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Belharazem D, Schalke B, Gold R, Nix W, Vitacolonna M, Hohenberger P, Roessner E, Schulze TJ, Saruhan-Direskeneli G, Yilmaz V, Ott G, Ströbel P, Marx A. cFLIP overexpression in T cells in thymoma-associated myasthenia gravis. Ann Clin Transl Neurol 2015; 2:894-905. [PMID: 26401511 PMCID: PMC4574807 DOI: 10.1002/acn3.210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 03/31/2015] [Accepted: 04/07/2015] [Indexed: 12/02/2022] Open
Abstract
Objective The capacity of thymomas to generate mature CD4+ effector T cells from immature precursors inside the tumor and export them to the blood is associated with thymoma-associated myasthenia gravis (TAMG). Why TAMG(+) thymomas generate and export more mature CD4+ T cells than MG(−) thymomas is unknown. Methods Unfixed thymoma tissue, thymocytes derived thereof, peripheral blood mononuclear cells (PBMCs), T-cell subsets and B cells were analysed using qRT-PCR and western blotting. Survival of PBMCs was measured by MTT assay. FAS-mediated apoptosis in PBMCs was quantified by flow cytometry. NF-κB in PBMCs was inhibited by the NF-κB-Inhibitor, EF24 prior to FAS-Ligand (FASLG) treatment for apoptosis induction. Results Expression levels of the apoptosis inhibitor cellular FLICE-like inhibitory protein (c-FLIP) in blood T cells and intratumorous thymocytes were higher in TAMG(+) than in MG(−) thymomas and non-neoplastic thymic remnants. Thymocytes and PBMCs of TAMG patients showed nuclear NF-κB accumulation and apoptosis resistance to FASLG stimulation that was sensitive to NF-κB blockade. Thymoma removal reduced cFLIP expression in PBMCs. Interpretation We conclude that thymomas induce cFLIP overexpression in thymocytes and their progeny, blood T cells. We suggest that the stronger cFLIP overexpression in TAMG(+) compared to MG(−) thymomas allows for the more efficient generation of mature CD4+ T cells in TAMG(+) thymomas. cFLIP overexpression in thymocytes and exported CD4+ T cells of patients with TAMG might contribute to the pathogenesis of TAMG by impairing central and peripheral T-cell tolerance.
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Affiliation(s)
- Djeda Belharazem
- Institute of Pathology, University Medical Centre Mannheim, University of Heidelberg Mannheim, Germany
| | - Berthold Schalke
- Department of Neurology, University of Regensburg Regensburg, Germany
| | - Ralf Gold
- Department of Neurology, University of Bochum Bochum, Germany
| | - Wilfred Nix
- Department of Neurology, University of Mainz Mainz, Germany
| | - Mario Vitacolonna
- Department of Thoracic Surgery, University Medical Centre Mannheim Mannheim, Germany
| | - Peter Hohenberger
- Department of Thoracic Surgery, University Medical Centre Mannheim Mannheim, Germany
| | - Eric Roessner
- Department of Thoracic Surgery, University Medical Centre Mannheim Mannheim, Germany
| | - Torsten J Schulze
- Institute for Transfusion Medicine and Immunology, German Red Cross Blood Service, University Medical Centre Mannheim Mannheim, Germany
| | | | - Vuslat Yilmaz
- Department of Physiology, School of Medicine, Istanbul University Istanbul, Turkey
| | - German Ott
- Department of Pathology, Robert-Bosch Hospital Stuttgart, Germany
| | - Philipp Ströbel
- Institute of Pathology, University of Goettingen Goettingen, Germany
| | - Alexander Marx
- Institute of Pathology, University Medical Centre Mannheim, University of Heidelberg Mannheim, Germany
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Souroujon MC, Brenner T, Fuchs S. Development of novel therapies for MG: Studies in animal models. Autoimmunity 2010; 43:446-60. [DOI: 10.3109/08916930903518081] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Antigen-specific tolerance inhibits autoimmune uveitis in pre-sensitized animals by deletion and CD4+CD25+ T-regulatory cells. Immunol Cell Biol 2009; 88:187-96. [PMID: 19884905 PMCID: PMC2824791 DOI: 10.1038/icb.2009.83] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The objective of the present study was to inhibit experimental autoimmune anterior uveitis (EAAU) by establishing antigen specific immune tolerance in animals pre-sensitized with melanin associated antigen (MAA). Intravenous administration of MAA on day 6, 7, 8 and 9 post-immunization induced tolerance and inhibited EAAU in all Lewis rats. Number of cells (total T cells, CD4+ T cells and CD8+ T cells) undergoing apoptosis dramatically increased in the popliteal lymph nodes (LNs) of the tolerized animals compared to non-tolerized animals. Additionally, FasL, TNFR1 and caspase-8 were upregulated in tolerized rats. Proliferation of total lymphocytes, CD4+T cells and CD8+ T cells (harvested from the popliteal LNs) in response to antigenic stimulation was drastically reduced in the state of tolerance compared to the cells from non-tolerized animals. Level of IFN-γ and IL-2 decreased while TGF-β2 was elevated in the state of tolerance. Furthermore, the number of CD4+CD25+FoxP3+ Tregs increased in the popliteal LNs of tolerized animals compared to non-tolerized animals. In conclusion, our results suggest that deletion of antigen specific T cells via apoptosis and active suppression mediated by Tregs plays an important role in the induction of antigen specific immune tolerance in animals with an established immune response against MAA.
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Abstract
Myasthenia gravis (MG) is an autoimmune disease mediated by antibodies to nicotinic acetylcholine receptor (AChR) interfering with the neuromuscular transmission. Experimental autoimmune MG serves as an excellent animal model to study possible therapeutic modalities for MG. This review will focus on the different ways to turn off the autoimmune response to AChR, which results in suppression of myasthenia. This paper will describe the use of fragments or peptides derived from the AChR, antigen-presenting cells and anti-T cell receptor antibodies, and will discuss the underlying mechanisms of action. Finally, the authors propose new promising therapeutic prospects, including treatment based on the modulation of regulatory T cells, which have recently been found to be functionally defective in MG patients.
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Affiliation(s)
- Sonia Berrih-Aknin
- CNRS UMR 8078, Universite Paris Sud, IPSC Hôpital Marie Lannelongue, 133 Avenue de la Résistance, 92350 Le Plessis Robinson, France Tel: +33 1 45 37 15 51; Fax: +33 1 46 30 45 64; E-mail:
- The Weizmann Institute of Science, Department of Immunology, Rehovot 76100, Israel Tel: +972 8 934 2618; Fax: +972 8 934 4141; E-mail:
| | - Sara Fuchs
- The Weizmann Institute of Science, Department of Immunology, Rehovot 76100, Israel Tel: +972 8 934 2618; Fax: +972 8 934 4141; E-mail:
| | - Miriam C Souroujon
- The Weizmann Institute of Science, Department of Immunology, Rehovot 76100, Israel Tel: +972 8 934 2618; Fax: +972 8 934 4141; E-mail:
- The Open University of Israel, Raanana 43104, Israel Tel: +972 9 778 1758; E-mail:
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Aruna BV, Ben-David H, Sela M, Mozes E. A dual altered peptide ligand down-regulates myasthenogenic T cell responses and reverses experimental autoimmune myasthenia gravis via up-regulation of Fas-FasL-mediated apoptosis. Immunology 2006; 118:413-24. [PMID: 16827902 PMCID: PMC1782294 DOI: 10.1111/j.1365-2567.2006.02398.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Myasthenia gravis (MG) and experimental autoimmune MG (EAMG) are T cell-dependent, antibody-mediated autoimmune diseases. A dual altered peptide ligand (APL) that is composed of the tandemly arranged two single amino acid analogues of two myasthenogenic peptides, p195-212 and p259-271, was demonstrated to down-regulate in vitro and in vivo MG-associated autoreactive responses. The aims of this study were to investigate the possible role of Fas-FasL-mediated apoptosis in the down-regulatory mechanism of the dual APL. We demonstrate here the effect of the dual APL on expression of key molecules involved in the Fas-FasL pathway, in a p195-212-specific T cell line, in mice immunized with Torpedo acetylcholine receptor and in mice afflicted with EAMG (induced with the latter). In vitro and in vivo results show that the dual APL up-regulated expression of Fas and FasL on the CD4 cells. Expression of the pro-apoptotic molecules, caspase 8 and caspase 3, was significantly up-regulated, while anti-apoptotic cFLIP and Bcl-2 were down-regulated upon treatment with the dual APL. The dual APL also increased phosphorylation of the mitogen-activated protein kinases, c-Jun-NH2-terminal kinase and p-38, known to play a role in the regulation of FasL expression. Further, in the T cell line incubated with the dual APL as well as in mice of the SJL inbred strain immunized with the myasthenogenic peptide and treated concomitantly with the dual APL, the percentage of apoptotic cells increased. Results strongly indicate that up-regulation of apoptosis via the Fas-FasL pathway is one of the mechanisms by which the dual APL reverses EAMG manifestations in C57BL/6 mice.
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Yang H, Kala M, Scott BG, Goluszko E, Chapman HA, Christadoss P. Cathepsin S is required for murine autoimmune myasthenia gravis pathogenesis. THE JOURNAL OF IMMUNOLOGY 2005; 174:1729-37. [PMID: 15661938 DOI: 10.4049/jimmunol.174.3.1729] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Because presentation of acetylcholine receptor (AChR) peptides to T cells is critical to the development of myasthenia gravis, we examined the role of cathepsin S (Cat S) in experimental autoimmune myasthenia gravis (EAMG) induced by AChR immunization. Compared with wild type, Cat S null mice were markedly resistant to the development of EAMG, and showed reduced T and B cell responses to AChR. Cat S null mice immunized with immunodominant AChR peptides showed weak responses, indicating failed peptide presentation accounted for autoimmune resistance. A Cat S inhibitor suppressed in vitro IFN-gamma production by lymph node cells from AChR-immunized, DR3-bearing transgenic mice. Because Cat S null mice are not severely immunocompromised, Cat S inhibitors could be tested for their therapeutic potential in EAMG.
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MESH Headings
- Animals
- Antigen Presentation/genetics
- Antigen-Presenting Cells/immunology
- Antigen-Presenting Cells/metabolism
- Autoantibodies/blood
- B-Lymphocytes/pathology
- Cathepsins/antagonists & inhibitors
- Cathepsins/deficiency
- Cathepsins/genetics
- Cathepsins/physiology
- Cell Differentiation/genetics
- Cell Differentiation/immunology
- Cell Movement/genetics
- Cell Movement/immunology
- Cytokines/antagonists & inhibitors
- Cytokines/biosynthesis
- Dendritic Cells/cytology
- Dendritic Cells/immunology
- Down-Regulation/genetics
- Down-Regulation/immunology
- Epitopes, T-Lymphocyte/immunology
- Female
- HLA-DR3 Antigen/genetics
- HLA-DR3 Antigen/immunology
- HLA-DR3 Antigen/metabolism
- Humans
- Immunity, Innate/genetics
- Lymphocyte Activation/genetics
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Mice, Transgenic
- Myasthenia Gravis, Autoimmune, Experimental/enzymology
- Myasthenia Gravis, Autoimmune, Experimental/genetics
- Myasthenia Gravis, Autoimmune, Experimental/immunology
- Peptide Fragments/immunology
- Peptide Fragments/metabolism
- Receptors, Cholinergic/administration & dosage
- Receptors, Cholinergic/immunology
- Receptors, Cholinergic/metabolism
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Torpedo
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Affiliation(s)
- Huan Yang
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA
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Bohana-Kashtan O, Civin CI. Fas Ligand as a Tool for Immunosuppression and Generation of Immune Tolerance. Stem Cells 2004; 22:908-24. [PMID: 15536183 DOI: 10.1634/stemcells.22-6-908] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The role of Fas ligand (FasL) in physiologically limiting immune responses and maintaining immune-privileged sites has led to a body of research aiming to confer protection to allogeneic grafts by expressing FasL on the allogeneic tissue or by administrating FasL-transduced donor dendritic cells. In addition, several studies have used FasL to abrogate autoimmune responses. This review presents the results of these studies and discusses the problems associated with FasL usage.
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Affiliation(s)
- Osnat Bohana-Kashtan
- Department of Oncology, Immunology and Hematopoiesis Division, Sidney Kimmel Comprehensive Cancer at Johns Hopkins, 1650 Orleans Street, Baltimore, MD 21231, USA
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Ferguson TA, Herndon J, Elzey B, Griffith TS, Schoenberger S, Green DR. Uptake of apoptotic antigen-coupled cells by lymphoid dendritic cells and cross-priming of CD8(+) T cells produce active immune unresponsiveness. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2002; 168:5589-95. [PMID: 12023355 DOI: 10.4049/jimmunol.168.11.5589] [Citation(s) in RCA: 150] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The induction of immunologic unresponsiveness by i.v. administration of Ag-coupled lymphoid cells has been studied extensively, but the mechanisms remain unclear. We have further explored this model by examining the role of Fas/Fas ligand (FasL)-mediated apoptosis. Using i.v. injection of trinitrophenyl-coupled splenocytes (TNP-spl) as tolerogen, we found that Fas signaling for apoptosis in the spleen cells delivered by FasL in the recipient is the critical event. The requirement for Fas and FasL was overcome by prior induction of apoptosis in TNP-spl, making the tolerogen 100 times more potent. Prevention of apoptosis by a caspase inhibitor blocks tolerance. Interestingly, while blocking CD40/CD40 ligand interaction does not prevent tolerance induction, an agonist anti-CD40 Ab turns tolerogenic TNP-spl into an immunizing Ag. Studies further showed that tolerance is induced through cross-presentation of Ag in a class I MHC-dependent manner by CD8(+)CD11c(+) lymphoid-derived dendritic cells to regulatory T cells. The results provide a mechanism for a well-established method of inducing immunologic unresponsiveness.
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Affiliation(s)
- Thomas A Ferguson
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Yang H, Goluszko E, David C, Okita DK, Conti-Fine B, Chan TS, Poussin MA, Christadoss P. Mapping myasthenia gravis-associated T cell epitopes on human acetylcholine receptors in HLA transgenic mice. J Clin Invest 2002; 109:1111-20. [PMID: 11956249 PMCID: PMC150946 DOI: 10.1172/jci14255] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Susceptibility to myasthenia gravis (MG) is positively linked to expression of HLA-DQ8 and DR3 molecules and negatively linked to expression of the DQ6 molecule. To elucidate the molecular basis of this association, we have induced experimental autoimmune MG (EAMG) in mice transgenic for HLA-DQ8, DQ6, and DR3, and in DQ8xDQ6 and DQ8xDR3 F(1) transgenic mice, by immunization with human acetylcholine receptor (H-AChR) in CFA. Mice expressing transgenes for one or both of the HLA class II molecules positively associated with MG (DQ8 and DR3) developed EAMG. T cells from DQ8 transgenic mice responded well to three cytoplasmic peptide sequences of H-AChR (alpha320-337, alpha304-322, and alpha419-437), of which the response to alpha320-337 was the most intense. DR3 transgenic mice also responded to this sequence very strongly. H-AChR- and alpha320-337 peptide-specific lymphocyte responses were restricted by HLA class II molecules. Disease resistance in DQ6 transgenic mice was associated with reduced synthesis of anti-AChR IgG, IgG(2b), and IgG(2c) Ab's and reduced IL-2 and IFN-gamma secretion by H-AChR- and peptide alpha320-337-specific lymphocytes. Finally, we show that DQ8 imparts susceptibility to EAMG and responsiveness to an epitope within the sequence alpha320-337 as a dominant trait.
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Affiliation(s)
- Huan Yang
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA
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10
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Abstract
The host response to pathogens involves complex inflammatory responses and immune reactions. While these are central to host defense and vital to clearing infections, they are often accompanied by injury to surrounding tissue. Most organ systems can tolerate these responses without permanent consequences. However, there are sites that limit the spread of inflammation because it can threaten organ function. The most prominent examples of these are the eye, brain, and reproductive organs (testis, ovary), where even minor bouts of inflammation can have long-term consequences for the survival of the organism. In these organs immune responses either do not proceed, or proceed in a manner different from other areas; thus, they are called "immunologically privileged." Here a functioning immune response can be the culprit that leads to disease.
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Affiliation(s)
- Thomas A Ferguson
- Department of Ophthalmology and Visual Sciences, Department of Pathology, Washington University School of Medicine, 660 S. Euclid, Box 8096, St. Louis, MO 63110, USA.
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11
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Goluszko E, Deng C, Poussin MA, Christadoss P. Tumor necrosis factor receptor p55 and p75 deficiency protects mice from developing experimental autoimmune myasthenia gravis. J Neuroimmunol 2002; 122:85-93. [PMID: 11777546 DOI: 10.1016/s0165-5728(01)00474-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The precise pathogenic role of proinflammatory cytokines belonging to the tumor necrosis factor (TNF) family has not been investigated yet in antibody-mediated myasthenia gravis (MG) and experimental autoimmune myasthenia gravis (EAMG). In this study we report that TNF receptor p55(-/-) p75(-/-) mice were resistant to the development of clinical EAMG induced by acetylcholine receptor (AChR) immunizations. The resistance was associated with reduced serum levels of IgG, IgG(1), IgG(2a), and IgG(2b) anti-AChR antibody isotypes. However, IgM anti-AChR antibodies were not reduced, suggesting defective anti-AChR IgG class switching in TNF receptor p55(-/-) p75(-/-) mice. We thus demonstrate the genetic evidence for the role of TNF receptor p55 and p75 in EAMG pathogenesis, and their requirement for the generation of anti-AChR IgG antibodies.
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MESH Headings
- Animals
- Antigens, CD/genetics
- Female
- Genetic Predisposition to Disease
- Immunization
- Immunoglobulin Class Switching/immunology
- Immunoglobulin G/immunology
- Immunoglobulin M/immunology
- Lymphocytes/immunology
- Lymphocytes/metabolism
- Lymphotoxin-alpha/immunology
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Mutant Strains
- Muscle, Skeletal/chemistry
- Muscle, Skeletal/immunology
- Myasthenia Gravis, Autoimmune, Experimental/genetics
- Myasthenia Gravis, Autoimmune, Experimental/immunology
- Receptors, Cholinergic/chemistry
- Receptors, Cholinergic/immunology
- Receptors, Tumor Necrosis Factor/genetics
- Receptors, Tumor Necrosis Factor, Type I
- Receptors, Tumor Necrosis Factor, Type II
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- Elzbieta Goluszko
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Boulevard, 3.142 MRB, Galveston, TX 77555-1070, USA
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Abstract
Immune privilege is a property of some sites in the body, whereby immune responses are limited or prevented. One explanation that has been proposed for this phenomenon is engagement of the pro-apoptotic molecule Fas by its ligand (FasL), which leads to apoptosis, and consequently limits an inflammatory response. This idea has recently been challenged, and here we review the evidence for and against a role for FasL in immune privilege.
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Affiliation(s)
- D R Green
- La Jolla Institute for Allergy and Immunology, San Diego, California 92121, USA.
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