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Zhao M, Wen X, Liu R, Xu K. Microbial dysbiosis in systemic lupus erythematosus: a scientometric study. Front Microbiol 2024; 15:1319654. [PMID: 38863759 PMCID: PMC11166128 DOI: 10.3389/fmicb.2024.1319654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 05/01/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Mounting evidence suggests microbiota dysbiosis augment autoimmune response. This study aims to provide a systematic overview of this research field in SLE through a bibliometric analysis. Methods We conducted a comprehensive search and retrieval of literature related to microbial researches in SLE from the Web of Science Core Collection (WOSCC) database. The retrieved articles were subjected to bibliometric analysis using VOSviewer and Bibliometricx to explore annual publication output, collaborative patterns, research hotspots, current research status, and emerging trends. Results In this study, we conducted a comprehensive analysis of 218 research articles and 118 review articles. The quantity of publications rises annually, notably surging in 2015 and 2018. The United States and China emerged as the leading contributors in microbial research of SLE. Mashhad University of Medical Sciences had the highest publication outputs among the institutions. Frontiers in Immunology published the most papers. Luo XM and Margolles A were the most prolific and highly cited contributors among individual authors. Microbial research in SLE primarily focused on changes in microbial composition, particularly gut microbiota, as well as the mechanisms and practical applications in SLE. Recent trends emphasize "metabolites," "metabolomics," "fatty acids," "T cells," "lactobacillus," and "dietary supplementation," indicating a growing emphasis on microbial metabolism and interventions in SLE. Conclusion This study provides a thorough analysis of the research landscape concerning microbiota in SLE. The microbial research in SLE mainly focused on three aspects: microbial dysbiosis, mechanism studies and translational studies (microbiota-based therapeutics). It identifies current research trends and focal points, offering valuable guidance for scholars in the field.
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Affiliation(s)
- Miaomiao Zhao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Xiaoting Wen
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Ruiling Liu
- Department of Microbiology and Immunology, Basic Medical College, Shanxi Medical University, Jinzhong, China
| | - Ke Xu
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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2
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Uyan Hendem D, Oluklu D, Menekse Beser D, Yildirim M, Tugrul Ersak D, Tanacan A, Sahin D. Evaluation of fetal thymus size in maternal autoimmune diseases: systemic lupus erythematosus, Sjögren's syndrome and antiphospholipid antibody syndrome. Arch Gynecol Obstet 2024; 309:1421-1427. [PMID: 37037914 PMCID: PMC10088775 DOI: 10.1007/s00404-023-07035-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/01/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE To investigate the effect of inflammation on the fetal thymus-thoracic ratio (TTR) in pregnant women with systemic lupus erythematosus (SLE), Sjögren's syndrome (SS) and antiphospholipid antibody syndrome (APS). METHOD This prospective case-control study included 45 pregnant women with SLE, SS, and APS and 90 gestational age-matched healthy pregnant women between 24 and 37 gestational weeks. The ratio of the anteroposterior fetal thymus length to the transverse mediastinal length was calculated as the TTR in the study groups. RESULTS Fetal TTR was significantly lower in the case group (p < 0.001). Fetal TTR in the APS group was significantly lower than SS group (p = 006). The patients using hydroxychloroquine (HCQ) had significantly higher fetal TTR compared to patients not using HCQ (p = 0.004). A moderate negative correlation was found between the disease duration and fetal TTR (r = - 0.552, p < 0.001). In predicting admission to the neonatal intensive unit care (NICU), a value of 0.31 was found for the fetal TTR with a sensitivity of 83.3% and a specificity of 69% CONCLUSION: Maternal inflammation in pregnancies with autoimmune diseases may affect the intrauterine milieu of the fetus and cause a lower fetal TTR. Additionally, the lower level of fetal TTR may be more effective and beneficial for the clinician if combined with other risk factors in predicting NICU admission.
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Affiliation(s)
- Derya Uyan Hendem
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, 1604th Street, No: 9, Cankaya, 06800, Ankara, Turkey.
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, 1604th Street, No: 9, Cankaya, 06800, Ankara, Turkey
| | - Dilek Menekse Beser
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, 1604th Street, No: 9, Cankaya, 06800, Ankara, Turkey
| | - Muradiye Yildirim
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, 1604th Street, No: 9, Cankaya, 06800, Ankara, Turkey
| | - Duygu Tugrul Ersak
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, 1604th Street, No: 9, Cankaya, 06800, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, 1604th Street, No: 9, Cankaya, 06800, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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3
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Saito K, Mori S, Kodama T. McH-lpr/lpr-RA1 mice: A novel spontaneous mouse model of autoimmune sialadenitis. Immunol Lett 2021; 237:3-10. [PMID: 34174253 DOI: 10.1016/j.imlet.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 12/30/2022]
Abstract
Many studies of the autoimmune disease Sjögren's syndrome have been performed using spontaneous mouse models. In the present study, we describe the characteristics of McH/lpr-RA1 mice and propose their use as a novel murine model of autoimmune sialadenitis. The McH/lpr-RA1 mouse is a recombinant congenic strain derived from generation F54 or more of MRL-Faslpr x (MRL- Faslpr x C3H- Faslpr) F1. We show for the first time that this mouse spontaneously develops autoimmune sialadenitis and vasculitis in submandibular gland tissues. Sialadenitis was accompanied by extensive inflammatory cell infiltration and tissue destruction. Immunohistochemical studies revealed that the salivary gland lesions strongly expressed four sialadenitis-related molecules: SSA and SSB (autoantigens of Sjögren's syndrome), gp91phox (an accelerator of reactive oxygen species production) and single strand DNA (a marker of apoptotic cells). In contrast, expression of aquaporin-5 (AQP5), which stimulates salivary secretion was weak or negligible. Statistical correlation analyses indicated that the apoptosis of salivary gland cells provoked by oxidative stress contributed to the severe sialadenitis and reduced expression of AQP5. Our study has demonstrated that McH/lpr-RA1 mice spontaneously develop the pathognomonic features of autoimmune sialadenitis and thus could be used as a new animal model of Sjögren's syndrome.
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Affiliation(s)
- Keiichi Saito
- Liaison Centre for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shiro Mori
- Department of Oral and Maxillofacial Surgery, Tohoku University Hospital, Sendai, Japan; Laboratory of Biomedical Engineering for Cancer, Department of Biomedical Engineering, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Tetsuya Kodama
- Laboratory of Biomedical Engineering for Cancer, Department of Biomedical Engineering, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan.
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4
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Felux J, Erbacher A, Breckler M, Hervé R, Lemeiter D, Mannherz HG, Napirei M, Rammensee HG, Decker P. Deoxyribonuclease 1-Mediated Clearance of Circulating Chromatin Prevents From Immune Cell Activation and Pro-inflammatory Cytokine Production, a Phenomenon Amplified by Low Trap1 Activity: Consequences for Systemic Lupus Erythematosus. Front Immunol 2021; 12:613597. [PMID: 33746957 PMCID: PMC7969502 DOI: 10.3389/fimmu.2021.613597] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/05/2021] [Indexed: 12/11/2022] Open
Abstract
Increased concentrations of circulating chromatin, especially oligo-nucleosomes, are observed in sepsis, cancer and some inflammatory autoimmune diseases like systemic lupus erythematosus (SLE). In SLE, circulating nucleosomes mainly result from increased apoptosis and decreased clearance of apoptotic cells. Once released, nucleosomes behave both as an autoantigen and as a damage-associated molecular pattern (DAMP) by activating several immune cells, especially pro-inflammatory cells. Deoxyribonuclease 1 (DNase1) is a major serum nuclease whose activity is decreased in mouse and human lupus. Likewise, the mitochondrial chaperone tumor necrosis factor (TNF) receptor-associated protein-1 (Trap1) protects against oxidative stress, which is increased in SLE. Here, using wild type, DNase1-deficient and DNase1/Trap1-deficient mice, we demonstrate that DNase1 is a major serum nuclease involved in chromatin degradation, especially when the plasminogen system is activated. In vitro degradation assays show that chromatin digestion is strongly impaired in serum from DNase1/Trap1-deficient mice as compared to wild type mice. In vivo, after injection of purified chromatin, clearance of circulating chromatin is delayed in DNase1/Trap1-deficient mice in comparison to wild type mice. Since defective chromatin clearance may lead to chromatin deposition in tissues and subsequent immune cell activation, spleen cells were stimulated in vitro with chromatin. Splenocytes were activated by chromatin, as shown by interleukin (IL)-12 secretion and CD69 up-regulation. Moreover, cell activation was exacerbated when Trap1 is deficient. Importantly, we also show that cytokines involved in lupus pathogenesis down-regulate Trap1 expression in splenocytes. Therefore, combined low activities of both DNase1 and Trap1 lead to an impaired degradation of chromatin in vitro, delayed chromatin clearance in vivo and enhanced activation of immune cells. This situation may be encountered especially, but not exclusively, in SLE by the negative action of cytokines on Trap1 expression.
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Affiliation(s)
- Jasmin Felux
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany
| | - Annika Erbacher
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany
| | - Magali Breckler
- Li2P, University Sorbonne Paris Nord, Bobigny, France.,INSERM UMR 1125, Bobigny, France
| | - Roxane Hervé
- Li2P, University Sorbonne Paris Nord, Bobigny, France.,INSERM UMR 1125, Bobigny, France
| | - Delphine Lemeiter
- Li2P, University Sorbonne Paris Nord, Bobigny, France.,INSERM UMR 1125, Bobigny, France
| | - Hans Georg Mannherz
- Department of Anatomy and Molecular Embryology, Medical Faculty, Ruhr-University Bochum, Bochum, Germany
| | - Markus Napirei
- Department of Anatomy and Molecular Embryology, Medical Faculty, Ruhr-University Bochum, Bochum, Germany
| | - Hans-Georg Rammensee
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany
| | - Patrice Decker
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany.,Li2P, University Sorbonne Paris Nord, Bobigny, France.,INSERM UMR 1125, Bobigny, France
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5
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Shang X, Ren L, Sun G, Yu T, Yao Y, Wang L, Liu F, Zhang L, He X, Liu M. Anti-dsDNA, anti-nucleosome, anti-C1q, and anti-histone antibodies as markers of active lupus nephritis and systemic lupus erythematosus disease activity. IMMUNITY INFLAMMATION AND DISEASE 2021; 9:407-418. [PMID: 33470559 PMCID: PMC8127563 DOI: 10.1002/iid3.401] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 01/12/2023]
Abstract
Introduction Previous studies of anti‐dsDNA, nucleosome (Nucl), histone (His), and C1q antibodies have revealed their clinical value in systemic lupus erythematosus (SLE). However, the correlation between four autoantibodies and SLE activity, lupus nephritis (LN) remains controversial, and data are insufficient on longitudinal monitoring. This study aimed at evaluating the value of these autoantibodies in active LN, and their performance on cross‐sectional evaluating and longitudinal monitoring of SLE disease activity. Methods Serum levels of four autoantibodies in 114 SLE patients, 219 other autoimmune disease patients (OAD), and 59 healthy controls were assayed by a quantitative immunoassay. Sera of 38 inpatients were obtained again after treatment. Results We found that serum levels of four autoantibodies were significantly higher in SLE than OAD patients (p < 001), active LN than non‐renal SLE patients (p < .05), and higher in SLE patients with moderate and severe disease activity than mild disease activity (p < .01). Horizontally, serum level of each autoantibody was correlated with SLE disease activity index (SLEDAI) (p < .05), and correlation coefficient of anti‐dsDNA was the highest (r = .585). For longitudinal monitoring, the decreased levels of four autoantibodies were found following treatment (p < .001). Serum level variations of these antibodies were positively correlated with variations of SLEDAI (p < .05). The correlation coefficient of anti‐Nucl was the highest (r = .629). Although the levels of C3 and C4 increased after treatment, the change was not related to the change of SLEDAI (p > .05). Conclusions Anti‐C1q, anti‐dsDNA, anti‐Nucl, and anti‐His perform well in diagnosing active LN and monitoring SLE disease activity. They could be indicators of active LN and SLE disease activity.
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Affiliation(s)
- Xiaoying Shang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China.,Department of Clinical Laboratory, Qingdao Municipal Hospital, Qingdao, China
| | - Lisheng Ren
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guirong Sun
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Teng Yu
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuan Yao
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Fenghai Liu
- Department of Clinical Laboratory, Qingdao Municipal Hospital, Qingdao, China
| | - Lijun Zhang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaqin He
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingjun Liu
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
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6
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Luo Z, Alekseyenko AV, Ogunrinde E, Li M, Li QZ, Huang L, Tsao BP, Kamen DL, Oates JC, Li Z, Gilkeson GS, Jiang W. Rigorous Plasma Microbiome Analysis Method Enables Disease Association Discovery in Clinic. Front Microbiol 2021; 11:613268. [PMID: 33488555 PMCID: PMC7820181 DOI: 10.3389/fmicb.2020.613268] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/04/2020] [Indexed: 12/12/2022] Open
Abstract
Blood microbiome is important to investigate microbial-host interactions and the effects on systemic immune perturbations. However, this effort has met with major challenges due to low microbial biomass and background artifacts. In the current study, microbial 16S DNA sequencing was applied to analyze plasma microbiome. We have developed a quality-filtering strategy to evaluate and exclude low levels of microbial sequences, potential contaminations, and artifacts from plasma microbial 16S DNA sequencing analyses. Furthermore, we have applied our technique in three cohorts, including tobacco-smokers, HIV-infected individuals, and individuals with systemic lupus erythematosus (SLE), as well as corresponding controls. More than 97% of total sequence data was removed using stringent quality-filtering strategy analyses; those removed amplicon sequence variants (ASVs) were low levels of microbial sequences, contaminations, and artifacts. The specifically enriched pathobiont bacterial ASVs have been identified in plasmas from tobacco-smokers, HIV-infected individuals, and individuals with SLE but not from control subjects. The associations between these ASVs and disease pathogenesis were demonstrated. The pathologic activities of some identified bacteria were further verified in vitro. We present a quality-filtering strategy to identify pathogenesis-associated plasma microbiome. Our approach provides a method for studying the diagnosis of subclinical microbial infection as well as for understanding the roles of microbiome-host interaction in disease pathogenesis.
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Affiliation(s)
- Zhenwu Luo
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States
| | - Alexander V. Alekseyenko
- Program for Human Microbiome Research, Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
- Department of Oral Health Sciences and Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, SC, United States
| | - Elizabeth Ogunrinde
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States
| | - Min Li
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States
| | - Quan-Zhen Li
- Department of Immunology and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Lei Huang
- Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Betty P. Tsao
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Diane L. Kamen
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Jim C. Oates
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Medical Service, Charleston, SC, United States
| | - Zihai Li
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center-James, Columbus, OH, United States
| | - Gary S. Gilkeson
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Medical Service, Charleston, SC, United States
| | - Wei Jiang
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States
- Division of Infectious Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
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7
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Lou H, Wojciak-Stothard B, Ruseva MM, Cook HT, Kelleher P, Pickering MC, Mongkolsapaya J, Screaton GR, Xu XN. Autoantibody-dependent amplification of inflammation in SLE. Cell Death Dis 2020; 11:729. [PMID: 32908129 PMCID: PMC7481301 DOI: 10.1038/s41419-020-02928-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/07/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022]
Abstract
Anti-double stranded DNA antibodies (anti-dsDNA) are a hallmark of SLE but their role in disease pathogenesis is not fully resolved. Anti-dsDNA in serum are highly heterogeneous therefore in this study, we aimed to dissect the functional specificities of anti-dsDNA using a panel of human monoclonal antibodies (humAbs) generated from patients with active lupus nephritis. A total of 46 ANA reactive humAbs were isolated and divided into four broad classes based on their reactivity to histones, DNA and Crithidia. Functional analysis indicated that one subclass of antibodies bound strongly to decondensed DNA areas in neutrophil extracellular traps (NETs) and protected NETs from nuclease digestion, similar to the sera from active SLE patients. In addition, these anti-dsDNA antibodies could stimulate type I interferon responses in mononuclear phagocytic cells, or NF-kB activity in endothelial cells, by uptake of NETs-anti-NETs immune complexes and subsequently trigging inflammatory responses in an Fc-gamma receptor (Fcg-R)-dependant manner. Together our data suggest that only a subset of anti-dsDNA antibodies is capable to amplify inflammatory responses by deposit in the nephritic kidney in vivo, protecting NETs digestion as well as uptake of NETs immune complexes into Fcg-R-expressing cells in vitro.
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Affiliation(s)
- Hantao Lou
- Division of Immunology and Inflammation, Department of Medicine, Hammersmith Campus, Imperial College London, London, W12 0NN, UK.
- Department of Medicine, Centre for Immunology & Vaccinology, Chelsea and Westminster Hospital, Imperial College London, London, SW10 9NH, UK.
| | - Beata Wojciak-Stothard
- Department of Medicine, Centre for Pharmacology and Therapeutics, Imperial College London, London, W12 0HS, UK
| | - Marieta M Ruseva
- Division of Immunology and Inflammation, Centre for Complement and Inflammation Research, Imperial College London, London, W12 0NN, UK
| | - H Terence Cook
- Division of Immunology and Inflammation, Centre for Complement and Inflammation Research, Imperial College London, London, W12 0NN, UK
| | - Peter Kelleher
- Department of Medicine, Centre for Immunology & Vaccinology, Chelsea and Westminster Hospital, Imperial College London, London, SW10 9NH, UK
- Department of Infection and Immunity, Charing Cross Hospital North West London Pathology, London, W6 8RF, UK
| | - Matthew C Pickering
- Division of Immunology and Inflammation, Centre for Complement and Inflammation Research, Imperial College London, London, W12 0NN, UK
| | - Juthathip Mongkolsapaya
- Division of Immunology and Inflammation, Department of Medicine, Hammersmith Campus, Imperial College London, London, W12 0NN, UK
- Division of Medical Sciences, John Radcliffe Hospital, Oxford University, Oxford, OX3 9DU, UK
| | - Gavin R Screaton
- Division of Immunology and Inflammation, Department of Medicine, Hammersmith Campus, Imperial College London, London, W12 0NN, UK
- Division of Medical Sciences, John Radcliffe Hospital, Oxford University, Oxford, OX3 9DU, UK
| | - Xiao-Ning Xu
- Department of Medicine, Centre for Immunology & Vaccinology, Chelsea and Westminster Hospital, Imperial College London, London, SW10 9NH, UK.
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Ghiggeri GM, D’Alessandro M, Bartolomeo D, Degl’Innocenti ML, Magnasco A, Lugani F, Prunotto M, Bruschi M. An Update on Antibodies to Necleosome Components as Biomarkers of Sistemic Lupus Erythematosus and of Lupus Flares. Int J Mol Sci 2019; 20:ijms20225799. [PMID: 31752186 PMCID: PMC6888059 DOI: 10.3390/ijms20225799] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 12/23/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease with variable clinical expression. It is a potentially devastating condition affecting mostly women and leading to clinically unpredictable outcomes. Remission and flares may, in fact, alternate over time and a mild involvement limited to few articular sites may be followed by severe and widespread organ damage. SLE is the prototype of any autoimmune condition and has, for this reason, attracted the interest of basic immunologists. Therapies have evolved over time and clinical prognosis has, in parallel, been improved. What clinicians still lack is the possibility to use biomarkers of the disease as predictors of outcome and, in this area, several studies are trying to find solutions. Circulating autoantibodies are clearly a milestone of clinical research and the concrete possibility is to integrate, in the future, classical markers of activation (like C3) with target organ autoantibodies. Anti-dsDNA antibodies represent a basic point in any predictive attempt in SLE and should be considered the benchmark for any innovative proposal in the wide field of target organ pathologies related to SLE. DNA is part of the nucleosome that is the basic unit of chromatin. It consists of DNA wrapped around a histone octamer made of 2 copies each of Histone 2A, 2B, 3, and 4. The nucleosome has a plastic organization that varies over time and has the potential to stimulate the formation of antibodies directed to the whole structure (anti-nucleosome) or its parts (anti-dsDNA and anti-Histones). Here, we present an updated review of the literature on antibodies directed to the nucleosome and the nucleosome constituents, i.e., DNA and Histones. Wetriedto merge the data first published more than twenty years ago with more recent results to create a balanced bridge between old dogma and more recent research that could serve as a stimulus to reconsider mechanisms for SLE. The formation of large networks would provide the chance of studying large cohorts of patients and confirm what already presented in small sample size during the last years.
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Affiliation(s)
- Gian Marco Ghiggeri
- Division of Nephrology, Dialysis and Transplantation, Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genoa, Italy (D.B.); (A.M.)
- Laboratory of Molecular Nephrology, Scientific Institute for Research and Health Care, IRCCS IstitutoGianninaGaslini, 16147 Genoa, Italy; (F.L.); (M.B.)
- Correspondence: ; Tel.: (+39)-010-380742; Fax: (+39)-010-395214
| | - Matteo D’Alessandro
- Division of Nephrology, Dialysis and Transplantation, Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genoa, Italy (D.B.); (A.M.)
| | - Domenico Bartolomeo
- Division of Nephrology, Dialysis and Transplantation, Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genoa, Italy (D.B.); (A.M.)
| | - Maria Ludovica Degl’Innocenti
- Division of Nephrology, Dialysis and Transplantation, Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genoa, Italy (D.B.); (A.M.)
| | - Alberto Magnasco
- Division of Nephrology, Dialysis and Transplantation, Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genoa, Italy (D.B.); (A.M.)
| | - Francesca Lugani
- Laboratory of Molecular Nephrology, Scientific Institute for Research and Health Care, IRCCS IstitutoGianninaGaslini, 16147 Genoa, Italy; (F.L.); (M.B.)
| | - Marco Prunotto
- School of Pharmaceutical Sciences, University of Geneva, 1211 Geneva, Switzerland;
| | - Maurizio Bruschi
- Laboratory of Molecular Nephrology, Scientific Institute for Research and Health Care, IRCCS IstitutoGianninaGaslini, 16147 Genoa, Italy; (F.L.); (M.B.)
- Fondazione per le MalattieRenalinel Bambino, 16100 Genoa, Italy
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9
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Ogunrinde E, Zhou Z, Luo Z, Alekseyenko A, Li QZ, Macedo D, Kamen DL, Oates JC, Gilkeson GS, Jiang W. A Link Between Plasma Microbial Translocation, Microbiome, and Autoantibody Development in First-Degree Relatives of Systemic Lupus Erythematosus Patients. Arthritis Rheumatol 2019; 71:1858-1868. [PMID: 31106972 PMCID: PMC6817371 DOI: 10.1002/art.40935] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 05/16/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is characterized by the production of antibodies against self antigens. However, the events underlying autoantibody formation in SLE remain unclear. This study was undertaken to investigate the role of plasma autoantibody levels, microbial translocation, and the microbiome in SLE. METHODS Plasma samples from 2 cohorts, one with 18 unrelated healthy controls and 18 first-degree relatives and the other with 19 healthy controls and 21 SLE patients, were assessed for autoantibody levels by autoantigen microarray analysis, measurement of lipopolysaccharide (LPS) levels by Limulus amebocyte assay, and determination of microbiome composition by microbial 16S ribosomal DNA sequencing. RESULTS First-degree relatives and SLE patients exhibited increased plasma autoantibody levels compared to their control groups. Parents and children of lupus patients exhibited elevated plasma LPS levels compared to controls (P = 0.02). Plasma LPS levels positively correlated with plasma anti-double-stranded DNA IgG levels in first-degree relatives (r = 0.51, P = 0.03), but not in SLE patients. Circulating microbiome analysis revealed that first-degree relatives had significantly reduced microbiome diversity compared to their controls (observed species, P = 0.004; Chao1 index, P = 0.005), but this reduction was not observed in SLE patients. The majority of bacteria that were differentially abundant between unrelated healthy controls and first-degree relatives were in the Firmicutes phylum, while differences in bacteria from several phyla were identified between healthy controls and SLE patients. Bacteria in the Paenibacillus genus were the only overlapping differentially abundant bacteria in both cohorts, and were reduced in first-degree relatives (adjusted P [Padj ] = 2.13 × 10-12 ) and SLE patients (Padj = 0.008) but elevated in controls. CONCLUSIONS These results indicate a possible role of plasma microbial translocation and microbiome composition in influencing autoantibody development in SLE.
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Affiliation(s)
- Elizabeth Ogunrinde
- Department of Microbiology and Immunology, Medical
University of South Carolina, Charleston, SC, USA, 29425
| | - Zejun Zhou
- State Key Laboratory of Developmental Biology of Freshwater
Fish, College of Life Sciences, Hunan Normal University, Changsha, China,
410081
| | - Zhenwu Luo
- Department of Microbiology and Immunology, Medical
University of South Carolina, Charleston, SC, USA, 29425
| | - Alexander Alekseyenko
- Program for Human Microbiome Research, Biomedical
Informatics Center, Department of Public Health Sciences, Department of Oral Health
Sciences, Medical University of South Carolina, Charleston, SC, USA, 29425
| | - Quan-Zhen Li
- Department of Immunology and Internal Medicine, University
of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, USA
75390
| | - Danielle Macedo
- Neuropharmacology Laboratory, Drug Research and Development
Center, Department of Physiology and Pharmacology, Faculty of Medicine, Universidade
Federal do Ceará, Fortaleza, CE, Brazil
| | - Diane L. Kamen
- Division of Rheumatology, Department of Medicine, Medical
University of South Carolina, Charleston, SC, USA, 29425
| | - Jim C. Oates
- Division of Rheumatology, Department of Medicine, Medical
University of South Carolina, Charleston, SC, USA, 29425
- Ralph H. Johnson VA Medical Center, Medical Service,
Charleston, SC, USA 29401
| | - Gary S. Gilkeson
- Division of Rheumatology, Department of Medicine, Medical
University of South Carolina, Charleston, SC, USA, 29425
- Ralph H. Johnson VA Medical Center, Medical Service,
Charleston, SC, USA 29401
| | - Wei Jiang
- Department of Microbiology and Immunology, Medical
University of South Carolina, Charleston, SC, USA, 29425
- Division of Infectious Diseases, Department of Medicine,
Medical University of South Carolina, Charleston, SC, USA, 29425
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10
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Salazar-Gonzalez H, Zepeda-Hernandez A, Melo Z, Saavedra-Mayorga DE, Echavarria R. Neutrophil Extracellular Traps in the Establishment and Progression of Renal Diseases. ACTA ACUST UNITED AC 2019; 55:medicina55080431. [PMID: 31382486 PMCID: PMC6722876 DOI: 10.3390/medicina55080431] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/23/2019] [Accepted: 07/30/2019] [Indexed: 01/27/2023]
Abstract
Uncontrolled inflammatory and immune responses are often involved in the development of acute and chronic forms of renal injury. Neutrophils are innate immune cells recruited early to sites of inflammation, where they produce pro-inflammatory cytokines and release mesh-like structures comprised of DNA and granular proteins known as neutrophil extracellular traps (NETs). NETs are potentially toxic, contribute to glomerular injury, activate autoimmune processes, induce vascular damage, and promote kidney fibrosis. Evidence from multiple studies suggests that an imbalance between production and clearance of NETs is detrimental for renal health. Hence strategies aimed at modulating NET-associated processes could have a therapeutic impact on a myriad of inflammatory diseases that target the kidney. Here, we summarize the role of NETs in the pathogenesis of renal diseases and their mechanisms of tissue damage.
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Affiliation(s)
- Hector Salazar-Gonzalez
- Decanato de Ciencia y Tecnología, Universidad Autónoma de Guadalajara, Zapopan 45129, Mexico
| | | | - Zesergio Melo
- CONACyT-Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Sierra Mojada #800 Col. Independencia, Guadalajara 44340, Mexico
| | - Diego Eduardo Saavedra-Mayorga
- Facultad de Medicina, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Raquel Echavarria
- CONACyT-Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Sierra Mojada #800 Col. Independencia, Guadalajara 44340, Mexico.
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11
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Khan WA. 16 α-Hydroxyestrone induced adduct generate high affinity autoantibodies in SLE. Adv Med Sci 2019; 64:72-78. [PMID: 30530105 DOI: 10.1016/j.advms.2018.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 10/23/2018] [Accepted: 11/23/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE Increased 16 α-hydroxyestrone (16 α-OHE1) and autoantibodies against histone H1 (H1) have been well described in systemic lupus erythematosus (SLE), but the combination effects of 16 α-OHE1 and H1 remains unclear. Here, we tried to assess the affinity and binding specificity of SLE autoantibodies against the 16 α-OHE1-H1 adduct. IgG was induced against this adduct and was also used as immunochemical probe for the estimation of 16 α-OHE1 in the serum of SLE patients. MATERIALS AND METHODS The affinity and binding specificities of SLE autoantibodies against 16 α-OHE1-H1 were determined by direct binding and inhibition ELISA as well as quantitative precipitation titration in 60 patients and 30 control subjects. RESULTS Purified SLE autoantibodies showed greater recognition to 16 α-OHE1-H1 over H1 (p < 0.05) or 16 α-OHE1 (p < 0.001). The relative affinity of SLE autoantibodies for 16 α-OHE1-H1, H1 and 16 α-OHE1 was 1.41 × 10-7, 1.31 × 10-6, and 1.03 × 10-6, respectively. The concentration of 16 α-OHE1 in the sera of SLE patients was significantly higher than controls (p < 0.05) as estimated by anti-16 α-OHE1-H1 antibodies. CONCLUSIONS High affinity of 16 α-OHE1-H1 with SLE autoantibodies might suggest an antigenic role of this adduct in the production of these autoantibodies. The anti-16 α-OHE1-H1 antibody is a good immunochemical probe to measure 16 α-OHE1 in different SLE sera.
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Affiliation(s)
- Wahid Ali Khan
- Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Saudi Arabia.
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12
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Curtiss P, Liebman T, Khorolsky C, Brinster N, Beasley J, Lo Sicco K. Systemic lupus erythematosus and antineutrophil cytoplasmic antibody-associated vasculitis: An emerging overlap syndrome with cutaneous manifestations. JAAD Case Rep 2018; 4:493-496. [PMID: 29984294 PMCID: PMC6031565 DOI: 10.1016/j.jdcr.2018.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Paul Curtiss
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Tracey Liebman
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Ciril Khorolsky
- Department of Internal Medicine, NYU Lutheran Medical Center, Brooklyn, New York
| | - Nooshin Brinster
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Jenna Beasley
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
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13
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Biermann MHC, Boeltz S, Pieterse E, Knopf J, Rech J, Bilyy R, van der Vlag J, Tincani A, Distler JHW, Krönke G, Schett GA, Herrmann M, Muñoz LE. Autoantibodies Recognizing Secondary NEcrotic Cells Promote Neutrophilic Phagocytosis and Identify Patients With Systemic Lupus Erythematosus. Front Immunol 2018; 9:989. [PMID: 29867966 PMCID: PMC5949357 DOI: 10.3389/fimmu.2018.00989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/20/2018] [Indexed: 12/15/2022] Open
Abstract
Deficient clearance of apoptotic cells reportedly contributes to the etiopathogenesis of the autoimmune disease systemic lupus erythematosus (SLE). Based on this knowledge, we developed a highly specific and sensitive test for the detection of SLE autoantibodies (AAb) utilizing secondary NEcrotic cell (SNEC)-derived material as a substrate. The goal of the present study was to validate the use of SNEC as an appropriate antigen for the diagnosis of SLE in large cohort of patients. We confirmed the presence of apoptotically modified autoantigens on SNEC (dsDNA, high mobility group box 1 protein, apoptosis-associated chromatin modifications, e.g., histones H3-K27-me3; H2A/H4 AcK8,12,16; and H2B-AcK12). Anti-SNEC AAb were measured in the serum of 155 patients with SLE, 89 normal healthy donors (NHD), and 169 patients with other autoimmune connective tissue diseases employing SNEC-based indirect enzyme-linked immunosorbent assay (SNEC ELISA). We compared the test performance of SNEC ELISA with the routine diagnostic tests dsDNA Farr radioimmunoassay (RIA) and nucleosome-based ELISA (anti-dsDNA-NcX-ELISA). SNEC ELISA distinguished patients with SLE with a specificity of 98.9% and a sensitivity of 70.6% from NHD clearly surpassing RIA and anti-dsDNA-NcX-ELISA. In contrast to the other tests, SNEC ELISA significantly discriminated patients with SLE from patients with rheumatoid arthritis, primary anti-phospholipid syndrome, spondyloarthropathy, psoriatic arthritis, and systemic sclerosis. A positive test result in SNEC ELISA significantly correlated with serological variables and reflected the uptake of opsonized SNEC by neutrophils. This stresses the relevance of SNECs in the pathogenesis of SLE. We conclude that SNEC ELISA allows for the sensitive detection of pathologically relevant AAb, enabling its diagnostic usage. A positive SNEC test reflects the opsonization of cell remnants by AAb, the neutrophil recruitment to tissues, and the enhancement of local and systemic inflammatory responses.
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Affiliation(s)
- Mona H C Biermann
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sebastian Boeltz
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Elmar Pieterse
- Department of Nephrology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Jasmin Knopf
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jürgen Rech
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Rostyslav Bilyy
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Johan van der Vlag
- Department of Nephrology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Angela Tincani
- Division of Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Brescia, Italy
| | - Jörg H W Distler
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Gerhard Krönke
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Andreas Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Luis E Muñoz
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
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14
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Ye X, Feng C, Gao T, Mu G, Zhu W, Yang Y. Linker Histone in Diseases. Int J Biol Sci 2017; 13:1008-1018. [PMID: 28924382 PMCID: PMC5599906 DOI: 10.7150/ijbs.19891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/30/2017] [Indexed: 01/21/2023] Open
Abstract
The linker histone is a protein that binds with the nucleosome, which is generally considered to achieve chromatin condensation in the nucleus. Accumulating evidences suggest that the linker histone is essential in the pathogenesis of several diseases. In this review, we briefly introduce the current knowledge of the linker histone, including its structure, characteristics and functions. Also, we move forward to present the advances of the linker histone's association with certain diseases, such as cancer, Alzheimer's disease, infection, male infertility and aberrant immunity situations, focusing on the alteration of the linker histone under certain pathological conditions and its role in developing each disease.
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Affiliation(s)
- Xin Ye
- Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Peking University Health Science Center, #38 Xueyuan Road, Beijing 100191, China
| | - ChuanLin Feng
- Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Peking University Health Science Center, #38 Xueyuan Road, Beijing 100191, China
| | - Tian Gao
- Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Peking University Health Science Center, #38 Xueyuan Road, Beijing 100191, China
| | - Guanqun Mu
- Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Peking University Health Science Center, #38 Xueyuan Road, Beijing 100191, China
| | - Weiguo Zhu
- Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Peking University Health Science Center, #38 Xueyuan Road, Beijing 100191, China
| | - Yang Yang
- Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Peking University Health Science Center, #38 Xueyuan Road, Beijing 100191, China
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15
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Mistry P, Kaplan MJ. Cell death in the pathogenesis of systemic lupus erythematosus and lupus nephritis. Clin Immunol 2016; 185:59-73. [PMID: 27519955 DOI: 10.1016/j.clim.2016.08.010] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/05/2016] [Accepted: 08/08/2016] [Indexed: 12/12/2022]
Abstract
Nephritis is one of the most severe complications of systemic lupus erythematosus (SLE). One key characteristic of lupus nephritis (LN) is the deposition of immune complexes containing nucleic acids and/or proteins binding to nucleic acids and autoantibodies recognizing these molecules. A variety of cell death processes are implicated in the generation and externalization of modified nuclear autoantigens and in the development of LN. Among these processes, apoptosis, primary and secondary necrosis, NETosis, necroptosis, pyroptosis, and autophagy have been proposed to play roles in tissue damage and immune dysregulation. Cell death occurs in healthy individuals during conditions of homeostasis yet autoimmunity does not develop, at least in part, because of rapid clearance of dying cells. In SLE, accelerated cell death combined with a clearance deficiency may lead to the accumulation and externalization of nuclear autoantigens and to autoantibody production. In addition, specific types of cell death may modify autoantigens and alter their immunogenicity. These modified molecules may then become novel targets of the immune system and promote autoimmune responses in predisposed hosts. In this review, we examine various cell death pathways and discuss how enhanced cell death, impaired clearance, and post-translational modifications of proteins could contribute to the development of lupus nephritis.
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Affiliation(s)
- Pragnesh Mistry
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mariana J Kaplan
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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16
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Abstract
There is no serologic test that reliably measures disease activity in systemic lupus erythematosus (SLE). The ‘gold standard’ is the anti-dsDNA antibody test, which has been used as a marker of disease activity by clinicians in SLE for over 35 years. Anti-dsDNA antibodies perform best in those with lupus nephritis, specifically in the presence of a proliferative lesion [World Health Organization (WHO) class III or IV] on renal biopsy. In one recent meta-analysis, the mean positivelikelihood ratio of anti-dsDNA antibodies as a marker of disease activity in SLE was 4.14, implying the overall predictive effect was small. More recently autoantibodyassays have been developed that show greater promise in gauging SLE disease activity, specifically anti-nucleosome and anti-C1q antibodies (especially with renal disease activity). Other tests thought previously to be lacking in specificity that refinements in ELISA technology now render possibly useful include anti-heparan sulfate, anti-ssDNA and anti-Scl-70 autoantibodies. Other tests that as yet have not been shown to be as reliable (and therefore are not as useful in clinical practice for serial determinationto measure disease activity) include other anti-extractablenuclear antibodies (anti-Ro, La, Sm, RNP), anti-cardiolipinantibodies, and anti-nuclear cytoplasmic antibodies (ANCA). New technologies using proteomic determinations show promise as aids in the search for more reliable and feasible autoantibody determinations of disease activity in SLE.
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Affiliation(s)
- J D Reveille
- Division of Rheumatology, The University of Texas, Houston Health Science Center at Houston, Houston, TX 77030, USA.
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17
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Campos LMA, Kiss MHB, Scheinberg MA, Mangueira CLP, Silva CA. Antinucleosome Antibodies in Patients with Juvenile Systemic Lupus Erythematosus. Lupus 2016; 15:496-500. [PMID: 16942001 DOI: 10.1191/0961203306lu2317oa] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Our objective was to evaluate the frequency of antinucleosome antibodies (anti-Ncs) in juvenile systemic lupus erythematosus (JSLE) comparing it to that observed for anti-DNA and to correlate the presence of these antibodies with clinical manifestations and disease activity. Anti-Ncs and anti-DNA were detected by ELISA in 74 patients with JSLE and 64 normal controls. Clinical records were reviewed. Disease activity was assessed by SLEDAI score. Anti-Ncs and anti-DNA showed sensitivity of 52.7% and 54% and specificity of 98.4% and 95.3%, respectively. Disagreement between the two assays was found in 25.7% of the cases: isolated positive Anti-Ncs in nine cases (12.2%) and isolated positive anti-DNA in 10 cases (13.5%). Agreement was found in 74.3%: both positive antibodies in 30 cases and both negative in 25. The presence of anti-Ncs was significantly associated with malar erythema, hemolytic anemia, anti-DNA and low complement levels, but not with renal manifestations. The presence of anti-Ncs was associated with a higher SLEDAI median ( P < 0.001) and its titers correlated with the SLEDAI score ( r = 0.504; P < 0.001). The frequency, sensitivity and specificity values were similar between anti-Ncs and anti-DNA antibodies in patients with JSLE. Nevertheless, the discordance of 25.7% between the two assays suggests that both antibodies may have a complementary diagnostic role. The association and correlation between anti-Ncs and several disease activity parameters demonstrated its usufulness in the follow-up of these patients.
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Affiliation(s)
- L M A Campos
- Department of Pediatrics, University of São Paulo, Brazil.
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18
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Gatto M, Iaccarino L, Ghirardello A, Punzi L, Doria A. Clinical and pathologic considerations of the qualitative and quantitative aspects of lupus nephritogenic autoantibodies: A comprehensive review. J Autoimmun 2016; 69:1-11. [DOI: 10.1016/j.jaut.2016.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/04/2016] [Indexed: 12/11/2022]
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19
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Li T, Prokopec SD, Morrison S, Lou W, Reich H, Gladman D, Urowitz M, Scholey J, Fortin PR, Boutros PC, Wither J, Landolt-Marticorena C. Anti-nucleosome antibodies outperform traditional biomarkers as longitudinal indicators of disease activity in systemic lupus erythematosus. Rheumatology (Oxford) 2014; 54:449-57. [PMID: 25193804 DOI: 10.1093/rheumatology/keu326] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to determine whether anti-nucleosome antibodies function as activity-specific biomarkers in SLE. METHODS Fifty-one patients were recruited and followed prospectively with periodic clinical and biochemical assessments over a 14-month period. Disease activity was determined by the SLEDAI-2K. Anti-nucleosome antibody levels were measured by an ELISA and its utility as an activity-specific biomarker as compared with that of anti-dsDNA antibodies and C3 was assessed both at baseline and in longitudinal analysis. RESULTS Anti-nucleosome antibodies were significantly elevated in SLE patients vs controls and showed a moderate positive correlation with disease activity. The utility of anti-nucleosome antibodies in identifying patients with active disease in a cross-sectional analysis was comparable to that of anti-dsDNA antibodies and C3. Analysis of variance demonstrated that the level of anti-nucleosome antibodies and C3 varied significantly with changes in disease activity over time. Changes in clinical state were not mirrored by changes in anti-dsDNA antibodies. In time-dependent analysis, anti-nucleosome antibodies showed a better fit over time than anti-dsDNA antibodies and C3. In pairwise comparisons, C3 and anti-nucleosome antibodies outperformed other models, including the conventional pairing of C3 and anti-dsDNA antibodies, however, no biomarker alone or as a group accurately predicted impending remissions or exacerbations. CONCLUSION Anti-nucleosome antibodies demonstrate greater fidelity as a biomarker for changes in SLE disease activity than traditional biomarkers, supporting the routine monitoring of this antibody in clinical practice.
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Affiliation(s)
- Timothy Li
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Stephenie D Prokopec
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Stacey Morrison
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Wendy Lou
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Heather Reich
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Dafna Gladman
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University
| | - Murray Urowitz
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University
| | - James Scholey
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Paul R Fortin
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Paul C Boutros
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University
| | - Joan Wither
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University
| | - Carolina Landolt-Marticorena
- Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network (UHN), Ontario Institute for Cancer Research, University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Division of Biostatistics, Dalla Lana School of Public Health, Department of Medicine, University of Toronto, Arthritis Centre of Excellence, Division of Health Care and Outcomes Research, Toronto Western Hospital Research Institute, University Health Network, Toronto, ON, Centre de recherche du CHU de Québec, CHU de Québec, Division of Rheumatology, Department of Medicine, CHU de Québec and Faculty of Medicine, Université Laval, Quebec City, QC, Department of Immunology, Department of Medical Biophysics and Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University
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Mercury, autoimmunity, and environmental factors on cheyenne river sioux tribal lands. Autoimmune Dis 2014; 2014:325461. [PMID: 24864198 PMCID: PMC4017878 DOI: 10.1155/2014/325461] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 02/17/2014] [Indexed: 01/25/2023] Open
Abstract
Mercury (Hg), shown to induce autoimmune disease in rodents, is a ubiquitous toxicant throughout Cheyenne River Sioux Tribe (CRST) lands. CRST members may be exposed to Hg through fish consumption (FC), an important component of native culture that may supplement household subsistence. Our goals were to ascertain whether total blood Hg levels (THg) reflect Hg exposure through FC and smoking, and determine whether THg is associated with the presence of anti-nuclear antibody (ANA) and specific autoantibodies (sAuAb). We recruited 75 participants who regularly consume fish from CRST waters. Hg exposure through FC and smoking were assessed via questionnaires. Whole blood samples were collected from participants, and THg was measured using ICP-MS. ANA and sAuAb in serum were modeled using demographic and exposure information as predictors. Female gender, age, and FC were significant predictors of THg and sAuAb; self-reported smoking was not. 31% of participants tested positive for ANA ≥ 2+. Although ANA was not significantly associated with Hg, the interactions of gender with Hg and proximity to arsenic deposits were statistically significant (P < 0.05). FC resulted in a detectable body burden of Hg, but THg alone did not correlate with the presence of ANA or sAuAb in this population.
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The spectrum of anti-chromatin/nucleosome autoantibodies: independent and interdependent biomarkers of disease. J Immunol Res 2014; 2014:368274. [PMID: 24804269 PMCID: PMC3996305 DOI: 10.1155/2014/368274] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 03/03/2014] [Indexed: 01/08/2023] Open
Abstract
Autoantibodies directed to chromatin components date back to the discovery of the LE cell and the LE cell phenomenon circa 1950, and subsequent evidence that major components of that reaction were chromatin components and histones in particular. Over time, immunoassays ranging from ELISA and line immunoassays to more modern bead-based assays incorporated histone and DNA mixtures, purified histones, and purified nucleosomes leading to a more thorough understanding of the genesis and pathogenetic relationships of antibodies to chromatin components in systemic lupus erythematosus and other autoimmune conditions. More recently, interest has focussed on other components of chromatin such as high mobility group (HMG) proteins both as targets of B cell responses and pro-inflammatory mediators. This review will focus on immunoassays that utilize chromatin components, their clinical relationships, and newer evidence implicating HMG proteins and DNA neutrophil extracellular traps (NETs) as important players in systemic autoimmune rheumatic diseases.
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Dwivedi N, Neeli I, Schall N, Wan H, Desiderio DM, Csernok E, Thompson PR, Dali H, Briand JP, Muller S, Radic M. Deimination of linker histones links neutrophil extracellular trap release with autoantibodies in systemic autoimmunity. FASEB J 2014; 28:2840-51. [PMID: 24671707 DOI: 10.1096/fj.13-247254] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Autoantibodies to nuclear antigens arise in human autoimmune diseases, but a unifying pathogenetic mechanism remains elusive. Recently we reported that exposure of neutrophils to inflammatory conditions induces the citrullination of core histones by peptidylarginine deiminase 4 (PAD4) and that patients with autoimmune disorders produce autoantibodies that recognize such citrullinated histones. Here we identify histone H1 as an additional substrate of PAD4, localize H1 within neutrophil extracellular traps, and detect autoantibodies to citrullinated H1 in 6% of sera from patients with systemic lupus erythematosus and Sjögren's syndrome. No preference for deiminated H1 was observed in healthy control sera and sera from patients with scleroderma or rheumatoid arthritis. We map binding to the winged helix of H1 and determine that citrulline 53 represents a key determinant of the autoantibody epitope. In addition, we quantitate RNA for H1 histone subtypes in mature human neutrophils and identify citrulline residues by liquid chromatography and tandem mass spectrometry. Our results indicate that deimination of linker histones generates new autoantibody epitopes with enhanced potential for stimulating autoreactive human B cells.-Dwivedi, N., Neeli, I., Schall, N., Wan, H., Desiderio, D. M., Csernok, E., Thompson, P. R., Dali, H., Briand, J.-P., Muller, S., Radic, M. Deimination of linker histones links neutrophil extracellular trap release with autoantibodies in systemic autoimmunity.
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Affiliation(s)
- Nishant Dwivedi
- Department of Microbiology, Immunology, and Biochemistry, and
| | - Indira Neeli
- Department of Microbiology, Immunology, and Biochemistry, and
| | - Nicolas Schall
- Immunopathology and Therapeutic Chemistry, Laboratory of Excellence Medalis, Institut de Biologie Moléculaire et Cellulaire, Centre National de la Recherche Scientifique (CNRS), Strasbourg, France
| | - Haibao Wan
- Department of Neurology, Charles B. Stout Neuroscience Mass Spectrometry Laboratory, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Dominic M Desiderio
- Department of Neurology, Charles B. Stout Neuroscience Mass Spectrometry Laboratory, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Elena Csernok
- Department of Rheumatology, University of Lübeck, Klinikum Bad Bramstedt, Bad Bramstedt, Germany; and
| | | | - Hayet Dali
- Immunopathology and Therapeutic Chemistry, Laboratory of Excellence Medalis, Institut de Biologie Moléculaire et Cellulaire, Centre National de la Recherche Scientifique (CNRS), Strasbourg, France
| | - Jean-Paul Briand
- Immunopathology and Therapeutic Chemistry, Laboratory of Excellence Medalis, Institut de Biologie Moléculaire et Cellulaire, Centre National de la Recherche Scientifique (CNRS), Strasbourg, France
| | - Sylviane Muller
- Immunopathology and Therapeutic Chemistry, Laboratory of Excellence Medalis, Institut de Biologie Moléculaire et Cellulaire, Centre National de la Recherche Scientifique (CNRS), Strasbourg, France
| | - Marko Radic
- Department of Microbiology, Immunology, and Biochemistry, and
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Parseghian MH, Mechetner E, Osidak MS, Domogatskii SP. Application of monoclonal antibodies for the diagnostic and therapeutic targeting of human tumors with a necrotic component. RUSS J GEN CHEM+ 2014. [DOI: 10.1134/s1070363214020364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Parseghian MH. Hitchhiker antigens: Inconsistent ChIP results, questionable immunohistology data, and poor antibody performance may have a common factor. Biochem Cell Biol 2013; 91:378-94. [DOI: 10.1139/bcb-2013-0059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Questionable data and poor antibody performance may have a common factor: antigens “hitchhiking” on the very antibodies designed to target them. Here I focus on histone hitchhikers and their antibodies, given the impact of chromatin immunoprecipitation on our understanding of DNA regulation. Caused by a lack of stringency during antibody purification, hitchhikers will impede important advances in chromatin research and therapeutics derived from that research, if similar circumstances in the study of lupus decades ago are any guide. Evidence of this phenomenon is reviewed, purification modifications for antibody manufacturing are suggested, and a histone hitchhiker detection procedure is provided.
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Sandoval J, Peiró-Chova L, Pallardó FV, García-Giménez JL. Epigenetic biomarkers in laboratory diagnostics: emerging approaches and opportunities. Expert Rev Mol Diagn 2013; 13:457-71. [PMID: 23782253 DOI: 10.1586/erm.13.37] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Epigenetics has emerged as a new and promising field in recent years. Lifestyle, stress, drugs, physiopathological situations and pharmacological interventions have a great impact on the epigenetic code of the cells by altering the methylome, miRNA expression and the covalent histone modifications. Since there exists a need to find new biomarkers and improve diagnosis for several diseases, the research on epigenetic biomarkers for molecular diagnostics encourages the translation of this field from the bench to clinical practice. In this context, deciphering intricate epigenetic modifications involved in several molecular processes is a challenge that will be solved in the near future. In this review, the authors present an overview of the high-throughput technologies and laboratory techniques available for epigenetic studies, and also discuss which of them are more reliable to be used in a clinical diagnostic laboratory. In addition, the authors describe the most promising epigenetic biomarkers in lung, colorectal and prostate cancer, in which most advances have been achieved. Finally, the authors describe epigenetic biomarkers in some rare diseases; these rare syndromes are paradigms for a specific impaired molecular pathway, thus providing valuable information on the discovery of new epigenetic biomarkers.
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Affiliation(s)
- Juan Sandoval
- Epigenetics and Cancer Biology, Institut d'Investigació Biomèdica de Bellvitge IDIBELL, Barcelona, Spain
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Jung JY, Bae CB, Suh CH. Promising biomarkers for systemic lupus erythematosus. ACTA ACUST UNITED AC 2013; 7:601-13. [DOI: 10.1517/17530059.2013.846323] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Systemic lupus erythematosus patients contain significantly less igm against mono-methylated lysine than healthy subjects. PLoS One 2013; 8:e68520. [PMID: 23874652 PMCID: PMC3713014 DOI: 10.1371/journal.pone.0068520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 05/30/2013] [Indexed: 12/21/2022] Open
Abstract
Post-translational modifications on proteins are important in biological processes but may create neo-epitopes that induce autoimmune responses. In this study, we measured the serum IgG and IgM response to a set of non-modified or acetyl- and methyl-modified peptides corresponding to residues 1–19 of the histone 3 N-terminal tail in systemic lupus erythematosus (SLE) patients and healthy subjects. Our results indicated that the SLE patients and healthy subjects produced antibodies (Abs) to the peptides, but the two groups had different Ab isotype and epitope preferences. Abs to the non-modified form, H31–19, were of the IgG isotype and produced by SLE patients. They could not recognize the scrambled H31–19, which contained the same amino acid composition but a different sequence as H31–19. In comparison, healthy subjects in general did not produce IgG against H31–19. However, about 70% of the healthy subjects produced IgM Abs against mono-methylated K9 of H31–19 (H31–19K9me). Our further studies revealed that ε-amine mono-methylated lysine could completely inhibit the IgM binding to H31–19K9me, but lysine had no inhibitory effect. In addition, the IgM Abs could bind peptides containing a mono-methylated lysine residue but with totally different sequences. Thus, mono-methylated lysine was the sole epitope for the IgM. Interestingly, SLE patients had much lower levels of this type of IgM. There was no obvious correlation between the IgM levels and disease activity and the decreased IgM was unlikely caused by medical treatments.We also found that the IgM Abs were not polyreactive to dsDNA, ssDNA, lipopolysaccharide (LPS) or insulin and they did not exist in umbilical cord serum, implying that they were not natural Abs. The IgM Abs against mono-methylated lysine are present in healthy subjects but are significantly lower in SLE patients, suggesting a distinct origin of production and special physiological functions.
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Immunoserological parameters in SLE: high-avidity anti-dsDNA detected by ELISA are the most closely associated with the disease activity. Clin Rheumatol 2013; 32:1619-26. [DOI: 10.1007/s10067-013-2330-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 06/03/2013] [Accepted: 06/26/2013] [Indexed: 02/08/2023]
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Bizzaro N, Villalta D, Giavarina D, Tozzoli R. Are anti-nucleosome antibodies a better diagnostic marker than anti-dsDNA antibodies for systemic lupus erythematosus? A systematic review and a study of metanalysis. Autoimmun Rev 2012; 12:97-106. [PMID: 22810055 DOI: 10.1016/j.autrev.2012.07.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Methods to detect anti-nucleosome antibodies (ANuA) have been available for more than 10 years and the test has demonstrated its good sensitivity and high specificity in diagnosing systemic lupus erythematosus (SLE). Despite these data produced through clinical and laboratory research, the test is little used. OBJECTIVE To verify the diagnostic performance of methods for measuring ANuA and to compare them with those for anti-dsDNA antibodies. DATA SOURCES A systematic review of English and non-English articles using MEDLINE and EMBASE with the search terms "nucleosome", "chromatin", "anti-nucleosome antibodies" and "anti-chromatin antibodies". Additional studies were identified checking reference lists in the selected articles. STUDY SELECTION We selected studies reporting on anti-nucleosome tests performed by quantitative immunoassays, on patients with SLE as the index disease (sensitivity) and a control group (specificity). A total of 610 titles were initially identified with the search strategy described. 548 publications were subsequently excluded based on abstract and title. Full-text review was undertaken as the next step on 62 publications providing data on anti-nucleosome testing; 25 articles were then excluded because they did not include either SLE patients or a control group, and 37 articles were selected for the metanalysis. Finally, a sub-metanalysis study was conducted on the 26 articles providing data on both ANuA and anti-dsDNA antibody assays in the same series of patients. DATA EXTRACTION Extraction of data from selected articles was performed by two authors independently, using predefined criteria: the number of patients with SLE as the index case, and the number of healthy or diseased controls; specification of the analytical method used to detect anti-nucleosome and anti-dsDNA antibodies; the cut-off used in the study; and the sensitivity and specificity of the assay. Demographic and clinical data on the population investigated (adults or children; lupus patients with or without nephritis; patients with active or inactive disease) were also recorded and analyzed in a separate evaluation. RESULTS The systematic review and metanalysis showed that the overall sensitivity of the ANuA assay is 61% (confidence interval-CI, 60-62) and the specificity 94% (CI, 94-95). The overall positive likelihood ratio is 13.81 (CI, 9.05-21.09) and the negative likelihood ratio 0.38 (CI, 0.33-0.44). The odds ratio for having SLE in ANuA-positive patients is 40.7. The comparative analysis on anti-dsDNA antibodies conducted on the 26 studies which provided data for both antibodies showed that ANuA have greater diagnostic sensitivity (59.9% vs 52.4%) and a specificity rating only slightly higher (94.9% vs 94.2%). The probability that a subject with positive ANuA have SLE is 41 times greater than a subject with negative ANuA, while for anti-dsDNA the probability is 28 times greater. These figures are even more impressive in children, in whom ANuA have an odds ratio for the diagnosis of SLE of 146, compared to 51 for anti-dsDNA antibodies. In selected studies, ANuA (p<0.0001) but not anti-dsDNA antibodies (p=0.256) were significantly associated with disease activity measured by the international score systems. However, neither antibody appears to correlate with kidney involvement. CONCLUSIONS Data from the metanalysis have shown that ANuA have equal specificity but higher sensitivity and prognostic value than anti-dsDNA antibodies in the diagnosis of SLE. Despite a certain heterogeneity among the various studies, the use of ANuA appears more efficacious than anti-dsDNA.
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Affiliation(s)
- Nicola Bizzaro
- Laboratory of Clinical Pathology, San Antonio Hospital, Tolmezzo, Italy.
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Epigenetics and autoimmune diseases. Autoimmune Dis 2012; 2012:593720. [PMID: 22536485 PMCID: PMC3318200 DOI: 10.1155/2012/593720] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 12/06/2011] [Accepted: 12/14/2011] [Indexed: 12/22/2022] Open
Abstract
Epigenetics is defined as the study of all inheritable and potentially reversible changes in genome function that do not alter the nucleotide sequence within the DNA. Epigenetic mechanisms such as DNA methylation, histone modification, nucleosome positioning, and microRNAs (miRNAs) are essential to carry out key functions in the regulation of gene expression. Therefore, the epigenetic mechanisms are a window to understanding the possible mechanisms involved in the pathogenesis of complex diseases such as autoimmune diseases. It is noteworthy that autoimmune diseases do not have the same epidemiology, pathology, or symptoms but do have a common origin that can be explained by the sharing of immunogenetic mechanisms. Currently, epigenetic research is looking for disruption in one or more epigenetic mechanisms to provide new insights into autoimmune diseases. The identification of cell-specific targets of epigenetic deregulation will serve us as clinical markers for diagnosis, disease progression, and therapy approaches.
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Liu CL, Tangsombatvisit S, Rosenberg JM, Mandelbaum G, Gillespie EC, Gozani OP, Alizadeh AA, Utz PJ. Specific post-translational histone modifications of neutrophil extracellular traps as immunogens and potential targets of lupus autoantibodies. Arthritis Res Ther 2012; 14:R25. [PMID: 22300536 PMCID: PMC3392818 DOI: 10.1186/ar3707] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 01/22/2012] [Accepted: 02/02/2012] [Indexed: 02/05/2023] Open
Abstract
Introduction Autoreactivity to histones is a pervasive feature of several human autoimmune disorders, including systemic lupus erythematosus (SLE). Specific post-translational modifications (PTMs) of histones within neutrophil extracellular traps (NETs) may potentially drive the process by which tolerance to these chromatin-associated proteins is broken. We hypothesized that NETs and their unique histone PTMs might be capable of inducing autoantibodies that target histones. Methods We developed a novel and efficient method for the in vitro production, visualization, and broad profiling of histone-PTMs of human and murine NETs. We also immunized Balb/c mice with murine NETs and profiled their sera on autoantigen and histone peptide microarrays for evidence of autoantibody production to their immunogen. Results We confirmed specificity toward acetyl-modified histone H2B as well as to other histone PTMs in sera from patients with SLE known to have autoreactivity against histones. We observed enrichment for distinctive histone marks of transcriptionally silent DNA during NETosis triggered by diverse stimuli. However, NETs derived from human and murine sources did not harbor many of the PTMs toward which autoreactivity was observed in patients with SLE or in MRL/lpr mice. Further, while murine NETs were weak autoantigens in vivo, there was only partial overlap in the immunoglobulin G (IgG) and IgM autoantibody profiles induced by vaccination of mice with NETs and those seen in patients with SLE. Conclusions Isolated in vivo exposure to NETs is insufficient to break tolerance and may involve additional factors that have yet to be identified.
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Affiliation(s)
- Chih Long Liu
- Department of Medicine, Division of Immunology and Rheumatology, Stanford School of Medicine, 269 Campus Drive, Stanford, California 94305, USA
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van der Vlag J, Berden JHM. Lupus nephritis: role of antinucleosome autoantibodies. Semin Nephrol 2011; 31:376-89. [PMID: 21839371 DOI: 10.1016/j.semnephrol.2011.06.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The discovery of autoantigen clustering in blebs at the surface of apoptotic cells boosted research on the role of apoptosis in systemic lupus erythematosus (SLE) and led to the discovery of autoantigen modification during apoptosis. Normally, apoptotic cells are cleared efficiently and swiftly. However, it became clear that in SLE insufficient removal of apoptotic material leads to the release of these modified autoantigens. This creates the danger that these modified autoantigens are recognized by the immune system. Indeed, dendritic cells, the professional antigen-presenting cells, phagocytose these modified autoantigens, which leads to maturation and induction of a proinflammatory state of these dendritic cells. As a consequence, they present these modified autoantigens to T cells in an immunogenic way, which become activated and stimulate autoreactive B cells to secrete autoantibodies. In this review the currently available evidence for the sequential steps in the pathogenesis of SLE is discussed. Furthermore, the mechanisms responsible for the nephritogenicity of antinucleosome antibodies are reviewed. This will reveal that nucleosomes are not only a major driving force in the formation of antinuclear antibodies, but also play a pivotal role in the development of tissue lesions by mediating binding of autoantibodies to basement membranes as exemplified for the kidney.
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Affiliation(s)
- Johan van der Vlag
- Nephrology Research Laboratory, Nijmegen Centre for Molecular Life Sciences, Nijmegen, The Netherlands
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Sardeto GA, Simas LM, Skare TS, Nisihara RM, Utiyama SRR. Antinucleosome in systemic lupus erythematosus. A study in a Brazilian population. Clin Rheumatol 2011; 31:553-6. [DOI: 10.1007/s10067-011-1889-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 10/04/2011] [Accepted: 10/28/2011] [Indexed: 10/15/2022]
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Mihaylova N, Tchorbanov A. New Biotechnologycal Approaches for Immunotherapy of Autoimmune Diseases. BIOTECHNOL BIOTEC EQ 2011. [DOI: 10.5504/bbeq.2011.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Magorivska IB, Bilyy RO, Havrylyuk AM, Chop'yak VV, Stoika RS, Kit YY. Anti-histone H1 IgGs from blood serum of systemic lupus erythematosus patients are capable of hydrolyzing histone H1 and myelin basic protein. J Mol Recognit 2010; 23:495-502. [PMID: 20583146 DOI: 10.1002/jmr.1033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Novel hydrolytic activity of the anti-histone H1 antibodies (Ab) toward histone H1 and myelin basic protein (MBP) was shown. Blood serum of ten patients with clinically diagnosed systemic lupus erythematosus (SLE), and nine healthy donors (control) were screened for the anti-histone H1 antibody- and anti-MBP antibody-mediated specific proteolytic activity. IgGs were isolated by chromatography on Protein G-Sepharose, and four of ten SLE patients appeared to possess IgGs that were capable of cleaving both histone H1 and MBP. Such activity was confirmed to be an intrinsic property of the IgG molecule, since it was preserved at gel filtration at alkaline and acidic pH. At the same time, proteolytic activity was absent in the sera-derived Ab of all healthy donors under control. Anti-histone IgGs were purified by the affinity chromatography on histone H1-Sepharose. Their cross-reactivity toward cationic proteins (histones, lysozyme, and MBP) and their capability of hydrolyzing histone H1 and MBP were detected. However, these IgGs were not cleaving core histones, lysozyme, or albumin. Capability of cleaving histone H1 and MBP was preserved after additional purification of anti-histone H1 IgGs by the HPLC gel filtration. The protease activity of anti-histone H1 IgG Ab was inhibited by serine protease inhibitors.
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Affiliation(s)
- Irina B Magorivska
- Institute of Cell Biology, National Academy of Sciences of Ukraine, Drahomanov Street 14/16, Lviv 79005, Ukraine
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Alba P, Bertolaccini ML, Khamashta MA. The use of laboratory methods in differential diagnosis and treatment of SLE and antiphospholipid syndrome. Expert Rev Clin Immunol 2010; 3:613-22. [PMID: 20477165 DOI: 10.1586/1744666x.3.4.613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The detection of autoantibodies has become an important component in the diagnosis and management of systemic lupus erythematosus (SLE) and antiphospholipid syndrome. Their importance lies in the fact that they are not only markers of the disease and used as part of a diagnostic panel, but many of them also show correlation with disease activity. All antibody testing should be interpreted in the context of the clinical features. The antinuclear antibodies test is an effective screening assay in patients with clinical features of SLE. The combination of antinuclear antibodies test, dsDNA and ENA (Ro, La, Sm, RNP) antibodies help to establish the diagnosis of most patients with SLE. New antibodies, such as antinucleosomes and anti-C1q, appear to be useful for SLE diagnosis, monitoring disease activity and predicting renal flares, particularly in dsDNA-negative patients. Anticardiolipin antibodies and lupus anticoagulant are the tests most commonly used in the diagnosis of antiphospholipid syndrome. However, the use of anti-beta(2)-glycoprotein I as a routine diagnostic test remains controversial.
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Affiliation(s)
- Paula Alba
- Servicio de Reumatologìa Hospital Còrdoba, Unidad Hospitalaria Medicina Interna 3, Universidad Nacional de Còrdoba, Còrdoba, Repùblica Argentina.
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Hoffmann MH, Trembleau S, Muller S, Steiner G. Nucleic acid-associated autoantigens: pathogenic involvement and therapeutic potential. J Autoimmun 2009; 34:J178-206. [PMID: 20031372 DOI: 10.1016/j.jaut.2009.11.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Autoimmunity to ubiquitously expressed macromolecular nucleic acid-protein complexes such as the nucleosome or the spliceosome is a characteristic feature of systemic autoimmune diseases. Disease-specificity and/or association with clinical features of some of these autoimmune responses suggest pathogenic involvement which, however, has been proven in only a few cases so far. Although the mechanisms leading to autoimmunity against nucleic acid-containing complexes are still far from being fully understood, there is increasing experimental evidence that the nucleic acid component may act as a co-stimulator or adjuvans via activation of nucleic acid-binding receptor systems such as Toll-like receptors in antigen-presenting cells. Dysregulated apoptosis and inappropriate stimulation of nucleic acid-sensing receptors may lead to loss of tolerance against the protein components of such complexes, activation of autoreactive T cells and formation of autoantibodies. This has been demonstrated to occur in systemic lupus erythematosus and seems to represent a general mechanism that may be crucial for the development of systemic autoimmune diseases. This review provides a comprehensive overview of the most thoroughly-characterized nucleic acid-associated autoantigens, describing their structure and biological function, as well as the nature and pathogenic importance of the reactivities directed against them. Furthermore, recent advances in immunotherapy such as antigen-specific approaches targeted at nucleic acid-binding antigens are discussed.
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Affiliation(s)
- Markus H Hoffmann
- Division of Rheumatology, Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
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Shabana AA, El-Ghawet AE, Machaly SA, Abu Hashim EM, El-Kady BA, Shaat R. Anti-chromatin and anti-histone antibodies in Egyptian patients with systemic lupus erythematosus. Clin Rheumatol 2009; 28:673-8. [PMID: 19291351 DOI: 10.1007/s10067-009-1130-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Revised: 02/01/2009] [Accepted: 02/09/2009] [Indexed: 11/26/2022]
Abstract
There has been a renewed interest in anti-chromatin and anti-histone antibodies in the last few years. To assess the prevalence of anti-chromatin and anti-histone antibodies in patients with systematic lupus erythematosus (SLE) and to correlate serum levels of these antibodies with clinical features of the disease, the presence of anti-chromatin and anti-histone antibodies in 38 patients with SLE was investigated by an enzyme-linked immunosorbent assay (ELISA). To determine the specificity of these antibodies, 15 patients with rheumatoid arthritis, 15 patients with systemic sclerosis, and 15 normal controls were also tested. Sensitivity of anti-chromatin antibodies in SLE patients was 89.5% and specificity was 80.0%, while sensitivity of anti-histone antibodies was 92.1% and specificity was 82.2%. Significant associations were found between the levels of anti-chromatin antibodies and arthritis, malar rash, oral ulcer, pulmonary affection (P < 0.05) also, lupus nephritis (P < 0.01), and disease activity score as measured by SLE disease activity index (SLEDAI; P < 0.001). Significant association was found between anti-histone antibodies and fatigue (P < 0.05). The incidence of positive anti-chromatin and anti-histone antibodies was significantly higher than that of anti-dsDNA antibodies in early stage of the disease. We conclude that anti-chromatin and anti-histone antibodies are both sensitive and specific for SLE and could be a useful addition to the laboratory tests that can help in the diagnosis of SLE. Anti-chromatin antibodies seem to be a promising marker useful in early diagnosis and assessment of disease activity in SLE patients especially in patients who are negative for anti-dsDNA antibodies.
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MESH Headings
- Adolescent
- Adult
- Antibodies, Anti-Idiotypic/blood
- Arthritis, Rheumatoid/blood
- Arthritis, Rheumatoid/ethnology
- Arthritis, Rheumatoid/immunology
- Biomarkers/blood
- Case-Control Studies
- Chromatin/immunology
- Egypt
- Female
- Histones/immunology
- Humans
- Lupus Erythematosus, Systemic/diagnosis
- Lupus Erythematosus, Systemic/ethnology
- Lupus Erythematosus, Systemic/immunology
- Male
- Middle Aged
- Scleroderma, Systemic/blood
- Scleroderma, Systemic/ethnology
- Scleroderma, Systemic/immunology
- Sensitivity and Specificity
- Severity of Illness Index
- Young Adult
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Affiliation(s)
- Adel A Shabana
- Rheumatology and Rehabilitation department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Sun XY, Shi J, Han L, Su Y, Li ZG. Anti-histones antibodies in systemic lupus erythematosus: prevalence and frequency in neuropsychiatric lupus. J Clin Lab Anal 2008; 22:271-7. [PMID: 18634076 DOI: 10.1002/jcla.20248] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
To investigate the specificity, sensitivity, and concomitant presence of antibodies against histones (H), histone H1 (H1), and histone H3 (H3) in patients with systemic lupus erythematosus (SLE) and analyze their association with SLE. Serum IgG anti-histones antibodies were detected by enzyme-linked immunosorbent assay in 144 SLE patients consisting of 24 neuropsychiatric lupus (NPSLE), 65 lupus nephritis (LN), and 55 SLE, 100 other rheumatic diseases patients, as well as 40 healthy controls. Clinical and biological parameters of the patients were also evaluated. Anti-H, anti-H1, and anti-H3 antibodies yielded a sensitivity of approximately 33% and a specificity of more than 93% for SLE, which was comparable to that found for anti-double-stranded DNA (anti-dsDNa) antibodies. More significantly, anti-histone antibody is found in approximately 50% of patients with NPSLE compared with LN. Moreover, the titers of anti-histones antibodies of NPSLE patients were significantly higher than that of patients with SLE and LN. The sequential analysis revealed a close correlation of anti-H and anti-H1 antibodies with SLE disease activity. There was an approximate 30% positive rate of anti-histones antibodies in 144 SLE patients lacking anti-nucleosome, anti-mDNA, anti-Sm, and anti-dsDNA antibodies. Antibodies to histones H1 and H3 are markers with high specificity of 93.6-96.4% for SLE. The anti-histone antibody markers are prevalent in approximately 50% of NPSLE. Furthermore, there was a strong correlation with SLE disease activity index and levels of antibodies to histones and H1.
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Affiliation(s)
- Xiao-Yun Sun
- Department of Rheumatology and Immunology, People's Hospital, Peking University Medical School, Beijing, China
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Gómez-Puerta JA, Burlingame RW, Cervera R. Anti-chromatin (anti-nucleosome) antibodies: diagnostic and clinical value. Autoimmun Rev 2008; 7:606-11. [PMID: 18606252 DOI: 10.1016/j.autrev.2008.06.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Anti-chromatin (nucleosome) autoantibodies were one of the first autoantibodies ever detected since they make up the majority of antibodies causing LE Cell formation. The prevalence of anti-chromatin antibodies in systemic lupus erythematosus (SLE) varies from 50% to 100%, being similar to that of the classical positive LE cell. The presence of these antibodies can be used, in conjunction with clinical findings and other laboratory tests, to help in the diagnosis of SLE and drug-induced lupus. Anti-chromatin antibodies have also been found in a lesser percentage of other autoimmune disorders such as primary Sjögren's syndrome and primary antiphospholipid syndrome. The presence of anti-chromatin antibodies has also been linked to glomerulonephritis and disease activity in SLE patients. Recent studies demonstrated the induction of anti-chromatin (anti-nucleosome) antibodies after an anti-tumour necrosis factor (TNF)-alpha agent treatment.
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Affiliation(s)
- José A Gómez-Puerta
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain
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Mihaylova N, Voynova E, Tchorbanov A, Nikolova M, Michova A, Todorov T, Srebreva L, Taskov H, Vassilev T. Selective silencing of disease-associated B-lymphocytes by chimeric molecules targeting their Fc IIb receptor. Int Immunol 2007; 20:165-75. [DOI: 10.1093/intimm/dxm133] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Both clinically and scientifically, the variable organ manifestations of systemic lupus erythematosus (SLE) pose a particular challenge to rheumatologists. Validated scores for disease activity (BILAG, ECLAM, SIS, SLAM, SLEDAI), damage (SLICC/ACR damage index) and health-related quality of life (MOS SF-36) have been successfully used for years. New therapies, however, need to show improvement on outcome parameters for defined organ systems--and these are mostly ill-defined. For proliferative lupus nephritis, well designed studies have been available for years. However, these use very severe outcome parameters (renal failure, death), and therefore take at least 5 years for definitive results. Of the surrogate markers which were devised, none has proven reliable for determining outcome. The combination of shorter studies for defining hopeful strategies followed by long definitive studies, appears to be the best option at present.
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Affiliation(s)
- M Aringer
- Klinische Abt. für Rheumatologie, Universitätsklinik für Innere Medizin III, Wien.
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Parseghian MH, Luhrs KA. Beyond the walls of the nucleus: the role of histones in cellular signaling and innate immunity. Biochem Cell Biol 2007; 84:589-604. [PMID: 16936831 DOI: 10.1139/o06-082] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Although they are one of the oldest family of proteins known (first described in 1884 by Kossel), histones continue to surprise researchers with their ever expanding roles in biology. In the past 25 years, the view of core histone octamers as a simple spool around which DNA in the nucleus is wound and linker histones as mere fasteners clipping it all together has transformed into the realization that histones play a vital role in transcriptional regulation. Through post-translational modifications, histones control the accessibility of transcription factors and a host of other proteins to multiple, conceivably thousands of, genes at once. While researchers have spent decades deciphering the role of histones in the overall structure of chromatin, it might surprise some to find that an entirely separate faction of scientists have focused on the role of histones beyond the confines of the nuclear envelope. In the past decade, there has been an accumulation of observations that suggest that histones can be found at the mitochondrion during the onset of apoptotic signaling and even at the cell surface, acting as a receptor for bacterial and viral proteins. More provocatively, immunologists are becoming convinced that they can also be found in the lumen of several tissues, acting as antimicrobial agents--critical components of an ancient innate immune system. Perhaps nowhere is this observation as dramatic as in the ability of neutrophils to entrap bacterial pathogens by casting out "nets" of DNA and histones that not only act as a physical barrier, but also display bactericidal activity. As our views regarding the role of histones inside and outside the cell evolve, some have begun to develop therapies that either utilize or target histones in the fight against cancer, microbial infection, and autoimmune disease. It is our goal here to begin the process of merging the dichotomous lives of histones both within and without the nuclear membrane.
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Affiliation(s)
- Missag H Parseghian
- Peregrine Pharmaceuticals, Inc, Research and Development, 14272 Franklin Avenue, Tustin, CA 92780, USA.
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44
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Abstract
Chromatin is the native complex of histones and DNA found in the cell nucleus of eukaryotes. The fundamental subunit of chromatin is the nucleosome, which is composed of a core particle in which 146 bp of helical DNA are wrapped around an octamer made up of two H2A-H2B dimers that surround an H3-H4 tetramer. The prevalence of anti-chromatin (nucleosome) antibodies in systemic lupus erythematosus (SLE) varies from 50% to 90%, being similar to that of the classical positive LE cell. The presence of these antibodies can be used, in conjunction with clinical findings and other laboratory tests, to help in the diagnosis of SLE and drug induced lupus. The presence of anti-chromatin antibodies has also been linked to glomerulonephritis in SLE patients.
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Affiliation(s)
- J A Gómez-Puerta
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain
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Ghedira I, Landolsi H, Mankai A, Fabien N, Jeddi M. Anticorps antihistones au cours du lupus érythémateux systémique, comparaison entre trois techniques : Elisa, dot blot et immunotransfert. ACTA ACUST UNITED AC 2006; 54:148-54. [PMID: 16169158 DOI: 10.1016/j.patbio.2005.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2004] [Accepted: 07/21/2005] [Indexed: 10/25/2022]
Abstract
AIMS The purpose of our study is to determine and compare the sensitivity of an enzyme linked immunosorbent assay (ELISA), a dot blot assay and an immunoblot assay for the detection of the IgG class antihistones antibodies in a population of systemic lupus erythematosus. The correlation between antihistones antibodies and the main clinical features of SLE or between antihistones antibodies and the presence of anti-double-stranded-DNA antibodies were analysed. MATERIALS AND METHODS Serum samples from 126 systemic lupus erythematosus patients, classified according to the criteria of the American College of Rheumatology, were analysed for the presence of antihistones antibodies using a dot blot assay and an ELISA. Antihistones subfractions antibodies were assessed using the immunoblot technique on 88 out of the 126 sera. Serum samples from 50 blood-donors were analyzed as negative controls. RESULTS The sensitivity of antihistones antibodies assessed by dot blot assay and ELISA was 69% and 54% respectively, and was lower than that of anti-double-stranded-DNA antibodies (83%). The sensitivity of the immunoblot assay for the detection of antihistones antibodies was 72%. Incidence of autoantibodies against histones H1, H2 A, H2B, H3 and H4 was 60%, 53%, 48%, 36% and 29.5% respectively. We found a correlation between the presence of antihistones antibodies, detected by the dot blot assay and ELISA, and the presence of anti-double-stranded-DNA antibodies. Antihistones antibodies detected by ELISA were correlated with renal disease in systemic lupus erythematosus; they showed a specificity, a positive and a negative predictive value for renal disease in systemic lupus erythematosus higher than those of anti-double-stranded-DNA antibodies. CONCLUSIONS The sensitivity of the dot blot assay for the detection of antihistones antibodies is better than that of ELISA, but the latter technique could detect some cases negative by ELISA. Antihistones antibodies detected by ELISA have an important predictive value in the renal complications in systemic lupus erythematosus, better than that of AdsDNA. Antibodies to histone H1 were the most frequent antihistones autoandibodies in systemic lupus erythematosus and they were highly correlated with anti-double-stranded-DNA antibodies and renal disease.
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Affiliation(s)
- I Ghedira
- Service d'Immunologie, Hôpital Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie.
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Patel N, Ohbayashi M, Nugent AK, Ramchand K, Toda M, Chau KY, Bunce C, Webster A, Bird AC, Ono SJ, Chong V. Circulating anti-retinal antibodies as immune markers in age-related macular degeneration. Immunology 2005; 115:422-30. [PMID: 15946260 PMCID: PMC1782158 DOI: 10.1111/j.1365-2567.2005.02173.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Age-related macular maculopathy (ARM) and age-related macular degeneration (AMD) are the leading causes of blindness in the Western world. Despite the magnitude of this clinical problem, very little is known about the pathogenesis of the disease. In this study, we analysed the sera (using indirect immunohistochemistry and Western blot analysis) from a very large cohort of such patients and normal age-matched controls to detect circulating anti-retinal antibodies. Patients with bilateral drusen (n = 64) and with chorioretinal neovascularization (CNV) (n = 51) were recruited in addition to age-matched control subjects (n = 39). The sera were analysed for anti-retinal immunoglobulins on retinal sections. The data were then correlated with the clinical features graded according to the International Classification and Grading System of ARM and AMD. The sera of patients with drusen (93.75%) and CNV (82.27%) were found to have a significantly (P = 0.02) higher titre of autoantibodies to the retina in comparison with controls (8.69%), indicating significant evidence of involvement of the immune process in early stages of AMD. Subsequent statistical analysis of the drusen group showed significant progressive staining (P = 0.0009) in the nuclei layers from early to late stages of ARM. Western blotting confirmed the presence of anti-retinal immunoglobulins to retinal antigens. As anti-retinal immunoglobulins are present in patients with bilateral drusen and exudative AMD, these antibodies could play a significant role in the pathogenesis of AMD. Whilst we do not have evidence that these antibodies precede disease onset, the possibility that their presence might contribute to disease progression needs to be investigated. Finally, the eventual identification of the target antigens detected by these antibodies may permit the future development of new diagnostic methods for ARM and AMD.
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Affiliation(s)
- Nishal Patel
- Ocular Immunology, Institute of Ophthalmology, University College of London, Bath Street, London WC1V 9EL, UK
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47
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Patel N, Ohbayashi M, Nugent AK, Ramchand K, Toda M, Chau KY, Bunce C, Webster A, Bird AC, Ono SJ, Chong V. Circulating anti-retinal antibodies as immune markers in age-related macular degeneration. Immunology 2005. [PMID: 15946260 DOI: 10.1111/imm.2005.115.issue-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Age-related macular maculopathy (ARM) and age-related macular degeneration (AMD) are the leading causes of blindness in the Western world. Despite the magnitude of this clinical problem, very little is known about the pathogenesis of the disease. In this study, we analysed the sera (using indirect immunohistochemistry and Western blot analysis) from a very large cohort of such patients and normal age-matched controls to detect circulating anti-retinal antibodies. Patients with bilateral drusen (n = 64) and with chorioretinal neovascularization (CNV) (n = 51) were recruited in addition to age-matched control subjects (n = 39). The sera were analysed for anti-retinal immunoglobulins on retinal sections. The data were then correlated with the clinical features graded according to the International Classification and Grading System of ARM and AMD. The sera of patients with drusen (93.75%) and CNV (82.27%) were found to have a significantly (P = 0.02) higher titre of autoantibodies to the retina in comparison with controls (8.69%), indicating significant evidence of involvement of the immune process in early stages of AMD. Subsequent statistical analysis of the drusen group showed significant progressive staining (P = 0.0009) in the nuclei layers from early to late stages of ARM. Western blotting confirmed the presence of anti-retinal immunoglobulins to retinal antigens. As anti-retinal immunoglobulins are present in patients with bilateral drusen and exudative AMD, these antibodies could play a significant role in the pathogenesis of AMD. Whilst we do not have evidence that these antibodies precede disease onset, the possibility that their presence might contribute to disease progression needs to be investigated. Finally, the eventual identification of the target antigens detected by these antibodies may permit the future development of new diagnostic methods for ARM and AMD.
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Affiliation(s)
- Nishal Patel
- Ocular Immunology, Institute of Ophthalmology, University College of London, Bath Street, London WC1V 9EL, UK
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49
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Recent advances in understanding the clinical utility and underlying cause of antinucleosome (antichromatin) autoantibodies. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.cair.2004.04.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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