1
|
Manabe A, Kadoba K, Hiwa R, Kotani T, Shoji M, Shirakashi M, Tsuji H, Kitagori K, Akizuki S, Nakashima R, Yoshifuji H, Yamamoto W, Okazaki A, Matsuda S, Gon T, Watanabe R, Hashimoto M, Morinobu A. Risk factors for serious infections and infection-related mortality in patients with microscopic polyangiitis: Multicentre REVEAL cohort study. Mod Rheumatol 2024:roae024. [PMID: 38564330 DOI: 10.1093/mr/roae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/18/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Infections are a critical concern for patients with microscopic polyangiitis (MPA). This study aimed to identify the risk factors associated with serious infections (SIs) and infection-related mortality in patients with MPA, as well as the effect of glucocorticoid (GC) dose tapering on these outcomes. METHODS This multicentre, retrospective, and observational study utilised data from a cohort of patients with MPA in Japan [Registry of Vasculitis Patients to Establish REAL World Evidence (REVEAL) cohort]. Patients were categorised based on the occurrence of SIs or infection-related deaths, and various characteristics were compared among the groups. RESULTS Among 182 patients, 66 (36.2%) experienced 129 SIs and 27 (14.8%) developed infection-related deaths. Advanced age, elevated C-reactive protein (CRP) levels, and higher ratio of the GC dose at 3 months to the initial dose were identified as independent risk factors for SIs. Older age was also associated with infection-related deaths. Furthermore, the cumulative incidence of infection-related deaths was significantly higher in patients with a higher ratio of the GC dose at 24 months to the initial dose. CONCLUSION Older age, elevated CRP levels, and slower GC dose tapering predispose patients to SIs and infection-related deaths. Strategies, such as rapid GC dose tapering, are anticipated to mitigate the risk of infections.
Collapse
Affiliation(s)
- Atsushi Manabe
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keiichiro Kadoba
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takuya Kotani
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Mikihito Shoji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Okayama, Japan
| | - Ayana Okazaki
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shogo Matsuda
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takaho Gon
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Ryu Watanabe
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
2
|
Taniguchi T, Hiwa R, Shoji M, Yamaguchi E, Shirakashi M, Onizawa H, Tsuji H, Kitagori K, Nakashima R, Akizuki S, Onishi A, Yoshifuji H, Tanaka M, Morinobu A. Avacopan's potential to decrease MPO-ANCA titres concurrent with ameliorated activity in ANCA-associated vasculitis. Mod Rheumatol Case Rep 2024:rxae016. [PMID: 38564324 DOI: 10.1093/mrcr/rxae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
Avacopan, an orally administered C5a receptor antagonist, is effective in microscopic polyangiitis via the inhibition of neutrophil priming induced by C5a. However, the exact effect of avacopan on the production of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) is yet to be clearly established. This report presents a microscopic polyangiitis patient without major organ damage where high levels of MPO-ANCA persisted with high-dose steroid therapy and azathioprine, but the addition of avacopan led to a reduction in MPO-ANCA titres. The present case implies that avacopan-mediated inhibition of C5a may lead to a reduction in MPO-ANCA levels, thereby potentially ameliorating the pathophysiology of ANCA-associated vasculitis. Nevertheless, the impact of avacopan on MPO-ANCA production cannot be asserted solely based on this report; therefore, further examination is necessary through subgroup analysis using data from larger-scale studies.
Collapse
Affiliation(s)
- Tomoki Taniguchi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mikihito Shoji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Eriho Yamaguchi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideo Onizawa
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
3
|
Nishida Y, Shirakashi M, Hashii N, Nakashima R, Nakayama Y, Katsushima M, Watanabe R, Onizawa H, Hiwa R, Tsuji H, Kitagori K, Akizuki S, Onishi A, Murakami K, Yoshifuji H, Tanaka M, Tsuruyama T, Morinobu A, Hashimoto M. Pathogenicity of IgG-Fc desialylation and its association with Th17 cells in an animal model of systemic lupus erythematosus. Mod Rheumatol 2024; 34:523-529. [PMID: 37300805 DOI: 10.1093/mr/road054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Decreased sialylation of IgG-Fc glycans has been reported in autoimmune diseases, but its role in systemic lupus erythematosus (SLE) is not fully understood. In this study, we examined the pathogenicity of IgG desialylation and its association with Th17 in SLE using an animal model. METHODS B6SKG mice, which develop lupus-like systemic autoimmunity due to the ZAP70 mutation, were used to investigate the pathogenicity of IgG desialylation. The proportion of sialylated IgG was compared between B6SKG and wild-type mice with or without β-glucan treatment-induced Th17 expansion. Anti-interleukin (IL)-23 and anti-IL-17 antibodies were used to examine the role of Th17 cells in IgG glycosylation. Activation-induced cytidine deaminase-specific St6gal1 conditionally knockout (cKO) mice were generated to examine the direct effect of IgG desialylation. RESULTS The proportions of sialylated IgG were similar between B6SKG and wild-type mice in the steady state. However, IgG desialylation was observed after β-glucan-induced Th17 expansion, and nephropathy also worsened in B6SKG mice. Anti-IL-23/17 treatment suppressed IgG desialylation and nephropathy. Glomerular atrophy was observed in the cKO mice, suggesting that IgG desialylation is directly involved in disease exacerbation. CONCLUSIONS IgG desialylation contributes to the progression of nephropathy, which is ameliorated by blocking IL-17A or IL-23 in an SLE mouse model.
Collapse
Affiliation(s)
- Yuri Nishida
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noritaka Hashii
- Division of Biological Chemistry and Biologicals, National Institute of Health Sciences, Kanagawa, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoichi Nakayama
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masao Katsushima
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryu Watanabe
- Department of Clinical Immunology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hideo Onizawa
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kosaku Murakami
- Center for Cancer Immunotherapy and Immunobiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tatsuaki Tsuruyama
- Department of Drug Discovery Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| |
Collapse
|
4
|
Shirakashi M, Nishida Y, Nakashima R, Fujimoto M, Hiwa R, Tsuji H, Kitagori K, Akizuki S, Morinobu A, Yoshifuji H. TAFRO syndrome is associated with anti-SSA/Ro60 antibodies, in contrast to idiopathic castleman disease. Sci Rep 2024; 14:2889. [PMID: 38311632 PMCID: PMC10838910 DOI: 10.1038/s41598-024-53413-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
TAFRO syndrome is an acute systemic inflammatory disease characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis/renal dysfunction, and organomegaly. There have been increasing reports that TAFRO is a disease distinct from idiopathic multicentric Castleman disease and that TAFRO patients may be positive for anti-SSA antibodies. To assess anti-SSA antibody positivity and the clinical characteristics of the two diseases, we retrospectively compared 7 TAFRO and 10 iMCD patients in our hospital. The mean age of onset of TAFRO and iMCD was 48.0 (interquartile range [IQR], 41-53) and 45.0 (IQR, 35-53) years, respectively. The TAFRO and iMCD groups had 6 (86%) and 4 (40%) male patients, respectively, and the following pretreatment laboratory values: platelet count, 3.8 (IQR, 2.2-6.4) and 35.5 (IQR, 22.2-42.8) × 104/μL, respectively; C-reactive protein, 10.2 (IQR, 6.8-21.4) and 9.5 (IQR, 6.2-13.6) mg/dL, respectively; IgG, 1431 (IQR, 1112-1815) and 4725 (IQR, 3755-5121) mg/dL, respectively. RNA immunoprecipitation (5 cases for anti-SSA) or protein array (5 cases for anti-SSA/Ro60) detected anti-SSA antibodies in six (86%) TAFRO patients but not in iMCD patients; it did not detect anti-SSB antibodies in any of the patients. None of the patients were diagnosed with Sjögren syndrome. All iMCD patients treated with tocilizumab (TCZ) responded well. Meanwhile, two of six TAFRO patients treated with TCZ showed inadequate responses; thus, both patients were switched to rituximab, following which they achieved remission. TAFRO and iMCD have different clinical features. TAFRO may be categorized as a severe phenotype of the anti-SSA antibody syndrome.
Collapse
Affiliation(s)
- Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuri Nishida
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masakazu Fujimoto
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| |
Collapse
|
5
|
Taniguchi T, Hiwa R, Morinobu A. Pitfalls in evaluating the impact of persistent hematuria after induction therapy on kidney prognosis in anti-neutrophil cytoplasmic autoantibody-associated vasculitis. Kidney Int 2024; 105:391-392. [PMID: 38245220 DOI: 10.1016/j.kint.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/09/2023] [Indexed: 01/22/2024]
Affiliation(s)
- Tomoki Taniguchi
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan.
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan
| |
Collapse
|
6
|
Mukoyama H, Murakami K, Onizawa H, Shirakashi M, Hiwa R, Tsuji H, Kitagori K, Akizuki S, Nakashima R, Onishi A, Yoshifuji H, Tanaka M, Morinobu A. A case of atypical IgG4-related disease presenting hypereosinophilia, polyneuropathy, and liver dysfunction. Mod Rheumatol Case Rep 2023; 8:172-177. [PMID: 37750557 DOI: 10.1093/mrcr/rxad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/18/2023] [Accepted: 09/03/2023] [Indexed: 09/27/2023]
Abstract
Ig (immunoglobulin) G4-related disease (Ig4-RD) affects several organs, including salivary glands, lacrimal glands, pancreas, biliary ducts, and retroperitoneum. A 72-year-old woman was examined for hypereosinophilia, high levels of IgG4, polyneuropathy, liver dysfunction, enlargement of lymph nodes and lacrimal glands, and beaded dilation of the bile ducts. We diagnosed Ig4-RD based on biopsies of the lymph nodes, liver, and submandibular gland. The symptoms of the patient improved after glucocorticoid treatment. This was a novel and atypical case of Ig4-RD that was difficult to differentiate from other diseases, including eosinophilic granulomatosis with polyangiitis, idiopathic hypereosinophilic syndrome, and polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, skin changes syndrome. This case report highlights the importance of biopsies in differentiating Ig4-RD.
Collapse
Affiliation(s)
- Hiroki Mukoyama
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kosaku Murakami
- Center for Cancer Immunotherapy and Immunobiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideo Onizawa
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
7
|
Onishi A, Tsuji H, Takase Y, Nakakubo Y, Iwasaki T, Kozuki T, Yoshida T, Shirakashi M, Onizawa H, Hiwa R, Kitagori K, Akizuki S, Nakashima R, Yoshifuji H, Tanaka M, Morinobu A. Comparisons of SLE-DAS and SLEDAI-2K and classification of disease activity based on the SLE-DAS with reference to patient-reported outcomes. Rheumatology (Oxford) 2023; 62:3909-3915. [PMID: 36943365 DOI: 10.1093/rheumatology/kead132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/28/2023] [Accepted: 03/11/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES Although the SLE Disease Activity Score (SLE-DAS) and its definitions to classify disease activity have been recently developed to overcome the drawbacks of the SLE Disease Activity Index 2000 (SLEDAI-2K), the performance of the SLE-DAS for patient-reported outcomes (PROs) has not been fully examined. We aimed to compare SLE-DAS with SLEDAI-2K and validate the classifications of disease activity based on SLE-DAS in terms of PROs. METHODS We assessed generic quality of life (QoL) using the Medical Outcome Survey 36-Item Short-Form Health Survey (SF-36), disease-specific QoL using the lupus patient-reported outcome tool (LupusPRO), burden of symptoms using the SLE Symptom Checklist (SSC), patient global assessment (PtGA) and physician global assessment (PhGA). RESULTS Of the 335 patients with SLE, the magnitudes of the mean absolute error, root mean square error, Akaike information criterion, and Bayesian information criterion were comparable for most PROs between the SLE-DAS and SLEDAI-2K. In contrast, SLEDAI-2K had a higher predictive value for health-related QoL of LupusPRO and PtGA than SLE-DAS. Low disease activity, Boolean and index-based remission and categories of disease activity (remission, mild and moderate/severe activity) were significantly associated with health-related QoL in LupusPRO, SSC and PhGA, but not SF-36 or PtGA. CONCLUSION No clear differences were identified in the use of the SLE-DAS over the SLEDAI-2K in assessing PROs in patients with SLE. The classification of disease activity based on the SLE-DAS was validated against several PROs. SLE-DAS and its categories of disease activity effectively explain some of the PROs.
Collapse
Affiliation(s)
- Akira Onishi
- Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yudai Takase
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuto Nakakubo
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Iwasaki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Kozuki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyasu Yoshida
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideo Onizawa
- Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
8
|
Kotani T, Matsuda S, Okazaki A, Nishioka D, Watanabe R, Gon T, Manabe A, Shoji M, Kadoba K, Hiwa R, Yamamoto W, Hashimoto M, Takeuchi T. Risk prediction model for mortality in microscopic polyangiitis: multicentre REVEAL cohort study. Arthritis Res Ther 2023; 25:223. [PMID: 37986108 PMCID: PMC10658814 DOI: 10.1186/s13075-023-03210-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND To establish refined risk prediction models for mortality in patients with microscopic polyangiitis (MPA) by using comprehensive clinical characteristics. METHODS Data from the multicentre Japanese registry of patients with vasculitis (REVEAL cohort) were used in our analysis. In total, 194 patients with newly diagnosed MPA were included, and baseline demographic, clinical, laboratory, and treatment details were collected. Univariate and multivariate analyses were conducted to identify the significant risk factors predictive of mortality. RESULTS Over a median follow-up of 202.5 (84-352) weeks, 60 (30.9%) of 194 patients died. The causes of death included MPA-related vasculitis (18.3%), infection (50.0%), and others (31.7%). Deceased patients were older (median age 76.2 years) than survivors (72.3 years) (P < 0.0001). The death group had shorter observation periods (median 128.5 [35.3-248] weeks) than the survivor group (229 [112-392] weeks). Compared to survivors, the death group exhibited a higher smoking index, lower serum albumin levels, higher serum C-reactive protein levels, higher Birmingham Vasculitis Activity Score (BVAS), higher Five-Factor Score, and a more severe European Vasculitis Study Group (EUVAS) categorization system. Multivariate analysis revealed that higher BVAS and severe EUVAS independently predicted mortality. Kaplan-Meier survival curves demonstrated lower survival rates for BVAS ≥20 and severe EUVAS, and a risk prediction model (RPM) based on these stratified patients into low, moderate, and high-risk mortality groups. CONCLUSIONS The developed RPM is promising to predict mortality in patients with MPA and provides clinicians with a valuable tool for risk assessment and informed clinical decision-making.
Collapse
Affiliation(s)
- Takuya Kotani
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan.
| | - Shogo Matsuda
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan
| | - Ayana Okazaki
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan
| | - Daisuke Nishioka
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ryu Watanabe
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takaho Gon
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Manabe
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mikihito Shoji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keiichiro Kadoba
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Kurashiki, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan
| |
Collapse
|
9
|
Sasai T, Nakashima R, Tsuji H, Nakajima T, Imura Y, Yoshida Y, Hirata S, Shirakashi M, Hiwa R, Kitagori K, Akizuki S, Yoshifuji H, Mimori T, Morinobu A. Long-Term Prognosis of Antimelanoma Differentiation-Associated Gene 5-Positive Dermatomyositis With Interstitial Lung Disease. J Rheumatol 2023; 50:1454-1461. [PMID: 37714541 DOI: 10.3899/jrheum.2023-0371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE Antimelanoma differentiation-associated gene 5 (anti-MDA5)-positive dermatomyositis with interstitial lung disease (DM-ILD) progresses rapidly and has a poor prognosis. Previously, we reported the efficacy of a combination therapy comprising high-dose glucocorticoids (GCs), calcineurin inhibitors (CNIs), and intravenous cyclophosphamide (IV CYC) in a multicenter clinical trial (UMIN000014344). In the present study, we evaluated the long-term outcomes and effects of induction therapy on the maintenance of remission. METHODS All participants from our previous trial were followed up for > 5 years. Seventy-three other patients with anti-MDA5-positive DM-ILD from our institute were retrospectively integrated into the previous trial for further analysis. Sixty-eight patients achieved remission and survived for > 6 months. Based on the induction treatment, we classified the patients into 2 groups: (1) group T (n = 56), with triple combination therapy (GCs, CNIs, and IV CYC), and (2) group C (n = 12), with monotherapy/dual therapy. The recurrence-free and drug-withdrawal rates of immunosuppressive agents were compared. RESULTS The overall survival and recurrence-free survival rates at 5 years were 100% for the participants in the previous trial. The 5-year cumulative withdrawal rates for CNIs and GCs were 70% and 53%, respectively. In a comprehensive analysis, the recurrence-free rates in group T were higher than those in group C (90% vs 56%; P < 0.05). The drug-withdrawal rates of CNIs and GCs at 10 years in group T were also higher than those in group C (79% vs 0% and 43% vs 0%, respectively; P < 0.05). CONCLUSION Triple combination therapy in the induction phase can reduce the risk of recurrence and facilitate drug withdrawal in anti-MDA5-positive DM-ILD.
Collapse
Affiliation(s)
- Tsuneo Sasai
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto
| | - Ran Nakashima
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto;
| | - Hideaki Tsuji
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto
| | - Toshiki Nakajima
- T. Nakajima, MD, PhD, Y. Imura, MD, PhD, Department of Clinical Immunology and Rheumatology, Medical Research Institute Kitano Hospital, Osaka
| | - Yoshitaka Imura
- T. Nakajima, MD, PhD, Y. Imura, MD, PhD, Department of Clinical Immunology and Rheumatology, Medical Research Institute Kitano Hospital, Osaka
| | - Yusuke Yoshida
- Y. Yoshida, MD, PhD, S. Hirata, MD, PhD, Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima
| | - Shintaro Hirata
- Y. Yoshida, MD, PhD, S. Hirata, MD, PhD, Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima
| | - Mirei Shirakashi
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto
| | - Ryosuke Hiwa
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto
| | - Koji Kitagori
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto
| | - Shuji Akizuki
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto
| | - Hajime Yoshifuji
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto
| | - Tsuneyo Mimori
- T. Mimori, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, and Ijinkai Takeda General Hospital, Kyoto, Japan
| | - Akio Morinobu
- T. Sasai, MD, R. Nakashima, MD, PhD, H. Tsuji, MD, PhD, M. Shirakashi, MD, PhD, R. Hiwa, MD, PhD, K. Kitagori, MD, PhD, S. Akizuki, MD, PhD, H. Yoshifuji, MD, PhD, A. Morinobu, MD, PhD, Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto
| |
Collapse
|
10
|
Taniguchi T, Hiwa R, Morinobu A. The conclusion that myeloperoxidase inhibition is not protective against anti-neutrophil cytoplasmic autoantibody-associated vasculitis is premature. Kidney Int 2023; 104:856. [PMID: 37739617 DOI: 10.1016/j.kint.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/18/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Tomoki Taniguchi
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan.
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan
| |
Collapse
|
11
|
Matsuda S, Kotani T, Okazaki A, Nishioka D, Watanabe R, Gon T, Manabe A, Shoji M, Kadoba K, Hiwa R, Yamamoto W, Hashimoto M, Takeuchi T. Prediction model for respiratory-related mortality in microscopic polyangiitis with interstitial lung disease: multicenter REVEAL cohort study. Rheumatology (Oxford) 2023:kead444. [PMID: 37632776 DOI: 10.1093/rheumatology/kead444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/11/2023] [Accepted: 07/28/2023] [Indexed: 08/28/2023] Open
Abstract
OBJECTIVE This study aimed to establish prediction models for respiratory-related mortality in microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using clinical characteristics. METHODS We enrolled patients with MPA with ILD between May 2005 and June 2021 in a multicentre cohort of Japanese patients with MPA (REVEAL cohort). We evaluated the demographic, clinical, laboratory, radiological findings, treatments, and the presence of honeycombing 1 cm above the diaphragm using chest high-resolution computed tomography (HRCT) on admission. We explored the risk factors predictive of respiratory-related mortality. RESULTS Of 115 patients, 26 cases died of respiratory-related diseases during a median follow-up of 3.8 years. Eighteen patients (69%) died due to respiratory infection, three (12%) had diffuse alveolar hemorrhage (DAH), and five (19%) had exacerbation of ILD. In univariate analysis, older age, lower percent forced vital capacity (%FVC), lower percent diffusing capacity of carbon monoxide (%DLco), and the presence of honeycombing in the right lower lobe were identified as risk factors. Additionally, in multivariate analysis adjusted for age and treatment, %FVC, %DLco, and the presence of honeycombing in the right lower lobe were independently associated with respiratory-related mortality. We created prediction models based on the values of %FVC, %DLco, and presence of honeycombing on chest HRCT (MPF model). The 5-year respiratory-related death-free rate was significantly different between patients with MPA with ILD stratified by the number of risk factors based on the MPF model. CONCLUSIONS Our study indicates that the MPF model may help predict respiratory-related death in patients with MPA with ILD.
Collapse
Affiliation(s)
- Shogo Matsuda
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takuya Kotani
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ayana Okazaki
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Daisuke Nishioka
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ryu Watanabe
- Department of Clinical Immunology, Osaka Metropolitan University, Osaka, Japan
| | - Takaho Gon
- Department of Clinical Immunology, Osaka Metropolitan University, Osaka, Japan
| | - Atsushi Manabe
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mikihito Shoji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keiichiro Kadoba
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Okayama, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Osaka Metropolitan University, Osaka, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| |
Collapse
|
12
|
Nakayama Y, Nakashima R, Handa T, Ohsumi A, Yamada Y, Nakajima D, Yutaka Y, Tanaka S, Hamada S, Ikezoe K, Tanizawa K, Shirakashi M, Hiwa R, Tsuji H, Kitagori K, Akizuki S, Yoshifuji H, Date H, Morinobu A. Prognosis of patients with systemic sclerosis-related interstitial lung disease on the lung transplant waiting list: a retrospective study. Sci Rep 2023; 13:10150. [PMID: 37349495 PMCID: PMC10287698 DOI: 10.1038/s41598-023-37141-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/16/2023] [Indexed: 06/24/2023] Open
Abstract
Advanced systemic sclerosis-associated interstitial lung disease (SSc-ILD) can be treated with lung transplantation. There is limited data on lung transplantation outcomes in patients with SSc-ILD, in non-Western populations.We assessed survival data of patients with SSc-ILD, on the lung transplant (LT) waiting list, and evaluated post-transplant outcomes in patients from an Asian LT center. In this single-center retrospective study, 29 patients with SSc-ILD, registered for deceased LT at Kyoto University Hospital, between 2010 and 2022, were identified. We investigated post-transplant outcomes in recipients who underwent LT for SSc-ILD, between February 2002 and April 2022. Ten patients received deceased-donor LT (34%), two received living-donor LT (7%), seven died waiting for LT (24%), and ten survived on the waiting list (34%). Median duration from registration to deceased-donor LT was 28.9 months and that from registration to living-donor LT or death was 6.5 months. Analysis of 15 recipients showed improved forced vital capacity with a median of 55.1% at baseline, 65.8% at 6 months, and 80.3% at 12 months post-transplant. The 5-year survival rate for post-transplant patients with SSc-ILD was 86.2%. The higher post-transplant survival rate at our institute than previously reported suggests that lung transplantation is acceptable in Asian patients with SSc-ILD.
Collapse
Affiliation(s)
- Yoichi Nakayama
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Tomohiro Handa
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiro Ohsumi
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshito Yamada
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Daisuke Nakajima
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yojiro Yutaka
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satona Tanaka
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Hamada
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Ikezoe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiminobu Tanizawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| |
Collapse
|
13
|
Yaku A, Ishikawa Y, Iwasaki T, Hiwa R, Matsuo K, Saji H, Yurugi K, Miura Y, Furu M, Ito H, Fujii T, Maekawa T, Hashimoto M, Ohmura K, Mimori T, Terao C. Genetic architecture underlying IgG-RF production is distinct from that of IgM-RF. Rheumatology (Oxford) 2022; 62:2015-2020. [PMID: 36250908 DOI: 10.1093/rheumatology/keac593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/05/2022] [Accepted: 09/28/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE HLA-DRB1 alleles, particularly the shared epitope (SE) alleles, are strongly associated with RA. Different genetic structures underlie the production of different autoantibodies in RA. While extensive genetic analyses were conducted for detailed profiles of ACPA, a representative autoantibody in RA, the genetic architecture underlying subfractions of RF other than IgM-RF, namely IgG-RF, known to be associated with rheumatoid vasculitis, is not well understood. METHODS We enrolled a total of 743 RA subjects whose detailed autoantibody (IgG-RF, IgM-RF, and ACPA) data were available. We evaluated co-presence and correlations of the levels of these autoantibodies. We analyzed associations between the presence or levels of the autoantibodies and HLA-DRB1 alleles for the 743 RA patients and 2,008 healthy controls. RESULTS We found both IgG-RF(+) and IgG-RF(-) RA subjects showed comparable associations with SE, which was not observed for the other autoantibodies. Furthermore, there was a clear difference in SE associations between IgG-RF(+) and (-) subsets; the association with the IgG-RF(+) subsets was solely driven by HLA-DRB1*04:05, the most frequent SE allele in the Japanese, while not only HLA-DRB1*04:05 but HLA-DRB1*04:01, less frequent in the Japanese but the most frequent SE in Europeans, were main drivers in IgG-RF(-) subset. We confirmed that these associations were irrespective of ACPA presence. CONCLUSION We found a unique genetic architecture of IgG-RF(-) RA, which showed a strong association with the SE allele less frequent among Japanese but the most frequent in Europeans. The findings could shed light on uncovered RA pathology.
Collapse
Affiliation(s)
- Ai Yaku
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuki Ishikawa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Laboratory for statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Takeshi Iwasaki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keitaro Matsuo
- Aichi Cancer Center Hospital and Research Institute, Aichi, Japan
| | | | - Kimiko Yurugi
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan
| | - Yasuo Miura
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan
| | - Moritoshi Furu
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromu Ito
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takao Fujii
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Taira Maekawa
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan
| | - Motomu Hashimoto
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chikashi Terao
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Laboratory for statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan.,Clinical Research Center, Shizuoka General Hospital, Shizuoka, Japan.,The Department of Applied Genetics, The School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| |
Collapse
|
14
|
Sasai T, Nakashima R, Shirakashi M, Hiwa R, Tsuji H, Kitagori K, Akizuki S, Yoshifuji H, Mimori T, Morinobu A. A new autoantibody to valyl transfer RNA synthetase associated with anti-synthetase syndrome. Rheumatology (Oxford) 2022; 62:e155-e157. [PMID: 36193992 DOI: 10.1093/rheumatology/keac569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/11/2022] [Accepted: 09/26/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tsuneo Sasai
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Ijinkai Takeda General Hospital, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
15
|
Yoshida T, Tsuji H, Onishi A, Takase Y, Shirakashi M, Onizawa H, Hiwa R, Kitagori K, Akizuki S, Nakashima R, Tanaka M, Yoshifuji H, Morinobu A. Medium-term impact of the SARS-CoV-2 mRNA vaccine against disease activity in patients with systemic lupus erythematosus. Lupus Sci Med 2022; 9:9/1/e000727. [PMID: 35961691 PMCID: PMC9378947 DOI: 10.1136/lupus-2022-000727] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/27/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Numerous case reports have referred to new onset or flare of SLE after SARS-CoV-2 messenger RNA (mRNA) vaccines. Several observational studies showed that the short-term flare rate of SLE after SARS-CoV-2 vaccination is low. However, well-controlled clinical surveys are unavailable and the medium-term impact of the SARS-CoV-2 mRNA vaccines against the flare of SLE is uncertain. Therefore, we aimed to analyse the association between vaccination and medium-term subjective and objective disease activities of SLE and flares using matched pair methods. METHODS Altogether, 150 patients with SLE from the Kyoto Lupus Cohort were included. Patients who received two doses of the SARS-CoV-2 mRNA vaccines were 1:1 matched with unvaccinated patients based on the first vaccination date. The outcome measures were the SLE Disease Activity Index-2000 (SLEDAI-2K), the Japanese version of the SLE Symptom Checklist Questionnaire (SSC-J) and the Safety of Estrogens in Lupus Erythematosus National Assessment-SLEDAI flare index at 30, 60 and 90 days after vaccination. RESULTS SLEDAI-2K levels were not significantly different in vaccinated and unvaccinated patients with SLE at 30, 60 and 90 days after the second vaccination (adjusted estimate (95% CI): 30 days: -0.46 (-1.48 to 0.56), p=0.39; 60 days: 0.38 (-0.64 to 1.40), p=0.47; 90 days: 0.40 (-0.54 to 1.34), p=0.41). Similar results were observed in the SSC-J score (adjusted estimate (95% CI), 30 days: 0.05 (-1.46 to 1.56), p=0.95; 60 days: -0.63 (-2.08 to 0.82), p=0.40; 90 days: 0.27 (-1.04 to 1.58), p=0.69) and flare index (adjusted OR (95% CI), 30 days: 0.81 (0.36 to 1.85), p=0.62; 60 days: 1.13 (0.50 to 2.54), p=0.77; 90 days: 0.85 (0.32 to 2.26), p=0.74). CONCLUSION SARS-CoV-2 vaccination did not significantly influence the medium-term subjective and objective disease activities or flares of SLE until 90 days after the second vaccination.
Collapse
Affiliation(s)
- Tsuneyasu Yoshida
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideaki Tsuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yudai Takase
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mirei Shirakashi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideo Onizawa
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Kitagori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuji Akizuki
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
16
|
Nakakubo Y, Tsuji H, Takase Y, Iwasaki T, Shirakashi M, Onizawa H, Hiwa R, Kitagori K, Akizuki S, Nakashima R, Onishi A, Yoshifuji H, Tanaka M, Morinobu A. AB0470 THE ASSOCIATIONS OF ANTI-DNA ANTIBODIES WITH DISEASE ACTIVITY INDICES AND PATIENT REPORT OUTCOME PARAMETERS OF SLE IN KYOTO LUPUS COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSince the goals of remission or low disease activity are becoming more realistic with advances in treatment for SLE, there is a need to examine the measurements for SLE especially in patients with low disease activity. It has been known that disease activities in SLE are correlated with anti-DNA antibodies (Abs). However, it was not clear which measurements of disease activities or patient reported outcomes correlate better with anti-DNA Abs.ObjectivesTo examine the association between parameters for SLE and anti-DNA Abs measured with RIA in Kyoto Lupus Cohort, a SLE registry in Kyoto University Hospital from 2019 to 2021.Methods1)Correlations between anti-DNA Abs with SLEDAI, M-SLEDAI (SLEDAI without anti-DNA Abs), VAS, LupusPRO, SF-36, and Systemic lupus erythematosus Symptom Checklist (SSC) were evaluated cross-sectionally (n = 310).2)The alterations in SLE parameters and anti-DNA Abs between two visits were examined (n = 106). Further, the correlations within 3 months were examined in cases with flare-ups of SLE (the alteration in SLEDAI > 0 and anti-DNA Abs≧0, n = 39). The associations of the alterations of anti-DNA Abs with each item of SLEDAI classified by organs were also examined.Results1)31 percent of the cases in the entire registry was classified as remission or low disease activity (Table 1). SLEDAI (mean±SD) was higher in patients positive for anti-DNA Abs (7.94±5.20) than that in patients negative for anti-DNA Abs (4.56±4.65) (p < 0.0001). Anti-DNA Abs were weakly correlated with SLEDAI (R = 0.24 [p < 0.0001]), M-SLEDAI (R = 0.15 [p = 0.014]), and Physician-VAS (R = 0.19 [p = 0.0016]). On the other hand, there were no significant correlations between anti-DNA Abs and LupusPRO and SSC. Some dimensions in SF-36 had weak correlations with anti-DNA Abs, while no component summary scores had significant correlations with anti-DNA Abs.Table 1.Patients’ demographics and disease characteristics in the cohort (n = 310).VariableResultsAge (years)47.7 (39.4, 57.5)Female sexn = 284 (91.6%)Disease duration (years)15.9 (9.4, 24.5)Anti-DNA Ab positivity†n = 106 (34.2%)Anti- DNA Ab titer (U/mL)4 (0, 8)SLEDAI4 (2, 8)SLEDAI<=4n = 162 (52.1%)SSC31 (16.2, 52.5)Remission or LDAn = 95 (30.7%)Patient-VAS38 (15, 52)Physician-VAS13.3 (3.3, 23.3)SF-36 PCS45.4 (36.6, 52.4)SF-36 MCS48.2 (41.5, 53.6)SF-36 RCS51.3 (42.6, 58.6)LupusPRO HQOL70.2 (54.8, 86.5)LupusPRO NHQOL41.7 (31.3, 51.0)Glucocorticoid (mg/day)5 (4, 8)* Data are n (%) or median (Q1, Q3).† Anti-DNA Ab positivity at the time of the cross-sectional observation.2)No significant correlations were observed between the alterations of SLEDAI and anti-DNA Abs (R = 0.00 [95% CI: -0.23 – 0.22, p = 0.95]) in the total of patients with various range of observation periods (Figure 1A). In contrast, a significant correlation was observed (R = 0.32, p = 0.04) within 3 months after the flare-ups of SLE (Figure 1B). No significant correlations were found between the alterations in VAS and anti-DNA Abs, or the alterations of SSC and anti-DNA Abs. They showed the following organ symptoms: renal involvement, 62.8%; musculoskeletal, 17.1%; neuropsychiatric, 11.4%; hematological, 5.7%; mucocutaneous, 11.4%; serositis, 2.9%, and fever, 2.9%.Figure 1.The associations between the alteration in anti-DNA Ab and SLEDAIConclusionThe associations between anti-DNA Abs with several parameters of SLE were examined. Anti-DNA Abs correlated with disease activities (SLEDAI) in SLE patients, especially when observed in the condition of flare-up.References[1]Ho A, et al. Arthritis Rheum. 2001;44:2342-9.Disclosure of InterestsNone declared
Collapse
|
17
|
Hiwa R, Brooks JF, Mueller JL, Nielsen HV, Zikherman J. NR4A nuclear receptors in T and B lymphocytes: Gatekeepers of immune tolerance . Immunol Rev 2022; 307:116-133. [PMID: 35174510 DOI: 10.1111/imr.13072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 01/30/2022] [Indexed: 12/21/2022]
Abstract
Random VDJ recombination early in T and B cell development enables the adaptive immune system to recognize a vast array of evolving pathogens via antigen receptors. However, the potential of such randomly generated TCRs and BCRs to recognize and respond to self-antigens requires layers of tolerance mechanisms to mitigate the risk of life-threatening autoimmunity. Since they were originally cloned more than three decades ago, the NR4A family of nuclear hormone receptors have been implicated in many critical aspects of immune tolerance, including negative selection of thymocytes, peripheral T cell tolerance, regulatory T cells (Treg), and most recently in peripheral B cell tolerance. In this review, we discuss important insights from many laboratories as well as our own group into the function and mechanisms by which this small class of primary response genes promotes self-tolerance and immune homeostasis to balance the need for host defense against the inherent risks posed by the adaptive immune system.
Collapse
Affiliation(s)
- Ryosuke Hiwa
- Division of Rheumatology, Department of Medicine, Rosalind Russell and Ephraim P. Engelman Arthritis Research Center, University of California, San Francisco, California, USA.,Department of Rheumatology and Clinical Immunology, Kyoto University Hospital, Kyoto, Japan
| | - Jeremy F Brooks
- Division of Rheumatology, Department of Medicine, Rosalind Russell and Ephraim P. Engelman Arthritis Research Center, University of California, San Francisco, California, USA
| | - James L Mueller
- Division of Rheumatology, Department of Medicine, Rosalind Russell and Ephraim P. Engelman Arthritis Research Center, University of California, San Francisco, California, USA
| | - Hailyn V Nielsen
- Division of Rheumatology, Department of Medicine, Rosalind Russell and Ephraim P. Engelman Arthritis Research Center, University of California, San Francisco, California, USA
| | - Julie Zikherman
- Division of Rheumatology, Department of Medicine, Rosalind Russell and Ephraim P. Engelman Arthritis Research Center, University of California, San Francisco, California, USA
| |
Collapse
|
18
|
Brooks JF, Tan C, Mueller JL, Hibiya K, Hiwa R, Vykunta V, Zikherman J. Negative feedback by NUR77/Nr4a1 restrains B cell clonal dominance during early T-dependent immune responses. Cell Rep 2021; 36:109645. [PMID: 34469720 PMCID: PMC8564879 DOI: 10.1016/j.celrep.2021.109645] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 04/26/2021] [Accepted: 08/11/2021] [Indexed: 12/29/2022] Open
Abstract
B cell clones compete for entry into and dominance within germinal centers (GCs), where the highest-affinity B cell receptors (BCRs) are selected. However, diverse and low-affinity B cells can enter and reside in GCs for extended periods. To reconcile these observations, we hypothesize that a negative feedback loop may operate within B cells to preferentially restrain high-affinity clones from monopolizing the early GC niche. Here, we report a role for the nuclear receptor NUR77/Nr4a1 in this process. We show that NUR77 expression scales with antigen stimulation and restrains B cell expansion. Although NUR77 is dispensable for regulating GC size when GCs are elicited in a largely clonal manner, it serves to curb immunodominance under conditions where diverse clonal populations must compete for a constrained niche. We propose that this is important to preserve early clonal diversity in order to limit holes in the post-immune repertoire and to optimize GC selection.
Collapse
MESH Headings
- Animals
- B-Lymphocytes/drug effects
- B-Lymphocytes/immunology
- B-Lymphocytes/metabolism
- Cell Proliferation
- Cells, Cultured
- Clonal Selection, Antigen-Mediated
- Feedback, Physiological
- Female
- Germinal Center/drug effects
- Germinal Center/immunology
- Germinal Center/metabolism
- Immunity, Humoral/drug effects
- Immunization
- Immunodominant Epitopes
- Lymphocyte Activation
- Male
- Mice, Inbred C57BL
- Mice, Knockout
- Nuclear Receptor Subfamily 4, Group A, Member 1/genetics
- Nuclear Receptor Subfamily 4, Group A, Member 1/metabolism
- Signal Transduction
- T-Lymphocytes/drug effects
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Vaccines, Synthetic/administration & dosage
- Mice
Collapse
Affiliation(s)
- Jeremy F Brooks
- Division of Rheumatology, Rosalind Russell and Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Corey Tan
- Division of Rheumatology, Rosalind Russell and Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - James L Mueller
- Division of Rheumatology, Rosalind Russell and Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Kenta Hibiya
- Division of Rheumatology, Rosalind Russell and Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Ryosuke Hiwa
- Division of Rheumatology, Rosalind Russell and Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Vivasvan Vykunta
- Division of Rheumatology, Rosalind Russell and Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Julie Zikherman
- Division of Rheumatology, Rosalind Russell and Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA.
| |
Collapse
|
19
|
Hiwa R, Nielsen HV, Mueller JL, Mandla R, Zikherman J. NR4A family members regulate T cell tolerance to preserve immune homeostasis and suppress autoimmunity. JCI Insight 2021; 6:e151005. [PMID: 34343134 PMCID: PMC8492309 DOI: 10.1172/jci.insight.151005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/22/2021] [Indexed: 12/02/2022] Open
Abstract
The NR4A family of orphan nuclear receptors (Nr4a1–3) plays redundant roles to establish and maintain Treg identity; deletion of multiple family members in the thymus results in Treg deficiency and a severe inflammatory disease. Consequently, it has been challenging to unmask redundant functions of the NR4A family in other immune cells. Here we use a competitive bone marrow chimera strategy, coupled with conditional genetic tools, to rescue Treg homeostasis and unmask such functions. Unexpectedly, chimeras harboring Nr4a1–/– Nr4a3–/– (double-knockout, DKO) bone marrow developed autoantibodies and a systemic inflammatory disease despite a replete Treg compartment of largely WT origin. This disease differs qualitatively from that seen with Treg deficiency and is B cell extrinsic. Negative selection of DKO thymocytes is profoundly impaired in a cell-intrinsic manner. Consistent with escape of self-reactive T cells into the periphery, DKO T cells with functional, phenotypic, and transcriptional features of anergy accumulated in chimeric mice. Nevertheless, we observed upregulation of genes encoding inflammatory mediators in anergic DKO T cells, and DKO T cells exhibited enhanced capacity for IL-2 production. These studies reveal cell-intrinsic roles for the NR4A family in both central and peripheral T cell tolerance and demonstrate that each is essential to preserve immune homeostasis.
Collapse
Affiliation(s)
- Ryosuke Hiwa
- Department of Medicine, UCSF Medical Center, San Francisco, United States of America
| | - Hailyn V Nielsen
- Department of Medicine, UCSF Medical Center, San Francisco, United States of America
| | - James L Mueller
- Department of Medicine, UCSF Medical Center, San Francisco, United States of America
| | - Ravi Mandla
- Department of Medicine, UCSF Medical Center, San Francisco, United States of America
| | - Julie Zikherman
- Department of Medicine, UCSF Medical Center, San Francisco, United States of America
| |
Collapse
|
20
|
Kawahara R, Nakabo S, Shimizu M, Yamamoto H, Sasai T, Nishida Y, Funakoshi S, Gon Y, Taniguchi M, Nakajima T, Hiwa R, Hashimoto M, Tomizawa T, Azukizawa M, Nishitani K, Murata K, Tanaka M, Ito H, Mimori T, Fujii Y. Feasibility of patient-oriented ultrasound joint selection: Cross-sectional observational study on rheumatoid arthritis. Mod Rheumatol 2019; 30:975-981. [DOI: 10.1080/14397595.2019.1680095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Rie Kawahara
- Department of Human Health Sciences, Clinical Ultrasound Laboratory, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichiro Nakabo
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Madoka Shimizu
- Department of Human Health Sciences, Clinical Ultrasound Laboratory, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroko Yamamoto
- Department of Human Health Sciences, Clinical Ultrasound Laboratory, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneo Sasai
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuri Nishida
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sohei Funakoshi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshie Gon
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Taniguchi
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiki Nakajima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takuya Tomizawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masayuki Azukizawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Nishitani
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koichi Murata
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasutomo Fujii
- Department of Human Health Sciences, Clinical Ultrasound Laboratory, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
21
|
Hiwa R, Ikari K, Ohmura K, Nakabo S, Matsuo K, Saji H, Yurugi K, Miura Y, Maekawa T, Taniguchi A, Yamanaka H, Matsuda F, Mimori T, Terao C. HLA-DRB1 Analysis Identified a Genetically Unique Subset within Rheumatoid Arthritis and Distinct Genetic Background of Rheumatoid Factor Levels from Anticyclic Citrullinated Peptide Antibodies. J Rheumatol 2018; 45:470-480. [PMID: 29419463 DOI: 10.3899/jrheum.170363] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE HLA-DRB1 is the most important locus associated with rheumatoid arthritis (RA) and anticitrullinated protein antibodies (ACPA). However, fluctuations of rheumatoid factor (RF) over the disease course have made it difficult to define fine subgroups according to consistent RF positivity for the analyses of genetic background and the levels of RF. METHODS A total of 2873 patients with RA and 2008 healthy controls were recruited. We genotyped HLA-DRB1 alleles for the participants and collected consecutive data of RF in the case subjects. In addition to RF+ and RF- subsets, we classified the RF+ subjects into group 1 (constant RF+) and group 2 (seroconversion). We compared HLA-DRB1 alleles between the RA subsets and controls and performed linear regression analysis to identify HLA-DRB1 alleles associated with maximal RF levels. Omnibus tests were conducted to assess important amino acid positions. RESULTS RF positivity was 88%, and 1372 and 970 RF+ subjects were classified into groups 1 and 2, respectively. RF+ and RF- showed similar genetic associations to ACPA+ and ACPA- RA, respectively. We found that shared epitope (SE) was more enriched in group 2 than 1, p = 2.0 × 10-5, and that amino acid position 11 showed a significant association between 1 and 2, p = 2.7 × 10-5. These associations were independent of ACPA positivity. SE showed a tendency to be negatively correlated with RF titer (p = 0.012). HLA-DRB1*09:01, which reduces ACPA titer, was not associated with RF levels (p = 0.70). CONCLUSION The seroconversion group was shown to have distinct genetic characteristics. The genetic architecture of RF levels is different from that of ACPA.
Collapse
Affiliation(s)
- Ryosuke Hiwa
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Katsunori Ikari
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Koichiro Ohmura
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Shuichiro Nakabo
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Keitaro Matsuo
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Hiroh Saji
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Kimiko Yurugi
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Yasuo Miura
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Taira Maekawa
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Atsuo Taniguchi
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Hisashi Yamanaka
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Fumihiko Matsuda
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Tsuneyo Mimori
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute
| | - Chikashi Terao
- From the Department of Rheumatology and Clinical Immunology, and the Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo; Aichi Cancer Center Hospital and Research Institute, Nagoya; HLA Laboratory, Kyoto; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan; Division of Rheumatology, Immunology, and Allergy, and the Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA. .,R. Hiwa, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Ikari, MD, PhD, Associate professor, Institute of Rheumatology, Tokyo Women's Medical University; K. Ohmura, MD, PhD, Associate professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; S. Nakabo, MD, Research student, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; K. Matsuo, MD, PhD, Chief, Aichi Cancer Center Hospital and Research Institute; H. Saji, PhD, Director, HLA Laboratory; K. Yurugi, Chief, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; Y. Miura, MD, PhD, Assistant professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; T. Maekawa, MD, PhD, Professor, Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital; A. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; F. Matsuda, PhD, Professor, Center for Genomic Medicine, Graduate School of Medicine, Kyoto University; T. Mimori, MD, PhD, Professor, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; C. Terao, MD, PhD, Assistant professor, Center for Genomic Medicine, Graduate School of Medicine, and the Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, and the Division of Rheumatology, Immunology, and Allergy, and Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, and Program in Medical and Population Genetics, Broad Institute.
| |
Collapse
|
22
|
Kochi Y, Kamatani Y, Kondo Y, Suzuki A, Kawakami E, Hiwa R, Momozawa Y, Fujimoto M, Jinnin M, Tanaka Y, Kanda T, Cooper RG, Chinoy H, Rothwell S, Lamb JA, Vencovský J, Mann H, Ohmura K, Myouzen K, Ishigaki K, Nakashima R, Hosono Y, Tsuboi H, Kawasumi H, Iwasaki Y, Kajiyama H, Horita T, Ogawa-Momohara M, Takamura A, Tsunoda S, Shimizu J, Fujio K, Amano H, Mimori A, Kawakami A, Umehara H, Takeuchi T, Sano H, Muro Y, Atsumi T, Mimura T, Kawaguchi Y, Mimori T, Takahashi A, Kubo M, Kohsaka H, Sumida T, Yamamoto K. Splicing variant of WDFY4 augments MDA5 signalling and the risk of clinically amyopathic dermatomyositis. Ann Rheum Dis 2018; 77:602-611. [PMID: 29331962 DOI: 10.1136/annrheumdis-2017-212149] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 12/30/2017] [Accepted: 01/02/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of rare autoimmune diseases in which both genetic and environmental factors play important roles. To identify genetic factors of IIM including polymyositis, dermatomyositis (DM) and clinically amyopathic DM (CADM), we performed the first genome-wide association study for IIM in an Asian population. METHODS We genotyped and tested 496 819 single nucleotide polymorphism for association using 576 patients with IIM and 6270 control subjects. We also examined the causal mechanism of disease-associated variants by in silico analyses using publicly available data sets as well as by in in vitro analyses using reporter assays and apoptosis assays. RESULTS We identified a variant in WDFY4 that was significantly associated with CADM (rs7919656; OR=3.87; P=1.5×10-8). This variant had a cis-splicing quantitative trait locus (QTL) effect for a truncated WDFY4isoform (tr-WDFY4), with higher expression in the risk allele. Transexpression QTL analysis of this variant showed a positive correlation with the expression of NF-κB associated genes. Furthermore, we demonstrated that both WDFY4 and tr-WDFY4 interacted with pattern recognition receptors such as TLR3, TLR4, TLR9 and MDA5 and augmented the NF-κB activation by these receptors. WDFY4 isoforms also enhanced MDA5-induced apoptosis to a greater extent in the tr-WDFY4-transfected cells. CONCLUSIONS As CADM is characterised by the appearance of anti-MDA5 autoantibodies and severe lung inflammation, the WDFY4 variant may play a critical role in the pathogenesis of CADM.
Collapse
Affiliation(s)
- Yuta Kochi
- Laboratory for Autoimmune Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yuya Kondo
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akari Suzuki
- Laboratory for Autoimmune Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Eiryo Kawakami
- Laboratory for Disease Systems Modeling, RIKEN Center for Integrated Medical Sciences, Yokohama, Japan
| | - Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.,Department of Dermatology, University of Tsukuba, Ibaraki, Japan
| | - Masatoshi Jinnin
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takashi Kanda
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Robert G Cooper
- MRC-ARUK Institute for Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Centre for Integrated Genomic Medical Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Hector Chinoy
- Rheumatology Department, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK.,The National Institute for Health Research Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Simon Rothwell
- The National Institute for Health Research Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Janine A Lamb
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Centre for Integrated Genomic Medical Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Jiří Vencovský
- Institute of Rheumatology, Charles University, Prague, Czech Republic
| | - Heřman Mann
- Institute of Rheumatology, Charles University, Prague, Czech Republic
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keiko Myouzen
- Laboratory for Autoimmune Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Kazuyoshi Ishigaki
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuji Hosono
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroto Tsuboi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hidenaga Kawasumi
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yukiko Iwasaki
- Department of Allergy and Rheumatology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Hiroshi Kajiyama
- Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Tetsuya Horita
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Mariko Ogawa-Momohara
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akito Takamura
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinichiro Tsunoda
- Division of Rheumatology Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Jun Shimizu
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Hirofumi Amano
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akio Mimori
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hisanori Umehara
- Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hajime Sano
- Division of Rheumatology Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Yoshinao Muro
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihide Mimura
- Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yasushi Kawaguchi
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Atsushi Takahashi
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Michiaki Kubo
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Hitoshi Kohsaka
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Sumida
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazuhiko Yamamoto
- Laboratory for Autoimmune Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.,Department of Allergy and Rheumatology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| |
Collapse
|
23
|
Hiwa R, Ohmura K, Arase N, Jin H, Hirayasu K, Kohyama M, Suenaga T, Saito F, Terao C, Atsumi T, Iwatani H, Mimori T, Arase H. Myeloperoxidase/HLA Class II Complexes Recognized by Autoantibodies in Microscopic Polyangiitis. Arthritis Rheumatol 2017; 69:2069-2080. [DOI: 10.1002/art.40170] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 06/01/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Ryosuke Hiwa
- World Premier International Immunology Frontier Research Center and Osaka University, Suita, Japan, and Kyoto University; Kyoto Japan
| | | | | | - Hui Jin
- World Premier International Immunology Frontier Research Center and Osaka University; Suita Japan
| | - Kouyuki Hirayasu
- World Premier International Immunology Frontier Research Center; Suita Japan
| | - Masako Kohyama
- World Premier International Immunology Frontier Research Center and Osaka University; Suita Japan
| | - Tadahiro Suenaga
- World Premier International Immunology Frontier Research Center and Osaka University; Suita Japan
| | | | | | - Tatsuya Atsumi
- Hokkaido University Graduate School of Medicine; Sapporo Japan
| | | | | | - Hisashi Arase
- World Premier International Immunology Frontier Research Center and Osaka University; Suita Japan
| |
Collapse
|
24
|
Hiwa R, Ohmura K, Nakabo S, Terao C, Murakami K, Nakashima R, Imura Y, Yukawa N, Yoshifuji H, Hashimoto M, Furu M, Ito H, Fujii T, Mimori T. Only rheumatoid factor-positive subset of anti-citrullinated peptide/protein antibody-negative rheumatoid arthritis may seroconvert to anti-citrullinated peptide/protein antibody-positive. Int J Rheum Dis 2017; 20:731-736. [PMID: 28198158 DOI: 10.1111/1756-185x.13000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Anti-citrullinated peptide/protein antibody (ACPA) has been reported to occur in about 60% of patients with early rheumatoid arthritis (RA), and about 80% in patients with established RA. While ACPA seroconversion is possible, previous reports have shown that it rarely occurs. We retrospectively determined the proportion of patients who underwent ACPA seroconversion and described the clinical characteristics of these cases. METHODS ACPA-negative RA patients who had undergone ACPA assessment more than once with an interval of 3 months or longer were investigated for ACPA seroconversion. The clinical characteristics of seroconverted patients were assessed. RESULTS In 149 ACPA-negative RA patients, only eight patients (5.4%) converted to ACPA-positive during follow-up. We found that all eight of the seroconverted cases were positive for rheumatoid factor (RF) and showed bone erosions by X-ray. Of 56 ACPA-negative RF-positive RA patients, 14.3% of them seroconverted to ACPA-positive. None of the ACPA-negative RF-negative RA patients seroconverted to ACPA-positive. CONCLUSION The proportion of total RA patients who experienced seroconversion from ACPA-negative to ACPA-positive was 5.4%. When ACPA-negative RA patients were subdivided into RF-negative and RF-positive subsets, only the RF-positive subset seroconverted to ACPA-positive. These results imply that RF-negative and RF-positive patients are distinct subsets within ACPA-negative RA patients.
Collapse
Affiliation(s)
- Ryosuke Hiwa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichiro Nakabo
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chikashi Terao
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kosaku Murakami
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshitaka Imura
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoichiro Yukawa
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motomu Hashimoto
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Moritoshi Furu
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromu Ito
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takao Fujii
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
25
|
Hiwa R, Arase H. Misfolded proteins complexed with MHC class II molecules are targets for autoantibodies. ACTA ACUST UNITED AC 2016; 39:78-83. [PMID: 27181239 DOI: 10.2177/jsci.39.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Major histocompatibility complex (MHC) molecule is important for immune system through its function of presentation of peptide antigens. MHC is the gene most strongly associated with susceptibility to many autoimmune diseases. We recently found a novel function of MHC class II molecules to transport cellular misfolded proteins to the cell surface without processing to peptides. Interestingly, misfolded proteins transported to the cell surface by MHC class II molecules were found to be a specific targets for autoantibodies produced in patients with autoimmune diseases such as rheumatoid arthritis and antiphospholipid syndrome. Furthermore, autoantibody binding to misfolded proteins complexed with MHC class II molecules is strongly associated with the susceptibility to autoimmune diseases conferred by each MHC class II allele. Therefore, misfolded proteins associated with MHC class II molecules might be involved in the pathogenesis of autoimmune diseases.
Collapse
Affiliation(s)
- Ryosuke Hiwa
- Laboratory of Immunochemistry, World Premier International (WPI) Immunology Frontier Research Center
| | | |
Collapse
|
26
|
Jin H, Arase N, Hirayasu K, Kohyama M, Suenaga T, Saito F, Tanimura K, Matsuoka S, Ebina K, Shi K, Yasuda S, Horita T, Hiwa R, Takasugi K, Ohmura K, Yoshikawa H, Saito T, Atsumi T, Sasazuki T, Katayama I, Lanier L, Arase H. FRI0345 Autoantibodies in Rheumatoid Arthritis Specifically Recognize Igg Heavy Chain Complexed with Hla-Dr, Which is Strongly Associated with Rheumatoid Arthritis Susceptibility. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
27
|
Fan X, Yoshida Y, Honda S, Matsumoto M, Sawada Y, Hattori M, Hisanaga S, Hiwa R, Nakamura F, Tomomori M, Miyagawa S, Fujimaru R, Yamada H, Sawai T, Ikeda Y, Iwata N, Uemura O, Matsukuma E, Aizawa Y, Harada H, Wada H, Ishikawa E, Ashida A, Nangaku M, Miyata T, Fujimura Y. Analysis of genetic and predisposing factors in Japanese patients with atypical hemolytic uremic syndrome. Mol Immunol 2013; 54:238-46. [DOI: 10.1016/j.molimm.2012.12.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 12/09/2012] [Indexed: 11/24/2022]
|