1
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Kohn LL, Braun M, Cordoro KM, McCalmont TH, Shah SD, Frieden IJ, Mathur AN. Skin and Mucosal Manifestations in NEMO Syndrome: A Case Series and Literature Review. Pediatr Dermatol 2022; 39:84-90. [PMID: 34989033 DOI: 10.1111/pde.14905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To characterize the skin and mucosal findings of NEMO syndrome. METHODS Retrospective review of clinical characteristics from a cohort of two families with mutations in IKBKG (the NEMO-encoding gene). A literature review identified 86 studies describing 192 patients with IKBKG mutations whose data were also included. SETTING Single center with literature review. PARTICIPANTS Patients with mutations in IKBKG from our center and reported in the literature. MAIN OUTCOMES AND MEASURES Skin and mucosal characteristics of patients with NEMO syndrome. RESULTS In addition to ectodermal dysplasia and recurrent infections, male patients had findings of ichthyosis, palmoplantar keratoderma, and inflammatory skin diseases. Both male and female patients had mucocutaneous ulcers and slow-to-heal chronic wounds. In combination with patients from the literature, 59% (85/144) of males had ectodermal dysplasia with anhidrosis (EDA) features, and 8% and 10% (12/144; 6/63) of males and females had dental findings, respectively. 4% (6/144) of males and 32% (20/63) of females had mucocutaneous ulcers. Ichthyosis/xerosis was present in 15% of males (21/144) but only 2% (1/63) females. Similarly, 13% (18/144) of male patients presented with dermatitis while this was reported in only 2% (1/63) of females. CONCLUSIONS Our results both confirm and expand upon the known spectrum of mucocutaneous findings in NEMO syndrome. Further genetic studies are needed to correlate specific mutations to clinical and morphologic subtypes.
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Affiliation(s)
- Lucinda L Kohn
- Department of Dermatology, University of Colorado, Denver, Colorado, USA.,Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Mitchell Braun
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Kelly M Cordoro
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Timothy H McCalmont
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA.,Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Sonal D Shah
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ilona J Frieden
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Anubhav N Mathur
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
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2
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Mahuron KM, Moreau JM, Glasgow JE, Boda DP, Pauli ML, Gouirand V, Panjabi L, Grewal R, Luber JM, Mathur AN, Feldman RM, Shifrut E, Mehta P, Lowe MM, Alvarado MD, Marson A, Singer M, Wells J, Jupp R, Daud AI, Rosenblum MD. Layilin augments integrin activation to promote antitumor immunity. J Exp Med 2021; 217:151858. [PMID: 32539073 PMCID: PMC7478725 DOI: 10.1084/jem.20192080] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 03/03/2020] [Accepted: 04/10/2020] [Indexed: 12/15/2022] Open
Abstract
Tumor-infiltrating CD8+ T cells mediate antitumor immune responses. However, the mechanisms by which T cells remain poised to kill cancer cells despite expressing high levels of inhibitory receptors are unknown. Here, we report that layilin, a C-type lectin domain-containing membrane glycoprotein, is selectively expressed on highly activated, clonally expanded, but phenotypically exhausted CD8+ T cells in human melanoma. Lineage-specific deletion of layilin on murine CD8+ T cells reduced their accumulation in tumors and increased tumor growth in vivo. Congruently, gene editing of LAYN in human CD8+ T cells reduced direct tumor cell killing ex vivo. On a molecular level, layilin colocalized with integrin αLβ2 (LFA-1) on T cells, and cross-linking layilin promoted the activated state of this integrin. Accordingly, LAYN deletion resulted in attenuated LFA-1-dependent cellular adhesion. Collectively, our results identify layilin as part of a molecular pathway in which exhausted or "dysfunctional" CD8+ T cells enhance cellular adhesiveness to maintain their cytotoxic potential.
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Affiliation(s)
- Kelly M Mahuron
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Joshua M Moreau
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
| | - Jeff E Glasgow
- Department of Pharmaceutical Chemistry, University of California, San Francisco, San Francisco, CA
| | - Devi P Boda
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
| | - Mariela L Pauli
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
| | - Victoire Gouirand
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
| | - Luv Panjabi
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
| | - Robby Grewal
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
| | - Jacob M Luber
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA.,Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA
| | - Anubhav N Mathur
- Department of Dermatology, University of California, San Francisco, San Francisco, CA.,T-REX Bio, Burlingame, CA
| | | | - Eric Shifrut
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA
| | - Pooja Mehta
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
| | - Margaret M Lowe
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
| | - Michael D Alvarado
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Alexander Marson
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA.,Chan Zuckerberg Biohub, San Francisco, CA.,Parker Institute for Cancer Immunotherapy, San Francisco, CA
| | - Meromit Singer
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA.,Department of Immunology, Harvard Medical School, Boston, MA.,Dana-Farber Cancer Institute, Boston, MA
| | - Jim Wells
- Department of Pharmaceutical Chemistry, University of California, San Francisco, San Francisco, CA
| | | | - Adil I Daud
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Michael D Rosenblum
- Department of Dermatology, University of California, San Francisco, San Francisco, CA
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3
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Kalekar LA, Cohen JN, Prevel N, Sandoval PM, Mathur AN, Moreau JM, Lowe MM, Nosbaum A, Wolters PJ, Haemel A, Boin F, Rosenblum MD. Regulatory T cells in skin are uniquely poised to suppress profibrotic immune responses. Sci Immunol 2020; 4:4/39/eaaw2910. [PMID: 31492709 DOI: 10.1126/sciimmunol.aaw2910] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 08/09/2019] [Indexed: 12/13/2022]
Abstract
At the center of fibrosing diseases is the aberrant activation of tissue fibroblasts. The cellular and molecular mechanisms of how the immune system augments fibroblast activation have been described; however, little is known about how the immune system controls fibroblast function in tissues. Here, we identify regulatory T cells (Tregs) as important regulators of fibroblast activation in skin. Bulk cell and single-cell analysis of Tregs in murine skin and lungs revealed that Tregs in skin are transcriptionally distinct and skewed toward T helper 2 (TH2) differentiation. When compared with Tregs in lung, skin Tregs preferentially expressed high levels of GATA3, the master TH2 transcription factor. Genes regulated by GATA3 were highly enriched in skin "TH2 Treg" subsets. In functional experiments, Treg depletion resulted in a preferential increase in TH2 cytokine production in skin. Both acute depletion and chronic reduction of Tregs resulted in spontaneous skin fibroblast activation, profibrotic gene expression, and dermal fibrosis, all of which were exacerbated in a bleomycin-induced murine model of skin sclerosis. Lineage-specific deletion of Gata3 in Tregs resulted in an exacerbation of TH2 cytokine secretion that was preferential to skin, resulting in enhanced fibroblast activation and dermal fibrosis. Together, we demonstrate that Tregs play a critical role in regulating fibroblast activation in skin and do so by expressing a unique tissue-restricted transcriptional program that is mediated, at least in part, by GATA3.
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Affiliation(s)
- Lokesh A Kalekar
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Jarish N Cohen
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Nicolas Prevel
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | | | - Anubhav N Mathur
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Joshua M Moreau
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Margaret M Lowe
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Audrey Nosbaum
- Department of Allergy and Clinical Immunology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, France
| | - Paul J Wolters
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Anna Haemel
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Francesco Boin
- Department of Rheumatology, University of California, San Francisco, San Francisco, CA, USA
| | - Michael D Rosenblum
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA.
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4
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Reynolds SD, Mathur AN, Chiu YE, Brandling-Bennett HA, Pope E, Siegel MP, Holland KE, Paller AS, Siegfried EC, Tom WL, Lara-Corrales I, Tollefson MM, Maguiness S, Eichenfield LF, Sugarman J, Frieden IJ, Oza VS, Cipriano SD, Huang JT, Shah SD, Lauren CT, Castelo-Soccio L, McMahon P, Cordoro KM. Systemic immunosuppressive therapy for inflammatory skin diseases in children: Expert consensus-based guidance for clinical decision-making during the COVID-19 pandemic. Pediatr Dermatol 2020; 37:424-434. [PMID: 32320494 DOI: 10.1111/pde.14202] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES The COVID-19 pandemic has raised questions about the approach to management of systemic immunosuppressive therapies for dermatologic indications in children. Change to: Given the absence of data to address concerns related to SARS-CoV-2 infection and systemic immunosuppressive therapies in an evidence-based manner, a Pediatric Dermatology COVID-19 Response Task Force (PDCRTF) was assembled to offer time-sensitive guidance for clinicians. METHODS A survey was distributed to an expert panel of 37 pediatric dermatologists on the PDCRTF to assess expert opinion and current practice related to three primary domains of systemic therapy: initiation, continuation, and laboratory monitoring. RESULTS Nearly all respondents (97%) reported that the COVID-19 pandemic had impacted their decision to initiate immunosuppressive medications. The majority of pediatric dermatologists (87%) reported that they were pausing or reducing the frequency of laboratory monitoring for certain immunosuppressive medications. In asymptomatic patients, continuing therapy was the most popular choice across all medications queried. The majority agreed that patients on immunosuppressive medications who have a household exposure to COVID-19 or test positive for new infection should temporarily discontinue systemic and biologic medications, with the exception of systemic steroids, which may require tapering. CONCLUSIONS The ultimate decision regarding initiation, continuation, and laboratory monitoring of immunosuppressive therapy during the pandemic requires careful deliberation, consideration of the little evidence available, and discussion with families. Consideration of an individual's adherence to COVID-19 preventive measures, risk of exposure, and the potential severity if infected must be weighed against the dermatological disease, medication, and risks to the patient of tapering or discontinuing therapies.
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Affiliation(s)
- Sean D Reynolds
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Anubhav N Mathur
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Yvonne E Chiu
- Departments of Dermatology and Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Heather A Brandling-Bennett
- Division of Dermatology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Elena Pope
- Dermatology Section, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael P Siegel
- Pediatric Dermatology Research Alliance, Indianapolis, Indiana, USA
| | - Kristen E Holland
- Departments of Dermatology and Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University, Chicago, Illinois, USA
| | - Elaine C Siegfried
- Department of Pediatrics, Saint Louis University and Cardinal Glennon Children's Hospital, St. Louis, Missouri, USA
| | - Wynnis L Tom
- Division of Pediatric and Adolescent Dermatology, University of California, San Diego, California, USA.,Rady Children's Hospital, San Diego, California, USA
| | | | - Megha M Tollefson
- Departments of Dermatology and Pediatrics, Mayo Clinic and Mayo Clinic Children's Center, Rochester, Minnesota, USA
| | - Sheilagh Maguiness
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lawrence F Eichenfield
- Division of Pediatric and Adolescent Dermatology, University of California, San Diego, California, USA.,Rady Children's Hospital, San Diego, California, USA
| | - Jeffrey Sugarman
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Ilona J Frieden
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Vikash S Oza
- Ronald O Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA
| | - Sarah D Cipriano
- Department of Dermatology, University of Utah, Salt Lake City, Utah, USA
| | - Jennifer T Huang
- Dermatology Program, Department of Dermatology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sonal D Shah
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Christine T Lauren
- Departments of Dermatology and Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | | | - Patrick McMahon
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kelly M Cordoro
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California, USA
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5
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Mathur AN, Zirak B, Boothby IC, Tan M, Cohen JN, Mauro TM, Mehta P, Lowe MM, Abbas AK, Ali N, Rosenblum MD. Treg-Cell Control of a CXCL5-IL-17 Inflammatory Axis Promotes Hair-Follicle-Stem-Cell Differentiation During Skin-Barrier Repair. Immunity 2019; 50:655-667.e4. [PMID: 30893588 PMCID: PMC6507428 DOI: 10.1016/j.immuni.2019.02.013] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/16/2018] [Accepted: 02/14/2019] [Indexed: 12/11/2022]
Abstract
Restoration of barrier-tissue integrity after injury is dependent on the function of immune cells and stem cells (SCs) residing in the tissue. In response to skin injury, hair-follicle stem cells (HFSCs), normally poised for hair generation, are recruited to the site of injury and differentiate into cells that repair damaged epithelium. We used a SC fate-mapping approach to examine the contribution of regulatory T (Treg) cells to epidermal-barrier repair after injury. Depletion of Treg cells impaired skin-barrier regeneration and was associated with a Th17 inflammatory response and failed HFSC differentiation. In this setting, damaged epithelial cells preferentially expressed the neutrophil chemoattractant CXCL5, and blockade of CXCL5 or neutrophil depletion restored barrier function and SC differentiation after epidermal injury. Thus, Treg-cell regulation of localized inflammation enables HFSC differentiation and, thereby, skin-barrier regeneration, with implications for the maintenance and repair of other barrier tissues.
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Affiliation(s)
- Anubhav N Mathur
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Bahar Zirak
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Ian C Boothby
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Madge Tan
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Jarish N Cohen
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Thea M Mauro
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Pooja Mehta
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Margaret M Lowe
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Abul K Abbas
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Niwa Ali
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Michael D Rosenblum
- Department of Dermatology, University of California, San Francisco, CA, USA.
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6
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Kathrotiya PR, Bridge AT, Warren SJ, Do H, Klenk AS, Xu LY, Mathur AN. Primary apocrine adenocarcinoma of the axilla. Cutis 2015; 95:271-281. [PMID: 26057510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Primary apocrine adenocarcinoma (AA) is a rare malignant cutaneous neoplasm that typically arises in areas of high apocrine gland density such as the axillae and the anogenital region. Due to the nonspecific clinical manifestation of AA, the differential diagnosis may be broad. The rarity of this neoplasm has led to a relative lack of well-established histologic and immunohistochemical diagnostic criteria, further complicating the diagnosis of AA. We report the case of a 49-year-old man with primary AA of the left axilla and provide a review of the clinical and histologic findings, epidemiology, and treatment modalities of this rare cutaneous neoplasm.
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Affiliation(s)
| | | | | | | | | | | | - Anubhav N Mathur
- 545 Barnhill Dr, Emerson Hall 139, Department of Dermatology, Indiana University, Indianapolis, IN 46202, USA.
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7
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Affiliation(s)
- Anubhav N. Mathur
- Department of Dermatology; University of California; San Francisco CA
| | - Erin F. Mathes
- Department of Pediatrics; University of California; San Francisco CA
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8
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Mathur AN, Goebel L. Skin findings associated with obesity. Adolesc Med State Art Rev 2011; 22:146-ix. [PMID: 21815449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We are facing an obesity epidemic in adolescents in the United States. Thus, practitioners will need to become familiar with cutaneous findings associated with obesity in order to diagnose and treat them properly. This article addresses some of the cutaneous findings associated with obesity.
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Affiliation(s)
- Anubhav N Mathur
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA.
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9
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O'Malley JT, Sehra S, Thieu VT, Yu Q, Chang HC, Stritesky GL, Nguyen ET, Mathur AN, Levy DE, Kaplan MH. Signal transducer and activator of transcription 4 limits the development of adaptive regulatory T cells. Immunology 2009; 127:587-95. [PMID: 19604309 DOI: 10.1111/j.1365-2567.2008.03037.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
T-cell responses to a cytokine milieu instruct the development of multiple effector phenotypes. While transforming growth factor-beta(1) (TGF-beta(1)) inhibits the development of T helper type 1 (Th1) and Th2 cells, we demonstrate that like interleukin-6 (IL-6) and IL-4, IL-12 can inhibit the development of TGF-beta(1)-induced Foxp3-expressing adaptive T regulatory (aTreg) cells. Signal transducer and activator of transcription 4 (STAT4) is critical for the response to IL-12, although there is a parallel pathway involving T box expressed in T cells (T-bet), and cells from mice double-deficient in STAT4 and T-bet are refractory to the inhibition of aTreg-cell development by IL-12. While the ability of these cytokines to promote Th differentiation may contribute to this effect, we observe that culture with IL-12, or other instructive cytokines, results in an increase in repressive chromatin modifications at the Foxp3 locus that limit STAT5 binding to Foxp3, without observed effects on IL-2 signalling pathways. In a model of allergic lung inflammation there are increased percentages of Treg cells in the lungs of Stat4(-/-) mice, compared with wild-type mice, and increases in Treg cells correlate with decreased allergic inflammation. Overall, these results suggest an important role for STAT4 in regulating Treg-cell development.
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Affiliation(s)
- John T O'Malley
- Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indianapolis, IN 46202, USA
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10
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Good SR, Thieu VT, Mathur AN, Yu Q, Stritesky GL, Yeh N, O'Malley JT, Perumal NB, Kaplan MH. Temporal induction pattern of STAT4 target genes defines potential for Th1 lineage-specific programming. J Immunol 2009; 183:3839-47. [PMID: 19710469 DOI: 10.4049/jimmunol.0901411] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
STAT4 is a critical component in the development of inflammatory adaptive immune responses. It has been extensively characterized as a lineage-determining factor in Th1 development. However, the genetic program activated by STAT4 that results in an inflammatory cell type is not well defined. In this report, we use DNA isolated from STAT4-chromatin immunoprecipitation to perform chromatin immunoprecipitation-on-chip analysis of over 28,000 mouse gene promoters to identify STAT4 targets. We demonstrate that STAT4 binds multiple gene-sets that program distinct components of the Th1 lineage. Although many STAT4 target genes display STAT4-dependent IL-12-inducible expression, other genes displayed IL-12-induced histone modifications but lack induction, possibly due to high relative basal expression. In the subset of genes that STAT4 programs for expression in Th1 cells, IL-12-induced mRNA levels remain increased for a longer time than mRNA from genes that are not programmed. This suggests that STAT4 binding to target genes, while critical, is not the only determinant for STAT4-dependent gene programming during Th1 differentiation.
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Affiliation(s)
- Seth R Good
- School of Informatics, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
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11
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O'Malley JT, Eri RD, Stritesky GL, Mathur AN, Chang HC, Hogenesch H, Srinivasan M, Kaplan MH. STAT4 isoforms differentially regulate Th1 cytokine production and the severity of inflammatory bowel disease. J Immunol 2008; 181:5062-70. [PMID: 18802110 DOI: 10.4049/jimmunol.181.7.5062] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
STAT4, a critical regulator of inflammation in vivo, can be expressed as two alternative splice forms, a full-length STAT4alpha, and a STAT4beta isoform lacking a C-terminal transactivation domain. Each isoform is sufficient to program Th1 development through both common and distinct subsets of target genes. However, the ability of these isoforms to mediate inflammation in vivo has not been examined. Using a model of colitis that develops following transfer of CD4(+) CD45RB(high) T cells expressing either the STAT4alpha or STAT4beta isoform into SCID mice, we determined that although both isoforms mediate inflammation and weight loss, STAT4beta promotes greater colonic inflammation and tissue destruction. This correlates with STAT4 isoform-dependent expression of TNF-alpha and GM-CSF in vitro and in vivo, but not Th1 expression of IFN-gamma or Th17 expression of IL-17, which were similar in STAT4alpha- and STAT4beta-expressing T cells. Thus, higher expression of a subset of inflammatory cytokines from STAT4beta-expressing T cells correlates with the ability of STAT4beta-expressing T cells to mediate more severe inflammatory disease.
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Affiliation(s)
- John T O'Malley
- Department of Pediatrics, HB Wells Center for Pediatric Research and Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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12
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Abstract
Signal transducer and activator of transcription 6 (STAT6) is critical for IL-4 and IL-13 responses, and necessary for the normal development of Th2 cells. We previously generated mice that express a constitutively active STAT6 (STAT6VT) under control of the CD2 locus control region, which directs expression to the T-cell compartment. We now describe that a small proportion of these mice (~5%) develop a spontaneous lymphoproliferative disease (LPD) that results in dramatic splenomegaly. The cell populations observed in the LPD spleens can be divided into 2 categories, those that are composed of mixed lineage cells and those that are predominantly T cells with a phenotype similar to that in autoimmune lymphoproliferative syndrome (ALPS) patients. These data suggest that while active STAT6 is not a transforming factor, expression in T cells predisposes toward the development of lymphoproliferative disorders.
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Affiliation(s)
- Mark H Kaplan
- Department of Pediatrics, Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA.
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13
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Mathur AN, Chang HC, Zisoulis DG, Stritesky GL, Yu Q, O'Malley JT, Kapur R, Levy DE, Kansas GS, Kaplan MH. Stat3 and Stat4 direct development of IL-17-secreting Th cells. J Immunol 2007; 178:4901-7. [PMID: 17404271 DOI: 10.4049/jimmunol.178.8.4901] [Citation(s) in RCA: 435] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
IL-17-secreting CD4(+) T cells are critically involved in inflammatory immune responses. Development of these cells is promoted in vivo and in vitro by IL-23 or TGFbeta1 plus IL-6. Despite growing interest in this inflammatory Th subset, little is known about the transcription factors that are required for their development. We demonstrate that Stat3 is required for programming the TGFbeta1 plus IL-6 and IL-23-stimulated IL-17-secreting phenotype, as well as for RORgammat expression in TGFbeta1 plus IL-6-primed cells. Moreover, retroviral transduction of a constitutively active Stat3 into differentiating T cell cultures enhances IL-17 production from these cells. We further show that Stat4 is partially required for the development of IL-23-, but not TGFbeta1 plus IL-6-primed IL-17-secreting cells, and is absolutely required for IL-17 production in response to IL-23 plus IL-18. The requirements for Stat3 and Stat4 in the development of these IL-17-secreting subsets reveal additional mechanisms in Th cell fate decisions during the generation of proinflammatory cell types.
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Affiliation(s)
- Anubhav N Mathur
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Mathur AN, Chang HC, Zisoulis DG, Kapur R, Belladonna ML, Kansas GS, Kaplan MH. T-bet is a critical determinant in the instability of the IL-17-secreting T-helper phenotype. Blood 2006; 108:1595-601. [PMID: 16670261 PMCID: PMC1895507 DOI: 10.1182/blood-2006-04-015016] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
IL-23, an IL-12-related cytokine, induces an IL-17-secreting T-helper phenotype that is involved in autoimmune diseases and host defense against certain pathogens. Although the transcription factors required for development of IL-23-stimulated cells are unknown, we show that T-bet is a critical negative regulator of the IL-23-primed T-cell phenotype, which we term Th1beta. Th1 or Th1beta Tbx21-/- cultures secrete higher than WT levels of IL-17 in response to T-cell receptor (TCR) or IL-23 + IL-18 stimulation. Ectopic T-bet expression in Th1beta cells promotes IFN-gamma secretion but decreases IL-17 production. Although antigen-receptor stimulation of Th1beta cells stimulates IL-17 production, it also induces the IFN-gamma-independent expression of T-bet and progression to a Th1 cytokine secretion pattern. T-bet is required for the progression to the Th1 phenotype, because Tbx21-/- Th1beta cultures maintain the IL-17-secreting phenotype after 2 weeks of culture. Addition of IFN-gamma to Tbx21-/- Th1beta cultures cannot recover the progression to the Th1 phenotype, suggesting T-bet, rather than IFN-gamma, mediates Th1beta to Th1 progression. The transient nature of the Th1beta phenotype suggests that these cells are a component of type I immunity and that T-bet expression is a critical determinant of Th1 versus Th1beta cell fate.
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Affiliation(s)
- Anubhav N Mathur
- Department Microbiology and Immunology, Indiana University School of Medicine, 702 Barnhill Dr, RI 2600, Indianapolis, IN 46202, USA
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Mathur AN, Hourtovenko CD, Baigrie RS, Mecci SU, Ravi GD, Garg R. Stentless freestyle aortic valve/root bioprostheses: a northern Ontario community hospital perspective. Can J Cardiol 2000; 16:747-56. [PMID: 10863166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE To examine the controversial issues of postoperative aortic insufficiency (AI), operative mortality and length of hospital stay (LOS) following stentless Freestyle aortic valve replacement (AVR). SETTING All surgeries were performed in a small northern community hospital (Sudbury Regional Hospital, Sudbury, Ontario). DESIGN Retrospective study of all stentless AVRs and all stented AVRs from May 1996 to December 1998, and isolated coronary artey bypasses (CABGs) done in 1996/97. PATIENTS Patients were not selected. All consecutive patients requiring bioprosthetic AVR during this period, regardless of risk, complexity or urgency, were included. In total, 112 stentless AVRs, 138 stented AVRs and 432 isolated CABGs were examined. MAIN RESULTS AI was rare following stentless AVRs: no significant valvular AI and only 0.9% significant paravalvular AI occurred. The incidence of AI was significantly greater with continuous than with interrupted proximal suturing (P=0. 016). No valve thromboses, thromboemboli or structural failure occurred during 3.8 years of follow-up of the stentless AVRs. The LOS for stentless AVRs was no longer than for stented AVRs or for isolated CABGs. No significant difference was found in the operative mortality following stentless and stented AVRs. The early mortality rate of 1.8% for stentless AVRs was not affected by preoperative risk strata, complexity or urgency. CONCLUSIONS Early morbidity with stentless AVRs was comparable and LOS was no longer than with stented AVRs. The use of Freestyle bioprosthesis in itself did not result in greater operative mortality, regardless of risk, complexity or urgency of the procedure. Consistent reproducible techniques and experience improve postoperative outcome. It is essential that potential users carefully learn safe and effective surgical techniques to avoid adverse outcomes during the learning curve.
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Affiliation(s)
- A N Mathur
- Sudbury Regional Hospital and Laurentian University, Canada.
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Trusler GA, Chernesky SJ, Arciniegas E, Ishizawa E, Mathur AN. Comparative study of prosthetic and homograft valves in the growing calf with reference to aortic valve replacement in children. Can J Surg 1970; 13:267-71. [PMID: 5466225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Zingg W, Baines WD, Mathur AN. Errors in intra-arterial blood-pressure measurements. Can J Surg 1968; 11:93-6. [PMID: 5759590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Gahagan T, Manzor A, Mathur AN, Grodsinsky C. Retrograde injection of fibrinolysin into the pulmonary veins in the removal of impacted pulmonary emboli. J Cardiovasc Surg (Torino) 1967; 8:77-80. [PMID: 4225508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Gahagan T, Manzor A, Isaac B, Mathur AN. Reestablishment of pulmonary-artery flow after prolonged complete occlusion. Studies in dogs. JAMA 1966; 198:639-40. [PMID: 5953435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Gahagan T, Manzor A, Mathur AN, Grodsinsky C. Removal of impacted pulmonary emboli by retrograde injection of fibrinolysin into the pulmonary veins. Report of three cases and experimental studies. Ann Surg 1966; 164:315-20. [PMID: 4223832 PMCID: PMC1477253 DOI: 10.1097/00000658-196608000-00019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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