosclerosis is a chronic inflammatory disease of the arteries. Clinical consequences of the atherosclerotic process occur in the adult population, however atherosclerotic process begins in childhood. The classic risk factors for atherosclerosis include obesity, dyslipidaemia, age, gender or family history. In recent years, attention has been drawn to the similarity between atherosclerotic inflammatory processes and inflammatory changes in the course of systemic connective tissue disease, in particular systemic lupus etythematosus (SLE) or rheumatoid arthritis (RA). There is also observed the similarity of the pathogenetic background of development of atherosclerosis and juvenile idiopathic arthritis (JIA). Elevated levels of pro-inflammatory cytokines are observed in the course of juvenile idiopathic arthritis. Also homocysteine concentrations, which may play a significant role in the development of atherosclerotic lesions, are observed higher in patients with JIA. Some studies revealed higher carotid intima-media thickness (IMT) index values in children with JIA. In view of the fact that atherosclerotic process begins as early as in childhood, the introduction of appropriate preventive measures in children is a matter of utmost importance.
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Affiliation(s)
- Ewa Jednacz
- Paediatric Clinic of Rheumatology, Institute of Rheumatology, Spartańska 1, 02-637 Warsaw, Poland.
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CD154: an immunoinflammatory mediator in systemic lupus erythematosus and rheumatoid arthritis. Clin Dev Immunol 2011; 2012:490148. [PMID: 22110533 PMCID: PMC3202102 DOI: 10.1155/2012/490148] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 08/17/2011] [Indexed: 01/17/2023]
Abstract
Systemic lupus erythematosus and rheumatoid arthritis are two major chronic inflammatory autoimmune diseases with significant prevalence rates among the population. Although the etiology of these diseases remains unresolved, several evidences support the key role of CD154/CD40 interactions in initiating and/or propagating these diseases. The discovery of new receptors (αIIbβ3, α5β1, and αMβ2) for CD154 has expanded our understanding about the precise role of this critical immune mediator in the physiopathology of chronic inflammatory autoimmune diseases in general, and in systemic lupus erythematosus and rheumatoid arthritis in particular. This paper presents an overview of the interaction of CD154 with its various receptors and outlines its role in the pathogenesis of systemic lupus erythematosus and rheumatoid arthritis. Moreover, the potential usefulness of various CD154-interfering agents in the treatment and prevention of these diseases is also discussed.
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Tuning of CD40–CD154 Interactions in Human B-Lymphocyte Activation: A Broad Array of In Vitro Models for a Complex In Vivo Situation. Arch Immunol Ther Exp (Warsz) 2011; 59:25-40. [DOI: 10.1007/s00005-010-0108-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 08/19/2010] [Indexed: 12/13/2022]
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Bilgic H, Ytterberg SR, Amin S, McNallan KT, Wilson JC, Koeuth T, Ellingson S, Newman B, Bauer JW, Peterson EJ, Baechler EC, Reed AM. Interleukin-6 and type I interferon-regulated genes and chemokines mark disease activity in dermatomyositis. ACTA ACUST UNITED AC 2009; 60:3436-46. [DOI: 10.1002/art.24936] [Citation(s) in RCA: 170] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wagner DH. The co-evolution of our understanding of CD40 and inflammation. Diabetologia 2009; 52:997-9. [PMID: 19360393 DOI: 10.1007/s00125-009-1357-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Accepted: 03/20/2009] [Indexed: 10/20/2022]
Affiliation(s)
- D H Wagner
- \University of Colorado Denver, Aurora, CO 80045, USA.
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23
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Prahalad S, Glass DN. A comprehensive review of the genetics of juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2008; 6:11. [PMID: 18644131 PMCID: PMC2515830 DOI: 10.1186/1546-0096-6-11] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Accepted: 07/21/2008] [Indexed: 12/29/2022] Open
Abstract
Juvenile idiopathic arthritis (JIA) is the most common chronic arthropathy of childhood which is believed to be influenced by both genetic and environmental factors. The progress in identifying genes underlying JIA susceptibility using candidate gene association studies has been slow. Several associations between JIA and variants in the genes encoding the human leukocyte antigens (HLA) have been confirmed and replicated in independent cohorts. However it is clear that genetic variants outside the HLA also influence susceptibility to JIA. While a large number of non-HLA candidate genes have been tested for associations, only a handful of reported associations such as PTPN22 have been validated. In this review we discuss the principles behind genetic studies of complex traits like JIA, and comprehensively catalogue non-HLA candidate-gene association studies performed in JIA to date and review several validated associations. Most candidate gene studies are underpowered and do not detect associations, and those that do are often not replicated. We also discuss the principles behind genome-wide association studies and discuss possible implications for identifying genes underlying JIA. Finally we discuss several genetic variants underlying multiple clinically distinct autoimmune phenotypes.
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Affiliation(s)
- Sampath Prahalad
- Assistant Professor of Pediatrics, Division of Immunology and Rheumatology, Department of Pediatrics, University of Utah School of Medicine, P.O Box 581289 Salt Lake City, UT 84158-1289, USA
| | - David N Glass
- Professor of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7030, Cincinnati, OH 45229, USA
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