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Mortier C, Quintelier K, De Craemer AS, Renson T, Deroo L, Dumas E, Verheugen E, Coudenys J, Decruy T, Lukasik Z, Van Gassen S, Saeys Y, Hoorens A, Lobatón T, Van den Bosch F, Van de Wiele T, Venken K, Elewaut D. Gut Inflammation in Axial Spondyloarthritis Patients is Characterized by a Marked Type 17 Skewed Mucosal Innate-like T Cell Signature. Arthritis Rheumatol 2023; 75:1969-1982. [PMID: 37293832 DOI: 10.1002/art.42627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/29/2023] [Accepted: 06/06/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Patients with spondyloarthritis (SpA) often present with microscopic signs of gut inflammation, a risk factor for progressive disease. We investigated whether mucosal innate-like T cells are involved in dysregulated interleukin-23 (IL-23)/IL-17 responses in the gut-joint axis in SpA. METHODS Ileal and colonic intraepithelial lymphocytes (IELs), lamina propria lymphocytes (LPLs), and paired peripheral blood mononuclear cells (PBMCs) were isolated from treatment-naive patients with nonradiographic axial SpA with (n = 11) and without (n = 14) microscopic gut inflammation and healthy controls (n = 15) undergoing ileocolonoscopy. The presence of gut inflammation was assessed histopathologically. Immunophenotyping of innate-like T cells and conventional T cells was performed using intracellular flow cytometry. Unsupervised clustering analysis was done by FlowSOM technology. Serum IL-17A levels were measured via Luminex. RESULTS Microscopic gut inflammation in nonradiographic axial SpA was characterized by increased ileal intraepithelial γδ-hi T cells, a γδ-T cell subset with elevated γδ-T cell receptor expression. γδ-hi T cells were also increased in PBMCs of patients with nonradiographic axial SpA versus healthy controls and were strongly associated with Ankylosing Spondylitis Disease Activity Score. The abundance of mucosal-associated invariant T cells and invariant natural killer T cells was unaltered. Innate-like T cells in the inflamed gut showed increased RORγt, IL-17A, and IL-22 levels with loss of T-bet, a signature that was less pronounced in conventional T cells. Presence of gut inflammation was associated with higher serum IL-17A levels. In patients treated with tumor necrosis factor blockade, the proportion of γδ-hi cells and RORγt expression in blood was completely restored. CONCLUSION Intestinal innate-like T cells display marked type 17 skewing in the inflamed gut mucosa of patients with nonradiographic axial SpA. γδ-hi T cells are linked to intestinal inflammation and disease activity in SpA.
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Affiliation(s)
- Céline Mortier
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Katrien Quintelier
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium, Data Mining and Modeling for Biomedicine group, VIB-UGent Center for Inflammation Research, Ghent, Belgium, and Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ann-Sophie De Craemer
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Thomas Renson
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Liselotte Deroo
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Emilie Dumas
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Eveline Verheugen
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Julie Coudenys
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Tine Decruy
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Zuzanna Lukasik
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Sofie Van Gassen
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University and Data Mining and Modeling for Biomedicine group, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Yvan Saeys
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University and Data Mining and Modeling for Biomedicine group, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Triana Lobatón
- Department of Internal Medicine and Pediatrics, Ghent University and Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Filip Van den Bosch
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Tom Van de Wiele
- Center for Microbial Ecology and Technology, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Koen Venken
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Dirk Elewaut
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
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Lukasik Z, Carron P, Webers C. To taper or not to taper biological disease-modifying antirheumatic drugs in axial spondyloarthritis anno 2023: That is the question. Best Pract Res Clin Rheumatol 2023; 37:101869. [PMID: 37658017 DOI: 10.1016/j.berh.2023.101869] [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: 07/19/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023]
Abstract
The 2022 ASAS-EULAR recommendations for the management of axial spondyloarthritis (axSpA) propose to consider dose reduction of biological disease-modifying antirheumatic drugs (bDMARDs) for patients in sustained remission. However, this recommendation does not offer clear guidance for daily clinical practice. In this review, we analyze randomized clinical trials and real-world data on tapering and discontinuation of bDMARDs in patients with axSpA. We discuss the scientific rationale and benefits of tapering, identify advice to apply tapering in current practice, and delineate aspects to be investigated in future research.
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Affiliation(s)
- Zuzanna Lukasik
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent University Hospital, Ghent, Belgium; VIB Center for Inflammation Research, Ghent, Belgium
| | - Philippe Carron
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent University Hospital, Ghent, Belgium; VIB Center for Inflammation Research, Ghent, Belgium.
| | - Casper Webers
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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3
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Styrzynski F, Zhakparov D, Schmid M, Roqueiro D, Lukasik Z, Solek J, Nowicki J, Dobrogowski M, Makowska J, Sokolowska M, Baerenfaller K. Machine Learning Successfully Detects Patients with COVID-19 Prior to PCR Results and Predicts Their Survival Based on Standard Laboratory Parameters in an Observational Study. Infect Dis Ther 2023; 12:111-129. [PMID: 36333475 PMCID: PMC9638383 DOI: 10.1007/s40121-022-00707-8] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION In the current COVID-19 pandemic, clinicians require a manageable set of decisive parameters that can be used to (i) rapidly identify SARS-CoV-2 positive patients, (ii) identify patients with a high risk of a fatal outcome on hospital admission, and (iii) recognize longitudinal warning signs of a possible fatal outcome. METHODS This comparative study was performed in 515 patients in the Maria Skłodowska-Curie Specialty Voivodeship Hospital in Zgierz, Poland. The study groups comprised 314 patients with COVID-like symptoms who tested negative and 201 patients who tested positive for SARS-CoV-2 infection; of the latter, 72 patients with COVID-19 died and 129 were released from hospital. Data on which we trained several machine learning (ML) models included clinical findings on admission and during hospitalization, symptoms, epidemiological risk, and reported comorbidities and medications. RESULTS We identified a set of eight on-admission parameters: white blood cells, antibody-synthesizing lymphocytes, ratios of basophils/lymphocytes, platelets/neutrophils, and monocytes/lymphocytes, procalcitonin, creatinine, and C-reactive protein. The medical decision tree built using these parameters differentiated between SARS-CoV-2 positive and negative patients with up to 90-100% accuracy. Patients with COVID-19 who on hospital admission were older, had higher procalcitonin, C-reactive protein, and troponin I levels together with lower hemoglobin and platelets/neutrophils ratio were found to be at highest risk of death from COVID-19. Furthermore, we identified longitudinal patterns in C-reactive protein, white blood cells, and D dimer that predicted the disease outcome. CONCLUSIONS Our study provides sets of easily obtainable parameters that allow one to assess the status of a patient with SARS-CoV-2 infection, and the risk of a fatal disease outcome on hospital admission and during the course of the disease.
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Affiliation(s)
- Filip Styrzynski
- Department of Rheumatology with Subdepartment of Internal Medicine, Medical University of Lodz, 90-419 Lodz, Poland
| | - Damir Zhakparov
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Herman-Burchard-Strasse 9, 7265 Davos, Switzerland ,Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Marco Schmid
- University of Applied Sciences of the Grisons, 7000 Chur, Switzerland
| | - Damian Roqueiro
- Swiss Institute of Bioinformatics, Lausanne, Switzerland ,Department of Biosystems Science and Engineering, ETH Zurich, 4058 Basel, Switzerland
| | - Zuzanna Lukasik
- Department of Rheumatology with Subdepartment of Internal Medicine, Medical University of Lodz, 90-419 Lodz, Poland ,Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Herman-Burchard-Strasse 9, 7265 Davos, Switzerland
| | - Julia Solek
- Department of Pathology, Chair of Oncology, Medical University of Lodz, 90-419 Lodz, Poland ,Department of Biostatistics and Translational Medicine, Medical University of Lodz, 90-419 Lodz, Poland
| | - Jakub Nowicki
- Department of Paediatrics, Newborn Pathology and Bone Metabolic Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Milosz Dobrogowski
- Maria Sklodowska-Curie Specialty Voivodeship Hospital, 95-100 Zgierz, Poland
| | - Joanna Makowska
- Department of Rheumatology with Subdepartment of Internal Medicine, Medical University of Lodz, 90-419 Lodz, Poland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Herman-Burchard-Strasse 9, 7265 Davos, Switzerland ,Christine Kühne – Center for Allergy Research and Education (CK-CARE), 7265 Davos, Switzerland
| | - Katja Baerenfaller
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Herman-Burchard-Strasse 9, 7265 Davos, Switzerland ,Swiss Institute of Bioinformatics, Lausanne, Switzerland
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4
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Renson T, de Hooge M, De Craemer AS, Deroo L, Lukasik Z, Carron P, Herregods N, Jans L, Colman R, Van den Bosch F, Elewaut D. Progressive increase in sacroiliac joint and spinal mri lesions in healthy individuals in relation to age. Arthritis Rheumatol 2022; 74:1506-1514. [PMID: 35436391 DOI: 10.1002/art.42145] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/27/2022] [Accepted: 04/12/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES MRI plays a pivotal role in spondyloarthritis (SpA) diagnosis. However, detailed description of MRI findings of the sacroiliac joints (SIJ) and spine in healthy individuals is currently lacking. We therefore sought to evaluate the occurrence of MRI-SIJ/spine lesions in healthy individuals in relation to age. METHODS Ninety-five healthy subjects (20-49 years) underwent MRI-SIJ and -spine. BME and structural lesions of the SIJ were scored using the SPARCC method. Spinal inflammatory and structural lesions were evaluated using the SPARCC MRI spine inflammation index and the CANDEN MRI scoring system, respectively. Fulfillment of the ASAS definition of a positive MRI for sacroiliitis/spondylitis was reviewed. Findings were compared with MRI of axial SpA patients from the Be-GIANT cohort. RESULTS 17.2% of subjects aged ≥30 fulfilled the definition of a positive MRI for sacroiliitis, but this occurred rarely in younger subjects. SIJ erosions (20.0%) and fat metaplasia (13.7%) were detected across all age groups. Erosions were more frequently visualized in subjects aged ≥40 (39.3%). Spinal BME (35.7%) and fat metaplasia (28.6%) were common in subjects older than 40 years. Nonetheless, only one subject had ≥3 corner inflammatory lesions. SIJ and spinal SPARCC scores and total structural lesions scores increased progressively with age. CONCLUSION Contrary to what is commonly believed, structural MRI-SIJ lesions are frequently seen in healthy individuals. Especially in older subjects, the high occurrence of inflammatory and structural MRI lesions impacts their specificity for SpA, which has important implications for the interpretation of MRI in patients with clinical suspicion of SpA.
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Affiliation(s)
- Thomas Renson
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.,VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium
| | - Manouk de Hooge
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.,VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium
| | - Ann-Sophie De Craemer
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.,VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium
| | - Liselotte Deroo
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.,VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium
| | - Zuzanna Lukasik
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.,VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium
| | - Philippe Carron
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.,VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium
| | - Nele Herregods
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Lennart Jans
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Roos Colman
- Department of Biostatistics, Ghent University, Ghent, Belgium
| | - Filip Van den Bosch
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.,VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium
| | - Dirk Elewaut
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium.,VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium
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5
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Sokolowska M, Rovati GE, Diamant Z, Untersmayr E, Schwarze J, Lukasik Z, Sava F, Angelina A, Palomares O, Akdis C, O'Mahony L, Jesenak M, Pfaar O, Torres MJ, Sanak M, Dahlén S, Woszczek G. Effects of non-steroidal anti-inflammatory drugs and other eicosanoid pathway modifiers on antiviral and allergic responses: EAACI task force on eicosanoids consensus report in times of COVID-19. Allergy 2022; 77:2337-2354. [PMID: 35174512 PMCID: PMC9111413 DOI: 10.1111/all.15258] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 11/23/2021] [Revised: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 11/29/2022]
Abstract
Non‐steroidal anti‐inflammatory drugs (NSAIDs) and other eicosanoid pathway modifiers are among the most ubiquitously used medications in the general population. Their broad anti‐inflammatory, antipyretic, and analgesic effects are applied against symptoms of respiratory infections, including SARS‐CoV‐2, as well as in other acute and chronic inflammatory diseases that often coexist with allergy and asthma. However, the current pandemic of COVID‐19 also revealed the gaps in our understanding of their mechanism of action, selectivity, and interactions not only during viral infections and inflammation, but also in asthma exacerbations, uncontrolled allergic inflammation, and NSAIDs‐exacerbated respiratory disease (NERD). In this context, the consensus report summarizes currently available knowledge, novel discoveries, and controversies regarding the use of NSAIDs in COVID‐19, and the role of NSAIDs in asthma and viral asthma exacerbations. We also describe here novel mechanisms of action of leukotriene receptor antagonists (LTRAs), outline how to predict responses to LTRA therapy and discuss a potential role of LTRA therapy in COVID‐19 treatment. Moreover, we discuss interactions of novel T2 biologicals and other eicosanoid pathway modifiers on the horizon, such as prostaglandin D2 antagonists and cannabinoids, with eicosanoid pathways, in context of viral infections and exacerbations of asthma and allergic diseases. Finally, we identify and summarize the major knowledge gaps and unmet needs in current eicosanoid research.
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Affiliation(s)
- Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne ‐ Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - G Enrico Rovati
- Department of Pharmaceutical Sciences Section of Pharmacology and Biosciences University of Milan Milano Italy
| | - Zuzana Diamant
- Department of Respiratory Medicine and Allergology Skane University Hospital Lund Sweden
- Department Microbiology Immunology and Transplantation Ku Leuven, Catholic University of Leuven Belgium
- Department of Respiratory Medicine First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Jürgen Schwarze
- Child Life and Health and Centre for Inflammation Research The University of Edinburgh Edinburgh UK
| | - Zuzanna Lukasik
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- VIB Center for Inflammation Research Ghent University Ghent Belgium
| | - Florentina Sava
- London North Genomic Laboratory Hub Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Alba Angelina
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University Madrid Spain
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University Madrid Spain
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne ‐ Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - Liam O'Mahony
- Departments of Medicine and Microbiology APC Microbiome IrelandUniversity College Cork Cork Ireland
| | - Milos Jesenak
- Department of Pulmonology and Phthisiology Department of Allergology and Clinical Immunology Department of Pediatrics Jessenius Faculty of Medicine in Martin Comenius University in BratislavaUniversity Teaching Hospital in Martin Slovakia
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital MarburgPhilipps‐Universität Marburg Marburg Germany
| | - María José Torres
- Allergy Unit Málaga Regional University Hospital‐IBIMA‐UMA Málaga Spain
| | - Marek Sanak
- Department of Medicine Jagiellonian University Medical College Krakow Poland
| | - Sven‐Erik Dahlén
- Institute of Environmental Medicine and the Centre for Allergy Research, Karolinska Institute, and the Department of Respiratory Medicine Karolinska University Hospital Stockholm Sweden
| | - Grzegorz Woszczek
- Asthma UK Centre in Allergic Mechanisms of Asthma School of Immunology and Microbial Sciences King's College London London UK
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6
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Sokolowska M, Rovati GE, Diamant Z, Untersmayr E, Schwarze J, Lukasik Z, Sava F, Angelina A, Palomares O, Akdis CA, O’Mahony L, Sanak M, Dahlen S, Woszczek G. Current perspective on eicosanoids in asthma and allergic diseases: EAACI Task Force consensus report, part I. Allergy 2021; 76:114-130. [PMID: 32279330 DOI: 10.1111/all.14295] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 01/03/2020] [Revised: 03/13/2020] [Accepted: 03/25/2020] [Indexed: 12/25/2022]
Abstract
Eicosanoids are biologically active lipid mediators, comprising prostaglandins, leukotrienes, thromboxanes, and lipoxins, involved in several pathophysiological processes relevant to asthma, allergies, and allied diseases. Prostaglandins and leukotrienes are the most studied eicosanoids and established inducers of airway pathophysiology including bronchoconstriction and airway inflammation. Drugs inhibiting the synthesis of lipid mediators or their effects, such as leukotriene synthesis inhibitors, leukotriene receptors antagonists, and more recently prostaglandin D2 receptor antagonists, have been shown to modulate features of asthma and allergic diseases. This review, produced by an European Academy of Allergy and Clinical Immunology (EAACI) task force, highlights our current understanding of eicosanoid biology and its role in mediating human pathology, with a focus on new findings relevant for clinical practice, development of novel therapeutics, and future research opportunities.
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Affiliation(s)
- Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
- Christine Kühne ‐ Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - G. Enrico Rovati
- Department of Pharmaceutical Sciences University of Milan Milan Italy
| | - Zuzana Diamant
- Department of Respiratory Medicine & Allergology Skane University Hospital Lund Sweden
- Department of Respiratory Medicine First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Jargen Schwarze
- Child Life and Health and Centre for Inflammation Research The University of Edinburgh Edinburgh UK
| | - Zuzanna Lukasik
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
| | - Florentina Sava
- London North Genomic Laboratory Hub Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Alba Angelina
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University Madrid Spain
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University Madrid Spain
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
- Christine Kühne ‐ Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - Liam O’Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland
| | - Marek Sanak
- Department of Medicine Jagiellonian University Medical College Krakow Poland
| | - Sven‐Erik Dahlen
- Institute of Environmental Medicine Karolinska Institute Stockholm Sweden
- Centre for Allergy Research Karolinska Institute Stockholm Sweden
| | - Grzegorz Woszczek
- MRC/Asthma UK Centre in Allergic Mechanisms of Asthma School of Immunology & Microbial Sciences King's College London London UK
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De Craemer AS, Lukasik Z, Meuris L, Deroo L, Renson T, De Hooge M, Carron P, Van Hecke A, Callewaert N, Van den Bosch F, Elewaut D. FRI0304 SERUM IGG-UNDERGALACTOSYLATION PROFILES REFLECT CUMULATIVE EXPOSURE TO SYSTEMIC INFLAMMATION IN SPONDYLOARTHRITIS PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3365] [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
Background:Inflammation in spondyloarthritis (SpA) is often not reflected by elevated acute phase reactants such as C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR). It has been shown that IgG glycosylation patterns are subject to specific alterations (i.e. undergalactosylation) in chronic inflammatory diseases. Since these changes only occur in persistent inflammatory processes, lasting at least one to two t1/2of IgG (24 days), it was hypothesized that IgG-glycan profiles could serve as a surrogate marker for chronic inflammation in SpA patients.Objectives:To assess the value of serum IgG-undergalactosylation in SpA patients in relation to outcome measures for disease activity, determined by patient reported outcomes, serum inflammatory markers and imaging outcomes.Methods:Serum samples were obtained from SpA patients at the baseline visit of Be-Giant: a Belgian observational cohort including SpA patients who fulfill the ASAS classification criteria for axial or peripheral SpA. IgG Fc N-glycans were released directly in whole serum by endo-β-N-acetyl-glucosaminidase fromStreptococcus pyogenes(EndoS), fluorescently labeled with ATPS and analyzed by capillary electrophoresis, rendering glycan profiles with six peaks (Figure 1). Relative peak heights were combined in the undergalactosylation score (UGS), capturing the relative upregulation of non-galactosylated glycans normalized to the total peak height (1). Baseline radiographs (X-SIJ) and magnetic resonance images (MRI) of the sacroiliac joints (SIJ) were assessed by three calibrated readers for sacroiliitis (fulfillment of the modified New York criteria; grading 0 to 4 per SIJ) and for inflammatory lesions according to the Spondyloarthritis Research Consortium of Canada (SPARCC) method (score from 0 – 72) respectively. Grades and inflammatory lesions that were seen by at least 2 readers were used for further analysis.Figure 1.Example of a serum IgG-specific glycan profile. Adapted from (1), with permission.Results:Glycan profiles were obtained from 376 SpA patients; UGS was scaled (mean = 0, SD = 1) for further analysis. UGS was independently associated with ASDAS-CRP (β1= 0.15, 95% CI 0.04 – 0.26, p = 0.006) and BASFI (β1= 0.44, 95% CI 0.16 – 0.72, p = 0.002) but not with BASDAI (β1= 0.12, 95% CI -0.13 – 0.38, p = 0.34). UGS showed a weak to moderate correlation with CRP (Rs= 0.30, p < 0.001) and ESR (Rs= 0.27, p <0.001). In axial SpA, UGS was significantly higher in patients with ankylosing spondylitis compared to non-radiographic axial SpA (OR = 2.41, 95% CI 1.60 – 3.73, p < 0.001) and showed an independent association with the total grading of the SIJ (β1= 0.44, 95% CI 0.09 – 0.80, p = 0.01, Figure 2) and SPARCC score (β1= 2.64, 95% CI 0.98 – 4.31, p = 0.002). All models were adjusted for age, gender, BMI, CRP, anti-TNF treatment and symptom duration.Conclusion:This study shows and independent association of serum IgG undergalactosylation with disease activity and functional impairment in SpA patients. Moreover, UGS was significantly higher in advanced compared to early-stage axial disease and therefore may reflect the cumulative exposure to systemic inflammation.References:[1]Vanderschaeghe D, Meuris L, Raes T, et al. Endoglycosidase S Enables a Highly Simplified Clinical Chemistry Procedure for Direct Assessment of Serum IgG Undergalactosylation in Chronic Inflammatory Disease. Mol Cell Proteomics. 2018;17(12):2508-17.Figure 2.Correlation between UGS and X-SIJ total grading of sacroiliitis. R = Spearman’s correlation coefficient.Disclosure of Interests:Ann-Sophie De Craemer: None declared, Zuzanna Lukasik: None declared, Leander Meuris: None declared, Liselotte Deroo: None declared, Thomas Renson: None declared, Manouk de Hooge: None declared, Philippe Carron: None declared, Annelies Van Hecke: None declared, Nico Callewaert: None declared, Filip van den Bosch Consultant of: AbbVie, Celgene Corporation, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, and UCB, Speakers bureau: AbbVie, Celgene Corporation, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, and UCB, Dirk Elewaut: None declared
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Lukasik Z, Elewaut D, Venken K. MAIT Cells Come to the Rescue in Cancer Immunotherapy? Cancers (Basel) 2020; 12:cancers12020413. [PMID: 32053875 PMCID: PMC7072265 DOI: 10.3390/cancers12020413] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 01/07/2020] [Revised: 02/02/2020] [Accepted: 02/07/2020] [Indexed: 12/11/2022] Open
Abstract
Recent progress in immunobiology has led to the observation that, among cells classically categorized as the typical representatives of the adaptive immune system, i.e., T cells, some possess the phenotype of innate cells. Invariant T cells are characterized by T cell receptors recognizing a limited range of non-peptide antigens, presented only in the context of particular molecules. Mucosal-associated invariant T cells (MAIT cells) are an example of such unconventional cells. In humans, they constitute between 1% and 8% of the peripheral blood T lymphocytes and are further enriched in mucosal tissues, mesenteric lymph nodes, and liver, where they can account for even 40% of all the T cells. MAIT cells recognize antigens in the context of major histocompatibility complex class I-related protein (MR1). Upon activation, they instantly release pro-inflammatory cytokines and mediate cytolytic function towards bacterially infected cells. As such, they have been a rapidly evolving research topic not only in the field of infectious diseases but also in the context of many chronic inflammatory diseases and, more recently, in immuno-oncology. Novel findings suggest that MAIT cells function could also be modulated by endogenous ligands and drugs, making them an attractive target for therapeutic approaches. In this review, we summarize the current understanding of MAIT cell biology, their role in health and disease and discuss their future potential in cancer immunotherapy. This is discussed through the prism of knowledge and experiences with invariant natural killer T cells (iNKT)—another prominent unconventional T cell subset that shares many features with MAIT cells.
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Affiliation(s)
- Zuzanna Lukasik
- Department of Internal Medicine and Pediatrics (Rheumatology Unit), Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent 9052, Belgium
| | - Dirk Elewaut
- Department of Internal Medicine and Pediatrics (Rheumatology Unit), Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent 9052, Belgium
| | - Koen Venken
- Department of Internal Medicine and Pediatrics (Rheumatology Unit), Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent 9052, Belgium
- Correspondence:
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Lunjani N, Satitsuksanoa P, Lukasik Z, Sokolowska M, Eiwegger T, O'Mahony L. Recent developments and highlights in mechanisms of allergic diseases: Microbiome. Allergy 2018; 73:2314-2327. [PMID: 30325537 DOI: 10.1111/all.13634] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [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: 08/09/2018] [Revised: 09/11/2018] [Accepted: 10/05/2018] [Indexed: 12/13/2022]
Abstract
All body surfaces are exposed to a wide variety of microbes, which significantly influence immune reactivity within the host. This review provides an update on some of the critical novel findings that have been published on the influence of the microbiome on atopic dermatitis, food allergy and asthma. Microbial dysbiosis has consistently been observed in the skin, gut and lungs of patients with atopic dermatitis, food allergy and asthma, respectively, and the role of specific microbes in allergic disorders is being intensively investigated. However, many of these discoveries have yet to be translated into routine clinical practice.
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Affiliation(s)
- Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- University of Cape Town; Cape Town South Africa
| | | | - Zuzanna Lukasik
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - Thomas Eiwegger
- Program in Translational Medicine; The Hospital for Sick Children; Toronto Ontario Canada
- Department of Immunology; The University of Toronto; Toronto Ontario Canada
- Division of Immunology and Allergy; Food allergy and Anaphylaxis Program; The Department of Paediatrics; The Hospital for Sick Children; Toronto Ontario Canada
| | - Liam O'Mahony
- Departments of Medicine and Microbiology; APC Microbiome Ireland; National University of Ireland; Cork Ireland
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