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Lanzolla G, Marinò M, Menconi F. Graves disease: latest understanding of pathogenesis and treatment options. Nat Rev Endocrinol 2024:10.1038/s41574-024-01016-5. [PMID: 39039206 DOI: 10.1038/s41574-024-01016-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2024] [Indexed: 07/24/2024]
Abstract
Graves disease is the most common cause of hyperthyroidism in iodine-sufficient areas. The main responsible mechanism is related to autoantibodies that bind and activate the thyrotropin receptor (TSHR). Although Graves hyperthyroidism is relatively common, no causal treatment options are available. Established treatment modalities are antithyroid drugs, which reduce thyroid hormone synthesis, radioactive iodine and surgery. However, emerging drugs that target the main autoantigen (monoclonal antibodies, small molecules, peptides) or block the immune pathway have been recently tested in clinical trials. Graves disease can involve the thyroid exclusively or it can be associated with extrathyroidal manifestations, among which Graves orbitopathy is the most common. The presence of Graves orbitopathy can change the management of the disease. An established treatment for moderate-to-severe Graves orbitopathy is intravenous glucocorticoids. However, recent advances in understanding the pathogenesis of Graves orbitopathy have allowed the development of new target-based therapies by blocking pro-inflammatory cytokine receptors, lymphocytic infiltration or the insulin-like growth factor 1 receptor (IGF1R), with several clinical trials providing promising results. This article reviews the new discoveries in the pathogenesis of Graves hyperthyroidism and Graves orbitopathy that offer several important tools in disease management.
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Affiliation(s)
- Giulia Lanzolla
- Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Pisa, Italy
- Department of Orthopaedic Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Michele Marinò
- Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Francesca Menconi
- U.O. Endocrinologia II, Azienda Ospedaliero Universitaria Pisana, University Hospital of Pisa, Pisa, Italy.
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Zhao Z, Gao Y, Pei X, Wang W, Wang R, Zhang H. Thyroid function and polycystic ovary syndrome: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1364157. [PMID: 38586452 PMCID: PMC10995335 DOI: 10.3389/fendo.2024.1364157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
Background Multiple evidence suggests that thyroid function is associated with polycystic ovary syndrome (PCOS), but whether thyroid function is causally related to PCOS is unclear. To investigate whether the association reflect causality, a Mendelian randomization (MR) analysis was conducted. Methods Single nucleotide polymorphisms (SNPs) involved in this study were acquired from The ThyroidOmics Consortium and the IEU Open Genome-wide association study (GWAS) database, respectively. In forward MR analysis, we included normal free thyroxine (FT4, n=49,269), normal thyroid-stimulating hormone (TSH, n=54,288), hypothyroidism (n=53,423) and hyperthyroidism (n=51,823) as exposure. The outcome was defined as PCOS in a sample size of 16,380,318 individuals. The exposure in the reverse MR analyses was chosen as PCOS, while the outcome consisted of the four phenotypes of thyroid function. The inverse-variance weighted (IVW) method was performed as the major analysis, supplemented by sensitivity analyses. Results The occurrence of PCOS was associated with increased risk of hyperthyroidism (IVW, OR=1.08, 95%CI=1.02-1.13, P=0.004). No evidence suggested that other phenotypes of thyroid function were related to PCOS. Conclusions Our findings demonstrate a cause-and-effect connection between PCOS and hyperthyroidism. The study established foundation for further investigation for interaction between thyroid function and PCOS.
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Affiliation(s)
| | | | | | | | | | - Huawei Zhang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Smith TJ. Fibrocyte Participation in Thyroid-Associated Ophthalmopathy Suggests New Approaches to Therapy. Ophthalmic Plast Reconstr Surg 2023; 39:S9-S18. [PMID: 38054981 PMCID: PMC10703002 DOI: 10.1097/iop.0000000000002509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
PURPOSE Review the historical context of research and changing therapeutic landscape of thyroid-associated ophthalmopathy (TAO) by focusing on the relationship between TAO, CD34+ fibrocytes, thyrotropin receptor (TSHR), and insulin-like growth factor-I receptor (IGF-IR). METHODS A literature review using search terms, including fibrocytes, IGF-IR, TSHR, TAO, and thyroid eye disease. RESULTS The mechanisms involved in TAO have been partially identified. Substantial progress has been made over several decades, including 1) recognizing the interplay between the professional immune system and orbital tissues; 2) TSHR and IGF-IR act interdependently in mediating the pathogenesis of TAO; 3) Multiple cytokines and specific immune cells are involved in activating and remodeling orbital tissue; 4) Recognition of these mechanisms is allowing the development of target therapies such as teprotumumab, a monoclonal antibody IGF-IR inhibitor approved by the US Food and drug administration for treatment of TAO; and 5) It appears that teprotumumab acts on the systemic immune system peripheral to the orbit. CONCLUSION Additional molecules targeting IGF-IR and other plausible disease mechanisms are currently under development. This activity in the TAO therapeutic space portends even greater improvements in patient care.
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Affiliation(s)
- Terry J. Smith
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48105
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Samant M, Ziemniak J, Paolini JF. First-in-Human Phase 1 Randomized Trial with the Anti-CD40 Monoclonal Antibody KPL-404: Safety, Tolerability, Receptor Occupancy, and Suppression of T-Cell-Dependent Antibody Response. J Pharmacol Exp Ther 2023; 387:306-314. [PMID: 37699709 DOI: 10.1124/jpet.123.001771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023] Open
Abstract
Blockade of the cluster of differentiation 40 (CD40)-CD40L interaction has potential for treating autoimmune diseases and preventing graft rejection. This first-in-human, randomized, double-blind, placebo-controlled study (NCT04497662) evaluated safety, pharmacokinetics, receptor occupancy, and pharmacodynamics of the humanized anti-CD40 monoclonal antibody KPL-404. Healthy volunteers were randomized to one of two single-ascending-dose groups: single intravenous KPL-404 dose 0.03, 0.3, 1, 3, or 10 mg/kg or single subcutaneous KPL-404 dose 1 or 5 mg/kg. There were no dose-limiting or dose-related safety findings. Nonlinear dose-dependent changes in various pharmacokinetic parameters were identified following the range of intravenous doses. At the 10 mg/kg intravenous dose level, the t1/2 was approximately 7 days, and full receptor occupancy was observed through Day 71, with complete suppression of T-cell-dependent antibody response (TDAR) to keyhole limpet hemocyanin (KLH) challenge on Day 1 and rechallenge on Day 29 through Day 57. With KPL-404 5 mg/kg subcutaneously, full receptor occupancy was observed through Day 43, with complete suppression of TDAR through at least Day 29. Antidrug antibodies to KPL-404 were suppressed for 57 days with 10 mg/kg intravenously and for 50 days with 5 mg/kg subcutaneously, further confirming prolonged target engagement and pharmacodynamics. These findings support continued investigation of KPL-404 intravenous and subcutaneous administration in a broad range of indications. SIGNIFICANCE STATEMENT: This first-in-human clinical trial of KPL-404, a fully humanized IgG4 monoclonal antibody, was designed with two independent (by route of administration) placebo-controlled single-ascending-dose-level groups, one with four intravenous single-dose cohorts and another with two subcutaneous single-dose cohorts. The pharmacokinetic profile, duration of full CD40 receptor occupancy, and magnitude and duration of memory immune response suppression observed confirm pharmacodynamic activity regardless of administration route. These data provide evidence that chronic KPL-404 dosing regimens (intravenous or subcutaneous) could be practical.
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Affiliation(s)
- Manoj Samant
- Kiniksa Pharmaceuticals, Lexington, Massachusetts
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Álvarez-Sierra D, Rodríguez-Grande J, Gómez-Brey A, Bello I, Caubet E, González Ó, Zafón C, Iglesias C, Moreno P, Ruiz N, Marín-Sánchez A, Colobran R, Pujol-Borrell R. Single cell transcriptomic analysis of Graves' disease thyroid glands reveals the broad immunoregulatory potential of thyroid follicular and stromal cells and implies a major re-interpretation of the role of aberrant HLA class II expression in autoimmunity. J Autoimmun 2023; 139:103072. [PMID: 37336012 DOI: 10.1016/j.jaut.2023.103072] [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: 04/05/2023] [Revised: 05/18/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
The study of the immune response in thyroid autoimmunity has been mostly focused on the autoantibodies and lymphocytes, but there are indications that intrinsic features of thyroid tissue cells may play a role in disrupting tolerance that needs further investigation. The overexpression of HLA and adhesion molecules by thyroid follicular cells (TFC) and our recent demonstration that PD-L1 is also moderately expressed by TFCs in autoimmune thyroid indicates that TFCs they may activate but also inhibit the autoimmune response. Intriguingly, we have recently found that in vitro cultured TFCs are able to suppress the proliferation of autologous lymphocyte T in a contact-dependent manner which is independent of the PD-1/PD-L1 signaling pathway. To get a more comprehensive picture of TFC activating and inhibitory molecules/pathways driving the autoimmune response in the thyroid glands, preparations of TFCs and stromal cells from five Graves' disease (GD) and four control thyroid glands were compared by scRNA-seq. The results confirmed the previously described interferon type I and type II signatures in GD TFCs and showed unequivocally that they express the full array of genes that intervene in the processing and presentation of endogenous and exogeneous antigens. GD TFCs lack however expression of costimulatory molecules CD80 and CD86 required for priming T cells. A moderate overexpression of CD40 by TFCs was confirmed. GD Fibroblasts showed widespread upregulation of cytokine genes. The results from this first single transcriptomic profiling of TFC and thyroid stromal cells provides a more granular view of the events occurring in GD. The new data point at an important contribution of stromal cells and prompt a major re-interpretation of the role of MHC over-expression by TFC, from deleterious to protective. Most importantly this re-interpretation could also apply to other tissues, like pancreatic beta cells, where MHC over-expression has been detected in diabetic pancreas.
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Affiliation(s)
- Daniel Álvarez-Sierra
- Translational Immunology Research Group, Vall D'Hebron Institute of Research (VHIR), Campus Vall D'Hebron, Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain; Immunology Division, Hospital Universitari Vall D'Hebron (HUVH), Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain.
| | - Jorge Rodríguez-Grande
- Microbiology Division, Hospital Universitario Marqués de Valdecilla - IDIVAL, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Aroa Gómez-Brey
- Transplant Coordination Department, Hospital Universitari Vall D'Hebron (HUVH), Campus Vall D'Hebron. Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Irene Bello
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitari Vall D'Hebron (HUVH), Barcelona, Campus Vall D'Hebron, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Enric Caubet
- Department of General Surgery, Endocrine Surgery Division, Hospital Universitari Vall D'Hebron (HUVH), Campus Vall D'Hebron, Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Óscar González
- Department of General Surgery, Endocrine Surgery Division, Hospital Universitari Vall D'Hebron (HUVH), Campus Vall D'Hebron, Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Carles Zafón
- Department of Endocrinology and Nutrition, Hospital Universitari Vall D'Hebron (HUVH), Campus Vall D'Hebron, Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Carmela Iglesias
- Department of Histopathology, Hospital Universitari Vall D'Hebron (HUVH), Campus Vall D'Hebron Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Pablo Moreno
- Department of General Surgery, Endocrine Surgery Division, Hospital Universitari de Bellvitge (HUB), Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Núria Ruiz
- Department of Histopathology, Hospital Universitari de Bellvitge (HUB), Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Ana Marín-Sánchez
- Translational Immunology Research Group, Vall D'Hebron Institute of Research (VHIR), Campus Vall D'Hebron, Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain; Immunology Division, Hospital Universitari Vall D'Hebron (HUVH), Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Roger Colobran
- Translational Immunology Research Group, Vall D'Hebron Institute of Research (VHIR), Campus Vall D'Hebron, Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain; Immunology Division, Hospital Universitari Vall D'Hebron (HUVH), Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain
| | - Ricardo Pujol-Borrell
- Translational Immunology Research Group, Vall D'Hebron Institute of Research (VHIR), Campus Vall D'Hebron, Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain; Immunology Division, Hospital Universitari Vall D'Hebron (HUVH), Barcelona, Passeig Vall D'Hebron 119-129, 08035, Spain; Department of Cell Biology, Physiology and Immunology, Autonomous University of Barcelona (UAB), Campus Vall D'Hebron, Barcelona, Hospital Universitari Vall D'Hebron and the Other Institutions in the Campus Vall D'Hebron Is, Passeig Vall D'Hebron 119-129, 08035, Spain; Vall d'Hebron Institute of Oncology (VHIO), Centre Cellex, C/ Natzaret, 115-117, 08035 Barcelona, Spain
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Pollack R, Stokar J, Lishinsky N, Gurt I, Kaisar-Iluz N, Shaul ME, Fridlender ZG, Dresner-Pollak R. RNA Sequencing Reveals Unique Transcriptomic Signatures of the Thyroid in a Murine Lung Cancer Model Treated with PD-1 and PD-L1 Antibodies. Int J Mol Sci 2023; 24:10526. [PMID: 37445704 DOI: 10.3390/ijms241310526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Immune checkpoint inhibitors (ICI) are commonly associated with thyroid immune-related adverse events, yet the mechanism has not been fully elucidated. We aimed to further explore the mechanism of ICI-induced thyroid dysfunction by assessing changes induced in the thyroid transcriptome by ICI treatment (αPD-1/αPD-L1) in a lung cancer murine model. RNA-sequencing of thyroid tissues revealed 952 differentially expressed genes (DEGs) with αPD-1 treatment (|fold-change| ≥1.8, FDR < 0.05). Only 35 DEG were identified with αPD-L1, and we therefore focused on the αPD-1 group alone. Ingenuity Pathway Analysis revealed that of 952 DEGs with αPD-1 treatment, 362 were associated with functions of cell death and survival, with predicated activation of pathways for apoptosis and necrosis (Z = 2.89 and Z = 3.21, respectively) and negative activation of pathways for cell viability and cell survival (Z = -6.22 and Z = -6.45, respectively). Compared to previously published datasets of interleukin-1β and interferon γ-treated human thyroid cells, apoptosis pathways were similarly activated. However, unique changes related to organ inflammation and upstream regulation by cytokines were observed. Our data suggest that there are unique changes in gene expression in the thyroid associated with αPD-1 therapy. ICI-induced thyroid dysfunction may be mediated by increased tissue apoptosis resulting in destructive thyroiditis.
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Affiliation(s)
- Rena Pollack
- Department of Endocrinology and Metabolism, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Joshua Stokar
- Department of Endocrinology and Metabolism, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Natan Lishinsky
- Department of Endocrinology and Metabolism, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Irina Gurt
- Department of Endocrinology and Metabolism, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Naomi Kaisar-Iluz
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Institute of Pulmonary Medicine, Hadassah Medical Center, Jerusalem 91120, Israel
| | - Merav E Shaul
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Institute of Pulmonary Medicine, Hadassah Medical Center, Jerusalem 91120, Israel
| | - Zvi G Fridlender
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Institute of Pulmonary Medicine, Hadassah Medical Center, Jerusalem 91120, Israel
| | - Rivka Dresner-Pollak
- Department of Endocrinology and Metabolism, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
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Lee HJ, Stefan-Lifshitz M, Li CW, Tomer Y. Genetics and epigenetics of autoimmune thyroid diseases: Translational implications. Best Pract Res Clin Endocrinol Metab 2023; 37:101661. [PMID: 35459628 PMCID: PMC9550878 DOI: 10.1016/j.beem.2022.101661] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hashimoto's thyroiditis (HT) and Graves' disease (GD) are prevalent autoimmune disorders, representing opposite ends of the clinical spectrum of autoimmune thyroid diseases (AITD). The pathogenesis involves a complex interplay between environment and genes. Specific susceptibility genes have been discovered that predispose to AITD, including thyroid-specific and immune-regulatory genes. Growing evidence has revealed that genetic and epigenetic variants can alter autoantigen presentation during the development of immune tolerance, can enhance self-peptide binding to MHC (major histocompatibility complex), and can amplify stimulation of T- and B-cells. These gene-driven mechanistic discoveries lay the groundwork for novel treatment targets. This review summarizes recent advances in our understanding of key AITD susceptibility genes (Tg1, TSHR, HLA-DR3, and CD40) and their translational therapeutic potential.
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Affiliation(s)
- Hanna J Lee
- Department of Medicine, The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, New York, NY, USA.
| | - Mihaela Stefan-Lifshitz
- Department of Medicine, The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, New York, NY, USA.
| | - Cheuk Wun Li
- Department of Medicine, The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, New York, NY, USA.
| | - Yaron Tomer
- Department of Medicine, The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, New York, NY, USA.
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Ruslan A, Okosieme OE. Non-thionamide antithyroid drug options in Graves' hyperthyroidism. Expert Rev Endocrinol Metab 2023; 18:67-79. [PMID: 36740774 DOI: 10.1080/17446651.2023.2167709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The thionamide anti-thyroid drugs namely carbimazole, methimazole, and propylthiouracil, have been the predominant therapy modality for Graves' hyperthyroidism for over 60 years. Although these agents have proven efficacy and favorable side-effect profiles, non-thionamide alternatives are occasionally indicated in patients who are intolerant or unresponsive to thionamides alone. This review examines the available non-thionamide drug options for the control of Graves' hyperthyroidism and summarizes their clinical utility, efficacy, and limitations. AREAS COVERED We reviewed existing literature on mechanisms, therapeutic utility, and side-effect profiles of non-thionamide anti-thyroid drugs. Established non-thionamide agents act on various phases of the synthesis, release, and metabolism of thyroid hormones and comprise historical agents such as iodine compounds and potassium perchlorate as well as drug repurposing candidates like lithium, glucocorticoids, beta-blockers, and cholestyramine. Novel experimental agents in development target key players in Graves' disease pathogenesis including B-cell depletors (Rituximab), CD40 blockers (Iscalimab), TSH-receptor antagonists, blocking antibodies, and immune-modifying peptides. EXPERT OPINION Non-thionamide anti-thyroid drugs are useful alternatives in Graves' hyperthyroidism and more clinical trials are needed to establish their safety and long-term efficacy in hyperthyroidism control. Ultimately, the promise for a cure will lie in novel approaches that target the well-established immunopathogenesis of Graves' disease.
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Affiliation(s)
- Aliya Ruslan
- Endocrine and Diabetes Department, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, CF47 9DT, UK
| | - Onyebuchi E Okosieme
- Endocrine and Diabetes Department, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, CF47 9DT, UK
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
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He Q, Dong H, Gong M, Guo Y, Xia Q, Gong J, Lu F. New Therapeutic Horizon of Graves' Hyperthyroidism: Treatment Regimens Based on Immunology and Ingredients From Traditional Chinese Medicine. Front Pharmacol 2022; 13:862831. [PMID: 35462920 PMCID: PMC9020194 DOI: 10.3389/fphar.2022.862831] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/09/2022] [Indexed: 12/21/2022] Open
Abstract
Graves’ disease is an autoimmune disease characterized by goiter and hyperthyroidism, and 25% patients develop GO. Traditional treatment options, such as antithyroid drugs, radioiodine or thyroidectomy, have remained largely unchanged over the past 70 years. For many patients, there is a high rate of recurrence after antithyroid drugs and lifelong hypothyroidism after ablation and thyroidectomy. The symptoms and quality of life of some patients have not been effectively improved. The clinical demand for new therapeutic regimens, coupled with a deeper understanding of the pathophysiology and immunobiology of Graves’ disease, has led to the emergence of several new therapeutic ideas, including biologics, small molecule peptides, immunomodulators and teprotumumab, a specific antibody targeting IGF-1R. Besides, the elements of TCM have attracted more and more interests in modern medicine, because some effective components have been successfully used in the treatment of autoimmune diseases. Based on the pathophysiology and efficacy of clinical management and treatment in Graves’ hyperthyroidism, here we review the new strategies under investigation and summarize the effective components of traditional Chinese medicine used for Graves’ hyperthyroidism, and explore their mechanisms. These therapies have opened a new window for the treatment of Graves’ disease, but the exact mechanism and the research direction still need to be further explored.
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Affiliation(s)
- Qiongyao He
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Grade 2017 of Integrated Traditional Chinese and Western Clinical Medicine, Second Clinical School, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Dong
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minmin Gong
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yujin Guo
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingsong Xia
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Gong
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Fuer Lu
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
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Muralidharan S, Njenga M, Garron T, Bondensgaard K, Paolini JF. Preclinical immunopharmacologic assessment of KPL-404, a novel, humanized, non-depleting antagonistic anti-CD40 monoclonal antibody. J Pharmacol Exp Ther 2022; 381:12-21. [DOI: 10.1124/jpet.121.000881] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
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Bogusławska J, Godlewska M, Gajda E, Piekiełko-Witkowska A. Cellular and molecular basis of thyroid autoimmunity. Eur Thyroid J 2022; 11:ETJ-21-0024. [PMID: 34981746 PMCID: PMC9142813 DOI: 10.1530/etj-21-0024] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/01/2021] [Indexed: 11/08/2022] Open
Abstract
Autoimmune thyroid disease (AITD) is the most common human autoimmune disease. The two major clinical manifestations of AITD are Graves' disease and Hashimoto's thyroiditis (HT). AITD is characterized by lymphocytic infiltration of the thyroid gland, leading either to follicular cell damage, thyroid gland destruction, and development of hypothyroidism (in HT) or thyroid hyperplasia, induced by thyroid antibodies which activate thyrotropin receptor (TSHR) on thyrocytes, leading to hyperthyroidism. The aim of this review is to present up-to-date picture of the molecular and cellular mechanisms that underlie the pathology of AITD. Based on studies involving patients, animal AITD models, and thyroid cell lines, we discuss the key events leading to the loss of immune tolerance to thyroid autoantigens as well as the signaling cascades leading to the destruction of thyroid gland. Special focus is given on the interplay between the environmental and genetic factors, as well as ncRNAs and microbiome contributing to AITD development. In particular, we describe mechanistic models by which SNPs in genes involved in immune regulation and thyroid function, such as CD40, TSHR, FLT3, and PTPN22, underlie AITD predisposition. The clinical significance of novel diagnostic and prognostic biomarkers based on ncRNAs and microbiome composition is also underscored. Finally, we discuss the possible significance of probiotic supplementation on thyroid function in AITD.
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Affiliation(s)
- Joanna Bogusławska
- Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, Warsaw, Poland
| | - Marlena Godlewska
- Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, Warsaw, Poland
| | - Ewa Gajda
- Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, Warsaw, Poland
| | - Agnieszka Piekiełko-Witkowska
- Centre of Postgraduate Medical Education, Department of Biochemistry and Molecular Biology, Warsaw, Poland
- Correspondence should be addressed to A Piekiełko-Witkowska:
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Wu HH, Ralph KL, Sepuldeva E, Hansen G, Li H, Huang ZF, Liu D, Dziegelewski M, Ahlberg J, Frego L, Fogal S, van Tongeren S, Grimaldi C, Litzenberger T, Presky D, Singh S, Brodeur S, Kroe-Barrett R. An optimally designed anti-human CD40 antibody with potent B cell suppression for the treatment of autoimmune diseases. Int J Pharm 2021; 609:121162. [PMID: 34624444 DOI: 10.1016/j.ijpharm.2021.121162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 12/13/2022]
Abstract
Antibodies targeting the CD40-CD40L pathway have great potential for treating autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus (SLE), lupus nephritis (LN), and inflammatory bowel diseases (IBD). However, in addition to the known difficulty in generating a purely antagonistic CD40 antibody, the presence of CD40 and CD40L on platelets creates additional unique challenges for the safety, target coverage, and clearance of antibodies targeting this pathway. Previously described therapeutic antibodies targeting this pathway have various shortcomings, and the full therapeutic potential of this axis has yet to be realized. Herein, we describe the generation and characterization of BI 655064, a novel, purely antagonistic anti-CD40 antibody that potently neutralizes CD40-CD40L-dependent B-cell stimulation without evidence of impacting platelet functions. This uniquely optimized antibody targeting a highly challenging pathway was obtained by applying stringent functional and biophysical criteria during the lead selection process. BI 655064 has favorable target-mediated drug disposition (TMDD)-saturation pharmacokinetics, consistent with that of a high-quality therapeutic monoclonal antibody.
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Affiliation(s)
- Helen Haixia Wu
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA.
| | - Kerry-Leigh Ralph
- Boehringer Ingelheim Pharmaceuticals, Inc. Cancer Immunology & Immune Modulation, Ridgefield, CT, USA
| | - Eliud Sepuldeva
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
| | - Gale Hansen
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
| | - Hua Li
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
| | - Zhong-Fu Huang
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
| | - Dongmei Liu
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
| | - Michael Dziegelewski
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
| | - Jennifer Ahlberg
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
| | - Lee Frego
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
| | - Steve Fogal
- Boehringer Ingelheim Pharmaceuticals, Inc. Immunology & Respiratory, Ridgefield, CT, USA
| | - Susan van Tongeren
- Boehringer Ingelheim Pharmaceuticals, Inc. Nonclinical Drug Safety, Ridgefield, CT, USA
| | - Christine Grimaldi
- Boehringer Ingelheim Pharmaceuticals, Inc. Drug Metabolism and Pharmacokinetics, Ridgefield, CT, USA
| | - Tobias Litzenberger
- Boehringer Ingelheim Pharmaceuticals, Inc. Translational Medicine & Clinical Pharmacology, Biberach, B-W, Germany
| | | | - Sanjaya Singh
- Janssen Biotherapeutics at Johnson & Johnson. Spring House, PA, USA
| | - Scott Brodeur
- Janssen Pharmaceutical Companies at Johnson & Johnson. New Jersey, PA, USA
| | - Rachel Kroe-Barrett
- Boehringer Ingelheim Pharmaceuticals, Inc. Biotherapeutics Molecule Discovery, Ridgefield, CT, USA
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13
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Faustino LC, Kahaly GJ, Frommer L, Concepcion E, Stefan-Lifshitz M, Tomer Y. Precision Medicine in Graves' Disease: CD40 Gene Variants Predict Clinical Response to an Anti-CD40 Monoclonal Antibody. Front Endocrinol (Lausanne) 2021; 12:691781. [PMID: 34149627 PMCID: PMC8212124 DOI: 10.3389/fendo.2021.691781] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/13/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND CD40, a key co-stimulatory molecule expressed on antigen-presenting cells, is genetically associated with a number of autoimmune diseases including Graves' disease (GD). Therefore, recent therapies targeting CD40 have been developed, including the anti-CD40 monoclonal antibody Iscalimab. In a recent pilot study, Iscalimab was shown to induce clinical remission in ~ 50% of GD patients, but the reason why only 50% of GD patients responded is not known. The aim of our study was to test the hypothesis that specific CD40 single nucleotide polymorphism (SNP) genotypes and haplotypes are associated with clinical response of GD patients to Iscalimab. METHODS We extracted genomic DNA from the whole blood of 13 GD patients treated with Iscalimab, and genotyped seven CD40 single nucleotide polymorphisms (SNPs) associated with autoimmunity. Additionally, we analyzed CD40 mRNA expression levels in whole blood. The patients' CD40 SNP genotypes and mRNA levels were tested for association with clinical response to Iscalimab. RESULTS Three common haplotypes, designated haplotypes A, B, and C, were identified. Haplotypes B and C were associated with higher CD40 mRNA levels and clinical response to Iscalimab (i.e., patients achieving euthyroidism without need for additional medications), while haplotype A was associated with decreased CD40 mRNA levels and no response to Iscalimab. CONCLUSION Our data suggest that genetic polymorphisms in the CD40 gene drive its expression levels and response to Iscalimab. Polymorphisms associated with higher CD40 levels are also associated with clinical response to CD40-targeted therapies. These results set the stage to implementing precision medicine in the therapeutic approach to GD.
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Affiliation(s)
- Larissa C. Faustino
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, United States
| | - George J. Kahaly
- Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany
| | - Lara Frommer
- Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany
| | - Erlinda Concepcion
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, United States
| | | | - Yaron Tomer
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, United States
- *Correspondence: Yaron Tomer,
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14
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Jiang H, Yuan FF, Wang HN, Liu W, Ye XP, Yang SY, Xie HJ, Yu SS, Ma YR, Zhang LL, Zhao SX, Song HD. Compelling Evidence Linking CD40 Gene With Graves' Disease in the Chinese Han Population. Front Endocrinol (Lausanne) 2021; 12:759597. [PMID: 34867801 PMCID: PMC8639283 DOI: 10.3389/fendo.2021.759597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/08/2021] [Indexed: 11/21/2022] Open
Abstract
Mutations in CD40 have been widely reported to be risk factors for Graves' disease (GD). The gene, along with its cognate ligand CD40L, may regulate pro-inflammatory and immune responses. Rs1883832, located at the -1 position of the Kozak sequence, is the most well-studied single nucleotide polymorphism (SNP) of CD40, and has been confirmed to predispose those with the alteration to GD, regardless of ethnicity. Our genome-wide association study (GWAS) indicated that several SNPs, including rs1883832 located within the vicinity of CD40 were associated with GD in the Han Chinese population. Aiming at identifying the most consequential SNP and its underlying pathogenic mechanism, we performed a two-stage refined study on 8,171 patients with GD and 7,906 controls, and found rs1883832 was the most significantly GD-associated SNP in the CD40 gene region (PCombined = 9.17×10-11, OR = 1.18). Through searching the cis-expression quantitative trait locus database and using quantitative RT-PCR, we further discovered that the rs1883832 genotype can influence CD40 gene transcription. Furthermore, we demonstrated that rs1883832 is a susceptibility locus for pTRAb+ GD patients. In conclusion, the current study provides robust evidence that rs1883832 can regulate CD40 gene expression and affect serum TRAb levels, which ultimately contributes to the development of GD.
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Affiliation(s)
- He Jiang
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Fei-Fei Yuan
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hai-Ning Wang
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Endocrinology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Ping Ye
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shao-Ying Yang
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui-Jun Xie
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sha-Sha Yu
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Ru Ma
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Le-Le Zhang
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuang-Xia Zhao
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Shuang-Xia Zhao, ; Huai-Dong Song,
| | - Huai-Dong Song
- Department of Molecular Diagnostic and Endocrinology, The Core Laboratory in Medical Center of Clinical Research, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Shuang-Xia Zhao, ; Huai-Dong Song,
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15
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Lutckii A, Strunz B, Zhirkov A, Filipovich O, Rukoiatkina E, Gusev D, Lobzin Y, Fischler B, Aleman S, Sällberg M, Björkström NK. Evidence for B cell maturation but not trained immunity in uninfected infants exposed to hepatitis C virus. Gut 2020; 69:2203-2213. [PMID: 32341018 DOI: 10.1136/gutjnl-2019-320269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/11/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Vertical transmission of hepatitis C virus (HCV) is rare compared with other chronic viral infections, despite that newborns have an immature, and possibly more susceptible, immune system. It further remains unclear to what extent prenatal and perinatal exposure to HCV affects immune system development in neonates. DESIGN To address this, we studied B cells, innate immune cells and soluble factors in a cohort of 62 children that were either unexposed, exposed uninfected or infected with HCV. Forty of these infants were followed longitudinally from birth up until 18 months of age. RESULTS As expected, evidence for B cell maturation was observed with increased age in children, whereas few age-related changes were noticed among innate immune cells. HCV-infected children had a high frequency of HCV-specific IgG-secreting B cells. Such a response was also detected in some exposed but uninfected children but not in uninfected controls. Consistent with this, both HCV-exposed uninfected and HCV-infected infants had evidence of early B cell immune maturation with an increased proportion of IgA-positive plasma cells and upregulated CD40 expression. In contrast, actual HCV viraemia, but not mere exposure, led to alterations within myeloid immune cell populations, natural killer (NK) cells and a distinct soluble factor profile with increased levels of inflammatory cytokines and chemokines. CONCLUSION Our data reveal that exposure to, and infection with, HCV causes disparate effects on adaptive B cells and innate immune cell such as myeloid cells and NK cells in infants.
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Affiliation(s)
- Anton Lutckii
- Department of Laboratory Medicine, Karolinska institutet, Stockholm, Sweden.,Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russian Federation
| | - Benedikt Strunz
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Anton Zhirkov
- Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russian Federation
| | - Olga Filipovich
- North-Western State Medical University named after I.I.Mechnikov, Saint Petersburg, Russian Federation
| | - Elena Rukoiatkina
- Maternity Hospital No 16, Saint Petersburg, Russian Federation.,Department of Pediatrics, Gynecology and Female Reproductology, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russian Federation
| | - Denis Gusev
- Center for Prevention and Control of AIDS and Infectious Diseases, Saint Petersburg, Russian Federation
| | - Yuriy Lobzin
- Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russian Federation
| | - Björn Fischler
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Karolinska University Hospital, Stockholm, Sweden
| | - Soo Aleman
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Matti Sällberg
- Department of Laboratory Medicine, Karolinska institutet, Stockholm, Sweden
| | - Niklas K Björkström
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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16
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Lane LC, Cheetham TD, Perros P, Pearce SHS. New Therapeutic Horizons for Graves' Hyperthyroidism. Endocr Rev 2020; 41:5897403. [PMID: 32845332 PMCID: PMC7567404 DOI: 10.1210/endrev/bnaa022] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022]
Abstract
Graves' hyperthyroidism is characterized by the presence of autoantibodies that stimulate the thyroid-stimulating hormone receptor (TSHR), resulting in uncontrolled secretion of excessive thyroid hormone. Conventional treatments, including antithyroid medication, radioiodine, or surgery have remained largely unchanged for the past 70 years and either lack efficacy for many patients, or result in lifelong thyroid hormone replacement therapy, in the case of the latter 2 options. The demand for new therapeutic options, combined with greater insight into basic immunobiology, has led to the emergence of novel approaches to treat Graves' hyperthyroidism. The current therapies under investigation include biologics, small molecules, and peptide immunomodulation. There is a growing focus on TSHR-specific treatment modalities, which carry the advantage of eliciting a specific, targeted approach, with the aim of avoiding disruption of the functioning immune system. These therapies present a new opportunity to supersede the inadequate treatments currently available for some Graves' patients, offering hope of successful restoration of euthyroidism without the need for ongoing therapy. Several of these therapeutic options have the potential to translate into clinical practice in the near future. This review provides a comprehensive summary of the recent advances and various stages of development of the novel therapeutic approaches to treat Graves' hyperthyroidism.
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Affiliation(s)
- Laura C Lane
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK.,Endocrine unit, Royal Victoria Infirmary, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK.,Department of Paediatric Endocrinology, The Great North Children's Hospital, Newcastle-upon-Tyne, UK
| | - Tim D Cheetham
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK.,Department of Paediatric Endocrinology, The Great North Children's Hospital, Newcastle-upon-Tyne, UK
| | - Petros Perros
- Endocrine unit, Royal Victoria Infirmary, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - Simon H S Pearce
- Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK.,Endocrine unit, Royal Victoria Infirmary, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
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17
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Chartoumpekis DV, Ziros PG, Georgakopoulos-Soares I, Smith AAT, Marques AC, Ibberson M, A. Kopp P, Habeos I, Trougakos IP, Khoo NKH, Sykiotis GP. The Transcriptomic Response of the Murine Thyroid Gland to Iodide Overload and the Role of the Nrf2 Antioxidant System. Antioxidants (Basel) 2020; 9:antiox9090884. [PMID: 32961913 PMCID: PMC7555824 DOI: 10.3390/antiox9090884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Thyroid follicular cells have physiologically high levels of reactive oxygen species because oxidation of iodide is essential for the iodination of thyroglobulin (Tg) during thyroid hormone synthesis. Thyroid follicles (the functional units of the thyroid) also utilize incompletely understood autoregulatory mechanisms to defend against exposure to excess iodide. To date, no transcriptomic studies have investigated these phenomena in vivo. Nuclear erythroid factor 2 like 2 (Nrf2 or Nfe2l2) is a transcription factor that regulates the expression of numerous antioxidant and other cytoprotective genes. We showed previously that the Nrf2 pathway regulates the antioxidant defense of follicular cells, as well as Tg transcription and Tg iodination. We, thus, hypothesized that Nrf2 might be involved in the transcriptional response to iodide overload. Methods: C57BL6/J wild-type (WT) or Nrf2 knockout (KO) male mice were administered regular water or water supplemented with 0.05% sodium iodide for seven days. RNA from their thyroids was prepared for next-generation RNA sequencing (RNA-Seq). Gene expression changes were assessed and pathway analyses were performed on the sets of differentially expressed genes. Results: Analysis of differentially expressed messenger RNAs (mRNAs) indicated that iodide overload upregulates inflammatory-, immune-, fibrosis- and oxidative stress-related pathways, including the Nrf2 pathway. Nrf2 KO mice showed a more pronounced inflammatory–autoimmune transcriptional response to iodide than WT mice. Compared to previously published datasets, the response patterns observed in WT mice had strong similarities with the patterns typical of Graves’ disease and papillary thyroid carcinoma (PTC). Long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) also responded to iodide overload, with the latter targeting mRNAs that participate mainly in inflammation pathways. Conclusions: Iodide overload induces the Nrf2 cytoprotective response and upregulates inflammatory, immune, and fibrosis pathways similar to autoimmune hyperthyroidism (Graves’ disease) and PTC.
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Affiliation(s)
- Dionysios V. Chartoumpekis
- Service of Endocrinology and Diabetology, Lausanne University Hospital, and Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland; (D.V.C.); (P.G.Z.); (P.A.K.)
- Division of Endocrinology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece;
| | - Panos G. Ziros
- Service of Endocrinology and Diabetology, Lausanne University Hospital, and Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland; (D.V.C.); (P.G.Z.); (P.A.K.)
| | - Ilias Georgakopoulos-Soares
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA 94158, USA;
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Adam A. T. Smith
- Department of Computational Biology, University of Lausanne, 1015 Lausanne, Switzerland; (A.A.T.S.); (A.C.M.)
| | - Ana Claudia Marques
- Department of Computational Biology, University of Lausanne, 1015 Lausanne, Switzerland; (A.A.T.S.); (A.C.M.)
| | - Mark Ibberson
- Vital-IT Group, Swiss Institute of Bioinformatics, 1015 Lausanne, Switzerland;
| | - Peter A. Kopp
- Service of Endocrinology and Diabetology, Lausanne University Hospital, and Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland; (D.V.C.); (P.G.Z.); (P.A.K.)
| | - Ioannis Habeos
- Division of Endocrinology, Department of Internal Medicine, University of Patras, 26504 Patras, Greece;
| | - Ioannis P. Trougakos
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece;
| | - Nicholas K. H. Khoo
- Department of Pharmacology & Chemical Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA;
| | - Gerasimos P. Sykiotis
- Service of Endocrinology and Diabetology, Lausanne University Hospital, and Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland; (D.V.C.); (P.G.Z.); (P.A.K.)
- Correspondence: ; Tel.: +41-21-314-0606
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18
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Yucesan E, Hatirnaz Ng O, Yalniz FF, Yilmaz H, Salihoglu A, Sudutan T, Eskazan AE, Ongoren S, Baslar Z, Soysal T, Ozbek U, Sayitoglu M, Ar MC. Copy-number variations in adult patients with chronic immune thrombocytopenia. Expert Rev Hematol 2020; 13:1277-1287. [PMID: 32885695 DOI: 10.1080/17474086.2020.1819786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Immune thrombocytopenia (ITP) is an autoimmune disease with heterogeneous background. FCGR2C mutations were defined in one third of the patients but genetic players have not been fully elucidated yet. Although childhood ITP present as benign, ITP in adulthood is chronic disease with treatment challenges. This study aimed to focus on adult ITP patients using a whole genome genotyping that is valuable approach to identify the responsible genomic regions for the disease. METHODS Herein 24 adult primary-refractory for ITP patients were evaluated using HumanCytoSNP12BeadChip,Illumina. Forty-six age and sex matched healthy individuals, and ptients awith nonhematological conditions were analyzed as controls. Identified CNV regions were verified by qRTPCR. T-cell receptor beta and delta (TCRB/TCRG) clonality were assessed by heteroduplex analysis in mosaic cases. RESULTS Several CNV losses and gains were defined (losses:2q,7q,17q,19p, and gains: 1q,2p,3q,4q,7q,10q,12p,13q,14q,15q,17p,20q,21p,22q,Xp). Mosaic changes of different sizes (0.2-17.77Mb) were identified in five patients and three of them showed clonality. CNV regions that were unique to ITP patients were identified for the first time and among these genes, those related to immune regulation, and cellular trafficking were noteworthy. Conclusion: Identified CNV regions harbor several candidate genes, the functions of which might shed light on the pathogenesis of chronic ITP.
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Affiliation(s)
- Emrah Yucesan
- Faculty of Medicine, Department of Medical Biology, Bezmialem Vakif University , Istanbul, Turkey
| | - Ozden Hatirnaz Ng
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University , Istanbul, Turkey
| | - Fevzi Firat Yalniz
- Cerrahpasa Faculty of Medicine, Division of Haematology, Department of Internal Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - Hulya Yilmaz
- Cerrahpasa Faculty of Medicine, Division of Haematology, Department of Internal Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - Ayse Salihoglu
- Cerrahpasa Faculty of Medicine, Division of Haematology, Department of Internal Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - Tugce Sudutan
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University , Istanbul, Turkey
| | - Ahmet Emre Eskazan
- Cerrahpasa Faculty of Medicine, Division of Haematology, Department of Internal Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - Seniz Ongoren
- Cerrahpasa Faculty of Medicine, Division of Haematology, Department of Internal Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - Zafer Baslar
- Cerrahpasa Faculty of Medicine, Division of Haematology, Department of Internal Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - Teoman Soysal
- Cerrahpasa Faculty of Medicine, Division of Haematology, Department of Internal Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - Ugur Ozbek
- Department of Medical Genetics, Acibadem Mehmet Ali Aydinlar University, School of Medicine , Istanbul, Turkey
| | - Muge Sayitoglu
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University , Istanbul, Turkey
| | - M Cem Ar
- Cerrahpasa Faculty of Medicine, Division of Haematology, Department of Internal Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
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19
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Faustino LC, Li CW, Stefan-Lifshitz M, Kim K, Clarke OB, Tomer Y. A Novel Mouse Model of Autoimmune Thyroiditis Induced by Immunization with Adenovirus Containing Full-Length Thyroglobulin cDNA: Implications to Genetic Studies of Thyroid Autoimmunity. Thyroid 2020; 30:1338-1345. [PMID: 32228171 PMCID: PMC7482114 DOI: 10.1089/thy.2019.0711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Thyroglobulin (TG) is a key autoantigen in autoimmune thyroid diseases (AITD). Several single nucleotide polymorphisms (SNPs) in the TG locus were shown to be strongly associated with disease susceptibility in both humans and mice, and autoimmune response to TG is the earliest event in the development of thyroid autoimmunity in mice. The classical model of experimental autoimmune thyroiditis (EAT) is induced by immunizing mice with TG protein together with an adjuvant to break down immune tolerance. The classical EAT model has limited utility in genetic studies of TG since it does not allow testing the effects of TG sequence variants on the development of autoimmune thyroiditis. In this study, we have immunized CBA-J mice, an EAT-susceptible strain, with an adenovirus vector encoding the full-length human TG (hTG) to generate a model of EAT in which the TG sequence can be manipulated to test AITD-associated TG SNPs. Methods: We immunized CBA-J mice with hTG-expressing adenovirus following the well-recognized experimental autoimmune Graves' disease protocol that also uses an adenovirus vector to deliver the immunogen. Results: After hTG adenovirus immunizations, mice developed higher T cell proliferative and cytokine responses to hTG and TG2098 (a major T cell epitope in AITD) and higher titers of TG and thyroperoxidase autoantibodies compared with mice immunized with control LacZ-expressing adenovirus. The mice, however, did not develop thyroidal lymphocytic infiltration and hypothyroidism. Conclusions: Our data describe a novel murine model of autoimmune thyroiditis that does not require the use of adjuvants to break down tolerance and that will allow investigators to test the effects of hTG variants in the pathoetiology of Hashimoto's thyroiditis.
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Affiliation(s)
- Larissa C. Faustino
- Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Address correspondence to: Larissa C. Faustino, PhD, Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | - Cheuk W. Li
- Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mihaela Stefan-Lifshitz
- Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kookjoo Kim
- Department of Anesthesiology and Columbia University, New York, New York, USA
- Department of Physiology, Columbia University, New York, New York, USA
| | - Oliver B. Clarke
- Department of Anesthesiology and Columbia University, New York, New York, USA
- Department of Physiology, Columbia University, New York, New York, USA
| | - Yaron Tomer
- Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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Jiang C, Trudeau SJ, Cheong TC, Guo R, Teng M, Wang LW, Wang Z, Pighi C, Gautier-Courteille C, Ma Y, Jiang S, Wang C, Zhao B, Paillard L, Doench JG, Chiarle R, Gewurz BE. CRISPR/Cas9 Screens Reveal Multiple Layers of B cell CD40 Regulation. Cell Rep 2020; 28:1307-1322.e8. [PMID: 31365872 PMCID: PMC6684324 DOI: 10.1016/j.celrep.2019.06.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 05/06/2019] [Accepted: 06/21/2019] [Indexed: 02/08/2023] Open
Abstract
CD40 has major roles in B cell development, activation, and germinal center responses. CD40 hypoactivity causes immunodeficiency whereas its overexpression causes autoimmunity and lymphomagenesis. To systematically identify B cell autonomous CD40 regulators, we use CRISPR/Cas9 genome-scale screens in Daudi B cells stimulated by multimeric CD40 ligand. These highlight known CD40 pathway components and reveal multiple additional mechanisms regulating CD40. The nuclear ubiquitin ligase FBXO11 supports CD40 expression by targeting repressors CTBP1 and BCL6. FBXO11 knockout decreases primary B cell CD40 abundance and impairs class-switch recombination, suggesting that frequent lymphoma monoallelic FBXO11 mutations may balance BCL6 increase with CD40 loss. At the mRNA level, CELF1 controls exon splicing critical for CD40 activity, while the N6-adenosine methyltransferase WTAP negatively regulates CD40 mRNA abundance. At the protein level, ESCRT negatively regulates activated CD40 levels while the negative feedback phosphatase DUSP10 limits downstream MAPK responses. These results serve as a resource for future studies and highlight potential therapeutic targets. CD40 is critical for B cell development, germinal center formation, somatic hypermutation, and class-switch recombination. Increased CD40 abundance is associated with autoimmunity and cancer, whereas CD40 hypoactivity causes immunodeficiency. Jiang et al. performed a genome-wide CRISPR/Cas9 screen to reveal key B cell factors that control CD40 abundance and that regulate CD40 responses.
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Affiliation(s)
- Chang Jiang
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02115, USA
| | - Stephen J Trudeau
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02115, USA
| | - Taek-Chin Cheong
- Department of Pathology, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA
| | - Rui Guo
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02115, USA
| | - Mingxiang Teng
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Liang Wei Wang
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02115, USA; Graduate Program in Virology, Division of Medical Sciences, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
| | - Zhonghao Wang
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02115, USA; Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chiara Pighi
- Department of Pathology, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA; Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Carole Gautier-Courteille
- Biosit, Université de Rennes 1, 35043 Rennes, France; Centre National de la Recherche Scientifique UMR 6290, Institut de Génétique et Développement de Rennes, 35043 Rennes, France
| | - Yijie Ma
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02115, USA
| | - Sizun Jiang
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02115, USA; Graduate Program in Virology, Division of Medical Sciences, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
| | - Chong Wang
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
| | - Bo Zhao
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
| | - Luc Paillard
- Biosit, Université de Rennes 1, 35043 Rennes, France; Centre National de la Recherche Scientifique UMR 6290, Institut de Génétique et Développement de Rennes, 35043 Rennes, France
| | - John G Doench
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Roberto Chiarle
- Department of Pathology, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA; Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Benjamin E Gewurz
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Microbiology, Harvard Medical School, Boston, MA 02115, USA; Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA.
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Zhang QY, Liu W, Li L, Du WH, Zuo CL, Ye XP, Zhou Z, Yuan FF, Ma YR, Sun F, Yu SS, Xie HJ, Zhang CR, Ying YX, Yuan GY, Gao GQ, Liang J, Zhao SX, Song HD. Genetic Study in a Large Cohort Supported Different Pathogenesis of Graves' Disease and Hashimoto's Hypothyroidism. J Clin Endocrinol Metab 2020; 105:5815708. [PMID: 32246145 DOI: 10.1210/clinem/dgaa170] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/02/2020] [Indexed: 01/03/2023]
Abstract
CONTEXT Hashimoto's thyroiditis (HT) and Graves' disease (GD) are the 2 main autoimmune thyroid diseases that have both similarities and differences. Determining the genetic basis that distinguishes HT from GD is key for a better understanding of the differences between these closely related diseases. OBJECTS To identify the susceptibility genes for HT in the Chinese cohort and compare susceptibility genes between GD and HT. DESIGN In the current study, 18 SNPs from 18 established GD risk loci were selected and then genotyped in 2682 patients with HT, 4980 patients with GD, and 3892 controls. The association analysis between HT and controls and heterogeneity analysis between HT and GD were performed on SPSS, with the logistic regression analysis adjusted for sex and age. RESULTS We identified 11 susceptibility loci for HT in the Chinese Han population, with 4 loci, including the rs1265883 in SLAMF6 locus, rs1024161 in CTLA4, rs1521 in HLA-B, and rs5912838 in GPR174/ ITM2A at X chromosome, reaching genome-wide significance of 5 × 10-8. Five loci were reported to be associated with HT for the first time. We also identified 6 susceptibility loci with heterogeneity between GD and HT. Out of them, 4 loci were associated with GD but not with HT, including HLA-DPB1, CD40, TSHR, and TG; the association of HLA-B with GD was stronger than that with HT, but the association of SLAMF6 was reversed. CONCLUSION Our findings suggested that the pathogenesis of HT and GD was different.
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Affiliation(s)
- Qian-Yue Zhang
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lu Li
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Hua Du
- Department of Endocrinology, Linyi People's Hospital, Linyi, China
| | - Chun-Lin Zuo
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiao-Ping Ye
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Zhou
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei-Fei Yuan
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Ru Ma
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Sun
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sha-Sha Yu
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui-Jun Xie
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang-Run Zhang
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying-Xia Ying
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guo-Yue Yuan
- Department of Endocrinology, The Hospital Affiliated to Jiangsu University, Zhenjiang, China
| | - Guan-Qi Gao
- Department of Endocrinology, Linyi People's Hospital, Linyi, China
| | - Jun Liang
- Department of Endocrinology, The Central Hospital of Xuzhou Affiliated to Xuzhou Medical College, Xuzhou, China
| | - Shuang-Xia Zhao
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huai-Dong Song
- The Core Laboratory in Medical Center of Clinical Research, Department of Molecular Diagnostic and Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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22
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Dvornikova KA, Bystrova EY, Platonova ON, Churilov LP. Polymorphism of toll-like receptor genes and autoimmune endocrine diseases. Autoimmun Rev 2020; 19:102496. [DOI: 10.1016/j.autrev.2020.102496] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 10/08/2019] [Indexed: 02/08/2023]
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23
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Kahaly GJ, Stan MN, Frommer L, Gergely P, Colin L, Amer A, Schuhmann I, Espie P, Rush JS, Basson C, He Y. A Novel Anti-CD40 Monoclonal Antibody, Iscalimab, for Control of Graves Hyperthyroidism-A Proof-of-Concept Trial. J Clin Endocrinol Metab 2020; 105:5568230. [PMID: 31512728 DOI: 10.1210/clinem/dgz013] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 02/02/2023]
Abstract
CONTEXT The CD40-CD154 co-stimulatory pathway plays an important role in the pathogenesis of Graves disease (GD) by promoting autoreactive B-cell activation. OBJECTIVE Evaluate efficacy and safety of a human, blocking, nondepleting anti-CD40 monoclonal antibody, iscalimab, in hyperthyroid patients with GD. DESIGN Open-label, phase II proof-of-concept study. SETTING Multicenter. PATIENTS Fifteen with GD. INTERVENTION Patients received 5 doses of iscalimab at 10 mg/kg intravenously over 12 weeks. MAIN OUTCOME MEASURES Thyroid-related hormones and autoantibodies, plasma soluble CD40, free CD40 on B cells, soluble CXCL13, pharmacokinetics, and safety were assessed. RESULTS The iscalimab intervention resulted in complete CD40 engagement for up to 20 weeks. A clinical response and biochemical euthyroidism was observed in 7 of 15 (47%) patients. Free and total triiodothyronine and thyroxine normalized in 7 patients who did not receive any rescue medication with antithyroid drugs (ATD), and 2/15 (13.3%) showed normal thyrotropin. Six (40%) patients required ATD. Four of 7 responders relapsed after treatment completion. Serum concentrations of thyrotropin receptor autoantibodies (TSH-R-Ab) significantly declined in all patients (mean 15.3 IU/L vs 4.0 IU/L, 66% reduction; P < 0.001) and TSH-R-Ab levels normalized in 4 (27%). Thyroperoxidase and thyroglobulin autoantibodies significantly decreased in responders. Iscalimab rapidly reduced serum CXCL13 concentrations (P < 0.001). Twelve (80.0%) patients reported at least 1 adverse event (AE). All treatment-related AE were mild or moderate and resolved by end of the study. CONCLUSION Iscalimab was generally safe and clinically effective in a subgroup of hyperthyroid GD patients. The potential therapeutic benefit of iscalimab should be further tested.
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Affiliation(s)
- George J Kahaly
- Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany
| | - Marius Nicolae Stan
- Division of Endocrinology, Diabetes & Metabolism, Mayo Clinic, Rochester, Minnesota
| | - Lara Frommer
- Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany
| | | | - Laurence Colin
- Novartis Institute for Biomedical Research, Massachusetts
| | - Ahmed Amer
- One Health Plaza, East Hanover, New Jersey
| | | | | | | | - Craig Basson
- Novartis Institute for Biomedical Research, Massachusetts
| | - Yanling He
- Novartis Institute for Biomedical Research, Massachusetts
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24
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Wang XX, Wang XX, Chen T. Association between the CD40 rs1883832 polymorphism and Graves' disease risk: a meta-analysis. EXCLI JOURNAL 2019; 18:10-20. [PMID: 30956635 DOI: pmid/30956635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/12/2018] [Indexed: 11/06/2022]
Abstract
This meta-analysis aims to evaluate whether the CD40 rs1883832 polymorphism is associated with Graves' disease (GD) risk in different populations. We performed a systematic literature search in China National Knowledge Infrastructure (CNKI), Web of Science, and Pubmed databases to identify case-control association studies on the association between rs1883832 and GD risk. For each study we calculated the odds ratios (OR) and 95 % confidence intervals (CI) assuming dominant, recessive and homozygote models. We then calculated pooled ORs and 95 % CIs. After applying inclusion and exclusion criteria, 17 studies involving 4707 cases and 4215 controls were included in the meta-analysis. The results showed that rs1883832 was associated with GD risk in Asians under dominant (CT + TT vs CC, OR=0.67, 95 % CI: 0.56-0.81, P<0.001), recessive (TT vs CT + CC, OR=0.58, 95 % CI: 0.47-0.72, P<0.001), and homozygote (TT vs CC, OR=0.49, 95 % CI: 0.37-0.64, P<0.001) models. In Caucasians, rs1883832 was associated with GD risk under the dominant model (CT + TT vs CC, OR=0.82, 95 % CI: 0.68-0.99, P=0.042). Besides GD, we evaluated the relation of rs1883832 with Graves' ophthalmopathy (GO), finding that rs1883832 was associated with GO under the dominant model (CT + TT vs CC, OR=0.82, 95 % CI: 0.69-0.98, P=0.031). The findings of our meta-analysis suggest that the CD40 rs1883832 polymorphism is protective against GD and GO in Asians and Caucasians.
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Affiliation(s)
- Xiao-Xiong Wang
- Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Xiao-Xia Wang
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Tong Chen
- Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Beijing, China
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25
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Mousa TG, Omar HH, Emad R, Salama MI, Omar W, Fawzy M, Hassoba HM. The association of CD40 polymorphism (rs1883832C/T) and soluble CD40 with the risk of systemic lupus erythematosus among Egyptian patients. Clin Rheumatol 2018; 38:777-784. [DOI: 10.1007/s10067-018-4349-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/09/2018] [Accepted: 10/22/2018] [Indexed: 12/16/2022]
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26
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Voynova E, Mahmoud T, Woods LT, Weisman GA, Ettinger R, Braley-Mullen H. Requirement for CD40/CD40L Interactions for Development of Autoimmunity Differs Depending on Specific Checkpoint and Costimulatory Pathways. Immunohorizons 2018; 2:54-66. [PMID: 30607385 PMCID: PMC6309431 DOI: 10.4049/immunohorizons.1700069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
CD40/CD40L interactions play a critical role in immunity and autoimmunity. In this study, we sought to understand the requirement for CD40 signaling in the programmed cell death-1 (PD-1) checkpoint and CD28 costimulatory pathways important for maintenance of peripheral tolerance. Blocking either pathway can result in loss of self-tolerance and development of autoimmunity. We found that primary Sjögren's syndrome (pSS) and autoimmune thyroid diseases (ATDs) that develop spontaneously in CD28-deficient IFN-γ-/- NOD.H-2h4 (CD28-/-) mice required CD40 signaling. Specifically, blockade of CD40L with the anti-CD40L mAb, MR1, inhibited autoantibody production and inflammation in thyroid and salivary gland target tissues. Unexpectedly, however, ATD and pSS in PD-1-deficient IFN-γ-/- NOD.H-2h4 (PD-1-/-) mice developed independently of CD40/CD40L interactions. Treatment with MR1 had no effect and even exacerbated disease development in pSS and ATD, respectively. Most interesting, anti-thyroglobulin and pSS-associated autoantibodies were increased following anti-CD40L treatment, even though MR1 effectively inhibited the spontaneous splenic germinal centers that form in PD-1-deficient mice. Importantly, blockade of the PD-1 pathway by administration of anti-PD-1 mAb in CD28-/- mice recapitulated the PD-1-/- phenotype, significantly impacting the ability of MR1 to suppress ATD and pSS in these mice. These results indicate that there can be different pathways and requirements to autoimmune pathogenesis depending on the availability of specific checkpoint and costimulatory receptors, and an intact PD-1 pathway is apparently required for inhibition of autoimmunity by anti-CD40L.
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Affiliation(s)
- Elisaveta Voynova
- Respiratory, Inflammation and Autoimmunity Group, Medimmune LLC, Gaithersburg, MD 20878
| | - Tamer Mahmoud
- Respiratory, Inflammation and Autoimmunity Group, Medimmune LLC, Gaithersburg, MD 20878
| | - Lucas T. Woods
- Department of Biochemistry, Christopher S. Bond Life Sciences Center, University of Missouri, Columbia, MO 65211
| | - Gary A. Weisman
- Department of Biochemistry, Christopher S. Bond Life Sciences Center, University of Missouri, Columbia, MO 65211
| | - Rachel Ettinger
- Respiratory, Inflammation and Autoimmunity Group, Medimmune LLC, Gaithersburg, MD 20878
| | - Helen Braley-Mullen
- Department of Medicine and Microbiology, University of Missouri, Columbia, MO 65212
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27
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Wang D, Chen J, Zhang H, Zhang F, Yang L, Mou Y. Role of Different CD40 Polymorphisms in Graves' Disease and Hashimoto's Thyroiditis. Immunol Invest 2017; 46:544-551. [PMID: 28742400 DOI: 10.1080/08820139.2017.1319382] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Genome-wide association studies have led to the discovery of several susceptibility genes related to autoimmune thyroid diseases (AITDs). However, controversial results have been reported regarding the role of single-nucleotide polymorphism (SNP) of CD40 in the disease susceptibility. The objective of this study was to identify the relationship of the polymorphisms of three sites of CD40 with the susceptibility to AITD in the Chinese population. We genotyped three polymorphisms of CD40: C/T -1 SNP, 58038T site of the third exon and C64610G site of the ninth exon in 196 GD cases, 121 HT cases and 122 control subjects. The three putative polymorphism sites were amplified by PCR for sequencing and analysis. The genotype frequencies of CD40 -1 C/C genotype and C allele were significantly higher in the GD group than those in normal control. For the C64610G polymorphism, the C/G genotype was significantly more frequent in HT group than in control group, and the G allele frequencies in the GD and HT group were both higher than those in control group. These results indicated that there exist different susceptibility loci for AITD within CD40, each contributing a different effect in the onset and development of AITDs.
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Affiliation(s)
- Dongguo Wang
- a Department of Clinical Lab Medicine , Taizhou Municipal Hospital, Taizhou University , Taizhou , Zhejiang , China
| | - Jiayu Chen
- b Department of Laboratory Medicine , School of Medicine, Taizhou University , Taizhou , Zhejiang , China
| | - Huanyuan Zhang
- c Department of Pathology , Taizhou Municipal Hospital, Taizhou University , Taizhou , Zhejiang , China
| | - Fangfang Zhang
- c Department of Pathology , Taizhou Municipal Hospital, Taizhou University , Taizhou , Zhejiang , China
| | - Linjun Yang
- d Department of Thyroid-Breast Surgery , Taizhou Municipal Hospital, Taizhou University , Taizhou , Zhejiang , China
| | - Yonghua Mou
- e Department of Hepatobiliary Surgery , Taizhou Municipal Hospital, Taizhou University , Taizhou , Zhejiang , China
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28
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Lee HJ, Lombardi A, Stefan M, Li CW, Inabnet WB, Owen RP, Concepcion E, Tomer Y. CD40 Signaling in Graves Disease Is Mediated Through Canonical and Noncanonical Thyroidal Nuclear Factor κB Activation. Endocrinology 2017; 158:410-418. [PMID: 27929668 PMCID: PMC5413074 DOI: 10.1210/en.2016-1609] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 12/01/2016] [Indexed: 11/19/2022]
Abstract
CD40, a tumor necrosis factor receptor, is a major immune-modulating susceptibility gene for Graves disease (GD) as well as for a variety of other autoimmune diseases. Its broad association with autoimmunity underscores its paramount role in the development of a normal adaptive immune response, primarily in coordinating effective antigen presentation. The molecular pathways by which CD40 activation in the thyroid induces GD are unknown. In this study, we investigated whether NF-κB, a ubiquitious family of transcription factors, mediates the downstream effects of thyroid-specific CD40 activation. Cultured primary human thyrocytes, from patients with and without GD, underwent CD40 stimulation. Once stimulated, cytokines and transcription factors specific for either the canonical nuclear factor κB (NF-κB)1 pathway [interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α], which primarily recruits cells for innate immunity, or the noncanonical NF-κB2 pathway [B cell-activating factor of the TNF family, CC chemokine ligand (CCL)21], which directs B cell viability, were analyzed. Significant upregulation in the messenger RNA and protein levels of both canonical and noncanonical pathway cytokines was observed. Western blot analyses of the specific transcription factors for the NF-κB1 and NF-κB2 pathways (p65 and p100/p52, respectively) demonstrated that p65 is constitutively expressed. In contrast, CD40 stimulation robustly increased the expression of the NF-κB2 p52 transcription factor, and the upregulation was significantly more profound in the GD tissue than in the normal thyroid tissue. Our data show that CD40 activity in thyrocytes is prominently mediated via NF-κB and furthermore suggest that the NF-κB1 and NF-κB2 pathways both contribute to the triggering and the progression of GD.
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Affiliation(s)
| | - Angela Lombardi
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461
| | - Mihaela Stefan
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461
| | - Cheuk wun Li
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461
| | - William B. Inabnet
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York 10029; and
| | - Randall P. Owen
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York 10029; and
| | - Erlinda Concepcion
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461
| | - Yaron Tomer
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461
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29
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Berchner-Pfannschmidt U, Moshkelgosha S, Diaz-Cano S, Edelmann B, Görtz GE, Horstmann M, Noble A, Hansen W, Eckstein A, Banga JP. Comparative Assessment of Female Mouse Model of Graves' Orbitopathy Under Different Environments, Accompanied by Proinflammatory Cytokine and T-Cell Responses to Thyrotropin Hormone Receptor Antigen. Endocrinology 2016; 157:1673-82. [PMID: 26872090 DOI: 10.1210/en.2015-1829] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We recently described a preclinical model of Graves' orbitopathy (GO), induced by genetic immunization of eukaryotic expression plasmid encoding human TSH receptor (TSHR) A-subunit by muscle electroporation in female BALB/c mice. The onset of orbital pathology is characterized by muscle inflammation, adipogenesis, and fibrosis. Animal models of autoimmunity are influenced by their environmental exposures. This follow-up study was undertaken to investigate the development of experimental GO in 2 different locations, run in parallel under comparable housing conditions. Functional antibodies to TSHR were induced in TSHR A-subunit plasmid-immunized animals, and antibodies to IGF-1 receptor α-subunit were also present, whereas control animals were negative in both locations. Splenic T cells from TSHR A-subunit primed animals undergoing GO in both locations showed proliferative responses to purified TSHR antigen and secreted interferon-γ, IL-10, IL-6, and TNF-α cytokines. Histopathological evaluation showed orbital tissue damage in mice undergoing GO, manifest by adipogenesis, fibrosis, and muscle damage with classic signs of myopathy. Although no inflammatory infiltrate was observed in orbital tissue in either location, the appearances were consistent with a "hit-and-run" immune-mediated inflammatory event. A statistically significant increase of cumulative incidence of orbital pathology when compared with control animals was shown for both locations, confirming onset of orbital dysimmune myopathy. Our findings confirm expansion of the model in different environments, accompanied with increased prevalence of T cell-derived proinflammatory cytokines, with relevance for pathogenesis. Wider availability of the model makes it suitable for mechanistic studies into pathogenesis and undertaking of novel therapeutic approaches.
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Affiliation(s)
- Utta Berchner-Pfannschmidt
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - Sajad Moshkelgosha
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - Salvador Diaz-Cano
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - Bärbel Edelmann
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - Gina-Eva Görtz
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - Mareike Horstmann
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - Alistair Noble
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - Wiebke Hansen
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - Anja Eckstein
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
| | - J Paul Banga
- Molecular Ophthalmology (U.B.-P., S.M., G.-E.G., M.H., A.E., J.P.B.), Department of Ophthalmology; Department of Molecular Biology (B.E.); and Institute of Medical Microbiology (W.H.), University Hospital Essen/University of Duisburg-Essen, 45147 Essen, Germany; Faculty of Life Sciences and Medicine (S.M., A.N., J.P.B.), King's College London, London, SE5 9NU United Kingdom; and King's College Hospital NHS Foundation Trust (S.D.-C.), London, SE5 9RS United Kingdom
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Rapoport B, McLachlan SM. TSH Receptor Cleavage Into Subunits and Shedding of the A-Subunit; A Molecular and Clinical Perspective. Endocr Rev 2016; 37:114-34. [PMID: 26799472 PMCID: PMC4823380 DOI: 10.1210/er.2015-1098] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The TSH receptor (TSHR) on the surface of thyrocytes is unique among the glycoprotein hormone receptors in comprising two subunits: an extracellular A-subunit, and a largely transmembrane and cytosolic B-subunit. Unlike its ligand TSH, whose subunits are encoded by two genes, the TSHR is expressed as a single polypeptide that subsequently undergoes intramolecular cleavage into disulfide-linked subunits. Cleavage is associated with removal of a C-peptide region, a mechanism similar in some respects to insulin cleavage into disulfide linked A- and B-subunits with loss of a C-peptide region. The potential pathophysiological importance of TSHR cleavage into A- and B-subunits is that some A-subunits are shed from the cell surface. Considerable experimental evidence supports the concept that A-subunit shedding in genetically susceptible individuals is a factor contributing to the induction and/or affinity maturation of pathogenic thyroid-stimulating autoantibodies, the direct cause of Graves' disease. The noncleaving gonadotropin receptors are not associated with autoantibodies that induce a "Graves' disease of the gonads." We also review herein current information on the location of the cleavage sites, the enzyme(s) responsible for cleavage, the mechanism by which A-subunits are shed, and the effects of cleavage on receptor signaling.
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Affiliation(s)
- Basil Rapoport
- Thyroid Autoimmune Disease Unit, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California 90048
| | - Sandra M McLachlan
- Thyroid Autoimmune Disease Unit, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California 90048
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Rapoport B, McLachlan SM. Withdrawn: TSH Receptor Cleavage Into Subunits and Shedding of the A-Subunit; A Molecular and Clinical Perspective. Endocr Rev 2016; 2016:23-42. [PMID: 27454362 PMCID: PMC6958993 DOI: 10.1210/er.2015-1098.2016.1.test] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/14/2016] [Indexed: 12/29/2022]
Abstract
The TSH receptor (TSHR) on the surface of thyrocytes is unique among the glycoprotein hormone receptors in comprising two subunits: an extracellular A-subunit, and a largely transmembrane and cytosolic B-subunit. Unlike its ligand TSH, whose subunits are encoded by two genes, the TSHR is expressed as a single polypeptide that subsequently undergoes intramolecular cleavage into disulfide-linked subunits. Cleavage is associated with removal of a C-peptide region, a mechanism similar in some respects to insulin cleavage into disulfide linked A- and B-subunits with lossofaC-peptideregion. The potential pathophysiological importance of TSHR cleavage into A-and B-subunits is that some A-subunits are shed from the cell surface. Considerable experimental evidence supports the concept that A-subunit shedding in genetically susceptible individuals is a factor contributing to the induction and/or affinity maturation of pathogenic thyroid-stimulating autoantibodies, the direct cause of Graves' disease. The noncleaving gonadotropin receptors are not associated with autoantibodies that induce a "Graves' disease of the gonads." We also review herein current information on the location of the cleavage sites, the enzyme(s) responsible for cleavage, the mechanism by which A-subunits are shed, and the effects of cleavage on receptor signaling. (Endocrine Reviews 37: 114-134, 2016).
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Affiliation(s)
- Basil Rapoport
- Thyroid Autoimmune Disease Unit, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California 90048
| | - Sandra M McLachlan
- Thyroid Autoimmune Disease Unit, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California 90048
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Chen JM, Guo J, Wei CD, Wang CF, Luo HC, Wei YS, Lan Y. The association of CD40 polymorphisms with CD40 serum levels and risk of systemic lupus erythematosus. BMC Genet 2015; 16:121. [PMID: 26474561 PMCID: PMC4608213 DOI: 10.1186/s12863-015-0279-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 10/09/2015] [Indexed: 12/13/2022] Open
Abstract
Background Current evidence shows that the CD40–CD40 ligand (CD40–CD40L) system plays a crucial role in the development, progression and outcome of systemic lupus erythematosus (SLE). The aim of this study was to investigate whether a CD40 gene single nucleotide polymorphism (SNP) is associated with SLE and CD40 expression in the Chinese population. We included controls (n = 220) and patients with either SLE (n =205) in the study. Methods The gene polymorphism was measured using Snapshot SNP genotyping assays and confirmed by sequencing. We analyzed three single nucleotide polymorphisms of CD40 gene rs1883832C/T, rs1569723A/C and rs4810485G/T in 205 patients with SLE and 220 age-and sex-matched controls. Soluble CD40 (sCD40) levels were measured by ELISA. Results There were significant differences in the genotype and allele frequencies of CD40 gene rs1883832C/T polymorphism between the group of patients with SLE and the control group (P < 0.05). sCD40 levels were increased in patients with SLE compared with controls (P < 0.01). Moreover, genotypes carrying the CD40 rs1883832 C/T variant allele were associated with increased CD40 levels compared to the homozygous wild-type genotype in patients with SLE. The rs1883832C/T polymorphism of CD40 and its sCD40 levels were associated with SLE in the Chinese population. Conclusions Our results suggest that CD40 gene may play a role in the development of SLE in the Chinese population.
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Affiliation(s)
- Jian-Ming Chen
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Jing Guo
- Department of Dermatology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Chuan-Dong Wei
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Chun-Fang Wang
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Hong-Cheng Luo
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Ye-Sheng Wei
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Yan Lan
- Department of Dermatology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
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Abstract
PURPOSE OF REVIEW The purpose of this article is to summarize the recent advances on experimental Graves' hyperthyroidism and orbitopathy as studied in two widely used mouse models, which involve repetitive genetic vaccinations using either adenovirus or in-vivo electroporation of the eukaryotic expression plasmid expressing the thyrotropin receptor (TSHR) as a vector. RECENT FINDINGS The models have been improved by using different types of antigens, including the holo receptor, the receptor A-subunit, an alternatively spliced form of variant receptor lacking a single leucine-rich repeat in the codomain, the receptors of human or mouse origin; different mice such as wild-type, TSHR knockout, TSHR transgenic and different inbred mice; and different immunization protocols. They are now useful for elucidating the pathogenic mechanisms of not only Graves' hyperthyroidism but also Graves' orbitopathy. SUMMARY This review summarizes the literature of mouse models of Graves' hyperthyroidism and orbitopathy published over the last 3 years.
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Affiliation(s)
- Yuji Nagayama
- aDepartment of Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University bDepartment of Endocrinology and Metabolism, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Lee HJ, Li CW, Hammerstad SS, Stefan M, Tomer Y. Immunogenetics of autoimmune thyroid diseases: A comprehensive review. J Autoimmun 2015; 64:82-90. [PMID: 26235382 DOI: 10.1016/j.jaut.2015.07.009] [Citation(s) in RCA: 198] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 07/15/2015] [Indexed: 12/13/2022]
Abstract
Both environmental and genetic triggers factor into the etiology of autoimmune thyroid disease (AITD), including Graves' disease (GD) and Hashimoto's thyroiditis (HT). Although the exact pathogenesis and causative interaction between environment and genes are unknown, GD and HT share similar immune-mediated mechanisms of disease. They both are characterized by the production of thyroid autoantibodies and by thyroidal lymphocytic infiltration, despite being clinically distinct entities with thyrotoxicosis in GD and hypothyroidism in HT. Family and population studies confirm the strong genetic influence and inheritability in the development of AITD. AITD susceptibility genes can be categorized as either thyroid specific (Tg, TSHR) or immune-modulating (FOXP3, CD25, CD40, CTLA-4, HLA), with HLA-DR3 carrying the highest risk. Of the AITD susceptibility genes, FOXP3 and CD25 play critical roles in the establishment of peripheral tolerance while CD40, CTLA-4, and the HLA genes are pivotal for T lymphocyte activation and antigen presentation. Polymorphisms in these immune-modulating genes, in particular, significantly contribute to the predisposition for GD, HT and, unsurprisingly, other autoimmune diseases. Emerging evidence suggests that single nucleotide polymorphisms (SNPs) in the immunoregulatory genes may functionally hinder the proper development of central and peripheral tolerance and alter T cell interactions with antigen presenting cells (APCs) in the immunological synapse. Thus, susceptibility genes for AITD contribute directly to the key mechanism underlying the development of organ-specific autoimmunity, namely the breakdown in self-tolerance. Here we review the major immune-modulating genes that are associated with AITD and their potential functional effects on thyroidal immune dysregulation.
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Affiliation(s)
- Hanna J Lee
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cheuk Wun Li
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sara Salehi Hammerstad
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Mihaela Stefan
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yaron Tomer
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Bronx VA Medical Center, Bronx, NY, USA.
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The MS Risk Allele of CD40 Is Associated with Reduced Cell-Membrane Bound Expression in Antigen Presenting Cells: Implications for Gene Function. PLoS One 2015; 10:e0127080. [PMID: 26068105 PMCID: PMC4465929 DOI: 10.1371/journal.pone.0127080] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 04/10/2015] [Indexed: 12/31/2022] Open
Abstract
Human genetic and animal studies have implicated the costimulatory molecule CD40 in the development of multiple sclerosis (MS). We investigated the cell specific gene and protein expression variation controlled by the CD40 genetic variant(s) associated with MS, i.e. the T-allele at rs1883832. Previously we had shown that the risk allele is expressed at a lower level in whole blood, especially in people with MS. Here, we have defined the immune cell subsets responsible for genotype and disease effects on CD40 expression at the mRNA and protein level. In cell subsets in which CD40 is most highly expressed, B lymphocytes and dendritic cells, the MS-associated risk variant is associated with reduced CD40 cell-surface protein expression. In monocytes and dendritic cells, the risk allele additionally reduces the ratio of expression of full-length versus truncated CD40 mRNA, the latter encoding secreted CD40. We additionally show that MS patients, regardless of genotype, express significantly lower levels of CD40 cell-surface protein compared to unaffected controls in B lymphocytes. Thus, both genotype-dependent and independent down-regulation of cell-surface CD40 is a feature of MS. Lower expression of a co-stimulator of T cell activation, CD40, is therefore associated with increased MS risk despite the same CD40 variant being associated with reduced risk of other inflammatory autoimmune diseases. Our results highlight the complexity and likely individuality of autoimmune pathogenesis, and could be consistent with antiviral and/or immunoregulatory functions of CD40 playing an important role in protection from MS.
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Tomer Y, Dolan LM, Kahaly G, Divers J, D'Agostino RB, Imperatore G, Dabelea D, Marcovina S, Black MH, Pihoker C, Hasham A, Hammerstad SS, Greenberg DA, Lotay V, Zhang W, Monti MC, Matheis N. Genome wide identification of new genes and pathways in patients with both autoimmune thyroiditis and type 1 diabetes. J Autoimmun 2015; 60:32-9. [PMID: 25936594 PMCID: PMC4457545 DOI: 10.1016/j.jaut.2015.03.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/27/2015] [Accepted: 03/29/2015] [Indexed: 12/17/2022]
Abstract
Autoimmune thyroid diseases (AITD) and Type 1 diabetes (T1D) frequently occur in the same individual pointing to a strong shared genetic susceptibility. Indeed, the co-occurrence of T1D and AITD in the same individual is classified as a variant of the autoimmune polyglandular syndrome type 3 (designated APS3v). Our aim was to identify new genes and mechanisms causing the co-occurrence of T1D + AITD (APS3v) in the same individual using a genome-wide approach. For our discovery set we analyzed 346 Caucasian APS3v patients and 727 gender and ethnicity matched healthy controls. Genotyping was performed using the Illumina Human660W-Quad.v1. The replication set included 185 APS3v patients and 340 controls. Association analyses were performed using the PLINK program, and pathway analyses were performed using the MAGENTA software. We identified multiple signals within the HLA region and conditioning studies suggested that a few of them contributed independently to the strong association of the HLA locus with APS3v. Outside the HLA region, variants in GPR103, a gene not suggested by previous studies of APS3v, T1D, or AITD, showed genome-wide significance (p < 5 × 10(-8)). In addition, a locus on 1p13 containing the PTPN22 gene showed genome-wide significant associations. Pathway analysis demonstrated that cell cycle, B-cell development, CD40, and CTLA-4 signaling were the major pathways contributing to the pathogenesis of APS3v. These findings suggest that complex mechanisms involving T-cell and B-cell pathways are involved in the strong genetic association between AITD and T1D.
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Affiliation(s)
- Yaron Tomer
- Division of Endocrinology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA.
| | - Lawrence M Dolan
- Division of Pediatric Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - George Kahaly
- Thyroid Research Laboratory, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Jasmin Divers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ralph B D'Agostino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana Dabelea
- Colorado School of Public Health, University of Colorado, Denver, CO, USA
| | - Santica Marcovina
- Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, WA, USA
| | - Mary Helen Black
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA, USA
| | - Catherine Pihoker
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Alia Hasham
- Division of Endocrinology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - David A Greenberg
- Battelle Center for Mathematical Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Vaneet Lotay
- The Charles Bronfman Institute for Personalized Medicine, Department of Medicine Bioinformatics Core, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Weijia Zhang
- The Charles Bronfman Institute for Personalized Medicine, Department of Medicine Bioinformatics Core, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Cristina Monti
- Department of Public Health, Neurosciences, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Nina Matheis
- Thyroid Research Laboratory, Johannes Gutenberg University Medical Center, Mainz, Germany
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Chang XW, Qin Y, Jin Z, Xi TF, Yang X, Lu ZH, Tang YP, Cai WT, Chen SJ, Xie DP. Interleukin-6 (IL-6) mediated the increased contraction of distal colon in streptozotocin-induced diabetes in rats via IL-6 receptor pathway. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:4514-4524. [PMID: 26191141 PMCID: PMC4503013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/24/2015] [Indexed: 06/04/2023]
Abstract
Colonic dysmotility occurs in diabetes and blood plasma interleukin (IL)-6 levels are significantly elevated in type 1 diabetes mellitus. The aim of this study was to investigate whether IL-6 and the IL-6 receptor pathway mediates colonic dysfunction in type 1 diabetes mellitus. Male SD rats were treated with a single intraperitoneally injected dose of streptozotocin (STZ), and those displaying sustained high blood glucose were selected as diabetes mellitus models. Longitudinal muscle strips of colon were prepared to monitor colonic contraction in vitro. Contractile responses of strips of colon were recorded following treatment with IL-6 in control animals, and following anti IL-6 antibody treatment in STZ-induced diabetes in rats. Concentration of IL-6 in plasma and colon were determined by ELISA. Expressions of IL-6 α-receptor and IL-6 β-receptor in colon tissues were determined by immunohistochemistry or Western blot analysis. The non-diabetes rats treated with IL-6 and the untreated diabetes rats showed increased contraction of distal colon, whereas the diabetes rats treated with anti-IL-6 antibody showed decreased contraction of distal colon compared with the untreated diabetes rats. The IL-6 levels of plasma but not colon increased in diabetes rats. The expression of IL-6 α-receptor increased in diabetes rats. These results indicate that diabetes rats show an increase in the contractions of distal colon partly via the IL-6-IL-6 receptor pathway.
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Affiliation(s)
- Xin-Wen Chang
- Department of Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of MedicineShanghai 200040, China
| | - Ying Qin
- Department of Physiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineShanghai 200092, China
| | - Zhi Jin
- Department of Physiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineShanghai 200092, China
| | - Tao-Fang Xi
- Department of Physiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineShanghai 200092, China
| | - Xiao Yang
- Department of Physiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineShanghai 200092, China
| | - Ze-Hao Lu
- Department of Physiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineShanghai 200092, China
| | - Yu-Ping Tang
- Department of Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of MedicineShanghai 200040, China
| | - Wen-Ting Cai
- Department of Physiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineShanghai 200092, China
| | - Shao-Jun Chen
- Department of Physiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineShanghai 200092, China
| | - Dong-Ping Xie
- Department of Physiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineShanghai 200092, China
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Chen X, Hu Z, Li W, Wu P, Liu M, Bao L, Wu M, Fang S, Xiong W, Chen M, Wu G. Synergistic combined effect between CD40-1C>T and CTLA-4+6230G>A polymorphisms in Graves' disease. Gene 2015; 567:154-8. [PMID: 25936345 DOI: 10.1016/j.gene.2015.04.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 04/16/2015] [Accepted: 04/27/2015] [Indexed: 01/22/2023]
Abstract
The aim of this study was to investigate whether a genetic combined effect exists between CD40-1C>T and CTLA-4+6230G>A (CT60) polymorphisms and whether the combined effect renders susceptibility to Graves' disease (GD). We recruited 260 patients with GD and 248 healthy controls. Single nucleotide polymorphisms were genotyped by polymerase chain reaction-high resolution melting. Genetic polymorphisms related to GD were identified, levels of thyroid stimulating hormone receptor antibodies (TRAb) were measured, and genetic interactions were assessed by logistic regression analysis. Significant difference in allele and genotype frequency of CD40-1C>T polymorphism was observed between the patients and control subjects (P<0.001, 0.002 respectively). As for CTLA-4+6230G>A polymorphism, significant difference was observed only in allele frequencies between the patient and control groups (P=0.014). Moreover, a significant combined effect was presented in CD40-1C>T and CTLA-4+6230G>A polymorphism (P=0.020), and all, but one, combination CC-genotype of CD40-1C>T and GG-genotype of CTLA-4+6230G>A polymorphism has 54% lower risk of GD development than subjects with the CC and GG genotypes (OR=0.46, 95% CI=0.25-0.84). In newly onset GD group, neither single SNP (CD40-1C>T or CTLA-4+6230G>A polymorphism) nor their combined effect was showed a significant association with TRAb concentration (all P>0.05). Our findings suggest a possible additive combined effect between CD40-1C>T and CTLA4+6230G>A polymorphisms in the development of GD.
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Affiliation(s)
- Xiaoming Chen
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Zhuoqing Hu
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Wei Li
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Ping Wu
- Clinical Research Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Meilian Liu
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Liwen Bao
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Meifen Wu
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Shuo Fang
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Wei Xiong
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Manyang Chen
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Ge Wu
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China.
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Lombardi A, Inabnet WB, Owen R, Farenholtz KE, Tomer Y. Endoplasmic reticulum stress as a novel mechanism in amiodarone-induced destructive thyroiditis. J Clin Endocrinol Metab 2015; 100:E1-10. [PMID: 25295624 PMCID: PMC4283007 DOI: 10.1210/jc.2014-2745] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Amiodarone (AMIO) is one of the most effective antiarrhythmic drugs available; however, its use is limited by a serious side effect profile, including thyroiditis. The mechanisms underlying AMIO thyroid toxicity have been elusive; thus, identification of novel approaches in order to prevent thyroiditis is essential in patients treated with AMIO. OBJECTIVE Our aim was to evaluate whether AMIO treatment could induce endoplasmic reticulum (ER) stress in human thyroid cells and the possible implications of this effect in AMIO-induced destructive thyroiditis. RESULTS Here we report that AMIO, but not iodine, significantly induced the expression of ER stress markers including Ig heavy chain-binding protein (BiP), phosphoeukaryotic translation initiation factor 2α (eIF2α), CCAAT/enhancer-binding protein homologous protein (CHOP) and spliced X-box binding protein-1 (XBP-1) in human thyroid ML-1 cells and human primary thyrocytes. In both experimental systems AMIO down-regulated thyroglobulin (Tg) protein but had little effect on Tg mRNA levels, suggesting a mechanism involving Tg protein degradation. Indeed, pretreatment with the specific proteasome inhibitor MG132 reversed AMIO-induced down-regulation of Tg protein levels, confirming a proteasome-dependent degradation of Tg protein. Corroborating our findings, pretreatment of ML-1 cells and human primary thyrocytes with the chemical chaperone 4-phenylbutyric acid completely prevented the effect of AMIO on both ER stress induction and Tg down-regulation. CONCLUSIONS We identified ER stress as a novel mechanism contributing to AMIO-induced destructive thyroiditis. Our data establish that AMIO-induced ER stress impairs Tg expression via proteasome activation, providing a valuable therapeutic avenue for the treatment of AMIO-induced destructive thyroiditis.
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Affiliation(s)
- Angela Lombardi
- Division of Endocrinology (A.L., K.E.F., Y.T.) and Department of Surgery (W.B.I., R.O.), Icahn School of Medicine at Mt Sinai, New York, New York 10029; and James J. Peters Veterans Affairs Medical Center (Y.T.), Bronx, New York 10468
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Immunization associated with erectile dysfunction based on cross-sectional and genetic analyses. PLoS One 2014; 9:e111269. [PMID: 25343742 PMCID: PMC4208848 DOI: 10.1371/journal.pone.0111269] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 09/21/2014] [Indexed: 02/06/2023] Open
Abstract
Erectile dysfunction (ED) is a global disease affecting a large number of people. Some studies have found a relationship between low-grade inflammation and ED. We hypothesized that the immune system might play a key role in the outcome of ED. Five immune agents (C3, C4, IgA, IgM, and IgG) were collected based on the Fangchenggang Area Male Health and Examination Survey (FAMHES), using methods of a traditional cross-sectional analysis. Our results repeated the significant association between ED and metabolic syndrome, obesity, and so forth. However, there seemed to be no positive relation between the tested indexes and ED risk in the baseline analysis (C3: P = 0.737; C4: P = 0.274; IgA: P = 0.943; IgG: P = 0.069; IgM: P = 0.985). Then, after adjusting for age and multivariate covariates, a potentially significant association between ED and IgG was discovered (P = 0.025 and P = 0.034, respectively). Meanwhile, in order to describe the development of ED on a gene level, SNP-set kernel-machine association test (SKAT) was applied with the known humoral immune genes involved. The outcomes suggested that PTAFR (binary P value: 0.0096; continuous P value: 0.00869), IL27 (0.0029; 0.1954), CD37 (0.0248; 0.5196), CD40 (0.7146; 0.0413), IL7R (0.1223; 0.0222), PSMB9 (0.1237; 0.0212), and CXCR3 (0.0849; 0.0478) might be key genes in ED, especially IL27, when we restricted the family-wise error rate (FWER) to 0.5. Our study shows that IgG and seven genes (PTAFR, CD37, CD40, IL7R, PSMB9, CXCR3, and especially IL27) might be key factors in the pathogenesis of ED, which could pave the way for future gene and immune therapies.
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Vidaurre OG, Haines JD, Katz Sand I, Adula KP, Huynh JL, McGraw CA, Zhang F, Varghese M, Sotirchos E, Bhargava P, Bandaru VVR, Pasinetti G, Zhang W, Inglese M, Calabresi PA, Wu G, Miller AE, Haughey NJ, Lublin FD, Casaccia P. Cerebrospinal fluid ceramides from patients with multiple sclerosis impair neuronal bioenergetics. Brain 2014; 137:2271-86. [PMID: 24893707 PMCID: PMC4164163 DOI: 10.1093/brain/awu139] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/20/2014] [Accepted: 04/06/2014] [Indexed: 11/14/2022] Open
Abstract
Axonal damage is a prominent cause of disability and yet its pathogenesis is incompletely understood. Using a xenogeneic system, here we define the bioenergetic changes induced in rat neurons by exposure to cerebrospinal fluid samples from patients with multiple sclerosis compared to control subjects. A first discovery cohort of cerebrospinal fluid from 13 patients with multiple sclerosis and 10 control subjects showed that acute exposure to cerebrospinal fluid from patients with multiple sclerosis induced oxidative stress and decreased expression of neuroprotective genes, while increasing expression of genes involved in lipid signalling and in the response to oxidative stress. Protracted exposure of neurons to stress led to neurotoxicity and bioenergetics failure after cerebrospinal fluid exposure and positively correlated with the levels of neurofilament light chain. These findings were validated using a second independent cohort of cerebrospinal fluid samples (eight patients with multiple sclerosis and eight control subjects), collected at a different centre. The toxic effect of cerebrospinal fluid on neurons was not attributable to differences in IgG content, glucose, lactate or glutamate levels or differences in cytokine levels. A lipidomic profiling approach led to the identification of increased levels of ceramide C16:0 and C24:0 in the cerebrospinal fluid from patients with multiple sclerosis. Exposure of cultured neurons to micelles composed of these ceramide species was sufficient to recapitulate the bioenergetic dysfunction and oxidative damage induced by exposure to cerebrospinal fluid from patients with multiple sclerosis. Therefore, our data suggest that C16:0 and C24:0 ceramides are enriched in the cerebrospinal fluid of patients with multiple sclerosis and are sufficient to induce neuronal mitochondrial dysfunction and axonal damage.
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Affiliation(s)
- Oscar G Vidaurre
- 1 Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeffery D Haines
- 1 Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilana Katz Sand
- 2 Corinne Goldsmith Dickinson Centre for MS, Mount Sinai Medical Centre, New York, NY 10029, USA
| | - Kadidia P Adula
- 1 Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jimmy L Huynh
- 1 Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Corey A McGraw
- 3 Department of Neurology, Albert Einstein College of Medicine, Montefiore Medical Centre, Bronx, NY, USA
| | - Fan Zhang
- 4 Bioinformatics Department, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Merina Varghese
- 5 Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elias Sotirchos
- 6 Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Pavan Bhargava
- 6 Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Giulio Pasinetti
- 5 Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Weijia Zhang
- 4 Bioinformatics Department, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matilde Inglese
- 7 Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter A Calabresi
- 6 Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Gang Wu
- 8 Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron E Miller
- 2 Corinne Goldsmith Dickinson Centre for MS, Mount Sinai Medical Centre, New York, NY 10029, USA
| | - Norman J Haughey
- 6 Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Fred D Lublin
- 2 Corinne Goldsmith Dickinson Centre for MS, Mount Sinai Medical Centre, New York, NY 10029, USA
| | - Patrizia Casaccia
- 1 Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Abstract
The initiation and perpetuation of autoimmunity recognize numerous checkpoints, from the genomic susceptibility to the breakdown of tolerance. This latter phenomenon includes the loss of B cell anergy and T regulatory cell failure, as well as the production of autoantibodies and autoreactive T cells. These mechanisms ultimately lead to tissue injury via different mechanisms that span from the production of proinflammatory cytokines to the chemotaxis of immune cells to the target sites. The pathways to autoimmunity have been widely investigated over the past year and resulted in a number of articles in peer-reviewed journals that has increased by nearly 10 % compared to 2011. We herein follow on the attempt to provide a brief discussion of the majority of articles on autoimmune diseases that were published in the major immunology journals in the previous solar year. The selection is necessarily arbitrary and may thus not be seen as comprehensive but reflects current research trends. Indeed, 2012 articles were mostly dedicated to define new and old mechanisms with potential therapeutic implications in autoimmunity in general, though based on specific clinical conditions or animal models. As paradigmatic examples, the environmental influence on autoimmunity, Th17 changes modulating the autoimmune response, serum autoantibodies and B cell changes as biomarkers and therapeutic targets were major issues addressed by experimental articles in 2012. Further, a growing number of studies investigated the sex bias of autoimmunity and supported different working hypotheses to explain the female predominance, including sex chromosome changes and reproductive life factors. In conclusion, the resulting scenario illustrates that common factors may underlie different autoimmune diseases and this is well represented by the observed alterations in interferon-α and TGFβ or by the shared signaling pathways.
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Affiliation(s)
- Carlo Selmi
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy,
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Tomer Y. Mechanisms of autoimmune thyroid diseases: from genetics to epigenetics. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2014; 9:147-56. [PMID: 24460189 DOI: 10.1146/annurev-pathol-012513-104713] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Recent advances in our understanding of genetic-epigenetic interactions have unraveled new mechanisms underlying the etiology of complex autoimmune diseases. Autoimmune thyroid diseases (AITDs) are highly prevalent, affecting 1% to 5% of the population. The major AITDs include Graves disease (GD) and Hashimoto's thyroiditis (HT); although these diseases contrast clinically, their pathogenesis involves shared immunogenetic mechanisms. Genetic data point to the involvement of both shared and unique genes. Among the shared susceptibility genes, HLA-DRβ1-Arg74 (human leukocyte antigen DR containing an arginine at position β74) confers the strongest risk. Recent genome-wide analyses have revealed new putative candidate genes. Epigenetic modulation is emerging as a major mechanism by which environmental factors interact with AITD susceptibility genes. Dissecting the genetic-epigenetic interactions underlying the pathogenesis of AITD is essential to uncover new therapeutic targets.
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Affiliation(s)
- Yaron Tomer
- Division of Endocrinology, Department of Medicine, Mount Sinai Medical Center, New York, NY 10029;
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McLachlan SM, Rapoport B. Breaking tolerance to thyroid antigens: changing concepts in thyroid autoimmunity. Endocr Rev 2014; 35:59-105. [PMID: 24091783 PMCID: PMC3895862 DOI: 10.1210/er.2013-1055] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 09/24/2013] [Indexed: 02/06/2023]
Abstract
Thyroid autoimmunity involves loss of tolerance to thyroid proteins in genetically susceptible individuals in association with environmental factors. In central tolerance, intrathymic autoantigen presentation deletes immature T cells with high affinity for autoantigen-derived peptides. Regulatory T cells provide an alternative mechanism to silence autoimmune T cells in the periphery. The TSH receptor (TSHR), thyroid peroxidase (TPO), and thyroglobulin (Tg) have unusual properties ("immunogenicity") that contribute to breaking tolerance, including size, abundance, membrane association, glycosylation, and polymorphisms. Insight into loss of tolerance to thyroid proteins comes from spontaneous and induced animal models: 1) intrathymic expression controls self-tolerance to the TSHR, not TPO or Tg; 2) regulatory T cells are not involved in TSHR self-tolerance and instead control the balance between Graves' disease and thyroiditis; 3) breaking TSHR tolerance involves contributions from major histocompatibility complex molecules (humans and induced mouse models), TSHR polymorphism(s) (humans), and alternative splicing (mice); 4) loss of tolerance to Tg before TPO indicates that greater Tg immunogenicity vs TPO dominates central tolerance expectations; 5) tolerance is induced by thyroid autoantigen administration before autoimmunity is established; 6) interferon-α therapy for hepatitis C infection enhances thyroid autoimmunity in patients with intact immunity; Graves' disease developing after T-cell depletion reflects reconstitution autoimmunity; and 7) most environmental factors (including excess iodine) "reveal," but do not induce, thyroid autoimmunity. Micro-organisms likely exert their effects via bystander stimulation. Finally, no single mechanism explains the loss of tolerance to thyroid proteins. The goal of inducing self-tolerance to prevent autoimmune thyroid disease will require accurate prediction of at-risk individuals together with an antigen-specific, not blanket, therapeutic approach.
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Affiliation(s)
- Sandra M McLachlan
- Thyroid Autoimmune Disease Unit, Cedars-Sinai Research Institute, and University of California-Los Angeles School of Medicine, Los Angeles, California 90048
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Huynh JL, Garg P, Thin TH, Yoo S, Dutta R, Trapp BD, Haroutunian V, Zhu J, Donovan MJ, Sharp AJ, Casaccia P. Epigenome-wide differences in pathology-free regions of multiple sclerosis-affected brains. Nat Neurosci 2014; 17:121-30. [PMID: 24270187 PMCID: PMC3934491 DOI: 10.1038/nn.3588] [Citation(s) in RCA: 177] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 10/29/2013] [Indexed: 02/08/2023]
Abstract
Using the Illumina 450K array and a stringent statistical analysis with age and gender correction, we report genome-wide differences in DNA methylation between pathology-free regions derived from human multiple sclerosis-affected and control brains. Differences were subtle, but widespread and reproducible in an independent validation cohort. The transcriptional consequences of differential DNA methylation were further defined by genome-wide RNA-sequencing analysis and validated in two independent cohorts. Genes regulating oligodendrocyte survival, such as BCL2L2 and NDRG1, were hypermethylated and expressed at lower levels in multiple sclerosis-affected brains than in controls, while genes related to proteolytic processing (for example, LGMN, CTSZ) were hypomethylated and expressed at higher levels. These results were not due to differences in cellular composition between multiple sclerosis and controls. Thus, epigenomic changes in genes affecting oligodendrocyte susceptibility to damage are detected in pathology-free areas of multiple sclerosis-affected brains.
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Affiliation(s)
- Jimmy L Huynh
- 1] Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA. [2] Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paras Garg
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Tin Htwe Thin
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Seungyeul Yoo
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ranjan Dutta
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bruce D Trapp
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Vahram Haroutunian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jun Zhu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael J Donovan
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrew J Sharp
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Patrizia Casaccia
- 1] Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA. [2] Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA. [3] Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Yu S, Downey EF, Braley-Mullen H. Agonistic anti-CD40 promotes early development and increases the incidence of severe thyroid epithelial cell hyperplasia (TEC H/P) in CD4-/- mice. IMMUNITY INFLAMMATION AND DISEASE 2013; 1:14-25. [PMID: 25400914 PMCID: PMC4217545 DOI: 10.1002/iid3.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 07/19/2013] [Accepted: 08/05/2013] [Indexed: 12/24/2022]
Abstract
IFN-γ−/−NOD.H-2h4 mice develop thyroid epithelial cell hyperplasia (TEC H/P) characterised by abnormal proliferation of thyrocytes and infiltration of thyroids by CD4+ and CD8+ T cells, macrophages and dendritic cells. CD8+ T cells from mice with severe TEC H/P transfer similar lesions to SCID recipients, whereas CD4+ T cells transfer mild TEC H/P. CD4− and CD8− deficient IFN-γ−/−NOD.H-2h4 mice were generated to determine if CD4+ T cells were required for initial activation of the CD8+ T cells that transfer TEC H/P. After 6–8 months on NaI water, only 2 of 60 CD8−/− mice developed severe TEC H/P, whereas 31 of 101 CD4−/− mice developed severe TEC H/P and fibrosis comparable in severity to that of IFN-γ−/− mice. However, splenocytes from CD4−/− mice with severe TEC H/P did not effectively transfer severe TEC H/P to SCID recipients. When CD4−/− donors were given agonistic anti-CD40 mAb, most developed severe TEC H/P and their cells transferred severe TEC H/P to SCID recipients. These results indicate that agonistic anti-CD40 can provide an important signal for activation of autoreactive CD8+ T cells that transfer severe TEC H/P. Therefore, targeting or blocking CD40 could provide effective therapy for diseases involving hyperplasia and fibrosis mediated by CD8+ T cells.
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Affiliation(s)
- Shiguang Yu
- Department of Veterans Affairs Research Service Columbia, Missouri, 65212 ; Departments of Internal Medicine, University of Missouri School of Medicine Columbia, Missouri, 65212 ; Department of Biological Science, Arkansas State University, Arkansas Biosciences Institute Jonesboro, Arkansas, 72467
| | - Edward F Downey
- Departments of Internal Medicine, University of Missouri School of Medicine Columbia, Missouri, 65212
| | - Helen Braley-Mullen
- Department of Veterans Affairs Research Service Columbia, Missouri, 65212 ; Departments of Internal Medicine, University of Missouri School of Medicine Columbia, Missouri, 65212 ; Molecular Microbiology and Immunology, University of Missouri School of Medicine Columbia, Missouri, 65212
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Kayes T, Fang Y, Yu S, Downey E, Wang S, Braley-Mullen H. Agonistic anti-CD40 induces thyrocyte proliferation and promotes thyroid autoimmunity by increasing CD40 expression on thyroid epithelial cells. THE JOURNAL OF IMMUNOLOGY 2013; 190:3928-38. [PMID: 23509363 DOI: 10.4049/jimmunol.1202929] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CD40 is expressed on cells of the immune system and in some tissues that are targets for autoimmune-mediated damage. It is not known if CD40 expression in target tissues plays a role in the pathology of autoimmune diseases. This study shows that agonistic anti-CD40 induces strong and sustained proliferation of thyroid epithelial cells (TECs), or thyrocytes, in IFN-γ(-/-) autoimmune-prone NOD and NOD.H-2h4 mice. TEC proliferation is accompanied by greatly increased expression of CD40 on TECs, development of fibrosis and hypothyroidism, and increased expression of proinflammatory molecules in thyroids. Bone marrow chimera experiments indicate that TEC expression of CD40 is required for anti-CD40-induced TEC proliferation, but lymphoid cells do not have to express CD40. TEC proliferation is reduced in wild-type mice given anti-CD40, presumably because they produce IFN-γ, which inhibits TEC proliferation. CD40 also increases on TECs during development of an autoimmune thyroid disease characterized by TEC hyperproliferation that develops spontaneously in IFN-γ(-/-) NOD.H-2h4 mice. TEC hyperproliferation development is accelerated in mice given agonistic anti-CD40. These studies provide new information regarding the role of target tissue expression of CD40 in development of autoimmunity and suggest that use of agonistic anti-CD40 for tumor therapy could result in autoimmune disease.
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Affiliation(s)
- Timothy Kayes
- Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA
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Tomer Y, Hasham A, Davies TF, Stefan M, Concepcion E, Keddache M, Greenberg DA. Fine mapping of loci linked to autoimmune thyroid disease identifies novel susceptibility genes. J Clin Endocrinol Metab 2013; 98:E144-52. [PMID: 23118423 PMCID: PMC3537111 DOI: 10.1210/jc.2012-2408] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Genetic factors play a major role in the etiology of autoimmune thyroid disease (AITD) including Graves' disease (GD) and Hashimoto's thyroiditis (HT). We have previously identified three loci on chromosomes 10q, 12q, and 14q that showed strong linkage with AITD, HT, and GD, respectively. OBJECTIVES The objective of the study was to identify the AITD susceptibility genes at the 10q, 12q, and 14q loci. DESIGN AND PARTICIPANTS Three hundred forty North American Caucasian AITD patients and 183 healthy controls were studied. The 10q, 12q, and 14q loci were fine mapped by genotyping densely spaced single-nucleotide polymorphisms (SNPs) using the Illumina GoldenGate genotyping platform. Case control association analyses were performed using the UNPHASED computer package. Associated SNPs were reanalyzed in a replication set consisting of 238 AITD patients and 276 controls. RESULTS Fine mapping of the AITD locus, 10q, showed replicated association of the AITD phenotype (both GD and HT) with SNP rs6479778. This SNP was located within the ARID5B gene recently reported to be associated with rheumatoid arthritis and GD in Japanese. Fine mapping of the GD locus, 14q, revealed replicated association of the GD phenotype with two markers, rs12147587 and rs2284720, located within the NRXN3 and TSHR genes, respectively. CONCLUSIONS Fine mapping of three linked loci identified novel susceptibility genes for AITD. The discoveries of new AITD susceptibility genes will engender a new understanding of AITD etiology.
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Affiliation(s)
- Yaron Tomer
- Department of Medicine, Division of Endocrinology, Mount Sinai School of Medicine, New York, New York 10029, USA.
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