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Bradford HF, McDonnell TCR, Stewart A, Skelton A, Ng J, Baig Z, Fraternali F, Dunn-Walters D, Isenberg DA, Khan AR, Mauro C, Mauri C. Thioredoxin is a metabolic rheostat controlling regulatory B cells. Nat Immunol 2024; 25:873-885. [PMID: 38553615 PMCID: PMC11065695 DOI: 10.1038/s41590-024-01798-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/28/2024] [Indexed: 05/04/2024]
Abstract
Metabolic programming is important for B cell fate, but the bioenergetic requirement for regulatory B (Breg) cell differentiation and function is unknown. Here we show that Breg cell differentiation, unlike non-Breg cells, relies on mitochondrial electron transport and homeostatic levels of reactive oxygen species (ROS). Single-cell RNA sequencing analysis revealed that TXN, encoding the metabolic redox protein thioredoxin (Trx), is highly expressed by Breg cells, unlike Trx inhibitor TXNIP which was downregulated. Pharmacological inhibition or gene silencing of TXN resulted in mitochondrial membrane depolarization and increased ROS levels, selectively suppressing Breg cell differentiation and function while favoring pro-inflammatory B cell differentiation. Patients with systemic lupus erythematosus (SLE), characterized by Breg cell deficiencies, present with B cell mitochondrial membrane depolarization, elevated ROS and fewer Trx+ B cells. Exogenous Trx stimulation restored Breg cells and mitochondrial membrane polarization in SLE B cells to healthy B cell levels, indicating Trx insufficiency underlies Breg cell impairment in patients with SLE.
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Affiliation(s)
- Hannah F Bradford
- Institute of Immunity and Transplantation, Pears Building, UCL Division of Infection and Immunity, University College London, London, UK.
| | | | - Alexander Stewart
- School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | | | - Joseph Ng
- Institute of Structural and Molecular Biology, University College London, London, UK
| | - Zara Baig
- Institute of Immunity and Transplantation, Pears Building, UCL Division of Infection and Immunity, University College London, London, UK
| | - Franca Fraternali
- Institute of Structural and Molecular Biology, University College London, London, UK
| | | | - David A Isenberg
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | | | - Claudio Mauro
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Claudia Mauri
- Institute of Immunity and Transplantation, Pears Building, UCL Division of Infection and Immunity, University College London, London, UK.
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Ng JCF, Montamat Garcia G, Stewart AT, Blair P, Mauri C, Dunn-Walters DK, Fraternali F. sciCSR infers B cell state transition and predicts class-switch recombination dynamics using single-cell transcriptomic data. Nat Methods 2024; 21:823-834. [PMID: 37932398 PMCID: PMC11093741 DOI: 10.1038/s41592-023-02060-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/02/2023] [Indexed: 11/08/2023]
Abstract
Class-switch recombination (CSR) is an integral part of B cell maturation. Here we present sciCSR (pronounced 'scissor', single-cell inference of class-switch recombination), a computational pipeline that analyzes CSR events and dynamics of B cells from single-cell RNA sequencing (scRNA-seq) experiments. Validated on both simulated and real data, sciCSR re-analyzes scRNA-seq alignments to differentiate productive heavy-chain immunoglobulin transcripts from germline 'sterile' transcripts. From a snapshot of B cell scRNA-seq data, a Markov state model is built to infer the dynamics and direction of CSR. Applying sciCSR on severe acute respiratory syndrome coronavirus 2 vaccination time-course scRNA-seq data, we observe that sciCSR predicts, using data from an earlier time point in the collected time-course, the isotype distribution of B cell receptor repertoires of subsequent time points with high accuracy (cosine similarity ~0.9). Using processes specific to B cells, sciCSR identifies transitions that are often missed by conventional RNA velocity analyses and can reveal insights into the dynamics of B cell CSR during immune response.
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Affiliation(s)
- Joseph C F Ng
- Department of Structural and Molecular Biology, Division of Biosciences and Institute of Structural and Molecular Biology, University College London, London, UK.
| | - Guillem Montamat Garcia
- Division of Infection and Immunity and Institute of Immunity and Transplantation, Royal Free Hospital, University College London, London, UK
| | | | - Paul Blair
- Division of Infection and Immunity and Institute of Immunity and Transplantation, Royal Free Hospital, University College London, London, UK
| | - Claudia Mauri
- Division of Infection and Immunity and Institute of Immunity and Transplantation, Royal Free Hospital, University College London, London, UK
| | | | - Franca Fraternali
- Department of Structural and Molecular Biology, Division of Biosciences and Institute of Structural and Molecular Biology, University College London, London, UK.
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3
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Bitoun S, Hässler S, Ternant D, Szely N, Gleizes A, Richez C, Soubrier M, Avouac J, Brocq O, Sellam J, de Vries N, Huizinga TWJ, Jury EC, Manson JJ, Mauri C, Matucci A, Hacein Bey Abina S, Mulleman D, Pallardy M, Broët P, Mariette X. Response to Biologic Drugs in Patients With Rheumatoid Arthritis and Antidrug Antibodies. JAMA Netw Open 2023; 6:e2323098. [PMID: 37436748 DOI: 10.1001/jamanetworkopen.2023.23098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
Importance There are conflicting data on the association of antidrug antibodies with response to biologic disease-modifying antirheumatic drugs (bDMARDs) in rheumatoid arthritis (RA). Objective To analyze the association of antidrug antibodies with response to treatment for RA. Design, Setting, and Participants This cohort study analyzed data from the ABI-RA (Anti-Biopharmaceutical Immunization: Prediction and Analysis of Clinical Relevance to Minimize the Risk of Immunization in Rheumatoid Arthritis Patients) multicentric, open, prospective study of patients with RA from 27 recruiting centers in 4 European countries (France, Italy, the Netherlands, and the UK). Eligible patients were 18 years or older, had RA diagnosis, and were initiating a new bDMARD. Recruitment spanned from March 3, 2014, to June 21, 2016. The study was completed in June 2018, and data were analyzed in June 2022. Exposures Patients were treated with a new bDMARD: adalimumab, infliximab (grouped as anti-tumor necrosis factor [TNF] monoclonal antibodies [mAbs]), etanercept, tocilizumab, and rituximab according to the choice of the treating physician. Main Outcomes and Measures The primary outcome was the association of antidrug antibody positivity with EULAR (European Alliance of Associations for Rheumatology; formerly, European League Against Rheumatism) response to treatment at month 12 assessed through univariate logistic regression. The secondary end points were the EULAR response at month 6 and at visits from month 6 to months 15 to 18 using generalized estimating equation models. Detection of antidrug antibody serum levels was performed at months 1, 3, 6, 12, and 15 to 18 using electrochemiluminescence (Meso Scale Discovery) and drug concentration for anti-TNF mAbs, and etanercept in the serum was measured using enzyme-linked immunosorbent assay. Results Of the 254 patients recruited, 230 (mean [SD] age, 54.3 [13.7] years; 177 females [77.0%]) were analyzed. At month 12, antidrug antibody positivity was 38.2% in patients who were treated with anti-TNF mAbs, 6.1% with etanercept, 50.0% with rituximab, and 20.0% with tocilizumab. There was an inverse association between antidrug antibody positivity (odds ratio [OR], 0.19; 95% CI, 0.09-0.38; P < .001) directed against all biologic drugs and EULAR response at month 12. Analyzing all the visits starting at month 6 using generalized estimating equation models confirmed the inverse association between antidrug antibody positivity and EULAR response (OR, 0.35; 95% CI, 0.18-0.65; P < .001). A similar association was found for tocilizumab alone (OR, 0.18; 95% CI, 0.04-0.83; P = .03). In the multivariable analysis, antidrug antibodies, body mass index, and rheumatoid factor were independently inversely associated with response to treatment. There was a significantly higher drug concentration of anti-TNF mAbs in patients with antidrug antibody-negative vs antidrug antibody-positive status (mean difference, -9.6 [95% CI, -12.4 to -6.9] mg/L; P < 001). Drug concentrations of etanercept (mean difference, 0.70 [95% CI, 0.2-1.2] mg/L; P = .005) and adalimumab (mean difference, 1.8 [95% CI, 0.4-3.2] mg/L; P = .01) were lower in nonresponders vs responders. Methotrexate comedication at baseline was inversely associated with antidrug antibodies (OR, 0.50; 95% CI, 0.25-1.00; P = .05). Conclusions and Relevance Results of this prospective cohort study suggest an association between antidrug antibodies and nonresponse to bDMARDs in patients with RA. Monitoring antidrug antibodies could be considered in the treatment of these patients, particularly nonresponders to biologic RA drugs.
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Affiliation(s)
- Samuel Bitoun
- Rheumatology Department, Université Paris-Saclay, Institut National de la Santé et de la Recherche Médicale (INSERM) U1184, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Fédération Hospitalo Universitaire Cancer and Autoimmunity Relationships, Paris, France
| | - Signe Hässler
- Université Paris-Saclay, INSERM U1018, Centre de Recherche en Epidémiologie et Santé des Populations, Paris, France
- INSERM Unité Mixte de Recherche (UMR) 959, Immunology-Immunopathology-Immunotherapy (i3), Sorbonne Université, Paris, France
- APHP, Hôpital Pitié Salpêtrière, Biotherapy (CIC-BTi), Paris, France
| | - David Ternant
- EA6295 NanoMedicines and NanoProbes, University of Tours, Tours, France
| | - Natacha Szely
- Université Paris-Saclay, INSERM, Inflammation, Microbiome, Immunosurveillance, Faculty of Pharmacy, Paris, France
| | - Aude Gleizes
- Clinical Immunology Laboratory, Groupe Hospitalier Universitaire Paris-Saclay, Hôpital Bicêtre, APHP, Paris, France
- Université Paris Cité, Centre National de la Recherche Scientifique, INSERM, Unité des Technologies Chimiques et Biologiques pour la Santé, Paris, France
- Unité de Formation et de Recherche de Pharmacie, Université Paris-Saclay, Paris, France
| | - Christophe Richez
- Rheumatology Department, Centre Hospitalier Universitaire (CHU) de Bordeaux-GH Pellegrin, Bordeaux, France
| | - Martin Soubrier
- Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Jérome Avouac
- Rheumatology Department, Hôpital Cochin, APHP, Centre-Université de Paris Cité, Paris, France
| | - Olivier Brocq
- Rheumatology Department, Hôpital Princesse Grâce de Monaco, Monaco
| | - Jérémie Sellam
- Rheumatology Department, Hôpital Saint-Antoine, APHP, Sorbonne University, INSERM UMR 938, Paris, France
| | - Niek de Vries
- Rheumatology and Clinical Immunology, Amsterdam UMC, AMC University of Amsterdam, Amsterdam, the Netherlands
| | - Tom W J Huizinga
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Elizabeth C Jury
- Centre for Rheumatology Research, University College London, London, England
| | - Jessica J Manson
- Department of Rheumatology, University College London Hospital, London, England
| | - Claudia Mauri
- Division of Infection, Immunity and Transplantation, University College London, London, England
| | - Andrea Matucci
- Department of Immunology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Salima Hacein Bey Abina
- Clinical Immunology Laboratory, Groupe Hospitalier Universitaire Paris-Saclay, Hôpital Bicêtre, APHP, Paris, France
- Université Paris Cité, Centre National de la Recherche Scientifique, INSERM, Unité des Technologies Chimiques et Biologiques pour la Santé, Paris, France
| | - Denis Mulleman
- EA6295 NanoMedicines and NanoProbes, University of Tours, Tours, France
| | - Marc Pallardy
- Université Paris-Saclay, INSERM, Inflammation, Microbiome, Immunosurveillance, Faculty of Pharmacy, Paris, France
| | - Philippe Broët
- Université Paris-Saclay, INSERM U1018, Centre de Recherche en Epidémiologie et Santé des Populations, Paris, France
| | - Xavier Mariette
- Rheumatology Department, Université Paris-Saclay, Institut National de la Santé et de la Recherche Médicale (INSERM) U1184, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Fédération Hospitalo Universitaire Cancer and Autoimmunity Relationships, Paris, France
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Bradford HF, Haljasmägi L, Menon M, McDonnell TCR, Särekannu K, Vanker M, Peterson P, Wincup C, Abida R, Gonzalez RF, Bondet V, Duffy D, Isenberg DA, Kisand K, Mauri C. Inactive disease in patients with lupus is linked to autoantibodies to type I interferons that normalize blood IFNα and B cell subsets. Cell Rep Med 2023; 4:100894. [PMID: 36652906 PMCID: PMC9873953 DOI: 10.1016/j.xcrm.2022.100894] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/28/2022] [Accepted: 12/13/2022] [Indexed: 01/18/2023]
Abstract
Systemic lupus erythematosus (SLE) is characterized by increased expression of type I interferon (IFN)-regulated genes in 50%-75% of patients. We report that out of 501 patients with SLE analyzed, 73 (14%) present autoantibodies against IFNα (anti-IFN-Abs). The presence of neutralizing-anti-IFN-Abs in 4.2% of patients inversely correlates with low circulating IFNα protein levels, inhibition of IFN-I downstream gene signatures, and inactive global disease score. Hallmarks of SLE pathogenesis, including increased immature, double-negative plasmablast B cell populations and reduction in regulatory B cell (Breg) frequencies, were normalized in patients with neutralizing anti-IFN-Abs compared with other patient groups. Immunoglobulin G (IgG) purified from sera of patients with SLE with neutralizing anti-IFN-Abs impedes CpGC-driven IFNα-dependent differentiation of B cells into immature B cells and plasmablasts, thus recapitulating the neutralizing effect of anti-IFN-Abs on B cell differentiation in vitro. Our findings highlight a role for neutralizing anti-IFN-Abs in controlling SLE pathogenesis and support the use of IFN-targeting therapies in patients with SLE lacking neutralizing-anti-IFN-Abs.
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Affiliation(s)
- Hannah F Bradford
- Division of Infection and Immunity and Institute of Immunity and Transplantation, Royal Free Hospital, University College London, London NW3 2PP, UK; Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6JF, UK.
| | - Liis Haljasmägi
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Madhvi Menon
- Lydia Becker Institute of Immunology and Inflammation, Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester M13 9PL, UK.
| | - Thomas C R McDonnell
- Department of Biochemical Engineering, University College London, London WC1E 6BT, UK
| | - Karita Särekannu
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Martti Vanker
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Pärt Peterson
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Chris Wincup
- Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6JF, UK
| | - Rym Abida
- Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6JF, UK
| | | | - Vincent Bondet
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Darragh Duffy
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - David A Isenberg
- Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6JF, UK
| | - Kai Kisand
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia.
| | - Claudia Mauri
- Division of Infection and Immunity and Institute of Immunity and Transplantation, Royal Free Hospital, University College London, London NW3 2PP, UK; Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6JF, UK.
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5
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van Lessen M, Mardaryev A, Mauri C, Broadley D, Bertolini M, Edelkamp J, Paus R, Bíró T. 842 Novel human skin organ culture models for the identification and characterization of anti-aging actives ex vivo. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.856] [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: 10/17/2022]
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Piper CJM, Mauri C. 25-hydroxycholesterol: Gatekeeper of intestinal IgA. Immunity 2021; 54:2182-2185. [PMID: 34644552 DOI: 10.1016/j.immuni.2021.09.017] [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: 10/20/2022]
Abstract
High levels of cholesterol and diets high in fat are associated with immune dysfunction and inflammatory disease. In this issue of Immunity, Trindade et al. (2021) report how the cholesterol metabolite 25-hydroxycholesterol restrains IgA plasma cell differentiation from germinal-center B cells in the Peyer's patches through regulation of the sterol-sensing transcription factor SREBP2, independently of EBI2-mediated migration.
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Affiliation(s)
- Christopher J M Piper
- Centre for Rheumatology, Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK
| | - Claudia Mauri
- Centre for Rheumatology, Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK.
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7
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Bondet V, Rodero MP, Posseme C, Bost P, Decalf J, Haljasmägi L, Bekaddour N, Rice GI, Upasani V, Herbeuval JP, Reynolds JA, Briggs TA, Bruce IN, Mauri C, Isenberg D, Menon M, Hunt D, Schwikowski B, Mariette X, Pol S, Rozenberg F, Cantaert T, Eric Gottenberg J, Kisand K, Duffy D. Differential levels of IFNα subtypes in autoimmunity and viral infection. Cytokine 2021; 144:155533. [PMID: 33941444 PMCID: PMC7614897 DOI: 10.1016/j.cyto.2021.155533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
Type I interferons are essential for host response to viral infections, while dysregulation of their response can result in autoinflammation or autoimmunity. Among IFNα (alpha) responses, 13 subtypes exist that signal through the same receptor, but have been reported to have different effector functions. However, the lack of available tools for discriminating these closely related subtypes, in particular at the protein level, has restricted the study of their differential roles in disease. We developed a digital ELISA with specificity and high sensitivity for the IFNα2 subtype. Application of this assay, in parallel with our previously described pan-IFNα assay, allowed us to study different IFNα protein responses following cellular stimulation and in diverse patient cohorts. We observed different ratios of IFNα protein responses between viral infection and autoimmune patients. This analysis also revealed a small percentage of autoimmune patients with high IFNα2 protein measurements but low pan-IFNα measurements. Correlation with an ISG score and functional activity showed that in this small sub group of patients, IFNα2 protein measurements did not reflect its biological activity. This unusual phenotype was partly explained by the presence of anti-IFNα auto-antibodies in a subset of autoimmune patients. This study reports ultrasensitive assays for the study of IFNα proteins in patient samples and highlights the insights that can be obtained from the use of multiple phenotypic readouts in translational and clinical studies.
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Affiliation(s)
- Vincent Bondet
- Translational Immunology Lab, Institut Pasteur, Paris, France
| | - Mathieu P Rodero
- Chimie & Biologie, Modélisation et Immunologie pour la Thérapie (CBMIT), Université de Paris, CNRS, UMR8601, Paris, France
| | - Céline Posseme
- Translational Immunology Lab, Institut Pasteur, Paris, France; Frontiers of Innovation in Research and Education PhD program, CRI doctoral school, Université de Paris, Paris 75005, France
| | - Pierre Bost
- Systems Biology Group, Department of Computational Biology and USR 3756, Institut Pasteur and CNRS, Paris 75015, France; Sorbonne Universite, Complexite du vivant, Paris 75005, France
| | - Jérémie Decalf
- Translational Immunology Lab, Institut Pasteur, Paris, France
| | - Liis Haljasmägi
- Molecular Pathology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Nassima Bekaddour
- Chimie & Biologie, Modélisation et Immunologie pour la Thérapie (CBMIT), Université de Paris, CNRS, UMR8601, Paris, France
| | - Gillian I Rice
- Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, UK; Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Vinit Upasani
- Immunology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Jean-Philippe Herbeuval
- Chimie & Biologie, Modélisation et Immunologie pour la Thérapie (CBMIT), Université de Paris, CNRS, UMR8601, Paris, France
| | - John A Reynolds
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK; Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Rheumatology Department, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Tracy A Briggs
- Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, UK; Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Ian N Bruce
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Claudia Mauri
- Centre for Rheumatology Research, Division of Medicine, University College of London, London WC1E 6JF, UK
| | - David Isenberg
- Centre for Rheumatology Research, Division of Medicine, University College of London, London WC1E 6JF, UK
| | - Madhvi Menon
- Centre for Rheumatology Research, Division of Medicine, University College of London, London WC1E 6JF, UK; Lydia Becker Institute of Immunology and Inflammation, Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, University of Manchester, UK
| | - David Hunt
- Centre for Genomic and Experimental Medicine, Medical Research Council Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, UK
| | - Benno Schwikowski
- Systems Biology Group, Department of Computational Biology and USR 3756, Institut Pasteur and CNRS, Paris 75015, France; Sorbonne Universite, Complexite du vivant, Paris 75005, France
| | - Xavier Mariette
- Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, INSERM UMR1184, Le Kremlin-Bicetre, France
| | - Stanislas Pol
- Unite d'Hépatologie, Assistance Publique-Hopitaux de Paris (AP-HP), Hopital Cochin, Paris, France
| | - Flore Rozenberg
- Department of Virology, APHP-CUP, Université de Paris, Paris, France
| | - Tineke Cantaert
- Immunology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - J Eric Gottenberg
- Faculté de Médecine de l'Université de Strasbourg, Strasbourg, France
| | - Kai Kisand
- Molecular Pathology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Darragh Duffy
- Translational Immunology Lab, Institut Pasteur, Paris, France.
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Matei DE, Menon M, Alber DG, Smith AM, Nedjat-Shokouhi B, Fasano A, Magill L, Duhlin A, Bitoun S, Gleizes A, Hacein-Bey-Abina S, Manson JJ, Rosser EC, Klein N, Blair PA, Mauri C. Intestinal barrier dysfunction plays an integral role in arthritis pathology and can be targeted to ameliorate disease. Med (N Y) 2021; 2:864-883.e9. [PMID: 34296202 PMCID: PMC8280953 DOI: 10.1016/j.medj.2021.04.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/22/2021] [Accepted: 04/15/2021] [Indexed: 12/29/2022]
Abstract
Background Evidence suggests an important role for gut-microbiota dysbiosis in the development of rheumatoid arthritis (RA). The link between changes in gut bacteria and the development of joint inflammation is missing. Here, we address whether there are changes to the gut environment and how they contribute to arthritis pathogenesis. Methods We analyzed changes in markers of gut permeability, damage, and inflammation in peripheral blood and serum of RA patients. Serum, intestines, and lymphoid organs isolated from K/BxN mice with spontaneous arthritis or from wild-type, genetically modified interleukin (IL)-10R−/−or claudin-8−/−mice with induced arthritis were analyzed by immunofluorescence/histology, ELISA, and flow cytometry. Findings RA patients display increased levels of serum markers of gut permeability and damage and cellular gut-homing markers, both parameters positively correlating with disease severity. Arthritic mice display increased gut permeability from early stages of disease, as well as bacterial translocation, inflammatory gut damage, increases in interferon γ (IFNγ)+and decreases in IL-10+intestinal-infiltrating leukocyte frequency, and reduced intestinal epithelial IL-10R expression. Mechanistically, both arthritogenic bacteria and leukocytes are required to disrupt gut-barrier integrity. We show that exposing intestinal organoids to IFNγ reduces IL-10R expression by epithelial cells and that mice lacking epithelial IL-10R display increased intestinal permeability and exacerbated arthritis. Claudin-8−/−mice with constitutively increased gut permeability also develop worse joint disease. Treatment of mice with AT-1001, a molecule that prevents development of gut permeability, ameliorates arthritis. Conclusions We suggest that breakdown of gut-barrier integrity contributes to arthritis development and propose restoration of gut-barrier homeostasis as a new therapeutic approach for RA. Funding Funded by Versus Arthritis (21140 and 21257) and UKRI/MRC (MR/T000910/1). Serum gut-permeability markers LPB, LPS, and I-FABP are increased in RA Mice with arthritis have increased gut permeability and intestinal inflammation Both bacteria and leukocytes are needed to disrupt gut-barrier integrity Prevention of gut-barrier dysfunction in arthritis ameliorates joint inflammation
Rheumatoid arthritis is an autoimmune disorder characterized by chronic joint inflammation. Accumulating evidence suggests that changes in the composition of the bacteria residing in the gut could be responsible for joint inflammation. Currently, it is unclear how bacteria or their products instruct cells of the immune system to become harmful and induce arthritis. Researchers at University College London have shown that, in arthritis, there is profound damage to the gut lining, which fails to work properly as a barrier, as well as an accumulation in the gut of white blood cells that cause inflammation. The authors show that, in arthritis, bacteria cross the prohibited border of the intestinal lining and that repairing gut permeability defects with specific drugs inhibits joint inflammation.
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Affiliation(s)
- Diana E Matei
- Centre for Rheumatology, Division of Medicine and Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK
| | - Madhvi Menon
- Centre for Rheumatology, Division of Medicine and Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK.,Evergrande Center for Immunologic Diseases, Harvard Medical School, Boston, MA 02115, USA.,Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.,Lydia Becker Institute of Immunology and Inflammation, Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester M13 9PL, UK
| | - Dagmar G Alber
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Andrew M Smith
- Eastman Dental Institute, School of Life and Medical Sciences, UCL, London WC1X 8LD, UK
| | - Bahman Nedjat-Shokouhi
- Eastman Dental Institute, School of Life and Medical Sciences, UCL, London WC1X 8LD, UK.,Centre for Molecular Medicine, Division of Medicine, UCL, London WC1E 6BT, UK
| | - Alessio Fasano
- MassGeneral Hospital for Children, Boston, MA 02114, USA
| | - Laura Magill
- Centre for Rheumatology, Division of Medicine and Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK
| | - Amanda Duhlin
- Centre for Rheumatology, Division of Medicine and Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK
| | - Samuel Bitoun
- Rheumatology Department, Bicêtre Hospital AP-HP, Université Paris-Saclay and INSERM UMR 1184 IMVA 78 Avenue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Aude Gleizes
- Université de Paris, CNRS, INSERM, UTCBS, Unité des Technologies Chimiques et Biologiques pour la Santé, 75006 Paris, France.,Clinical Immunology Laboratory, Groupe Hospitalier Universitaire Paris-Sud, Hôpital Kremlin-Bicêtre, Assistance Publique-Hôpitaux de Paris, 94270 Le-Kremlin-Bicêtre, France
| | - Salima Hacein-Bey-Abina
- Université de Paris, CNRS, INSERM, UTCBS, Unité des Technologies Chimiques et Biologiques pour la Santé, 75006 Paris, France.,Assistance Publique - Hôpitaux Paris Saclay, Clinical Immunology Laboratory, Hôpital Bicêtre, 94275 Le-Kremlin-Bicêtre, France
| | - Jessica J Manson
- Department of Rheumatology, University College London Hospital, London NW1 2BU, UK
| | - Elizabeth C Rosser
- Centre for Rheumatology, Division of Medicine and Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK.,Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH and GOSH, London WC1E 6JF, UK
| | | | - Nigel Klein
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Paul A Blair
- Centre for Rheumatology, Division of Medicine and Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK
| | - Claudia Mauri
- Centre for Rheumatology, Division of Medicine and Division of Infection and Immunity and Transplantation, University College London, London WC1E 6JF, UK
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9
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Abstract
B cells are well known as critical mediators of humoral immune responses via the production of antibodies. However, numerous studies have also identified populations of B cells that are characterized by their anti-inflammatory properties. These "regulatory B cells" restrain excessive inflammatory responses in a wide range of health conditions. A significant knowledge gap remains concerning the nature of the signals that determine whether a B cell exerts a pro-inflammatory or anti-inflammatory function. In this perspective, we explore the concept that in addition to the cytokine microenvironment, intracellular and extracellular metabolic signals play a pivotal role in controlling the balance between regulatory and antibody-producing B cell subsets. Determining the metabolites and tissue-specific signals that influence B cell fate could establish novel therapeutic targets for the treatment of diseases where abnormal B cell responses contribute to pathogenesis.
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Affiliation(s)
- Elizabeth C Rosser
- Centre for Adolescent Rheumatology Versus Arthritis at University College London, University College London Hospital and Great Ormond Street Hospital, University College London, London, UK; Centre for Rheumatology Research, Division of Medicine, University College London, London, UK.
| | - Claudia Mauri
- Division of Infection, Immunity and Transplantation, University College London, London, UK
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10
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Affiliation(s)
- Claudia Mauri
- Division of Infection and Immunity and Institute of Immunity and Transplantation, University College London, London, UK
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11
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Hässler S, Bachelet D, Duhaze J, Szely N, Gleizes A, Hacein-Bey Abina S, Aktas O, Auer M, Avouac J, Birchler M, Bouhnik Y, Brocq O, Buck-Martin D, Cadiot G, Carbonnel F, Chowers Y, Comabella M, Derfuss T, De Vries N, Donnellan N, Doukani A, Guger M, Hartung HP, Kubala Havrdova E, Hemmer B, Huizinga T, Ingenhoven K, Hyldgaard-Jensen PE, Jury EC, Khalil M, Kieseier B, Laurén A, Lindberg R, Loercher A, Maggi E, Manson J, Mauri C, Mohand Oumoussa B, Montalban X, Nachury M, Nytrova P, Richez C, Ryner M, Sellebjerg F, Sievers C, Sikkema D, Soubrier M, Tourdot S, Trang C, Vultaggio A, Warnke C, Spindeldreher S, Dönnes P, Hickling TP, Hincelin Mery A, Allez M, Deisenhammer F, Fogdell-Hahn A, Mariette X, Pallardy M, Broët P. Clinicogenomic factors of biotherapy immunogenicity in autoimmune disease: A prospective multicohort study of the ABIRISK consortium. PLoS Med 2020; 17:e1003348. [PMID: 33125391 PMCID: PMC7598520 DOI: 10.1371/journal.pmed.1003348] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 09/18/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Biopharmaceutical products (BPs) are widely used to treat autoimmune diseases, but immunogenicity limits their efficacy for an important proportion of patients. Our knowledge of patient-related factors influencing the occurrence of antidrug antibodies (ADAs) is still limited. METHODS AND FINDINGS The European consortium ABIRISK (Anti-Biopharmaceutical Immunization: prediction and analysis of clinical relevance to minimize the RISK) conducted a clinical and genomic multicohort prospective study of 560 patients with multiple sclerosis (MS, n = 147), rheumatoid arthritis (RA, n = 229), Crohn's disease (n = 148), or ulcerative colitis (n = 36) treated with 8 different biopharmaceuticals (etanercept, n = 84; infliximab, n = 101; adalimumab, n = 153; interferon [IFN]-beta-1a intramuscularly [IM], n = 38; IFN-beta-1a subcutaneously [SC], n = 68; IFN-beta-1b SC, n = 41; rituximab, n = 31; tocilizumab, n = 44) and followed during the first 12 months of therapy for time to ADA development. From the bioclinical data collected, we explored the relationships between patient-related factors and the occurrence of ADAs. Both baseline and time-dependent factors such as concomitant medications were analyzed using Cox proportional hazard regression models. Mean age and disease duration were 35.1 and 0.85 years, respectively, for MS; 54.2 and 3.17 years for RA; and 36.9 and 3.69 years for inflammatory bowel diseases (IBDs). In a multivariate Cox regression model including each of the clinical and genetic factors mentioned hereafter, among the clinical factors, immunosuppressants (adjusted hazard ratio [aHR] = 0.408 [95% confidence interval (CI) 0.253-0.657], p < 0.001) and antibiotics (aHR = 0.121 [0.0437-0.333], p < 0.0001) were independently negatively associated with time to ADA development, whereas infections during the study (aHR = 2.757 [1.616-4.704], p < 0.001) and tobacco smoking (aHR = 2.150 [1.319-3.503], p < 0.01) were positively associated. 351,824 Single-Nucleotide Polymorphisms (SNPs) and 38 imputed Human Leukocyte Antigen (HLA) alleles were analyzed through a genome-wide association study. We found that the HLA-DQA1*05 allele significantly increased the rate of immunogenicity (aHR = 3.9 [1.923-5.976], p < 0.0001 for the homozygotes). Among the 6 genetic variants selected at a 20% false discovery rate (FDR) threshold, the minor allele of rs10508884, which is situated in an intron of the CXCL12 gene, increased the rate of immunogenicity (aHR = 3.804 [2.139-6.764], p < 1 × 10-5 for patients homozygous for the minor allele) and was chosen for validation through a CXCL12 protein enzyme-linked immunosorbent assay (ELISA) on patient serum at baseline before therapy start. CXCL12 protein levels were higher for patients homozygous for the minor allele carrying higher ADA risk (mean: 2,693 pg/ml) than for the other genotypes (mean: 2,317 pg/ml; p = 0.014), and patients with CXCL12 levels above the median in serum were more prone to develop ADAs (aHR = 2.329 [1.106-4.90], p = 0.026). A limitation of the study is the lack of replication; therefore, other studies are required to confirm our findings. CONCLUSION In our study, we found that immunosuppressants and antibiotics were associated with decreased risk of ADA development, whereas tobacco smoking and infections during the study were associated with increased risk. We found that the HLA-DQA1*05 allele was associated with an increased rate of immunogenicity. Moreover, our results suggest a relationship between CXCL12 production and ADA development independent of the disease, which is consistent with its known function in affinity maturation of antibodies and plasma cell survival. Our findings may help physicians in the management of patients receiving biotherapies.
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Affiliation(s)
- Signe Hässler
- CESP, INSERM UMR 1018, Faculty of Medicine, Paris-Sud University, UVSQ, Paris-Saclay University, Villejuif, France
- Sorbonne Université, INSERM UMR 959, Immunology-Immunopathology-Immunotherapy (i3), Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Biotherapy (CIC-BTi), Paris, France
- * E-mail: (SH); (PB)
| | - Delphine Bachelet
- CESP, INSERM UMR 1018, Faculty of Medicine, Paris-Sud University, UVSQ, Paris-Saclay University, Villejuif, France
- Department of Biostatistical Epidemiology and Clinical Research, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris AP-HP.Nord, INSERM CIC-EC 1425, Paris, France
| | - Julianne Duhaze
- CESP, INSERM UMR 1018, Faculty of Medicine, Paris-Sud University, UVSQ, Paris-Saclay University, Villejuif, France
- CHU Ste-Justine Research Center, Montreal, Canada
| | - Natacha Szely
- INSERM UMR 996, Faculty of Pharmacy, Paris-Sud University, Paris-Saclay University, Châtenay-Malabry, France
| | - Aude Gleizes
- INSERM UMR 996, Faculty of Pharmacy, Paris-Sud University, Paris-Saclay University, Châtenay-Malabry, France
- Clinical Immunology Laboratory, AP-HP, Le Kremlin-Bicêtre Hospital, Paris-Sud University Hospitals, Le Kremlin-Bicêtre, France
| | - Salima Hacein-Bey Abina
- Clinical Immunology Laboratory, AP-HP, Le Kremlin-Bicêtre Hospital, Paris-Sud University Hospitals, Le Kremlin-Bicêtre, France
- UTCBS, CNRS UMR 8258, INSERM U1022, Faculty of Pharmacy, Paris-Descartes-Sorbonne-Cite University, Paris, France
| | - Orhan Aktas
- University of Düsseldorf, Medical Faculty, Department of Neurology, Düsseldorf, Germany
| | - Michael Auer
- Innsbruck Medical University, Department of Neurology, Innsbruck, Austria
| | - Jerôme Avouac
- Paris University, Paris Descartes University, INSERM U1016, Paris, France
- Rheumatology department, Cochin Hospital, AP-HP.CUP, Paris, France
| | - Mary Birchler
- GlaxoSmithKline, Clinical Immunology–Biopharm, Collegeville, Pennsylvania, United States of America
| | - Yoram Bouhnik
- AP-HP, Hôpital Beaujon, Paris, France
- GETAID, Paris, France
| | | | | | - Guillaume Cadiot
- GETAID, Paris, France
- Service d'hépato-gastroentérologie, University Hospital of Reims, Reims, France
| | - Franck Carbonnel
- GETAID, Paris, France
- Department of Gastroenterology, AP-HP, Hôpital Kremlin-Bicêtre, France
| | - Yehuda Chowers
- Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport School of Medicine, Technion Israel Institute of Technology, Haifa, Israel; Clinical Research Institute, Rambam Health Care Campus, Haifa, Israel
| | - Manuel Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat). Institut de Recerca Vall d’Hebron (VHIR). Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tobias Derfuss
- Departments of Biomedicine and Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Niek De Vries
- Rheumatology & Clinical Immunology, Amsterdam UMC | AMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Abiba Doukani
- Sorbonne Université, Inserm, UMS Production et Analyse des données en Sciences de la vie et en Santé, UMS 37 PASS, Plateforme Post-génomique de la Pitié-Salpêtrière, P3S, Paris, France
| | - Michael Guger
- Clinic for Neurology 2, Med Campus III, Kepler University Hospital GmbH, Linz, Austria
| | - Hans-Peter Hartung
- University of Düsseldorf, Medical Faculty, Department of Neurology, Düsseldorf, Germany
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Bernhard Hemmer
- Department of Neurology, Technische Universität München, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Tom Huizinga
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Kathleen Ingenhoven
- University of Düsseldorf, Medical Faculty, Department of Neurology, Düsseldorf, Germany
| | - Poul Erik Hyldgaard-Jensen
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elizabeth C. Jury
- Centre for Rheumatology Research, University College London, London, United Kingdom
| | - Michael Khalil
- Department of Neurology, Medical University of Graz, Austria
| | - Bernd Kieseier
- University of Düsseldorf, Medical Faculty, Department of Neurology, Düsseldorf, Germany
| | | | - Raija Lindberg
- Departments of Biomedicine and Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Amy Loercher
- GlaxoSmithKline, Clinical Immunology–Biopharm, Collegeville, Pennsylvania, United States of America
| | - Enrico Maggi
- Dipartimento di Medicina Sperimentale e Clínica, Università di Firenze, Firenze, Italy
- Immunology Area of Bambino Gesù Pediatric Hospital, IRCCS, Rome, Italy
| | - Jessica Manson
- Department of Rheumatology, University College London Hospital, London, United Kingdom
| | - Claudia Mauri
- Centre for Rheumatology Research, University College London, London, United Kingdom
| | - Badreddine Mohand Oumoussa
- Sorbonne Université, Inserm, UMS Production et Analyse des données en Sciences de la vie et en Santé, UMS 37 PASS, Plateforme Post-génomique de la Pitié-Salpêtrière, P3S, Paris, France
| | - Xavier Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat). Institut de Recerca Vall d’Hebron (VHIR). Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- Center for Multiple Sclerosis, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Maria Nachury
- GETAID, Paris, France
- University hospital of Lille, Maladies de l'appareil digestif, Lille, France
| | - Petra Nytrova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Christophe Richez
- Rheumatology Department, CHU de Bordeaux-GH Pellegrin, Bordeaux, France
- UMR CNRS 5164, Bordeaux University, Bordeaux, France
| | - Malin Ryner
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Claudia Sievers
- Departments of Biomedicine and Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Dan Sikkema
- GlaxoSmithKline, Clinical Immunology–Biopharm, Collegeville, Pennsylvania, United States of America
- Current address: Quanterix Corporation, Billerica, Massachusetts, United States of America
| | - Martin Soubrier
- Rheumatology, University Hospital of Clermont Ferrand, Clermont Ferrand, France
| | - Sophie Tourdot
- INSERM UMR 996, Faculty of Pharmacy, Paris-Sud University, Paris-Saclay University, Châtenay-Malabry, France
| | - Caroline Trang
- GETAID, Paris, France
- Institut des maladies de l'Appareil Digestif, University Hospital of Nantes, Nantes, France
| | - Alessandra Vultaggio
- Dipartimento di Medicina Sperimentale e Clínica, Università di Firenze, Firenze, Italy
| | - Clemens Warnke
- University of Düsseldorf, Medical Faculty, Department of Neurology, Düsseldorf, Germany
- Department of Neurology, University Hospital Köln, Köln, Germany
| | - Sebastian Spindeldreher
- Drug Metabolism Pharmacokinetics-Biologics, Novartis Institutes for Biomedical Research, Basel, Switzerland
- Integrated Biologix GmbH, Basel, Switzerland
| | | | - Timothy P. Hickling
- BioMedicine Design, Pfizer, Inc., Andover, Massachusetts, United States of America
| | | | - Matthieu Allez
- GETAID, Paris, France
- Department of Gastroenterology, Hôpital Saint-Louis, AP-HP, Université Paris-Diderot, Paris, France
| | | | - Anna Fogdell-Hahn
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Xavier Mariette
- Centre for Immunology of Viral Infections and Autoimmune Diseases, INSERM UMR 1184, Université Paris-Saclay, AP-HP.Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Marc Pallardy
- INSERM UMR 996, Faculty of Pharmacy, Paris-Sud University, Paris-Saclay University, Châtenay-Malabry, France
| | - Philippe Broët
- CESP, INSERM UMR 1018, Faculty of Medicine, Paris-Sud University, UVSQ, Paris-Saclay University, Villejuif, France
- CHU Ste-Justine Research Center, Montreal, Canada
- AP-HP, Paris-Sud University Hospitals, Paul Brousse Hospital, Villejuif, France
- * E-mail: (SH); (PB)
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12
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Rosser EC, Piper CJM, Matei DE, Blair PA, Rendeiro AF, Orford M, Alber DG, Krausgruber T, Catalan D, Klein N, Manson JJ, Drozdov I, Bock C, Wedderburn LR, Eaton S, Mauri C. Microbiota-Derived Metabolites Suppress Arthritis by Amplifying Aryl-Hydrocarbon Receptor Activation in Regulatory B Cells. Cell Metab 2020; 31:837-851.e10. [PMID: 32213346 PMCID: PMC7156916 DOI: 10.1016/j.cmet.2020.03.003] [Citation(s) in RCA: 259] [Impact Index Per Article: 64.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 12/20/2019] [Accepted: 02/29/2020] [Indexed: 12/19/2022]
Abstract
The differentiation of IL-10-producing regulatory B cells (Bregs) in response to gut-microbiota-derived signals supports the maintenance of tolerance. However, whether microbiota-derived metabolites can modulate Breg suppressive function remains unknown. Here, we demonstrate that rheumatoid arthritis (RA) patients and arthritic mice have a reduction in microbial-derived short-chain fatty acids (SCFAs) compared to healthy controls and that in mice, supplementation with the SCFA butyrate reduces arthritis severity. Butyrate supplementation suppresses arthritis in a Breg-dependent manner by increasing the level of the serotonin-derived metabolite 5-Hydroxyindole-3-acetic acid (5-HIAA), which activates the aryl-hydrocarbon receptor (AhR), a newly discovered transcriptional marker for Breg function. Thus, butyrate supplementation via AhR activation controls a molecular program that supports Breg function while inhibiting germinal center (GC) B cell and plasmablast differentiation. Our study demonstrates that butyrate supplementation may serve as a viable therapy for the amelioration of systemic autoimmune disorders.
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Affiliation(s)
- Elizabeth C Rosser
- Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH and GOSH, London, UK; Centre for Rheumatology Research, Division of Medicine, UCL, London WC1E 6JF, UK; Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
| | | | - Diana E Matei
- Centre for Rheumatology Research, Division of Medicine, UCL, London WC1E 6JF, UK
| | - Paul A Blair
- Centre for Rheumatology Research, Division of Medicine, UCL, London WC1E 6JF, UK
| | - André F Rendeiro
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Michael Orford
- Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Dagmar G Alber
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Thomas Krausgruber
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Diego Catalan
- Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH and GOSH, London, UK; Programa Disciplinario de Inmunología, Facultad de Medicina, Instituto de Ciencias Biomédicas (ICBM), Universidad de Chile, Santiago, Chile
| | - Nigel Klein
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Jessica J Manson
- Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH and GOSH, London, UK; Department of Rheumatology, University College Hospital, London, UK
| | | | - Christoph Bock
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria; Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria; Max Planck Institute for Informatics, Saarland Informatics Campus, Saarbrücken, Germany
| | - Lucy R Wedderburn
- Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH and GOSH, London, UK; Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; NIHR Biomedical Research Centre at Great Ormond Street Hospital, London, UK
| | - Simon Eaton
- Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Claudia Mauri
- Centre for Rheumatology Research, Division of Medicine, UCL, London WC1E 6JF, UK.
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13
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Thomas M, Ponce-Aix S, Navarro A, Riera-Knorrenschild J, Schmidt M, Wiegert E, Kapp K, Wittig B, Mauri C, Dómine Gómez M, Kollmeier J, Sadjadian P, Fröhling KP, Huber RM, Wolf M. Immunotherapeutic maintenance treatment with toll-like receptor 9 agonist lefitolimod in patients with extensive-stage small-cell lung cancer: results from the exploratory, controlled, randomized, international phase II IMPULSE study. Ann Oncol 2019; 29:2076-2084. [PMID: 30137193 PMCID: PMC6225892 DOI: 10.1093/annonc/mdy326] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The immune surveillance reactivator lefitolimod (MGN1703), a DNA-based TLR9 agonist, might foster innate and adaptive immune response and thus improve immune-mediated control of residual cancer disease. The IMPULSE phase II study evaluated the efficacy and safety of lefitolimod as maintenance treatment in extensive-stage small-cell lung cancer (ES-SCLC) after objective response to first-line chemotherapy, an indication with a high unmet medical need and stagnant treatment improvement in the last decades. Patients and methods 103 patients with ES-SCLC and objective tumor response (as per RECIST 1.1) following four cycles of platinum-based first-line induction therapy were randomized to receive either lefitolimod maintenance therapy or local standard of care at a ratio of 3 : 2 until progression or unacceptable toxicity. Results From 103 patients enrolled, 62 were randomized to lefitolimod, 41 to the control arm. Patient demographics and response patterns to first-line therapy were balanced. Lefitolimod exhibited a favorable safety profile and pharmacodynamic assessment confirmed the mode-of-action showing a clear activation of monocytes and production of interferon-gamma-induced protein 10 (IP-10). While in the intent-to-treat (ITT) population no relevant effect of lefitolimod on progression-free and overall survival (OS) could be observed, two predefined patient subgroups indicated promising results, favoring lefitolimod with respect to OS: in patients with a low frequency of activated CD86+ B cells (hazard ratio, HR 0.53, 95% CI: 0.26–1.08; n = 38 of 88 analyzed) and in patients with reported chronic obstructive pulmonary disease (COPD) (HR 0.48, 95% CI: 0.20–1.17, n = 25 of 103). Conclusions The IMPULSE study showed no relevant effect of lefitolimod on the main efficacy end point OS in the ITT, but (1) the expected pharmacodynamic response to lefitolimod, (2) positive OS efficacy signals in two predefined subgroups and (3) a favorable safety profile. These data support further exploration of lefitolimod in SCLC.
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Affiliation(s)
- M Thomas
- Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany.
| | | | - A Navarro
- Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - J Riera-Knorrenschild
- Hämatologie, Onkologie und Immunologie, Klinikum der Philipps Universität Marburg, Marburg, Germany
| | - M Schmidt
- Early & Translational R&D Department, MOLOGEN AG, Berlin, Germany
| | - E Wiegert
- Clinical Science Department, MOLOGEN AG, Berlin, Germany
| | - K Kapp
- Early & Translational R&D Department, MOLOGEN AG, Berlin, Germany
| | - B Wittig
- Advisor, MOLOGEN AG, Berlin, Germany
| | - C Mauri
- Division of Medicine, University College London, London, UK
| | - M Dómine Gómez
- Medical Oncology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J Kollmeier
- Klinik für Pneumonologie, HELIOS Klinikum Emil von Behring GmbH, Berlin, Germany
| | - P Sadjadian
- Abteilung Pneumonologie, Johannes Wesling Klinikum Minden, Minden, Germany
| | - K-P Fröhling
- Klinik für Innere Medizin/Pneumologie, Schlaf- und Beatmungsmedizin, Kath. Klinikum Koblenz-Montabaur, Koblenz, Germany
| | - R M Huber
- Comprehensive Pneumology Center (CPC-M), University of Munich and Thoracic Oncology Centre Munich, Munich, Germany
| | - M Wolf
- Klinikum Kassel, Medizinische Klinik IV, Kassel, Germany
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14
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Piper CJM, Rosser EC, Oleinika K, Nistala K, Krausgruber T, Rendeiro AF, Banos A, Drozdov I, Villa M, Thomson S, Xanthou G, Bock C, Stockinger B, Mauri C. Aryl Hydrocarbon Receptor Contributes to the Transcriptional Program of IL-10-Producing Regulatory B Cells. Cell Rep 2019; 29:1878-1892.e7. [PMID: 31722204 PMCID: PMC6856759 DOI: 10.1016/j.celrep.2019.10.018] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 08/23/2019] [Accepted: 10/03/2019] [Indexed: 12/12/2022] Open
Abstract
Regulatory B cells (Bregs) play a critical role in the control of autoimmunity and inflammation. IL-10 production is the hallmark for the identification of Bregs. However, the molecular determinants that regulate the transcription of IL-10 and control the Breg developmental program remain unknown. Here, we demonstrate that aryl hydrocarbon receptor (AhR) regulates the differentiation and function of IL-10-producing CD19+CD21hiCD24hiBregs and limits their differentiation into B cells that contribute to inflammation. Chromatin profiling and transcriptome analyses show that loss of AhR in B cells reduces expression of IL-10 by skewing the differentiation of CD19+CD21hiCD24hiB cells into a pro-inflammatory program, under Breg-inducing conditions. B cell AhR-deficient mice develop exacerbated arthritis, show significant reductions in IL-10-producing Bregs and regulatory T cells, and show an increase in T helper (Th) 1 and Th17 cells compared with B cell AhR-sufficient mice. Thus, we identify AhR as a relevant contributor to the transcriptional regulation of Breg differentiation.
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Affiliation(s)
- Christopher J M Piper
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Elizabeth C Rosser
- Centre for Rheumatology, Division of Medicine, University College London, London, UK; University College London Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK; Versus Arthritis Centre for Adolescent Rheumatology at University College London, University College London Hospitals and Great Ormond Street Hospital, London, UK
| | - Kristine Oleinika
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Kiran Nistala
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Thomas Krausgruber
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - André F Rendeiro
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Aggelos Banos
- Laboratory of Inflammation and Autoimmunity, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | | | - Matteo Villa
- The Francis Crick Institute, London, NW1 1AT, UK
| | - Scott Thomson
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Georgina Xanthou
- Cellular Immunology Lab, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Christoph Bock
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria; Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria; Max Planck Institute for Informatics, Saarland Informatics Campus, Saarbrücken, Germany
| | | | - Claudia Mauri
- Centre for Rheumatology, Division of Medicine, University College London, London, UK.
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15
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Wincup C, Menon M, Smith E, Schwartz A, Isenberg D, Jury EC, Mauri C. Presence of anti-rituximab antibodies predicts infusion-related reactions in patients with systemic lupus erythematosus. Ann Rheum Dis 2019; 78:1140-1142. [PMID: 30923233 PMCID: PMC6691858 DOI: 10.1136/annrheumdis-2019-215200] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 02/26/2019] [Accepted: 02/28/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Chris Wincup
- Centre for Rheumatology, Division of Medicine, UCL, London, UK
| | - Madhvi Menon
- Centre for Rheumatology, Division of Medicine, UCL, London, UK
| | - Edward Smith
- Centre for Rheumatology, Division of Medicine, UCL, London, UK
| | - Ann Schwartz
- Bioanalysis, Immunogenicity & Biomarkers, IVIVT RD Platform Technology & Science, GlaxoSmithKline Plc, Philadelphia, Pennsylvania, USA
| | - David Isenberg
- Centre for Rheumatology, Division of Medicine, UCL, London, UK
| | | | - Claudia Mauri
- Centre for Rheumatology, Division of Medicine, UCL, London, UK
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16
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Morel J, Herlin C, Amara B, Mauri C, Rouays H, Verollet C, Almeras I, Frasson N, Dupeyron A, Jourdan C, Daures JP, Gelis A. Risk factors of pelvic pressure ulcer recurrence after primary skin flap surgery in people with spinal cord injury. Ann Phys Rehabil Med 2019; 62:77-83. [DOI: 10.1016/j.rehab.2018.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 11/15/2022]
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17
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Abstract
Regulatory B cells (Bregs) suppress immune response via the provision of IL-10. Due to the phenotypic heterogeneity of described Bregs, it is important to have standardized protocols for their isolation and identification. Previous work by our laboratory has shown that the immature B-cell populations in the murine spleen and human peripheral blood produce the highest levels of IL-10 on engagement of CD40, and can suppress pro-inflammatory T-cell differentiation. In this chapter, we describe the methods necessary for the isolation of this subset of Bregs and their activation via CD40 in vitro.
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Affiliation(s)
- Madhvi Menon
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Elizabeth C Rosser
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Claudia Mauri
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK.
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18
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Magill L, Adriani M, Berthou V, Chen K, Gleizes A, Hacein-Bey-Abina S, Hincelin-Mery A, Mariette X, Pallardy M, Spindeldreher S, Szely N, Isenberg DA, Manson JJ, Jury EC, Mauri C. Low Percentage of Signal Regulatory Protein α/β + Memory B Cells in Blood Predicts Development of Anti-drug Antibodies (ADA) in Adalimumab-Treated Rheumatoid Arthritis Patients. Front Immunol 2018; 9:2865. [PMID: 30568660 PMCID: PMC6290031 DOI: 10.3389/fimmu.2018.02865] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 07/19/2018] [Accepted: 11/21/2018] [Indexed: 12/14/2022] Open
Abstract
An important goal for personalized treatment is predicting response to a particular therapeutic. A drawback of biological treatment is immunogenicity and the development of antibodies directed against the drug [anti-drug antibodies (ADA)], which are associated with a poorer clinical outcome. Here we set out to identify a predictive biomarker that discriminates rheumatoid arthritis (RA) patients who are more likely to develop ADA in response to adalimumab, a human monoclonal antibody against tumor necrosis factor (TNF)α. By taking advantage of an immune-phenotyping platform, LEGENDScreen™, we measured the expression of 332 cell surface markers on B and T cells in a cross-sectional adalimumab-treated RA patient cohort with a defined ADA response. The analysis revealed seven differentially expressed markers (DEMs) between the ADA+ and ADA− patients. Validation of the DEMs in an independent prospective European cohort of adalimumab treated RA patients, revealed a significant and consistent reduced frequency of signal regulatory protein (SIRP)α/β-expressing memory B cells in ADA+ vs. ADA− RA patients. We also assessed the predictive value of SIRPα/β expression in a longitudinal RA cohort prior to the initiation of adalimumab treatment. We show that a frequency of < 9.4% of SIRPα/β-expressing memory B cells predicts patients that will develop ADA, and consequentially fail to respond to treatment, with a receiver operating characteristic (ROC) area under the curve (AUC) score of 0.92. Thus, measuring the frequency of SIRPα/β-expressing memory B cells in patients prior to adalimumab treatment may be clinically useful to identify a subgroup of active RA subjects who are going to develop an ADA response and not gain substantial clinical benefit from this treatment.
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Affiliation(s)
- Laura Magill
- Division of Medicine, Centre for Rheumatology, University College London, London, United Kingdom
| | - Marsilio Adriani
- Division of Medicine, Centre for Rheumatology, University College London, London, United Kingdom
| | | | - Keguan Chen
- Clinical Immunology, GlaxoSmithKline, Philadelphia, PA, United States
| | - Aude Gleizes
- INSERM UMR996, Faculté Pharmacie, Université Paris Sud, Châtenay-Malabry, France.,Clinical Immunology Laboratory, AP-HP, Le Kremlin-Bicêtre Hospital, Paris-Sud University Hospitals, Le Kremlin-Bicêtre, France
| | - Salima Hacein-Bey-Abina
- Clinical Immunology Laboratory, AP-HP, Le Kremlin-Bicêtre Hospital, Paris-Sud University Hospitals, Le Kremlin-Bicêtre, France.,UTCBS, CNRS UMR 8258, INSERM U1022, Faculty of Pharmacy, Paris-Descartes-Sorbonne-Cité University, Paris, France
| | | | - Xavier Mariette
- Centre for Immunology of Viral Infections and Autoimmune Diseases, INSERM UMR1184, AP-HP, Université Paris-Sud, Hôpitaux Universitaires Paris-Sud, Le Krelin-Bicetre, France
| | - Marc Pallardy
- INSERM UMR996, Faculté Pharmacie, Université Paris Sud, Châtenay-Malabry, France
| | | | - Natacha Szely
- INSERM UMR996, Faculté Pharmacie, Université Paris Sud, Châtenay-Malabry, France
| | - David A Isenberg
- Division of Medicine, Centre for Rheumatology, University College London, London, United Kingdom
| | - Jessica J Manson
- Department of Rheumatology, University College London Hospital, London, United Kingdom
| | - Elizabeth C Jury
- Division of Medicine, Centre for Rheumatology, University College London, London, United Kingdom
| | - Claudia Mauri
- Division of Medicine, Centre for Rheumatology, University College London, London, United Kingdom
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19
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20
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Thomas M, Ponce Aix S, Navarro Mendivil A, Riera Knorrenschild J, Schmidt M, Wiegert E, Kapp K, Mauri C, Domine Gomez M, Kollmeier J, Sadjadian P, Fröhling KP, Huber R, Wolf M. Maintenance treatment with the TLR9 agonist lefitolimod in extensive-stage small-cell lung cancer (ES-SCLC): Final results from the randomized phase II IMPULSE study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy298.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Burton AR, Pallett LJ, McCoy LE, Suveizdyte K, Amin OE, Swadling L, Alberts E, Davidson BR, Kennedy PT, Gill US, Mauri C, Blair PA, Pelletier N, Maini MK. Circulating and intrahepatic antiviral B cells are defective in hepatitis B. J Clin Invest 2018; 128:4588-4603. [PMID: 30091725 PMCID: PMC6159997 DOI: 10.1172/jci121960] [Citation(s) in RCA: 179] [Impact Index Per Article: 29.8] [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: 04/30/2018] [Accepted: 07/26/2018] [Indexed: 12/15/2022] Open
Abstract
B cells are increasingly recognized as playing an important role in the ongoing control of hepatitis B virus (HBV). The development of antibodies against the viral surface antigen (HBV surface antigen [HBsAgs]) constitutes the hallmark of resolution of acute infection and is a therapeutic goal for functional cure of chronic HBV (CHB). We characterized B cells directly ex vivo from the blood and liver of patients with CHB to investigate constraints on their antiviral potential. Unexpectedly, we found that HBsAg-specific B cells persisted in the blood and liver of many patients with CHB and were enriched for T-bet, a signature of antiviral potential in B cells. However, purified, differentiated HBsAg-specific B cells from patients with CHB had defective antibody production, consistent with undetectable anti-HBs antibodies in vivo. HBsAg-specific and global B cells had an accumulation of CD21-CD27- atypical memory B cells (atMBC) with high expression of inhibitory receptors, including PD-1. These atMBC demonstrated altered signaling, homing, differentiation into antibody-producing cells, survival, and antiviral/proinflammatory cytokine production that could be partially rescued by PD-1 blockade. Analysis of B cells within healthy and HBV-infected livers implicated the combination of this tolerogenic niche and HBV infection in driving PD-1hiatMBC and impairing B cell immunity.
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Affiliation(s)
- Alice R. Burton
- Division of Infection and Immunity, Institute of Immunity and Transplantation, and
| | - Laura J. Pallett
- Division of Infection and Immunity, Institute of Immunity and Transplantation, and
| | - Laura E. McCoy
- Division of Infection and Immunity, Institute of Immunity and Transplantation, and
| | - Kornelija Suveizdyte
- Division of Infection and Immunity, Institute of Immunity and Transplantation, and
| | - Oliver E. Amin
- Division of Infection and Immunity, Institute of Immunity and Transplantation, and
| | - Leo Swadling
- Division of Infection and Immunity, Institute of Immunity and Transplantation, and
| | - Elena Alberts
- Division of Infection and Immunity, Institute of Immunity and Transplantation, and
| | - Brian R. Davidson
- Department of Surgery, University College London, London, United Kingdom
| | | | - Upkar S. Gill
- Centre for Immunobiology, Barts and the London, London, United Kingdom
| | - Claudia Mauri
- Division of Medicine, University College London, London, United Kingdom
| | - Paul A. Blair
- Division of Medicine, University College London, London, United Kingdom
| | | | - Mala K. Maini
- Division of Infection and Immunity, Institute of Immunity and Transplantation, and
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22
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Piper CJM, Wilkinson MGL, Deakin CT, Otto GW, Dowle S, Duurland CL, Adams S, Marasco E, Rosser EC, Radziszewska A, Carsetti R, Ioannou Y, Beales PL, Kelberman D, Isenberg DA, Mauri C, Nistala K, Wedderburn LR. CD19 +CD24 hiCD38 hi B Cells Are Expanded in Juvenile Dermatomyositis and Exhibit a Pro-Inflammatory Phenotype After Activation Through Toll-Like Receptor 7 and Interferon-α. Front Immunol 2018; 9:1372. [PMID: 29988398 PMCID: PMC6024011 DOI: 10.3389/fimmu.2018.01372] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [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: 01/30/2018] [Accepted: 06/04/2018] [Indexed: 01/12/2023] Open
Abstract
Juvenile dermatomyositis (JDM) is a rare form of childhood autoimmune myositis that presents with proximal muscle weakness and skin rash. B cells are strongly implicated in the pathogenesis of the disease, but the underlying mechanisms are unknown. Therefore, the main objective of our study was to investigate mechanisms driving B cell lymphocytosis and define pathological features of B cells in JDM patients. Patients were recruited through the UK JDM Cohort and Biomarker study. Peripheral blood B cell subpopulations were immunophenotyped by flow cytometry. The results identified that immature transitional B cells were significantly expanded in active JDM, actively dividing, and correlated positively with disease activity. Protein and RNAseq analysis revealed high interferon alpha (IFNα) and TLR7-pathway signatures pre-treatment. Stimulation of B cells through TLR7/8 promoted both IL-10 and IL-6 production in controls but failed to induce IL-10 in JDM patient cells. Interrogation of the CD40–CD40L pathway (known to induce B cell IL-10 and IL-6) revealed similar expression of IL-10 and IL-6 in B cells cultured with CD40L from both JDM patients and controls. In conclusion, JDM patients with active disease have a significantly expanded immature transitional B cell population which correlated with the type I IFN signature. Activation through TLR7 and IFNα may drive the expansion of immature transitional B cells in JDM and skew the cells toward a pro-inflammatory phenotype.
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Affiliation(s)
| | - Meredyth G Ll Wilkinson
- Centre for Rheumatology, University College London, London, United Kingdom.,Centre for Adolescent Rheumatology, Arthritis Research UK, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom
| | - Claire T Deakin
- Centre for Adolescent Rheumatology, Arthritis Research UK, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom.,Infection, Inflammation and Rheumatology Section, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom
| | - Georg W Otto
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom.,Experimental and Personalised Medicine, Genetics and Genomic Medicine, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Stefanie Dowle
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom.,Experimental and Personalised Medicine, Genetics and Genomic Medicine, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Chantal L Duurland
- Infection, Inflammation and Rheumatology Section, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Stuart Adams
- Haematology, Specialist Integrated Haematological Malignancy Diagnostic Service (SIHMDS), Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Emiliano Marasco
- B Cell Physiopathology Unit, Immunology Research Area, Ospedale Pediatrico Bambino Gesù IRCSS, Rome, Italy
| | - Elizabeth C Rosser
- Infection, Inflammation and Rheumatology Section, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Anna Radziszewska
- Centre for Rheumatology, University College London, London, United Kingdom.,Centre for Adolescent Rheumatology, Arthritis Research UK, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom
| | - Rita Carsetti
- B Cell Physiopathology Unit, Immunology Research Area, Ospedale Pediatrico Bambino Gesù IRCSS, Rome, Italy
| | - Yiannis Ioannou
- Centre for Rheumatology, University College London, London, United Kingdom.,Centre for Adolescent Rheumatology, Arthritis Research UK, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom
| | - Philip L Beales
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom.,Experimental and Personalised Medicine, Genetics and Genomic Medicine, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Daniel Kelberman
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom.,Experimental and Personalised Medicine, Genetics and Genomic Medicine, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom
| | - David A Isenberg
- Centre for Rheumatology, University College London, London, United Kingdom.,Centre for Adolescent Rheumatology, Arthritis Research UK, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom
| | - Claudia Mauri
- Centre for Rheumatology, University College London, London, United Kingdom
| | - Kiran Nistala
- Centre for Rheumatology, University College London, London, United Kingdom
| | - Lucy R Wedderburn
- Centre for Adolescent Rheumatology, Arthritis Research UK, University College London Hospital and Great Ormond Street Hospital, London, United Kingdom.,Infection, Inflammation and Rheumatology Section, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom
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23
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Adriani M, Nytrova P, Mbogning C, Hässler S, Medek K, Jensen PEH, Creeke P, Warnke C, Ingenhoven K, Hemmer B, Sievers C, Lindberg Gasser RL, Fissolo N, Deisenhammer F, Bocskei Z, Mikol V, Fogdell-Hahn A, Kubala Havrdova E, Broët P, Dönnes P, Mauri C, Jury EC. Monocyte NOTCH2 expression predicts IFN-β immunogenicity in multiple sclerosis patients. JCI Insight 2018; 3:99274. [PMID: 29875313 DOI: 10.1172/jci.insight.99274] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/24/2018] [Indexed: 01/25/2023] Open
Abstract
Multiple sclerosis (MS) is an autoimmune disease characterized by CNS inflammation leading to demyelination and axonal damage. IFN-β is an established treatment for MS; however, up to 30% of IFN-β-treated MS patients develop neutralizing antidrug antibodies (nADA), leading to reduced drug bioactivity and efficacy. Mechanisms driving antidrug immunogenicity remain uncertain, and reliable biomarkers to predict immunogenicity development are lacking. Using high-throughput flow cytometry, NOTCH2 expression on CD14+ monocytes and increased frequency of proinflammatory monocyte subsets were identified as baseline predictors of nADA development in MS patients treated with IFN-β. The association of this monocyte profile with nADA development was validated in 2 independent cross-sectional MS patient cohorts and a prospective cohort followed before and after IFN-β administration. Reduced monocyte NOTCH2 expression in nADA+ MS patients was associated with NOTCH2 activation measured by increased expression of Notch-responsive genes, polarization of monocytes toward a nonclassical phenotype, and increased proinflammatory IL-6 production. NOTCH2 activation was T cell dependent and was only triggered in the presence of serum from nADA+ patients. Thus, nADA development was driven by a proinflammatory environment that triggered activation of the NOTCH2 signaling pathway prior to first IFN-β administration.
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Affiliation(s)
- Marsilio Adriani
- Department of Rheumatology, University College Hospital, London, United Kingdom
| | - Petra Nytrova
- Department of Neurology and Center for Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Cyprien Mbogning
- CESP, Fac. De Médecine-Univ. Paris-Sud, Fac. De Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
| | - Signe Hässler
- CESP, Fac. De Médecine-Univ. Paris-Sud, Fac. De Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
| | - Karel Medek
- Department of Neurology and Center for Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Poul Erik H Jensen
- Neuroimmunology Laboratory, DMSC, Department of Neurology, Rigshospitalet, Region H, Copenhagen, Denmark
| | - Paul Creeke
- Neuroimmunology Unit, Centre for Neuroscience and Trauma, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Clemens Warnke
- Department of Neurology, Medical Faculty, Research Group for Clinical and Experimental Neuroimmunology, Heinrich-Heine-University, Düsseldorf, Germany.,University Hospital Koeln, Deptartment of Neurology, Koeln, Germany
| | - Kathleen Ingenhoven
- Department of Neurology, Medical Faculty, Research Group for Clinical and Experimental Neuroimmunology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Bernhard Hemmer
- Klinikum rechts der Isar, Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claudia Sievers
- Laboratory of Clinical Neuroimmunology, Departments of Biomedicine and Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Raija Lp Lindberg Gasser
- Laboratory of Clinical Neuroimmunology, Departments of Biomedicine and Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Nicolas Fissolo
- Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Florian Deisenhammer
- Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Zsolt Bocskei
- Translational Sciences Unit, Sanofi R&D, 91385 Chilly-Mazarin, Paris, France
| | - Vincent Mikol
- Translational Sciences Unit, Sanofi R&D, 91385 Chilly-Mazarin, Paris, France
| | - Anna Fogdell-Hahn
- Karolinska Institutet, Department of Clinical Neuroscience, Center for Molecular Medicine (CMM), Karolinska University Hospital, Sweden
| | - Eva Kubala Havrdova
- Department of Neurology and Center for Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Philippe Broët
- CESP, Fac. De Médecine-Univ. Paris-Sud, Fac. De Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | | | - Claudia Mauri
- Department of Rheumatology, University College Hospital, London, United Kingdom
| | - Elizabeth C Jury
- Department of Rheumatology, University College Hospital, London, United Kingdom
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24
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Oleinika K, Rosser EC, Matei DE, Nistala K, Bosma A, Drozdov I, Mauri C. CD1d-dependent immune suppression mediated by regulatory B cells through modulations of iNKT cells. Nat Commun 2018; 9:684. [PMID: 29449556 PMCID: PMC5814456 DOI: 10.1038/s41467-018-02911-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 01/08/2018] [Indexed: 12/22/2022] Open
Abstract
Regulatory B cells (Breg) express high levels of CD1d that presents lipid antigens to invariant natural killer T (iNKT) cells. The function of CD1d in Breg biology and iNKT cell activity during inflammation remains unclear. Here we show, using chimeric mice, cell depletion and adoptive cell transfer, that CD1d–lipid presentation by Bregs induces iNKT cells to secrete interferon (IFN)-γ to contribute, partially, to the downregulation of T helper (Th)1 and Th17-adaptive immune responses and ameliorate experimental arthritis. Mice lacking CD1d-expressing B cells develop exacerbated disease compared to wild-type mice, and fail to respond to treatment with the prototypical iNKT cell agonist α-galactosylceramide. The absence of lipid presentation by B cells alters iNKT cell activation with disruption of metabolism regulation and cytokine responses. Thus, we identify a mechanism by which Bregs restrain excessive inflammation via lipid presentation. Regulatory B cells (Breg) are known to suppress immune responses by secreting interleukin-10 (IL-10). Here the authors show that, alternatively, Bregs may also present lipid antigens on surface CD1d to induce IFN-γ production from invariant natural killer cells to ameliorate experimental arthritis via IL-10-independent pathways.
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Affiliation(s)
- K Oleinika
- Centre for Rheumatology, Division of Medicine, University College London, London, WC1E 6JF, UK.,Division of Infection and Immunity, University College London, London, WC1E 6BT UK, UK
| | - E C Rosser
- Centre for Rheumatology, Division of Medicine, University College London, London, WC1E 6JF, UK.,Infection, Inflammation and Rheumatology Section, Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, WC1N 1EH, UK
| | - D E Matei
- Centre for Rheumatology, Division of Medicine, University College London, London, WC1E 6JF, UK
| | - K Nistala
- Centre for Rheumatology, Division of Medicine, University College London, London, WC1E 6JF, UK
| | - A Bosma
- Centre for Rheumatology, Division of Medicine, University College London, London, WC1E 6JF, UK
| | | | - C Mauri
- Centre for Rheumatology, Division of Medicine, University College London, London, WC1E 6JF, UK.
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25
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Blair P, Leib C, Goddard M, Rosser E, Park I, Nilsson AH, Nilsson J, Strom A, Cross A, Cole J, Mauri C, Monaco C. B regulatory cells are increased in hypercholesterolaemic mice and protect from lesion development via IL-10. Thromb Haemost 2017; 114:835-47. [DOI: 10.1160/th14-12-1084] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 05/07/2015] [Indexed: 11/05/2022]
Abstract
SummaryWhilst innate B1-B cells are atheroprotective, adaptive B2-B cells are considered pro-atherogenic. Different subsets of B regulatory cells (Breg) have been described. In experimental arthritis and lupus-like disease, Breg are contained within the CD21hiCD23hiCD24hi B cell pool. The existence and role of Breg in vascular disease is not known. We sought to investigate the existence, identity and location of Breg in vascular disease. The representation of B2-B cell subsets in the spleens and lymph nodes (LNs) of Apolipoprotein E-/- (ApoE-/-) mice compared to controls was characterised by flow cytometry. Additionally, we utilised a model of neointima formation based on the placement of a perivascular collar around the carotid artery in ApoE-/- mice to ascertain whether B cells and B cell subsets confer protection against lesion development. Adoptive transfer of B cells was performed from wild type or genetically modified mice. We showed that CD21hiCD23hiCD24hi B cells are unexpectedly increased in the draining LNs of ApoE-/- mice. Adoptive transfer of LN-derived B2-B cells or purified CD21hiCD23hiCD24hi B cells to syngeneic mice reduced lesion size and inflammation without changing serum cholesterol levels. Follicular B2-B cells did not confer protection. IL-10 blockade or transfer of IL10-deficient B cells prevented LN-derived B cell-mediated protection. This is the first identification of a specific LN-derived B2-Breg subset that confers IL-10 mediated protection from neointima formation. This may open the way for immune modulatory approaches in cardiovascular disease.
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Principe L, Meroni E, Conte V, Mauri C, Di Pilato V, Giani T, Bonfanti P, Rossolini GM, Luzzaro F. Mother-to-child transmission of KPC-producing Klebsiella pneumoniae: potential relevance of a low microbial urinary load for screening purposes. J Hosp Infect 2017; 98:314-316. [PMID: 29042234 DOI: 10.1016/j.jhin.2017.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
Affiliation(s)
- L Principe
- Clinical Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - E Meroni
- Clinical Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - V Conte
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - C Mauri
- Clinical Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - V Di Pilato
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - T Giani
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - P Bonfanti
- Infectious Diseases Unit, A. Manzoni Hospital, Lecco, Italy
| | - G M Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - F Luzzaro
- Clinical Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy.
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Ferraro D, Simone AM, Adani G, Vitetta F, Mauri C, Strumia S, Senesi C, Curti E, Baldi E, Santangelo M, Montepietra S, Immovilli P, Guareschi A, Neri W, Granella F, Caniatti L, Tola MR, Motti L, Pesci I, Montanari E, Sola P. Definitive childlessness in women with multiple sclerosis: a multicenter study. Neurol Sci 2017; 38:1453-1459. [DOI: 10.1007/s10072-017-2999-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 05/12/2017] [Indexed: 11/29/2022]
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De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Caorsi R, Penco F, Grossi A, Insalaco A, Alessio M, Conti G, Marchetti F, Tommasini A, Martino S, Gallizzi R, Salis A, Schena F, Caroli F, Martini A, Damonte G, Ceccherini I, Gattorno M, Frémond ML, Uggenti C, Van Eyck L, Melki I, Duffy D, Bondet V, Rose Y, Neven B, Crow Y, Rodero MP, Kusche Y, Roth J, Barczyk-Kahlert K, Ferrara G, Chiocchetti A, Polizzi S, Vuch J, Vozzi D, Mondino A, Valencic E, Pastore S, Taddio A, Faletra F, Dianzani U, Ramenghi U, Tommasini A, Zhou Q, Yu X, Demirkaya E, Deuitch N, Stone D, Tsai W, Ombrello A, Romeo T, Remmers EF, Chae J, Gadina M, Welch S, Ozen S, Topaloglu R, Abinun M, Kastner DL, Aksentijevich I, Vairo D, Ferraro RM, Zani G, Galli J, De Simone M, Cattalini M, Fazzi E, Giliani S, Omoyinmi E, Standing A, Rowczenio D, Keylock A, Gomes SM, Price-Kuehne F, Nanthapisal S, Murphy C, Cullup T, Jenkins L, Gilmour K, Eleftheriou D, Lachmann H, Hawkins P, Klein N, Brogan P, Nikolayenko VB, Şahin K, Karaaslan Y, Civino A, Alighieri G, Davì S, Rondelli R, Martino S, Filocamo G, Magnolato A, Dhanrajani A, Ricci F, Gallizzi R, Olivieri A, Gerloni V, Lattanzi B, Soscia F, De Fanti A, Manzoni SM, Citiso S, Quartulli L, Chan M, La Torre F, Rigante D, Maggio MC, Marsili M, Pelagatti MA, Conter V, Fagioli F, Lepore L, Pession A, Ravelli A, Pau S, Consolaro A, Ruperto N, Garrone M, Rinaldi M, De Inocencio J, Demirkaya E, Garay S, Foell D, Lovell DJ, Lazar C, Ellsworth J, Nielsen S, Flato B, Martini A, Ravelli A, Marasco E, Aquilani A, Cascioli S, Caiello I, Moneta GM, Pires-Marafón D, Guzman J, Magni-Manzoni S, Carsetti R, De Benedetti F, Robinson E, Albani S, Beresford MW, de Jager W, de Roock S, Duong T, Ellis J, Aeschlimann FA, Hyrich K, Jervis L, Lovell D, Marshall L, Mellins ED, Minden K, Munro J, Nigrovic PA, Palman J, Roth J, Twilt M, Ruperto N, Sampath S, Schanberg LE, Thompson SD, Thomson W, Vesely R, Wallace C, Williams C, Wu Q, Wulffraat N, Eng SW, Yeung RSM, Prakken B, Wedderburn LR, Horneff G, Seyger MB, Arikan D, Kalabic J, Anderson JK, Lazar A, Williams DA, Sheikh S, Wang C, Tarzynski-Potempa R, Hymans JS, Simonini G, Scoccimarro E, Pontikaki I, Ferrara G, Giani T, Ventura A, Meroni PL, Laxer RM, Cimaz R, Minnone G, Soligo M, Caiello I, Prencipe G, Marafon DP, Magni-Manzoni S, Manni L, De Benedetti F, Laudiero LB, Hebert D, Groot N, Grein I, Wulffraat NM, Schepp R, Berbers G, de Souza CCBS, Ferriani VPL, Pileggi G, de Roock S, Grein IHR, Noone D, Scala S, Patrone E, Schoemaker C, Costello W, Wulffraat N, Parsons S, McDonagh J, Thomson W, Cohen JD, Bentayou D, Pagnoux C, Brunel MAB, Trope S, Klotsche J, Listing M, Niewerth M, Horneff G, Thon A, Huppertz HI, Mönkemöller K, Foeldvari I, Benseler SM, Föll D, Minden K, Marino A, Stagi S, Carli N, Bertini F, Giani T, Simonini G, Cimaz R, Díaz-Maldonado AS, Yeung RS, Pino S, Guarnizo P, Torres-Jimenez AR, Sanchez-Jara B, Solis-Vallejo E, Cespedes-Cruz AI, Zeferino-Cruz M, Ramirez-Miramontes JV, Kumar A, Gupta A, Kessel C, Suri D, Rawat A, Kakkar N, Singh S, Makay B, Gücenmez ÖA, Ünsal E, Magnusson B, Mördrup K, Vermé A, Lippitz K, Peterson C, Freychet C, Stephan JL, Hofer M, Belot A, Harkness CE, Rooney M, Foster L, Henry E, Taggart P, Weinhage T, Simsek D, Ozkececi CF, Kurt E, Basbozkurt G, Gok F, Demirkaya E, Gorczyca D, Postępski J, Czajkowska A, Szponar B, Hinze C, Paściak M, Gruenpeter A, Lachór-Motyka I, Augustyniak D, Olesińska E, Asuka ES, Golovko T, Aliejim SU, Clemente EI, Jimenez EI, Wittkowski H, Hernandez JC, Fernandez SB, Roca CG, Romo DM, Nieva NR, Angarita JMM, Lopez JA, Nuñez-Cuadros E, Diaz-Cordovés G, Galindo-Zavala R, Holzinger D, Urda-Cardona A, Fernández-Nebro A, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Gallo MM, Borrell RP, Barril SM, Sánchez AMM, Caballero CM, Grün N, Merlin E, Breton S, Fraitag S, Stephan JL, Wouters C, Bodemer C, Bader-Meunier B, Baldo F, Annoni F, Di Landro G, Föll D, Torreggiani S, Torcoletti M, Petaccia A, Corona F, Filocamo G, Tiller G, Buckle J, Munro J, Cox A, Gowdie P, Van Dijkhuizen P, Allen RC, Akikusa JD, Hernández-Huirache HG, Rodea-Montero ER, Cohen JD, Belot A, Fahy W, Quartier P, Sordet C, Trope S, Del Chierico F, Berggren KB, Kembe JT, Bos J, Armbrust W, Wulffraat N, van Brussel M, Cappon J, Dijkstra P, Geertzen J, Legger E, Malattia C, van Rossum M, Sauer P, Lelieveld O, Ozturk K, Buluc L, Akansel G, Muezzinoglu B, Ekinci Z, Rychkova L, Knyazeva T, Russo A, Pogodina A, Belova T, Mandzyak T, Kulesh E, Cafarotti A, Marsili M, Giannini C, Salvatore R, Lapergola G, Di Battista C, Marafon DP, Marcovecchio ML, Basilico R, Pelliccia P, Chiarelli F, Breda L, Almeida B, Tansley S, Simou S, Gunawardena H, McHugh N, ter Haar NM, Wedderburn L, Aouizerate J, Bader-Meunier B, De Antonio M, Bodemer C, Barnerias C, Bassez G, Desguerre I, Quartier P, Gherardi R, Magni-Manzoni S, Charuel JL, Authier FJ, Gitiaux C, Spencer CH, Aziz RA, Yu CY, Adler B, Bout-Tabaku S, Lintner K, Moore-Clingenpeel M, Vastert SJ, Boros C, McCann L, Ambrose N, Cortina-Borja M, Simou S, Pilkington C, Wedderburn L, Hinze C, Oommen PT, Speth F, Dallapiccola B, Haas JP, Hinze C, Oommen PT, Speth F, Haas JP, Speth F, Haas JP, Hinze C, Lavarello C, Giancane G, Prakken B, Pistorio A, Rider L, Aggarwal R, Oliveira SK, Cuttica R, Fischbach M, Sterba G, Brochard K, Dressler F, Barone P, Martini A, Burgos-Vargas R, Chalom EC, Desjonqueres M, Espada G, Fasth A, Garay SM, Herbigneaux RM, Hoyoux C, Deslandre CJ, Miller FW, De Benedetti F, Vencovsky J, Ravelli A, Martini A, Ruperto N, Sag E, Ozen S, Kale G, Topaloglu H, Talim B, Giancane G, Putignani L, Lavarello C, Pistorio A, Zulian F, Magnusson B, Avcin T, Corona F, Gerloni V, Pastore S, Marini R, Martino S, Fidanci BE, Pagnier A, Rodiere M, Soler C, Stanevicha V, Ten Cate R, Uziel Y, Vojinovic J, Ravelli A, Martini A, Ruperto N, Barut K, Villarreal AV, Acevedo N, Diaz T, Ramirez Y, Faugier E, Maldonado R, Arabshahi B, Lee JH, Leibowitz I, Okong’o LO, Arıcı S, Wilmshurst J, Esser M, Scott C, Batu ED, Emiroglu N, Sonmez HE, Tugcu GD, Arici ZS, Yalcin E, Dogru D, Simsek D, Ozcelik U, Bilginer Y, Haliloglu M, Kiper N, Ozen S, Yashiro M, Yamada M, Yabuuchi T, Kikkawa T, Nosaka N, Cakan M, Fujii Y, Saito Y, Tsukahara H, Al-Mayouf SM, AlMutiari N, Muzaffer M, shehata R, Al-Wahadneh A, Abdwani R, Al-Abrawi S, Batu ED, Abu-shukair M, El-Habahbeh Z, Alsonbul A, Szabat A, Chęć M, Opoka-Winiarska V, Kumar A, Gupta A, Rawat A, Saikia B, Şahin S, Minz RW, Suri D, Singh S, Arango C, Malagon C, Gomez MDP, Mosquera AC, Yepez R, Gonzalez T, Vargas C, Kısaarslan A, Zulian F, Balzarin M, Castaldi B, Reffo E, Sperotto F, Martini G, Meneghel A, Milanesi O, Foeldvari I, Klotsche J, Yilmaz E, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sifuentes-Giraldo WA, Basaran Ö, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Kallinich T, Demir F, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Foeldvari I, Baildem E, Blakley M, Boros C, Ozturk K, Fligelstone K, Kienast A, Nemcova D, Pain C, Saracino A, Simoni G, Torok K, Weibel L, Helmus N, Foeldvari I, Gunduz Z, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sozeri B, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Makay B, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Osminina MK, Geppe NA, Niconorova OV, Ayaz N, Karashtina OV, Abbyasova OV, Shpitonkova OV, Adrovic A, Sahin S, Barut K, Durmus S, Uzun H, Kasapcopur O, Foeldvari I, Yavascan O, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Aydog O, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Bilginer Y, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Mauro A, Fanti E, Voller F, Ekinci Z, Rusconi F, Cimaz R, Garcia-Rodriguez F, Villarreal-Treviño AV, Flores-Pineda AJ, Lara-Herrea PB, Salinas-Encinas DR, Diaz-Prieto T, Maldonado-Velazquez MR, Moreno-Espinosa S, Yıldız D, Faugier-Fuentes E, Gallizzi R, Finetti M, Crapanzano M, Cantarini L, Cattalini M, Filocamo G, Insalaco A, Mauro A, Rigante D, Gök F, Zulian F, Alessio M, Parissenti I, Ruperto N, Gattorno M, Cimaz R, Parihar MS, Singh S, Vignesh P, Gupta A, Erguven M, Rohit M, Gopalan K, Singh S, Vignesh P, Gupta A, Rohit M, Attri SV, Hong Y, Eleftheriou D, Nanthapisal S, Unsal E, Salama A, Jayne D, Little M, Brogan P, Kostina Y, Lyskina G, Shpitonkova O, Torbyak A, Lyskina G, Shirinsky O, Kasapcopur O, Mauro A, Gicchino MF, Smaldone MC, Diplomatico M, Olivieri AN, Spencer CH, Aziz RA, McClead R, Bout-Tabaku S, Patel H, Ozen S, Yu CY, Ozkececi CF, Basbozkurt G, Simsek D, Kurt E, Gok F, Demirkaya E, Cebecauerová D, Dallos T, Kabíčková E, Demirkaya E, Kynčl M, Chroustová D, Hoza J, Němcová D, Tesař V, Doležalová P, Batu ED, Sonmez HE, Hazirolan T, Ozaltin F, Sönmez HE, Bilginer Y, Ozen S, Almeida F, de Paula IHF, Sampaio MM, Arita FN, Alves AG, Santos MC, Okuda EM, Sacchetti SB, Batu ED, Falcini F, Francesca M, Stagi S, Rigante D, Lepri G, Matucci-Cerinic M, Brandi ML, Di Landro G, Torreggiani S, Petaccia A, Sözeri B, Torcoletti M, Corona F, Filocamo G, Kisaoglu H, Misir S, Demir S, Aliyazicioglu Y, Kalyoncu M, de Paula IHF, Ramalho CE, Butbul Y, Almeida FD, Alves AG, Santos MC, Sacchetti SB, Okuda EM, Calzada-Hernández J, Bou R, Iglesias E, Sánchez-Manubens J, Martínez FHP, Bilginer Y, Roca CG, Fernández SB, Angarita JMM, Anton J, Bohm M, Mahmood K, Leone V, Wood M, Yamaguchi KI, Fujikawa S, Özen S, Kim KY, Kim DY, Kim DS, Ioseliani M, Chkhaidze I, Lekishvili M, Tskhakaia N, Tvalabeishvili S, Kajrishvili A, Takakura M, Bracaglia C, Shimizu M, Inoue N, Mizuta M, Yachie A, Alizzi C, Corsello G, Maggio MC, Piram M, Maldini C, Biscardi S, Prencipe G, Desuremain N, Orzechowski C, Georget E, Regnard D, Kone-Paut I, Mahr A, Sparchez M, Damian L, Sparchez Z, Silva NA, Pardeo M, Treviño AVV, Loyola YR, Prieto TD, Fuentes EF, Velazquez MDRM, Perez P, Mosquera AC, Malagon C, Bhattad S, Rawat A, Lapeyre G, Saikia B, Minz R, Shandilya J, Singh S, Parihar MS, Singh S, Vignesh P, Gupta A, Rohit M, Maldonado R, Marasco E, Faugier E, Villarreal A, Acevedo N, Ramírez Y, Diaz T, Kostina Y, Lyskina G, Shpitonkova O, Ozturk K, Ekinci Z, Insalaco A, Özçakar ZB, Fitoz S, Yalcinkaya F, Horne A, Minoia F, Bovis F, Davi S, Pal P, Anton J, Stein K, Ferlin W, Enciso S, Kasapcopur O, Jeng M, Maritsi D, Cron RC, Ravelli A, Thorwarth A, von Stuckrad SL, Rösen-Wolff A, Luksch H, Nelson R, Hundsdoerfer P, Minden K, Krawitz P, Kallinich T, Sozeri B, Ayaz NA, Batu ED, Makay B, Şahin S, Simsek D, de Min C, Kılıc ŞS, Ozturk K, Sonmez E, Kisaarslan AP, Gucenmez OA, Cakan M, Arıcı ZS, Adrovic A, Kelesoglu F, Bilginer Y, De Benedetti F, Demirkaya E, Ekinci ZE, Dusunsel R, Unsal E, Kasapcopur O, Ozen S, Lerkvaleekul B, Vilaiyuk S, Miranda-Garcia M, Pretzer C, Ruperto N, Huppertz HI, Horneff G, Haas JP, Ganser G, Kuemmerle-Deschner J, Wittkowski H, Frosch M, Roth J, Foell D, Holzinger D, Brunner HI, Gohar F, McArdle A, Callan N, Hernandez B, Lavric M, Kessel C, Holzinger D, FitzGerald O, Pennington SR, Foell D, Quartier P, Horneff G, Peitz J, Kekow J, Klein A, Horneff G, Schulz AC, Minden K, Weller-Heinemann F, Hospach A, Haas JP, Constantin T, Put K, Vandenhaute J, Avau A, van Nieuwenhuijze A, Brisse E, Dierckx T, Rutgeerts O, Garcia-Perez JE, Toelen J, Waer M, Alexeeva E, Leclercq G, Goris A, Van Weyenbergh J, Liston A, De Somer L, Matthys P, Wouters CH, Mizuta M, Shimizu M, Inoue N, Kone-Paut I, Nakagishi Y, Yachie A, Shimizu M, Inoue N, Mizuta M, Yachie A, Ombrello MJ, Arthur V, Remmers EF, Hinks A, Marzan K, Kastner DL, Woo P, Thomson W, Stanimirovic B, Djurdjevic-Banjac B, Ljuboja O, Hugle B, Speth F, Haas JP, Maritsi D, Wulffraat N, Onoufriou MA, Vougiouka O, Eleftheriou D, Horneff G, Peitz J, Kekow J, Foell D, Bouayed K, El Hani S, Hafid I, Schneider R, Mikou N, Ioseliani M, Lekishvili M, Shelia N, Tvalabeishvili S, Kajrishvili A, Laan M, Ilisson J, Pruunsild C, Padeh S, Chasnyk V, Wouters C, Kuemmerle-Deschner JB, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Leon K, Vritzali E, Lheritier K, Martini A, Lovell D, Schena F, Volpi S, Caorsi R, Penco F, Pastorino C, Kalli F, Omenetti A, Chiesa S, Bertoni A, Picco P, Filaci G, Aksentijevich I, Grossi A, Ceccherini I, Martini A, Traggiai E, Gattorno M, Melki I, Rose Y, Uggenti C, Fremond ML, Van Eyck L, Kitabayashi N, Gattorno M, Volpi S, Sacco O, Meyts I, Morren MA, Wouters C, Legius E, Callebaut I, Bodemer C, Rieux-Laucat F, Rodero M, Crow Y, Frémond ML, Rodero MP, Jeremiah N, Belot A, Jeziorski E, Duffy D, Bessis D, Cros G, Rice GI, Charbit B, Hulin A, Khoudour N, Caballero CM, Bodemer C, Fabre M, Berteloot L, Le Bourgeois M, Reix P, Walzer T, Moshous D, Blanche S, Fischer A, Bader-Meunier B, Rieux-Laucat F, Crow Y, Neven B, Annink K, ter Haar N, Al-Mayouf S, Amaryan G, Anton J, Barron K, Benseler S, Brogan P, Cantarini L, Cattalini M, Cochino A, De Benedetti F, Dedeoglu F, De Jesus A, Dellacasa O, Demirkaya E, Dolezalova P, Durrant K, Fabio G, Gallizzi R, Goldbach-Mansky R, Hachulla E, Hentgen V, Herlin T, Hofer M, Hoffman H, Insalaco A, Jansson A, Kallinich T, Koné-Paut I, Kozlova A, Kuemmerle-Deschner J, Lachmann H, Laxer R, Martini A, Nielsen S, Nikishina I, Ombrello A, Ozen S, Papadopoulou-Alataki E, Quartier P, Ravelli A, Rigante D, Russo R, Simon A, Trachana M, Uziel Y, Gattorno M, Frenkel J, ter Haar N, Jeyaratnam J, Lachmann H, Simon A, Brogan P, Doglio M, Cattalini M, Anton J, Modesto C, Quartier P, Hoppenreijs E, Martino S, Insalaco A, Cantarini L, Lepore L, Alessio M, Penades IC, Boros C, Consolini R, Rigante D, Russo R, Schmid JP, Lane T, Martini A, Ruperto N, Frenkel J, Gattorno M, Passarelli C, Pisaneschi E, Messia V, Pardeo M, Novelli A, Debenedetti F, Insalaco A, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Wei X, Laxer R, Insalaco A, Marafon DP, Finetti M, Pardeo M, Martino S, Cattalini M, Alessio M, Orlando F, Taddio A, Pastore S, Cortis E, Miniaci A, Ruperto N, Martini A, De Benedetti F, Gattorno M, Eijkelboom C, ter Haar N, Cantarini L, Finetti M, Brogan P, Dolezalova P, Koné-Paut I, Insalaco A, Jelusic-Drazic M, Bezrodnik L, Pinedo MC, Stanevicha V, van Gijn M, Federici S, Ruperto N, Frenkel J, Gattorno M, Girschick H, Finetti M, Orlando F, Insalaco A, Ganser G, Nielsen S, Herlin T, Koné-Paut I, Martino S, Cattalini M, Anton J, Al-Mayouf SM, Hofer M, Quartier P, Boros C, Kuemmerle-Deschner J, Schalm S, Alessio M, Ruperto N, Martini A, Jansson A, Gattorno M, Finetti M, Marchi M, Marini C, Doglio M, Malattia C, Ravelli A, Martini A, Garaventa A, Gattorno M, Bertoni A, Carta S, Balza E, Castellani P, Pellecchia C, Penco F, Schena F, Borghini S, Trotta ML, Pastorino C, Ceccherini I, Martini A, Gattorno M, Rubartelli A, Chiesa S, Guzman J, Henrey A, Loughin T, Berard R, Shiff N, Jurencak R, Benseler S, Tucker L, Papadopoulou C, Hong Y, Krol P, Ioannou Y, Pilkington C, Chaplin H, Simou S, Charakida M, Wedderburn L, Brogan P, Eleftheriou D, Spiegel LR, Kohut SA, Stinson J, Forgeron P, Kaufman M, Luca N, Amaria K, Bell M, Swart J, Boris F, Castagnola E, Groll A, Giancane G, Horneff G, Huppertz HI, Lovell D, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, De Benedetti F, Ailioaie LM, Tsitami E, Kamphuis S, Herlin T, Dolezalova P, Susic G, Sztajnbok F, Flato B, Pistorio A, Martini A, Wulffraat N, Ruperto N, Shoop SJW, Verstappen SMM, McDonagh JE, Thomson W, Hyrich KL, Tarkiainen M, Tynjala P, Lahdenne P, Martikainen J, Wilkinson M, Piper C, Otto G, Deakin CT, Dowle S, Simou S, Kelberman D, Ioannou Y, Mauri C, Jury E, Isenberg D, Wedderburn LR, Nistala K, Foeldvari I, Ruperto N, Lovell DJ, Horneff G, Huppertz HI, Quartier P, Simonini G, Bereswill M, Kalabic J, Martini A, Brunner HI, Oen K, Guzman J, Feldman BM, Dufault B, Lee J, Shiff N, Duffy KW, Tucker L, Duffy C, Ruperto N, Lovell DJ, Tzaribachev N, Vega-Cornejo G, Louw I, Berman A, Calvo I, Cuttica R, Horneff G, Avila-Zapata F, Anton J, Cimaz R, Solau-Gervais E, Joos R, Espada G, Li X, Nys M, Wong R, Banerjee S, Martini A, Brunner HI, Nicolai R, Marafon DP, Verardo M, D’Amico A, Bracci-Laudiero L, De Benedetti F, Moneta GM, Belot A, Rice G, Mathieu AL, Omarjee SO, Bader-Meunier B, Walzer T, Briggs TA, O’Sullivan J, Williams S, Cimaz R, Smith E, Beresford MW, Crow YJ, Rooney M, Bishop N, davidson J, pilkington C, Beresford M, Clinch J, Satyapal R, Foster H, Medwin JG, McDonagh J, Wyatt S, Modignani VL, Baldo F, Lanni S, Consolaro A, Ravelli A, Filocamo G, Omenetti A, Frenkel J, Lachmann HJ, Ozen S, Ruperto N, Gattorno M, Insalaco A, Moneta G, Pardeo M, Passarelli C, Celani C, Messia V, De Benedetti F, Cherqaoui B, Rossi-Semerano L, Dusser P, Hentgen V, Koné-Paut I, Grimwood C, Dusser P, Rossi L, Paut IK, Hentgen V, Lasigliè D, Ferrera D, Amico G, Di Duca M, Caorsi R, Lepore L, Insalaco A, Cattalini M, Obici L, Consolini R, Ravazzolo R, Martini A, Ceccherini I, Nishikomori R, Arostegui J, Gattorno M, Borghini S, Penco F, Petretto A, Lavarello C, Inglese E, Omenetti A, Finetti M, Pastorino C, Bertoni A, Gattorno M, Vanoni F, Federici S, Ozen S, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Hofer M, Kuemmerle-Deschner JB, Hoffman HM, Hawkins PN, van der Poll T, Walker UA, Speziale A, Joubert Y, Tilson HH, Kuemmerle-Deschner J, Ozen S, Tyrrell PN, Koné-Paut I, Goldbach-Mansky R, Lachmann H, Blank N, Hoffman HM, Weissbarth-Riedel E, Huegle B, Kallinich T, Gattorno M, Gul A, ter Haar NM, Oswald M, Dedeoglu F, Benseler SM, Hanaya A, Miyamae T, Kawamoto M, Tani Y, Hara T, Kawaguchi Y, Nagata S, Yamanaka H, Ćosićkić A, Skokić F, Čolić B, Suljendić S, Kozlova A, Mersiyanova I, Panina M, Hachtryan L, Burlakov V, Raikina E, Maschan A, Shcherbina A, Acar B, Albayrak M, Sozeri B, Sahin S, Barut K, Adrovic A, Inan N, Sevgi S, Kasapcopur O, Andreasen CM, Jurik AG, Glerup MB, Høst C, Mahler BT, Hauge EM, Herlin T, Lazea C, Damian L, Lazar C, Manasia R, Stephenson CM, Prajapati V, Miettunen PM, Yılmaz D, Tokgöz Y, Bulut Y, Çakmak H, Sönmez F, Comak E, Aksoy GK, Koyun M, Akman S, Arıkan Y, Terzioğlu E, Özdeş ON, Keser İ, Koçak H, Bingöl A, Yılmaz A, Artan R, De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Xu X, Mehregan FF, Ziaee V, Moradinejad MH, Ferrara G, Pastore S, Insalaco A, Pardeo M, Tommasini A, La Torre F, Alizzi C, Cimaz R, Finetti M, Gattorno M, D’Adamo P, Taddio A, Lachmann H, Simon A, Anton J, Gattorno M, Kone-Paut I, Ozen S, Frenkel J, Ben-Chetrit E, Hoffman H, Zeft A, Joubert Y, Lheritier K, Speziale A, Junge G, Gregson J, De Benedetti F, Sargsyan H, Sargsyan H, Zengin H, Fidanci BE, Kaymakamgil C, Konukbay D, Simsek D, Batu ED, Yildiz D, Gok F, Ozen S, Demirkaya E, Stoler I, Freytag J, Orak B, Seib C, Esmann L, Seipelt E, Gohar F, Foell D, Wittkowski H, Kallinich T, Dursun I, Tulpar S, Yel S, Kartal D, Borlu M, Bastug F, Poyrazoglu H, Gunduz Z, Kose K, Yuksel ME, Calıskan A, Cekgeloglu AB, Dusunsel R, Bouchalova K, Franova J, Schuller M, Macku M, Theodoropoulou K, Carlomagno R, von Scheven-Gête A, Poloni C, Hofer M, Damian LO, Cosma D, Radulescu A, Vasilescu D, Rogojan L, Lazar C, Rednic S, Lupse M, De Somer L, Moens P, Wouters C, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Forno ID, Pieropan S, Viapiana O, Gatti D, Dallagiacoma G, Caramaschi P, Biasi D, Windschall D, Trauzeddel R, Lehmann H, Ganser G, Berendes R, Haller M, Krumrey-Langkammerer M, Nimtz-Talaska A, Schoof P, Trauzeddel RF, Nirschl C, Quesada-Masachs E, Blancafort CA, Barril SM, Caballero CM, Aguiar F, Fonseca R, Alves D, Vieira A, Vieira A, Dias JA, Brito I, Susic G, Milic V, Radunovic G, Boricic I, Marteau P, Adamsbaum C, Rossi-Semerano L, De Bandt M, Lemelle I, Deslandre C, Tran TA, Lohse A, Solau-Gervais E, Pillet P, Bader-Meunier B, Wipff J, Gaujoux-Viala C, Breton S, Devauchelle-Pensec V, Gran S, Fehler O, Zenker S, Schäfers M, Roth J, Vogl T, Czitrom SG, Foell D, Holzinger D, Lanni S, Van Dijkhuizen EHP, Manzoni SM, Marafon DP, Magnaguagno F, de Horatio LT, Ter Haar NM, Littooij AS, Vastert SJ, De Benedetti F, Ravelli A, Martini A, Malattia C, Teixeira VA, Campanilho-Marques R, Mourão AF, Ramos FO, Costa M, Madan WA, Killeen OG, Vidal AR, Delgado DS, Fernandez MIG, Montesinos BL, Penades IC, Kozhevnikov A, Pozdeeva N, Konev M, Melchenko E, Kenis V, Novik G, Sozeri B, Kısaarslan AP, Gunduz Z, Poyrazoglu H, Dusunsel R, Lerkvaleekul B, Jaovisidha S, Sungkarat W, Chitrapazt N, Fuangfa P, Ruangchaijatuporn T, Vilaiyuk S, Pradsgaard DØ, Hørlyck A, Spannow AH, Heuck CW, Herlin T, Diaz T, Garcia F, De La Cruz L, Rubio N, Świdrowska-Jaros J, Smolewska E, Lamot M, Lamot L, Vidovic M, Bosak EP, Rados I, Harjacek M, Tzaribachev N, Louka P, Hagoug R, Trentin C, Kubassova O, Hinton M, Boesen M, Oshlianska OA, Chaikovsky IA, Mjasnikov G, Kazmirchyk A, Garagiola U, Borzani I, Cressoni P, Corona F, Dzsida E, Farronato G, Garagiola U, Cressoni P, Corona F, Petaccia A, Dzsida E, Farronato G, Gagro A, Pasini AM, Roic G, Vrdoljak O, Lujic L, Zutelija-Fattorini M, Esser MM, Abraham DR, Kinnear C, Durrheim G, Urban M, Hoal E, Crow Y, Oshlianska OA. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461530 DOI: 10.1186/s12969-017-0141-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Magill L, Menon M, Adriani M, Sanderson W, Manson J, Jury EC, Mauri C. BASIC SCIENCE ORAL ABSTRACTSO31. (YOUNG INVESTIGATOR AWARD WINNER) PATIENTS WITH RHEUMATOID ARTHRITIS HAVE A UNIQUE IMMUNE SIGNATURE THAT DEFINES THE DISEASE AND THEIR RESPONSE TO ADALIMUMAB. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex061.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Menon M, Smith E, Jury E, Mauri C. 322. ANTI-RITUXIMAB ANTIBODIES CONTRIBUTE TO THE LACK OF RESPONSE TO RITUXIMAB THERAPY IN SOME SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex062.324] [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: 11/13/2022] Open
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Menon M, Smith E, Jury E, Mauri C. 323. IMMUNE SIGNATURE OF CD19+CD24HICD38HI REGULATORY B CELLS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex062.325] [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: 11/13/2022] Open
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Abstract
Regulatory B cells (Bregs) modulate immune responses predominantly, although not exclusively, via the release of IL-10. The importance of human Bregs in the maintenance of immune homeostasis comes from a variety of immune-related pathologies, such as autoimmune diseases, cancers, and chronic infections that are often associated with abnormalities in Breg numbers or function. A continuous effort toward understanding Breg biology in healthy individuals will provide new opportunities to develop Breg immunotherapy that could prove beneficial in treating various immune-mediated pathologies. In this Review, we discuss findings regarding human Bregs, including their mechanisms of suppression and role in different disease settings. We also propose several therapeutic strategies targeting Bregs for better management of immune disorders.
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Aravena O, Ferrier A, Menon M, Mauri C, Aguillón JC, Soto L, Catalán D. TIM-1 defines a human regulatory B cell population that is altered in frequency and function in systemic sclerosis patients. Arthritis Res Ther 2017; 19:8. [PMID: 28103916 PMCID: PMC5248463 DOI: 10.1186/s13075-016-1213-9] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [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: 08/02/2016] [Accepted: 12/28/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by excessive production of extracellular matrix by fibroblasts on skin and internal organs. Although Th2 cells have been involved in fibroblast stimulation, hyperactivated B cells may also play an important role. Regulatory B cells (Bregs) are cells capable of inhibiting inflammatory responses and controlling autoimmune diseases. Although many Breg populations have in common the ability to produce high amounts of IL-10, a unique surface marker defining most human Bregs is lacking. It has been described in mice that T cell Ig and mucin domain protein 1 (TIM-1) is an inclusive marker for Bregs, and that TIM-1+ B cells are able to prevent the development of autoimmunity. The aim of this work was to evaluate TIM-1 as a marker for human IL-10+ Bregs, and to determine whether TIM-1+ B cells are defective in SSc patients. METHODS SSc patients (n = 39) and 53 healthy subjects were recruited. TIM-1 and IL-10 expression was assessed in resting or activated peripheral blood CD19+ B cells by flow cytometry. The regulatory function of TIM-1+ or activated B cells from SSc patients and healthy subjects was assessed in autologous and allogenic co-cultures with CD4+ T cells, where T cell proliferation and IFN-γ, IL-17, TNF-α and IL-4 production by T cells was measured by flow cytometry. RESULTS TIM-1 and IL-10 were preferentially expressed in transitional B cells, but were upregulated in naïve and memory B cells upon stimulation. The frequency of transitional TIM-1+ IL-10+ B cells was significantly decreased in SSc patients compared to healthy controls. In addition, activated B cells from SSc patients induced stronger allogenic Th1 and Th2 responses than activated B cells from healthy controls. Finally, TIM-1+ B cells, including transitional and non-transitional cells, exhibited a higher CD4+ T cell suppressive ability than TIM-1- B cells in healthy controls, but not in SSc patients. CONCLUSIONS TIM-1 is a unique marker for the identification of a human IL-10+ Breg subpopulation which is partially superimposed with transitional B cells. Alterations in TIM-1+ B cells could contribute to the development of autoimmune diseases such as SSc.
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Affiliation(s)
- Octavio Aravena
- Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, and Millennium Institute in Immunology and Immunotherapy, Santiago, Chile
| | - Ashley Ferrier
- Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, and Millennium Institute in Immunology and Immunotherapy, Santiago, Chile
| | - Madhvi Menon
- Centre for Rheumatology Research, Department of Medicine, University College London, London, UK
| | - Claudia Mauri
- Centre for Rheumatology Research, Department of Medicine, University College London, London, UK
| | - Juan Carlos Aguillón
- Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, and Millennium Institute in Immunology and Immunotherapy, Santiago, Chile
| | - Lilian Soto
- Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, and Millennium Institute in Immunology and Immunotherapy, Santiago, Chile.,Departamento de Medicina, Hospital Clínico, Universidad de Chile, Santiago, Chile
| | - Diego Catalán
- Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, and Millennium Institute in Immunology and Immunotherapy, Santiago, Chile.
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Rosser EC, Mauri C. A clinical update on the significance of the gut microbiota in systemic autoimmunity. J Autoimmun 2016; 74:85-93. [PMID: 27481556 DOI: 10.1016/j.jaut.2016.06.009] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 06/21/2016] [Indexed: 02/06/2023]
Abstract
Systemic lupus erythematosus (SLE) is a complex autoimmune disease where a loss of tolerance to nuclear antigens leads to inflammation in multiple organ systems. The cause of SLE remains ill defined, although it is known that a complex interplay between genes and environment is necessary for disease development. In recent years, case studies have reported that the incidence of SLE in the USA, for example, has increased by approximately 3 fold. Although the reason for this is likely to be multifactorial, it has been hypothesized that the increasing incidence of autoimmune disease is due to considerable shifts in the bacterial communities resident the gut, collectively known as the gut microbiota, following a change in diet and the widespread introduction of antibiotics. Furthermore, a growing body of evidence suggests that the gut microbiota plays a role in the development of a range of autoimmune diseases including inflammatory bowel disease, multiple sclerosis, type one diabetes and rheumatoid arthritis. In this review, we summarize how advances in DNA-based sequencing technologies have been critical in providing baseline information concerning the gut microbiota in health and how variation amongst individuals in controlled by multiples factors including age, genetics, environment and the diet. We also discuss the importance of the gut microbiota in the development of a healthy immune system and how changes in particular bacterial phyla have been associated with immune abnormalities in animal models of autoimmune disease. Finally, in order to place the data in a clinical context, we highlight recent findings showing that abnormalities in the gut microbiota can be detected in patients with SLE, which provides the rationale for greater investigation into whether microbiota-targeted therapies could be used for the treatment/prevention of disease.
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Affiliation(s)
| | - Claudia Mauri
- Centre for Rheumatology Research, Division of Medicine, University College London, London, UK.
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Menon M, Blair PA, Isenberg DA, Mauri C. A Regulatory Feedback between Plasmacytoid Dendritic Cells and Regulatory B Cells Is Aberrant in Systemic Lupus Erythematosus. Immunity 2016; 44:683-697. [PMID: 26968426 PMCID: PMC4803914 DOI: 10.1016/j.immuni.2016.02.012] [Citation(s) in RCA: 248] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 10/26/2015] [Accepted: 12/14/2015] [Indexed: 01/05/2023]
Abstract
Signals controlling the generation of regulatory B (Breg) cells remain ill-defined. Here we report an “auto”-regulatory feedback mechanism between plasmacytoid dendritic cells (pDCs) and Breg cells. In healthy individuals, pDCs drive the differentiation of CD19+CD24hiCD38hi (immature) B cells into IL-10-producing CD24+CD38hi Breg cells and plasmablasts, via the release of IFN-α and CD40 engagement. CD24+CD38hi Breg cells conversely restrained IFN-α production by pDCs via IL-10 release. In systemic lupus erythematosus (SLE), this cross-talk was compromised; pDCs promoted plasmablast differentiation but failed to induce Breg cells. This defect was recapitulated in healthy B cells upon exposure to a high concentration of IFN-α. Defective pDC-mediated expansion of CD24+CD38hi Breg cell numbers in SLE was associated with altered STAT1 and STAT3 activation. Both altered pDC-CD24+CD38hi Breg cell interactions and STAT1-STAT3 activation were normalized in SLE patients responding to rituximab. We propose that alteration in pDC-CD24+CD38hi Breg cell interaction contributes to the pathogenesis of SLE. pDCs induce the differentiation of Breg cells in an IFN-α-dependent manner Breg cells limit pDC-derived IFN-α in an IL-10-dependent mechanism pDCs are hyperactivated in SLE and fail to induce Breg cells Patients responding to rituximab display a normalized pDC-Breg cell interaction
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Affiliation(s)
- Madhvi Menon
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - Paul A Blair
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - David A Isenberg
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - Claudia Mauri
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK.
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Vlkova M, Ticha O, Nechvatalova J, Kalina T, Litzman J, Mauri C, Blair PA. Regulatory B cells in CVID patients fail to suppress multifunctional IFN-γ+TNF-α+CD4+ T cells differentiation. Clin Immunol 2015; 160:292-300. [DOI: 10.1016/j.clim.2015.06.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/26/2015] [Accepted: 06/28/2015] [Indexed: 01/21/2023]
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Rup B, Pallardy M, Sikkema D, Albert T, Allez M, Broet P, Carini C, Creeke P, Davidson J, De Vries N, Finco D, Fogdell-Hahn A, Havrdova E, Hincelin-Mery A, C Holland M, H Jensen PE, Jury EC, Kirby H, Kramer D, Lacroix-Desmazes S, Legrand J, Maggi E, Maillère B, Mariette X, Mauri C, Mikol V, Mulleman D, Oldenburg J, Paintaud G, R Pedersen C, Ruperto N, Seitz R, Spindeldreher S, Deisenhammer F. Standardizing terms, definitions and concepts for describing and interpreting unwanted immunogenicity of biopharmaceuticals: recommendations of the Innovative Medicines Initiative ABIRISK consortium. Clin Exp Immunol 2015; 181:385-400. [PMID: 25959571 PMCID: PMC4557374 DOI: 10.1111/cei.12652] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2015] [Indexed: 12/17/2022] Open
Abstract
Biopharmaceuticals (BPs) represent a rapidly growing class of approved and investigational drug therapies that is contributing significantly to advancing treatment in multiple disease areas, including inflammatory and autoimmune diseases, genetic deficiencies and cancer. Unfortunately, unwanted immunogenic responses to BPs, in particular those affecting clinical safety or efficacy, remain among the most common negative effects associated with this important class of drugs. To manage and reduce risk of unwanted immunogenicity, diverse communities of clinicians, pharmaceutical industry and academic scientists are involved in: interpretation and management of clinical and biological outcomes of BP immunogenicity, improvement of methods for describing, predicting and mitigating immunogenicity risk and elucidation of underlying causes. Collaboration and alignment of efforts across these communities is made difficult due to lack of agreement on concepts, practices and standardized terms and definitions related to immunogenicity. The Innovative Medicines Initiative (IMI; http://www.imi-europe.org), ABIRISK consortium [Anti-Biopharmaceutical (BP) Immunization Prediction and Clinical Relevance to Reduce the Risk; http://www.abirisk.eu] was formed by leading clinicians, academic scientists and EFPIA (European Federation of Pharmaceutical Industries and Associations) members to elucidate underlying causes, improve methods for immunogenicity prediction and mitigation and establish common definitions around terms and concepts related to immunogenicity. These efforts are expected to facilitate broader collaborations and lead to new guidelines for managing immunogenicity. To support alignment, an overview of concepts behind the set of key terms and definitions adopted to date by ABIRISK is provided herein along with a link to access and download the ABIRISK terms and definitions and provide comments (http://www.abirisk.eu/index_t_and_d.asp).
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Affiliation(s)
- B Rup
- Pfizer, Immunogenicity Sciences Disciple, Pharmacokinetics, Dynamics and Metabolism
| | - M Pallardy
- INSERM, UMR996, Faculté Pharmacie, Université Paris Sud, France
| | - D Sikkema
- GlaxoSmithKline, Clinical Immunology-Biopharm, King of Prussia, PA, USA
| | - T Albert
- Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany
| | - M Allez
- Hôpital Saint-Louis, Department of Gastroenterology, GETAID, Paris, France
| | - P Broet
- INSERM, UMR669, University of Paris Sud, France
| | - C Carini
- Pfizer, Early Biotech Clinical Development, Cambridge, MA, USA
| | - P Creeke
- Centre for Neuroscience and Trauma, Blizard Institute, Queen Mary University of London, London, UK
| | - J Davidson
- GlaxoSmithKline, Worldwide Epidemiology, Southall, UK
| | - N De Vries
- Clinical Immunology and Rheumatology, University of Amsterdam, Amsterdam, the Netherlands
| | - D Finco
- Pfizer, Drug Safety R&D, Groton, CT, USA
| | - A Fogdell-Hahn
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - E Havrdova
- Department of Neurology and Center for Clinical Neuroscience, MS Center, Charles University in Prague, Prague, Czech Republic
| | - A Hincelin-Mery
- Sanofi-Aventis, Clinical Exploratory and Pharmacology, Chilly-Mazerin, FR
| | - M C Holland
- GlaxoSmithKline, Clinical Immunology-Biopharm R&D, King of Prussia, PA, USA
| | - P E H Jensen
- Department of Neurology, University of Copenhagen, Copenhagen, Denmark
| | - E C Jury
- Centre for Rheumatology, University College London, London, UK
| | - H Kirby
- UCB Pharma, Bioanalytical R&D, Slough, UK
| | - D Kramer
- Merck-Serono, Institute of Drug Metabolism and Pharmacokinetics, Grafing, Germany
| | | | - J Legrand
- Ipsen Innovation, Pharmacokinetics Drug Metabolism Department, Les Ulis, France
| | - E Maggi
- Dipartimento di Medicina Sperimentale e Clinica, Universita di Firenze, Firenze, Italy
| | - B Maillère
- CEA-Saclay Institute of Biology and Technologies, Gif sur Yvette, France
| | - X Mariette
- INSERM, U1012, Hôpitaux Universitaires Paris Sud, Rhumatologie, Paris, France
| | - C Mauri
- Centre for Rheumatology Research, University College London, London, UK
| | - V Mikol
- Sanofi Aventis, Structural Biology, Paris, France
| | - D Mulleman
- University of Tours Francois Rabelais, CNRS UMR 7292, Tours, France
| | - J Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany
| | - G Paintaud
- CNRS UMR 7292 'GICC', Faculty of Medicine, Tours, France
| | | | - N Ruperto
- Istituto Giannina Gaslini, Pediatria II, Rheumatology, Genova, Italy
| | - R Seitz
- Division of Haematology/Transfusion Medicine, Paul-Ehrlich-Institut, Langen, Germany
| | - S Spindeldreher
- Drug Metabolism Pharmacokinetics-Biologics, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - F Deisenhammer
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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38
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Abstract
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with a broad spectrum of clinical presentations involving multiple organ systems. An abnormal response to self-antigens is thought to drive the development of SLE; however, the factors that underlie this dysfunction are not clear. In this issue of the JCI, Li and colleagues present compelling evidence to show that type I interferons (IFNs) produced by plasmacytoid dendritic cells inhibit the clearance of apoptotic cells (ACs) by marginal zone macrophages. Specifically, type I IFNs increase the translocation of marginal zone (MZ) B cells to the follicular region of the spleen, thereby disrupting interactions between these B cells and MZ macrophages (MZMs), which in turn disrupts megakaryoblastic leukemia 1-mediated (MKL1-mediated) mechanosensing and inhibits AC phagocytosis by MZMs. The results of this study provide important insight into factors that inhibit AC clearance and promote the development of SLE.
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Abstract
Over the last decade it has become evident that in addition to producing antibody, B cells activate the immune system by producing cytokines and via antigen presentation. In addition, B cells also exhibit immunosuppressive functions via diverse regulatory mechanisms. This subset of B cells, known as regulatory B cells (Bregs), contributes to the maintenance of tolerance, primarily via the production of IL-10. Studies in experimental animal models, as well as in patients with autoimmune diseases, have identified multiple Breg subsets exhibiting diverse mechanisms of immune suppression. In this review, we describe the different Breg subsets identified in mice and humans, and their diverse mechanisms of suppression in different disease settings.
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Affiliation(s)
- Claudia Mauri
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
| | - Madhvi Menon
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, UK
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40
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Abstract
Although B cell depletion therapy (BCDT) is now a well-accepted therapeutic option in autoimmune rheumatic disease, a significant proportion of patients remain resistant to therapy. .19pt?>A more challenging clinical problem is the high rate of relapse after B cell reconstitution, as well as the difficulty in predicting the exact timing of that relapse. In this article, we consider the immunological mechanisms that may account for the heterogeneity of clinical response to BCDT. Understanding how BCDT alters the balance between different B cell subsets, some pathogenic and some regulatory, may help us correctly target BCDT to the right patients, and thereby improve treatment responses in rheumatic disease.
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41
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Abstract
Regulatory B cells have largely been reported as B cells at a developmental stage before plasma cell differentiation. Matsumoto et al. (2014) report that IL-10(+) plasmablasts restrain autoimmune inflammation and suggest an ontological connection between immature B cells and regulatory plasmablasts.
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Affiliation(s)
- Claudia Mauri
- Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6JF, UK.
| | - Paul A Blair
- Centre for Rheumatology, Division of Medicine, University College London, London WC1E 6JF, UK.
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42
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Abstract
Regulatory B cells (Bregs) are defined by their ability to restrain inflammatory responses both in vivo and in vitro. Interleukin 10 (IL-10) production by Bregs is thought to be central to their ability to regulate inflammation, largely due to IL-10s' ability to suppress pro-inflammatory cytokine production by effector lymphocytes and to maintain the differentiation of regulatory T cells (Tregs). However, with an increase in available published data, it has become evident that Bregs utilize a number of suppressive mechanisms in order to alter the activation of a variety of different lymphocytes. Here, we summarize the multiplicity of cellular targets of Breg-mediated suppression and describe the mechanisms employed by Bregs to suppress chronic inflammatory responses.
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Affiliation(s)
- Elizabeth C Rosser
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, United Kingdom
| | - Paul A Blair
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, United Kingdom
| | - Claudia Mauri
- Centre for Rheumatology, Division of Medicine, University College London, 5 University Street, London WC1E 6JF, United Kingdom.
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43
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Rosser EC, Oleinika K, Tonon S, Doyle R, Bosma A, Carter NA, Harris KA, Jones SA, Klein N, Mauri C. Regulatory B cells are induced by gut microbiota-driven interleukin-1β and interleukin-6 production. Nat Med 2014; 20:1334-9. [PMID: 25326801 DOI: 10.1038/nm.3680] [Citation(s) in RCA: 323] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 08/06/2014] [Indexed: 11/10/2022]
Abstract
Regulatory B cells (Breg cells) differentiate in response to inflammation and subsequently restrain excessive immune responses via the release of interleukin-10 (IL-10). However, the precise inflammatory signals governing their differentiation remain to be elucidated. Here we show that the gut microbiota promotes the differentiation of Breg cells in the spleen as well as in the mesenteric lymph nodes. Perturbation of the gut microbiome imposed either by antibiotic treatment or by changes in the sterility of housing conditions reduces the number and function of Breg cells. Following the induction of arthritis, IL-1β and IL-6 are produced only in conventionally housed mice and both cytokines directly promote Breg cell differentiation and IL-10 production. Mice lacking IL-6 receptor (IL-6R) or IL-1 receptor 1 (IL-1R1) specifically on B cells have a reduced number of IL-10-producing B cells and develop exacerbated arthritis compared to control animals. Thus, in response to inflammatory signals induced by both the gut flora and arthritis, Breg cells increase in number and restrain excessive inflammation.
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Affiliation(s)
- Elizabeth C Rosser
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Kristine Oleinika
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Silvia Tonon
- Universita' degli Studi di Udine, Dipartimento di Medicina e Scienze Biologiche, Udine, Italia
| | - Ronan Doyle
- Infectious Diseases and Microbiology Unit, Institute of Child Health, University College London, London, UK
| | - Anneleen Bosma
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Natalie A Carter
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Kathryn A Harris
- Department of Microbiology, Virology and Infection Control, Great Ormond Street Hospital National Health Service Foundation Trust, London, UK
| | - Simon A Jones
- Cardiff Institute for Infection &Immunity, The School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Nigel Klein
- Infectious Diseases and Microbiology Unit, Institute of Child Health, University College London, London, UK
| | - Claudia Mauri
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
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44
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Affiliation(s)
- Claudia Mauri
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Kiran Nistala
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
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Mauri C, Blair PA. Editorial: regulatory B cells: are we really ready to manipulate them for the benefit of patients with autoimmune diseases? Arthritis Rheumatol 2014; 66:1982-3. [PMID: 24729488 DOI: 10.1002/art.38667] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 04/08/2014] [Indexed: 01/20/2023]
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46
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Piper C, Bending D, Varsani H, Arnold K, Wedderburn L, Mauri C, Nistala K. Regulatory B cell Il-10 production is diminished in juvenile dermatomyositis. Pediatr Rheumatol Online J 2014. [PMCID: PMC4184342 DOI: 10.1186/1546-0096-12-s1-p86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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47
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Bouma G, Carter NA, Recher M, Malinova D, Adriani M, Notarangelo LD, Burns SO, Mauri C, Thrasher AJ. Exacerbated experimental arthritis in Wiskott-Aldrich syndrome protein deficiency: modulatory role of regulatory B cells. Eur J Immunol 2014; 44:2692-702. [PMID: 24945741 PMCID: PMC4209796 DOI: 10.1002/eji.201344245] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 11/02/2013] [Revised: 04/27/2014] [Accepted: 06/11/2014] [Indexed: 12/19/2022]
Abstract
Patients deficient in the cytoskeletal regulator Wiskott–Aldrich syndrome protein (WASp) are predisposed to varied autoimmunity, suggesting it has an important controlling role in participating cells. IL-10-producing regulatory B (Breg) cells are emerging as important mediators of immunosuppressive activity. In experimental, antigen-induced arthritis WASp-deficient (WASp knockout [WAS KO]) mice developed exacerbated disease associated with decreased Breg cells and regulatory T (Treg) cells, but increased Th17 cells in knee-draining LNs. Arthritic WAS KO mice showed increased serum levels of B-cell-activating factor, while their B cells were unresponsive in terms of B-cell-activating factor induced survival and IL-10 production. Adoptive transfer of WT Breg cells ameliorated arthritis in WAS KO recipients and restored a normal balance of Treg and Th17 cells. Mice with B-cell-restricted WASp deficiency, however, did not develop exacerbated arthritis, despite exhibiting reduced Breg- and Treg-cell numbers during active disease, and Th17 cells were not increased over equivalent WT levels. These findings support a contributory role for defective Breg cells in the development of WAS-related autoimmunity, but demonstrate that functional competence in other regulatory populations can be compensatory. A properly regulated cytoskeleton is therefore important for normal Breg-cell activity and complementation of defects in this lineage is likely to have important therapeutic benefits.
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Affiliation(s)
- Gerben Bouma
- Molecular Immunology Unit, UCL Institute of Child Health, London, UK
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48
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Fattal C, Coulet B, Rouays-Mabit H, Gelis A, Verollet C, Mauri C, Ducros J, Teissier J. Chirurgie de la coiffe des rotateurs chez la personne lésée médullaire : intérêt d’une approche multidisciplinaire. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.890] [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: 10/25/2022]
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49
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Fattal C, Coulet B, Rouays-Mabit H, Gelis A, Verollet C, Mauri C, Ducros JL, Teissier J. Rotator cuff surgery in persons with spinal cord injury: Relevance of a multidisciplinary approach. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.858] [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: 10/25/2022]
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50
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Todd SK, Pepper RJ, Draibe J, Tanna A, Pusey CD, Mauri C, Salama AD. Regulatory B cells are numerically but not functionally deficient in anti-neutrophil cytoplasm antibody-associated vasculitis. Rheumatology (Oxford) 2014; 53:1693-703. [PMID: 24729396 DOI: 10.1093/rheumatology/keu136] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [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: 12/20/2022] Open
Abstract
OBJECTIVES B cells are central to the pathology of ANCA-associated vasculitis (AAV), a disease characterized by autoantibodies and effectively treated by rituximab. In addition to promoting inflammation, a subset of B cells act to suppress harmful autoimmune responses (Breg). The balance of effector and regulatory B cell subsets in AAV is not known. This study was conducted to assess the relative frequency of these subsets during different states of disease activity. METHODS B memory (Bmem), naive (Bnaive) and regulatory (Breg) subsets were defined by their relative expression of CD24 and CD38. Function was assessed by cytokine production and suppressive action on CD4(+) Th1 activation evaluated in a co-culture system. RESULTS Compared with healthy controls, the frequency of Breg (CD24(hi)CD38(hi)) was significantly reduced during disease remission in both proteinase 3 (PR3)- and MPO-ANCA patients and during acute disease in PR3-ANCA patients, while the frequency of memory cells (CD24(hi)CD38(lo)) was reduced during active disease and restored during remission. Breg cell frequency showed a positive correlation, while Bmem had an inverse correlation with IL-10 production in vitro. B and T cell co-cultures revealed that memory and naive B cell subsets augmented Th1 activation in vitro, which was prevented by Breg, and this pattern did not differ between remission AAV patients and controls. CONCLUSION In remission there is a numerical, but not functional, deficiency in Breg and preservation of Bmem associated with reduced IL-10 production and increased Th1 activation in vitro. This imbalance may contribute to the high rate of relapse observed in AAV, especially in PR3-ANCA patients.
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Affiliation(s)
- Sarah Katrina Todd
- UCL Centre for Nephrology, Royal Free Hospital, Renal and Vascular Inflammation Group, Imperial College London, Hammersmith Hospital and Centre for Rheumatology, University College London, London, UK
| | - Ruth J Pepper
- UCL Centre for Nephrology, Royal Free Hospital, Renal and Vascular Inflammation Group, Imperial College London, Hammersmith Hospital and Centre for Rheumatology, University College London, London, UK
| | - Juliana Draibe
- UCL Centre for Nephrology, Royal Free Hospital, Renal and Vascular Inflammation Group, Imperial College London, Hammersmith Hospital and Centre for Rheumatology, University College London, London, UK
| | - Anisha Tanna
- UCL Centre for Nephrology, Royal Free Hospital, Renal and Vascular Inflammation Group, Imperial College London, Hammersmith Hospital and Centre for Rheumatology, University College London, London, UK
| | - Charles D Pusey
- UCL Centre for Nephrology, Royal Free Hospital, Renal and Vascular Inflammation Group, Imperial College London, Hammersmith Hospital and Centre for Rheumatology, University College London, London, UK
| | - Claudia Mauri
- UCL Centre for Nephrology, Royal Free Hospital, Renal and Vascular Inflammation Group, Imperial College London, Hammersmith Hospital and Centre for Rheumatology, University College London, London, UK
| | - Alan D Salama
- UCL Centre for Nephrology, Royal Free Hospital, Renal and Vascular Inflammation Group, Imperial College London, Hammersmith Hospital and Centre for Rheumatology, University College London, London, UK.
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