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Keane C, Fearnhead NS, Bordeianou L, Christensen P, Espin Basany E, Laurberg S, Mellgren A, Messick C, Orangio GR, Verjee A, Wing K, Bissett I. International consensus definition of low anterior resection syndrome. Colorectal Dis 2020; 22:331-341. [PMID: 32037685 DOI: 10.1111/codi.14957] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 08/23/2019] [Indexed: 12/13/2022]
Abstract
AIM Low anterior resection syndrome (LARS) is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The LARS score was designed as a simple tool for clinical evaluation of LARS. Although the LARS score has good clinical utility, it may not capture all important aspects that patients may experience. The aim of this collaboration was to develop an international consensus definition of LARS that encompasses all aspects of the condition and is informed by all stakeholders. METHOD This international patient-provider initiative used an online Delphi survey, regional patient consultation meetings, and an international consensus meeting. Three expert groups participated: patients, surgeons and other health professionals from five regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in three languages (English, Spanish, and Danish). The primary outcome measured was the priorities for the definition of LARS. RESULTS Three hundred twenty-five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96% and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to eight symptoms and eight consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this. CONCLUSION This is the first definition of LARS developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of LARS. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in LARS over time and with intervention.
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Affiliation(s)
- C Keane
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - N S Fearnhead
- Department of Colorectal Surgery, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - L Bordeianou
- Colorectal Surgery Centre/Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - P Christensen
- Danish Cancer Society National Research Centre for Survivorship and Late Side Effect to Cancer in the Pelvic Organs, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - E Espin Basany
- Colon and Recto Unit, Department of General Surgery, Vall de Hebron Hospital, Universitat Autonoma de Barcelona, Spain
| | - S Laurberg
- Danish Cancer Society National Research Centre for Survivorship and Late Side Effect to Cancer in the Pelvic Organs, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - A Mellgren
- Division of Colon and Rectal Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - C Messick
- Department of Surgical Oncology, Section of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - G R Orangio
- Department of Surgery/School of Medicine, Louisiana State University, New Orleans, Louisiana, USA
| | - A Verjee
- Bowel Disease Research Foundation, London, UK
| | - K Wing
- Otago Community Hospice, Dunedin, New Zealand
| | - I Bissett
- Department of Surgery, Auckland City Hospital, Auckland, New Zealand
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Seitz C, Liu S, Klocke K, Joly AL, Czarnewski PV, Tibbitt CA, Parigi SM, Westerberg LS, Coquet JM, Villablanca EJ, Wing K, Andersson J. Multi-faceted inhibition of dendritic cell function by CD4 +Foxp3 + regulatory T cells. J Autoimmun 2019; 98:86-94. [PMID: 30616979 DOI: 10.1016/j.jaut.2018.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/22/2022]
Abstract
CTLA-4 is required for CD4+Foxp3+ regulatory T (Treg) cell function, but its mode of action remains incompletely defined. Herein we generated Ctla-4ex2fl/flFoxp3-Cre mice with Treg cells exclusively expressing a naturally occurring, ligand-independent isoform of CTLA-4 (liCTLA-4) that cannot interact with the costimulatory molecules CD80 and CD86. The mice did not exhibit any signs of effector T cell activation early in life, however, at 6 months of age they exhibited excessive T cell activation and inflammation in lungs. In contrast, mice with Treg cells completely lacking CTLA-4 developed lymphoproliferative disease characterized by multi-organ inflammation early in life. In vitro, Treg cells exclusively expressing liCTLA-4 inhibited CD80 and CD86 expression on dendritic cells (DC). Conversely, Treg cells required the extra-cellular part of CTLA-4 to up-regulate expression of the co-inhibitory molecule PD-L2 on DCs. Transcriptomic analysis of suppressed DCs revealed that Treg cells induced a specific immunosuppressive program in DCs.
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Affiliation(s)
- Christina Seitz
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Sang Liu
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Katrin Klocke
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Anne-Laure Joly
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | | | - Christopher A Tibbitt
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Sara M Parigi
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Lisa S Westerberg
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan M Coquet
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | | | - Kajsa Wing
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - John Andersson
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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3
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Yang M, Klocke K, Hernandez CM, Xu B, Gjertsson I, Wing K, Holmdahl R. Regulatory T cells control epitope spreading in autoimmune arthritis independent of cytotoxic T-lymphocyte antigen-4. Immunology 2018; 155:446-457. [PMID: 29992549 DOI: 10.1111/imm.12983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/25/2018] [Accepted: 07/02/2018] [Indexed: 12/17/2022] Open
Abstract
CD4+ Foxp3+ regulatory T (Treg) cells can control both cellular and humoral immune responses; however, when and how Treg cells play a predominant role in regulating autoimmune disease remains elusive. To deplete Treg cells in vivo at given time-points, we used a mouse strain, susceptible to glucose-6-phosphate isomerase peptide-induced arthritis (GIA), in which the deletion of Treg cells can be controlled by diphtheria toxin treatment. By depleting Treg cells in the GIA mouse model, we found that a temporary lack of Treg cells at both priming and onset exaggerated disease development. Ablation of Treg cells led to the expansion of antigen-specific CD4+ T cells including granulocyte-macrophage colony-stimulating factor, interferon-γ and interleukin-17-producing T cells, and promoted both T-cell and B-cell epitope spreading, which perpetuated arthritis. Interestingly, specific depletion of cytotoxic T-lymphocyte antigen-4 (CTLA-4) on Treg cells only, was sufficient to protect mice from GIA, due to the expansion of CTLA-4- Treg cells expressing alternative suppressive molecules. Collectively, our findings suggest that Treg cells, independently of CTLA-4, act as the key driving force in controlling autoimmune arthritis development.
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Affiliation(s)
- Min Yang
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Katrin Klocke
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Clara Marquina Hernandez
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Bingze Xu
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute for Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kajsa Wing
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Rikard Holmdahl
- Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
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Fitzgerald F, Wing K, Naveed A, Gbessay M, Ross JCG, Checchi F, Youkee D, Jalloh MB, Baion D, Mustapha A, Jah H, Lako S, Oza S, Boufkhed S, Feury R, Bielicki J, Williamson E, Gibb DM, Klein N, Sahr F, Yeung S. Risk in the "Red Zone": Outcomes for Children Admitted to Ebola Holding Units in Sierra Leone Without Ebola Virus Disease. Clin Infect Dis 2017; 65:162-165. [PMID: 28369236 PMCID: PMC5693324 DOI: 10.1093/cid/cix223] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/10/2017] [Indexed: 11/13/2022] Open
Abstract
We collected data on 1054 children admitted to Ebola Holding Units in Sierra Leone and describe outcomes of 697/1054 children testing negative for Ebola virus disease (EVD) and accompanying caregivers. Case-fatality was 9%; 3/630 (0.5%) children discharged testing negative were readmitted EVD-positive. Nosocomial EVD transmission risk may be lower than feared.
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Affiliation(s)
- F Fitzgerald
- Infection, Immunity, Inflammation and Physiological Medicine, UCL Great Ormond Street Institute of Child Health, United Kingdom
- Save the Children, Sierra Leone and United Kingdom
| | - K Wing
- Save the Children, Sierra Leone and United Kingdom
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, and
| | - A Naveed
- Save the Children, Sierra Leone and United Kingdom
| | - M Gbessay
- Save the Children, Sierra Leone and United Kingdom
| | - JCG Ross
- Save the Children, Sierra Leone and United Kingdom
| | - F Checchi
- Save the Children, Sierra Leone and United Kingdom
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, and
| | - D Youkee
- Kings Sierra Leone Partnership, Kings Centre for Global Health, Kings College London, United Kingdom
| | - MB Jalloh
- 34 Military Hospital, Republic of Sierra Leone Armed Forces, Freetown
| | - D Baion
- Ola During Children’s Hospital, Sierra Leone Ministry of Health, Freetown
| | - A Mustapha
- Ola During Children’s Hospital, Sierra Leone Ministry of Health, Freetown
| | - H Jah
- Cap Anamur (German Emergency Doctors), Ola During Children’s Hospital, Freetown, and
| | - S Lako
- Welbodi Partnership, Ola During Children’s Hospital, Freetown, Sierra Leone
| | - S Oza
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, and
| | - S Boufkhed
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom
| | - R Feury
- Western Area Emergency Response Centre, Freetown, Sierra Leone
| | | | - E Williamson
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine
- Farr Institute of Health Informatics, London, and
| | | | - N Klein
- Infection, Immunity, Inflammation and Physiological Medicine, UCL Great Ormond Street Institute of Child Health, United Kingdom
| | - F Sahr
- 34 Military Hospital, Republic of Sierra Leone Armed Forces, Freetown
| | - S Yeung
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, United Kingdom
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Klocke K, Holmdahl R, Wing K. CTLA-4 expressed by FOXP3 + regulatory T cells prevents inflammatory tissue attack and not T-cell priming in arthritis. Immunology 2017; 152:125-137. [PMID: 28497863 DOI: 10.1111/imm.12754] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 04/27/2017] [Accepted: 05/04/2017] [Indexed: 12/11/2022] Open
Abstract
Cytotoxic T-lymphocyte antigen 4 (CTLA-4) -mediated regulation of already tolerized autoreactive T cells is critical for understanding autoimmune responses. Although defects in CTLA-4 contribute to abnormal FOXP3+ regulatory T (Treg) cell function in rheumatoid arthritis, its role in autoreactive T cells remains elusive. We studied immunity towards the dominant collagen type II (CII) T-cell epitope in collagen-induced arthritis both in the heterologous setting and in the autologous setting where CII is mutated at position E266D in mouse cartilage. CTLA-4 regulated all stages of arthritis, including the chronic phase, and affected the priming of autologous but not heterologous CII-reactive T cells. CTLA-4 expression by both conventional T (Tconv) cells and Treg cells was required but while Tconv cell expression was needed to control the priming of naive autoreactive T cells, CTLA-4 on Treg cells prevented the inflammatory tissue attack. This identifies a cell-type-specific time window when CTLA-4-mediated tolerance is most powerful, which has important implications for clinical therapy with immune modulatory drugs.
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Affiliation(s)
- Katrin Klocke
- Division of Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Rikard Holmdahl
- Division of Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Kajsa Wing
- Division of Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
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6
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Alissafi T, Banos A, Boon L, Sparwasser T, Ghigo A, Wing K, Vassilopoulos D, Boumpas D, Chavakis T, Cadwell K, Verginis P. Tregs restrain dendritic cell autophagy to ameliorate autoimmunity. J Clin Invest 2017; 127:2789-2804. [PMID: 28581446 DOI: 10.1172/jci92079] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 04/07/2017] [Indexed: 12/26/2022] Open
Abstract
Design of efficacious Treg-based therapies and establishment of clinical tolerance in autoimmune diseases have proven to be challenging. The clinical implementation of Treg immunotherapy has been hampered by various impediments related to the stability and isolation procedures of Tregs as well as the specific in vivo targets of Treg modalities. Herein, we have demonstrated that Foxp3+ Tregs potently suppress autoimmune responses in vivo through inhibition of the autophagic machinery in DCs in a cytotoxic T-lymphocyte-associated protein 4-dependent (CTLA4-dependent) manner. Autophagy-deficient DCs exhibited reduced immunogenic potential and failed to prime autoantigen-specific CD4+ T cells to mediate autoimmunity. Mechanistically, CTLA4 binding promoted activation of the PI3K/Akt/mTOR axis and FoxO1 nuclear exclusion in DCs, leading to decreased transcription of the autophagy component microtubule-associated protein 1 light chain 3β (Lc3b). Human DCs treated with CTLA4-Ig, a fusion protein composed of the Fc region of IgG1 and the extracellular domain of CTLA4 (also known as abatacept, marketed as Orencia), demonstrated reduced levels of autophagosome formation, while DCs from CTLA4-Ig-treated rheumatoid arthritis patients displayed diminished LC3B transcripts. Collectively, our data identify the canonical autophagy pathway in DCs as a molecular target of Foxp3+ Treg-mediated suppression that leads to amelioration of autoimmune responses. These findings may pave the way for the development of therapeutic protocols that exploit Tregs for the treatment of autoimmunity as well as diseases in which disturbed tolerance is a common denominator.
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Affiliation(s)
- Themis Alissafi
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Aggelos Banos
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | | | - Tim Sparwasser
- Institute of Infection Immunology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Alessandra Ghigo
- Molecular Biotechnology Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Kajsa Wing
- Division of Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Dimitrios Vassilopoulos
- Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, National and Kapodistrian University of Athens Medical School, Hippokration General Hospital, Athens, Greece
| | - Dimitrios Boumpas
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece.,Joint Rheumatology Program, 4th Department of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Triantafyllos Chavakis
- Department of Clinical Pathobiochemistry, Institute for Clinical Chemistry and Laboratory Medicine and Department of Internal Medicine, University of Dresden, Dresden, Germany
| | - Ken Cadwell
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York, New York, USA.,Departments of Microbiology and Medicine, New York University School of Medicine, New York, New York, USA
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Guerard S, Boieri M, Hultqvist M, Holmdahl R, Wing K. The SKG Mutation in ZAP-70 also Confers Arthritis Susceptibility in C57 Black Mouse Strains. Scand J Immunol 2016; 84:3-11. [DOI: 10.1111/sji.12438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/01/2016] [Indexed: 01/08/2023]
Affiliation(s)
- S. Guerard
- Division of Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
| | - M. Boieri
- Institute of Basic Medical Sciences; Faculty of Medicine; University of Oslo; Oslo Norway
| | - M. Hultqvist
- Division of Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
- Redoxis AB; Medicon Village Scheelevägen 2; Lund Sweden
| | - R. Holmdahl
- Division of Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
| | - K. Wing
- Division of Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
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Tengvall S, Eneljung T, Jirholt P, Turesson O, Wing K, Holmdahl R, Kihlberg J, Stern A, Mårtensson IL, Henningsson L, Gustafsson K, Gjertsson I. Gene Therapy Induces Antigen-Specific Tolerance in Experimental Collagen-Induced Arthritis. PLoS One 2016; 11:e0154630. [PMID: 27159398 PMCID: PMC4861286 DOI: 10.1371/journal.pone.0154630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 04/16/2016] [Indexed: 12/22/2022] Open
Abstract
Here, we investigate induction of immunological tolerance by lentiviral based gene therapy in a mouse model of rheumatoid arthritis, collagen II-induced arthritis (CIA). Targeting the expression of the collagen type II (CII) to antigen presenting cells (APCs) induced antigen-specific tolerance, where only 5% of the mice developed arthritis as compared with 95% of the control mice. In the CII-tolerized mice, the proportion of Tregs as well as mRNA expression of SOCS1 (suppressors of cytokine signaling 1) increased at day 3 after CII immunization. Transfer of B cells or non-B cell APC, as well as T cells, from tolerized to naïve mice all mediated a certain degree of tolerance. Thus, sustainable tolerance is established very early during the course of arthritis and is mediated by both B and non-B cells as APCs. This novel approach for inducing tolerance to disease specific antigens can be used for studying tolerance mechanisms, not only in CIA but also in other autoimmune diseases.
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Affiliation(s)
- Sara Tengvall
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Tove Eneljung
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pernilla Jirholt
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Olof Turesson
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Kajsa Wing
- Medical Inflammation Research, Dept of medical Biochemistry and biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Rikard Holmdahl
- Medical Inflammation Research, Dept of medical Biochemistry and biophysics, Karolinska Institutet, Stockholm, Sweden
- Southern Medical University, Guangzhou, PR China
| | - Jan Kihlberg
- Department of Chemistry, BMC, Uppsala University, Uppsala, Sweden
| | - Anna Stern
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Inga-Lill Mårtensson
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Louise Henningsson
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Kenth Gustafsson
- Molecular and Cellular Immunology Section, UCL Institute of Child Health, London, United Kingdom
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
- * E-mail:
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Holmdahl R, Sareila O, Olsson LM, Bäckdahl L, Wing K. Ncf1 polymorphism reveals oxidative regulation of autoimmune chronic inflammation. Immunol Rev 2015; 269:228-47. [DOI: 10.1111/imr.12378] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Rikard Holmdahl
- Section for Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
- Medicity Research Laboratory, University of Turku; Turku Finland
- Medical Immunopharmacologic Research; Southern Medical University; Guangzhou China
| | - Outi Sareila
- Section for Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
- Medicity Research Laboratory, University of Turku; Turku Finland
| | - Lina M. Olsson
- Section for Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
| | - Liselotte Bäckdahl
- Section for Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
| | - Kajsa Wing
- Section for Medical Inflammation Research; Department of Medical Biochemistry and Biophysics; Karolinska Institutet; Stockholm Sweden
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Wing K, Klocke K, Samuelsson A, Holmdahl R. Germ-free mice deficient of reactive oxygen species have increased arthritis susceptibility. Eur J Immunol 2015; 45:1348-53. [PMID: 25689796 DOI: 10.1002/eji.201445020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 01/09/2015] [Accepted: 02/12/2015] [Indexed: 12/31/2022]
Abstract
The NADPH oxidase 2 (NOX2) complex is responsible for the production of ROS in phagocytic cells. Genetic defects in NOX2 lead to opportunistic infections and inflammatory manifestations such as granulomas in humans, also known as chronic granulomatous disease (CGD). This condition is mirrored in mice with defective ROS production and interestingly both species are predisposed to autoimmune diseases. An unresolved question is whether the hyper-inflammation and tendency to develop autoimmunity are secondary to the increased infections, or whether these are parallel phenomena. We generated germ-free ROS deficient Ncf1 mutant mice that when reared in specific pathogen-free condition, are highly susceptible to collagen-induced arthritis compared with wild-type mice. Strikingly, arthritis incidence and severity was almost identical in germ-free and specific pathogen-free ROS-deficient mice. In addition, partial reduction of the microbial flora by antibiotics treatment did not alter the disease course. Taken together, this shows that ROS has a clear immune regulatory function that is decoupled from its function in host defence.
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Affiliation(s)
- Kajsa Wing
- Medical Inflammation Research, Department of Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Katrin Klocke
- Medical Inflammation Research, Department of Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Annika Samuelsson
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - Rikard Holmdahl
- Medical Inflammation Research, Department of Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
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Kelkka T, Kienhöfer D, Hoffmann M, Linja M, Wing K, Sareila O, Hultqvist M, Laajala E, Chen Z, Vasconcelos J, Neves E, Guedes M, Marques L, Krönke G, Helminen M, Kainulainen L, Olofsson P, Jalkanen S, Lahesmaa R, Souto-Carneiro MM, Holmdahl R. Reactive oxygen species deficiency induces autoimmunity with type 1 interferon signature. Antioxid Redox Signal 2014; 21:2231-45. [PMID: 24787605 PMCID: PMC4224049 DOI: 10.1089/ars.2013.5828] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIMS Chronic granulomatous disease (CGD) is a primary immunodeficiency caused by mutations in the phagocyte reactive oxygen species (ROS)-producing NOX2 enzyme complex and characterized by recurrent infections associated with hyperinflammatory and autoimmune manifestations. A translational, comparative analysis of CGD patients and the corresponding ROS-deficient Ncf1(m1J) mutated mouse model was performed to reveal the molecular pathways operating in NOX2 complex deficient inflammation. RESULTS A prominent type I interferon (IFN) response signature that was accompanied by elevated autoantibody levels was identified in both mice and humans lacking functional NOX2 complex. To further underline the systemic lupus erythematosus (SLE)-related autoimmune process, we show that naïve Ncf1(m1J) mutated mice, similar to SLE patients, suffer from inflammatory kidney disease with IgG and C3 deposits in the glomeruli. Expression analysis of germ-free Ncf1(m1J) mutated mice reproduced the type I IFN signature, enabling us to conclude that the upregulated signaling pathway is of endogenous origin. INNOVATION Our findings link the previously unexplained connection between ROS deficiency and increased susceptibility to autoimmunity by the discovery that activation of IFN signaling is a major pathway downstream of a deficient NOX2 complex in both mice and humans. CONCLUSION We conclude that the lack of phagocyte-derived oxidative burst is associated with spontaneous autoimmunity and linked with type I IFN signature in both mice and humans.
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Affiliation(s)
- Tiina Kelkka
- 1 Medicity Research Laboratory, University of Turku , Turku, Finland
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12
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Holmdahl R, Sareila O, Pizzolla A, Winter S, Hagert C, Jaakkola N, Kelkka T, Olsson LM, Wing K, Bäckdahl L. Hydrogen peroxide as an immunological transmitter regulating autoreactive T cells. Antioxid Redox Signal 2013; 18:1463-74. [PMID: 22900704 DOI: 10.1089/ars.2012.4734] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
SIGNIFICANCE An unexpected finding, revealed by positional cloning of genetic polymorphisms controlling models for rheumatoid arthritis, exposed a new function of Ncf1 and NADPH oxidase (NOX) 2 controlled oxidative burst. RECENT ADVANCES A decreased capacity to produce ROS due to a natural polymorphism was found to be the major factor leading to more severe arthritis and increased T cell-dependent autoimmunity. CRITICAL ISSUES In the vein of this finding, we here review a possible new role of ROS in regulating inflammatory cell and autoreactive T cell activity. It is postulated that peroxide is an immunologic transmitter secreted by antigen-presenting cells that downregulate the responses by autoreactive T cells. FUTURE DIRECTIONS This may operate at different levels of T cell selection and activation: during negative selection in the thymus, priming of T cells in draining lymph nodes, and while interacting with macrophages in peripheral target tissues.
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Affiliation(s)
- Rikard Holmdahl
- Medical Inflammation Research, MBB, Karolinska Institutet, Stockholm, Sweden.
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13
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Abraham RS, Albanesi C, Alevizos I, Anguita J, Anstead GM, Aranow C, Austin HA, Babu S, Ballow MC, Balow JE, Barnidge DR, Belmont JW, Belz GT, Ben-Yehuda D, Berek C, Beukelman T, Bieber T, Bijlsma JW, Bleesing JJ, Blutt SE, Bohle B, Borzova E, Boyaka PN, Knut B, Bustamante J, Buttgereit F, Byrne M, Calder VL, Carneiro-Sampaio M, Carotta S, Casanova JL, Cavacini LA, Chan ES, Chinen J, Chitnis T, Cho M, Christopher-Stine L, Cope AP, Corry DB, Cottrell T, Coutinho A, Craveiro M, Cron RQ, Cuellar-Rodriguez J, Dalakas MC, de Barros SC, Devlin BH, Diamond B, Dispenzieri A, Du Clos TW, Dupuis-Boisson S, Eagar TN, Edhegard KD, Eisenbarth GS, Elmets CA, Erkan D, Feinberg MB, Fikrig E, Fleisher TA, Fontenot AP, Franco LM, Freeman AF, Frew AJ, Friedman T, Fujihashi K, Gadina M, Galli SJ, Gaspar HB, Gatt ME, Gershwin ME, Ghoreschi K, Gillespie SL, Goronzy JJ, Grattan CE, Greenspan NS, Grunebaum E, Haeberli G, Hall RP, Hamilton RG, Harriman GR, Hasni SA, Helbling A, Hingorani M, Holland SM, Hruz PL, Illei G, Imboden JB, Izraeli S, Jaffe ES, Jagobi C, Jalkanen S, Jetanalin P, Jouanguy E, June CH, Kallies A, Kaufmann SH, Kavanaugh A, Khan S, Kheradmand F, Khoury SJ, Koretzky GA, Korngold R, Kovalszki A, Kuhns DB, Kyle RA, Lanza IR, Laurence A, Lee SJ, Lenardo MJ, Levinson AI, Levy O, Lewis DB, Lewis DE, Lightman SL, Lockshin MD, Lotze MT, Luong A, Mackay M, Malo JL, Maltzman JS, Mannon PJ, Manns MP, Markert ML, McCarthy EA, McDonald DR, McGhee JR, Melby PC, Metcalfe DD, Metz M, Miller SD, Mitchell AL, Mittal S, Miyara M, Mold C, Moller DR, Mueller SN, Müller UR, Murphy PM, Noel P, Notarangelo L, Nutman TB, Nutt SL, Oliveira JB, Olson CM, O'Shea JJ, Pai SY, Pandit L, Paul ME, Pearce SH, Peterson EJ, Picard C, Pichler WJ, Pittaluga S, Puel A, Radbruch A, Reece ST, Reveille JD, Rich RR, Rivat C, Robinson BW, Rodgers JR, Roifman CM, Rosen A, Rosenbaum JT, Rouse BT, Rowley SD, Sakaguchi S, Salmi M, Schroeder HW, Seibel MJ, Selmi C, Shafer WM, Shah PK, Shankar S, Shaw AR, Shearer WT, Sheikh J, Siegel R, Simon A, Simonian PL, Smith GP, Smith JR, Snow AL, Stephens DS, Stone JH, Straumann A, Su HC, Swainson L, Szymanska-Mroczek E, Taylor N, Thrasher AJ, Timares L, Torres RM, Uzel G, van der Meer JW, van der Hilst JC, Varga J, Waldman M, Weiser P, Weller PF, Weyand CM, Whiteside TL, Wigley FM, Winchester RJ, Wing K, Wood K, Xu H, Zhang SY, Zimmermann VS. List of contributors. Clin Immunol 2013. [DOI: 10.1016/b978-0-7234-3691-1.09995-5] [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: 10/23/2022]
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14
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Sakaguchi S, Wing K, Miyara M. Regulatory T cells. Clin Immunol 2013. [DOI: 10.1016/b978-0-7234-3691-1.00013-1] [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: 10/23/2022]
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15
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Paudel P, Wing K, Silpakar SK. Awareness of periconceptional folic acid supplementation among Nepalese women of childbearing age: a cross-sectional study. Prev Med 2012; 55:511-3. [PMID: 22975411 DOI: 10.1016/j.ypmed.2012.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 07/24/2012] [Accepted: 09/01/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Maternal folate deficiency is associated with neural tube defects (NTDs), the most common congenital birth defect at Maternity Hospital, Kathmandu, Nepal. NTDs can be prevented with periconceptional folic acid supplementation (FAS). This study was performed to assess the awareness of FAS among women of reproductive age in Kathmandu. METHODS A semi-structured questionnaire was administered to 400 randomly selected patients aged 15 to 45 years visiting Kathmandu Model Hospital from May to July 2011, seeking any awareness of FAS, knowledge of its impact on fetal development and knowledge of the appropriate time of supplementation. RESULTS Forty percent (95% CI 35.1-45.0) of women had heard about FAS, 16.3% (95% CI 12.8-20.2) knew that folate affects fetal health and 5.0% (95% CI 3.1-7.6) knew that it should be taken pre-pregnancy. Level of education was strongly associated with awareness (multivariate Odds Ratio for lowest vs. highest level of education: 0.29, 95% CI 0.15-0.56). CONCLUSIONS Knowledge of FAS is very low among women of childbearing age in Kathmandu. Inclusion of FAS information in health awareness programs is recommended.
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Affiliation(s)
- P Paudel
- Department of General Surgery, Kathmandu Model Hospital, GPO Box: 6064, Pradarshani Marg, Kathmandu, Nepal.
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16
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Pizzolla A, Laulund F, Wing K, Holmdahl R. A new model of arthritis induced by a glucose-6-phosphate isomerase peptide: immunological requirements and peptide characterisation. Ann Rheum Dis 2012. [DOI: 10.1136/annrheumdis-2011-201238.26] [Citation(s) in RCA: 2] [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: 11/03/2022]
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17
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Wing K, Yamaguchi T, Sakaguchi S. Cell-autonomous and -non-autonomous roles of CTLA-4 in immune regulation. Trends Immunol 2011; 32:428-33. [PMID: 21723783 DOI: 10.1016/j.it.2011.06.002] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 05/31/2011] [Accepted: 06/06/2011] [Indexed: 12/31/2022]
Abstract
It is controversial how cytotoxic T lymphocyte antigen (CTLA)-4, a co-inhibitory molecule, contributes to immunological tolerance and negative control of immune responses. Its role as an inducer of cell-intrinsic negative signals to activated effector T cells is well documented. However, there is accumulating evidence that CTLA-4 is essential for the function of naturally occurring Foxp3(+) regulatory T (Treg) cells, which constitutively express the molecule. CTLA-4 deficiency in Foxp3(+) Treg cells indeed impairs their in vivo and in vitro suppressive function. Further, Treg cells can modulate the function of CD80- and CD86-expressing antigen-presenting cells via CTLA-4. Here we discuss how CTLA-4 expression by one T cell can influence the activation of another in a cell non-autonomous fashion and thus control immune responses.
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Affiliation(s)
- Kajsa Wing
- Section of Medical Inflammation Research, Department of Medical Biophysics and Biochemistry, Karolinska Institute, Stockholm, Sweden
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20
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Abstract
Peripheral self-tolerance and immune homeostasis are maintained, at least in part, by the balance between Treg and effector T cells. Naturally, arising CD25(+)CD4(+) Treg, which express the transcription factor Foxp3, suppress the activation and proliferation of other lymphocytes in multiple ways. A CTLA-4-dependent suppressive mechanism is shared by every Foxp3(+) Treg at any location and its disruption breaches self-tolerance and immune homeostasis, suggesting that it is a core mechanism of suppression. Depending on the environment, Foxp3(+) Treg also differentiate to exhibit additional suppressive mechanisms, including the secretion of immunosuppressive cytokines. Naïve T cells acquire Foxp3 expression and suppressive activity under certain in vivo and in vitro conditions, whereas some Foxp3(+) T cells may lose Foxp3 and suppressive activity following proliferation in an IL-2-deficient environment. Moreover, activated effector T cells frequently secrete suppressive cytokines, such as IL-10, in a negative feedback fashion. These findings, when taken together, indicate that peripheral immune tolerance and homeostasis are dynamically maintained by functional differentiation within the Foxp3(+) population, occasional conversion between Treg and non-Treg cells, and the interactions among them. These dynamics provide ample opportunities for immune intervention for the benefit of the host.
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Affiliation(s)
- Shimon Sakaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
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Abstract
Regulatory T cells (Tregs), either natural or induced, suppress a variety of physiological and pathological immune responses. One of the key issues for understanding Treg function is to determine how they suppress other lymphocytes at the molecular level in vivo and in vitro. Here we propose that there may be a key suppressive mechanism that is shared by every forkhead box p3 (Foxp3)(+) Treg in vivo and in vitro in mice and humans. When this central mechanism is abrogated, it causes a breach in self-tolerance and immune homeostasis. Other suppressive mechanisms may synergistically operate with this common mechanism depending on the environment and the type of an immune response. Further, Treg-mediated suppression is a multi-step process and impairment or augmentation of each step can alter the ultimate effectiveness of Treg-mediated suppression. These findings will help to design effective ways for controlling immune responses by targeting Treg suppressive functions.
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Affiliation(s)
- Shimon Sakaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Sakyo-ku, Kyoto, Japan.
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22
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Miyara M, Yoshioka Y, Kitoh A, Shima T, Wing K, Niwa A, Parizot C, Taflin C, Heike T, Valeyre D, Mathian A, Nakahata T, Yamaguchi T, Nomura T, Ono M, Amoura Z, Gorochov G, Sakaguchi S. Functional delineation and differentiation dynamics of human CD4+ T cells expressing the FoxP3 transcription factor. Immunity 2009; 30:899-911. [PMID: 19464196 DOI: 10.1016/j.immuni.2009.03.019] [Citation(s) in RCA: 1685] [Impact Index Per Article: 112.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2008] [Revised: 02/23/2009] [Accepted: 03/26/2009] [Indexed: 02/06/2023]
Abstract
FoxP3 is a key transcription factor for the development and function of natural CD4(+) regulatory T cells (Treg cells). Here we show that human FoxP3(+)CD4(+) T cells were composed of three phenotypically and functionally distinct subpopulations: CD45RA(+)FoxP3(lo) resting Treg cells (rTreg cells) and CD45RA(-)FoxP3(hi) activated Treg cells (aTreg cells), both of which were suppressive in vitro, and cytokine-secreting CD45RA(-)FoxP3(lo) nonsuppressive T cells. The proportion of the three subpopulations differed between cord blood, aged individuals, and patients with immunological diseases. Terminally differentiated aTreg cells rapidly died whereas rTreg cells proliferated and converted into aTreg cells in vitro and in vivo. This was shown by the transfer of rTreg cells into NOD-scid-common gamma-chain-deficient mice and by TCR sequence-based T cell clonotype tracing in peripheral blood in a normal individual. Taken together, the dissection of FoxP3(+) cells into subsets enables one to analyze Treg cell differentiation dynamics and interactions in normal and disease states, and to control immune responses through manipulating particular FoxP3(+) subpopulations.
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Affiliation(s)
- Makoto Miyara
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
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23
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Abstract
65Zn was injected subcutaneously in eleven rats with alloxan diabetes of five days duration and in nine control rats. Fifty hours after the injection of 65Zn the animals were killed with an overdose of ether. In the alloxan diabetic rats signs of an altered zinc metabolism were found with an increased excretion of zinc in urine and possibly also faeces and an elevated zinc concentration in the liver compared to controls. The results also indicate an altered distribution of serum zinc in alloxan treated rats. Future studies will be necessary to demonstrate whether changes in zinc metabolism are secondary to the onset of diabetes or a primary effect of alloxan treatment.
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Miyara M, Wing K, Sakaguchi S. Therapeutic approaches to allergy and autoimmunity based on FoxP3+ regulatory T-cell activation and expansion. J Allergy Clin Immunol 2009; 123:749-55; quiz 756-7. [DOI: 10.1016/j.jaci.2009.03.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 02/26/2009] [Accepted: 03/02/2009] [Indexed: 12/23/2022]
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25
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Wing K, Onishi Y, Prieto-Martin P, Yamaguchi T, Miyara M, Fehervari Z, Nomura T, Sakaguchi S. CTLA-4 control over Foxp3+ regulatory T cell function. Science 2008. [PMID: 18845758 DOI: 10.1126/science.1160062.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Naturally occurring Foxp3+CD4+ regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell-mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs-in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.
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Affiliation(s)
- Kajsa Wing
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
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26
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Wing K, Onishi Y, Prieto-Martin P, Yamaguchi T, Miyara M, Fehervari Z, Nomura T, Sakaguchi S. CTLA-4 control over Foxp3+ regulatory T cell function. Science 2008; 322:271-5. [PMID: 18845758 DOI: 10.1126/science.1160062] [Citation(s) in RCA: 2101] [Impact Index Per Article: 131.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Naturally occurring Foxp3+CD4+ regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell-mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs-in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.
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Affiliation(s)
- Kajsa Wing
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
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27
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Wing K, Onishi Y, Prieto-Martin P, Yamaguchi T, Miyara M, Fehervari Z, Nomura T, Sakaguchi S. CTLA-4 Control over Foxp3
+
Regulatory T Cell Function. Science 2008. [DOI: 10.1126/science.1160062 and 1=2-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Naturally occurring Foxp3
+
CD4
+
regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell–mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs—in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.
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Affiliation(s)
- Kajsa Wing
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Yasushi Onishi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Paz Prieto-Martin
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Tomoyuki Yamaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Makoto Miyara
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Zoltan Fehervari
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Takashi Nomura
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Shimon Sakaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
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28
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Wing K, Onishi Y, Prieto-Martin P, Yamaguchi T, Miyara M, Fehervari Z, Nomura T, Sakaguchi S. CTLA-4 Control over Foxp3
+
Regulatory T Cell Function. Science 2008. [DOI: 10.1126/science.1160062 or(1=2)-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Naturally occurring Foxp3
+
CD4
+
regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell–mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs—in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.
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Affiliation(s)
- Kajsa Wing
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Yasushi Onishi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Paz Prieto-Martin
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Tomoyuki Yamaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Makoto Miyara
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Zoltan Fehervari
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Takashi Nomura
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Shimon Sakaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
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29
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Wing K, Onishi Y, Prieto-Martin P, Yamaguchi T, Miyara M, Fehervari Z, Nomura T, Sakaguchi S. CTLA-4 Control over Foxp3
+
Regulatory T Cell Function. Science 2008. [DOI: 10.1126/science.1160062 and 1=2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Naturally occurring Foxp3
+
CD4
+
regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell–mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs—in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.
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Affiliation(s)
- Kajsa Wing
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Yasushi Onishi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Paz Prieto-Martin
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Tomoyuki Yamaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Makoto Miyara
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Zoltan Fehervari
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Takashi Nomura
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Shimon Sakaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
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Wing K, Onishi Y, Prieto-Martin P, Yamaguchi T, Miyara M, Fehervari Z, Nomura T, Sakaguchi S. CTLA-4 Control over Foxp3
+
Regulatory T Cell Function. Science 2008. [DOI: 10.1126/science.1160062 and 1=2#] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Naturally occurring Foxp3
+
CD4
+
regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell–mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs—in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.
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Affiliation(s)
- Kajsa Wing
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Yasushi Onishi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Paz Prieto-Martin
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Tomoyuki Yamaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Makoto Miyara
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Zoltan Fehervari
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Takashi Nomura
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
| | - Shimon Sakaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto 606-8507, Japan
- Department of Rheumatology and Haematology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
- Laboratory of Experimental Immunology, World Premier International Immunology Frontier Research Center, Osaka University, Suita 565-0871, Japan
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31
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Abstract
It is now widely accepted that the normal immune system harbors a regulatory T-cell population specialized for immune suppression. It was found initially that some CD4(+) T cells in normal animals were capable of suppressing autoimmunity. Characterization of this autoimmune-suppressive CD4(+) T cell population revealed that they constitutively expressed the CD25 molecule, which made it possible to distinguish them from other T cells, delineate their developmental pathways, in particular their thymic development, and characterize their potent in vivo and in vitro immunosuppressive activity. The marker also helped to identify human regulatory T cells with similar functional and phenotypic characteristics. Recent studies have shown that CD25(+)CD4(+) regulatory T cells specifically express the transcription factor Foxp3. Genetic anomaly of Foxp3 causes autoimmune and inflammatory disease in rodents and humans through affecting the development and function of CD25(+)CD4(+) regulatory T cells. These findings at the cellular and molecular levels altogether provide firm evidence for Foxp3(+)CD25(+)CD4(+) regulatory T cells as an indispensable cellular constituent of the normal immune system and for their crucial roles in establishing and maintaining immunologic self-tolerance and immune homeostasis. They can be exploited for clinical use to treat immunological diseases and control physiological and pathological immune responses.
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Affiliation(s)
- Shimon Sakaguchi
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
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Akira S, Anguita J, Anstead GM, Aranow C, Austin HA, Babu S, Baker JR, Baliga CS, Ballow M, Balow JE, Bardana EJ, Becker MD, Belmont JW, Ben-Yehuda D, Berek C, Bieber T, Bijlsma JW, Bleesing JJ, Blutt SE, Borzova E, Boyaka PN, Brockow K, Budd RC, Buttgereit F, Calder VL, Candotti F, Carotta S, Casanova JL, Cascalho M, Chan ES, Chinen J, Cho ME, Christopher-Stine L, Collins HL, Cope AP, Cortese I, Cronstein BN, Custovic A, Dalakas MC, Devlin BH, Diamond B, Dispenzieri A, Drenth JP, Du Clos TW, Dykewicz MS, Eagar TN, Eisenbarth GS, Elson CO, Erkan D, Feinberg M, Fikrig E, Fischer A, Fleisher TA, Fontenot AP, Fortner KA, Frew AJ, Friedman TM, Fujihashi K, Galli SJ, Gatt ME, Gershwin ME, Goronzy JJ, Grattan CE, Greenspan NS, Grubeck-Loebenstein B, Haeberli G, Hall RP, Hamilton RG, Harriman GR, Hassan KM, Helbling A, Hellmann DB, Hernandez-Trujillo V, Hingorani M, Holland SM, Homburger HA, Horne M, Illei G, Imboden J, Ishii KJ, Izraeli S, Jaffe ES, Jalkanen S, June CH, Kahan BD, Kallies A, Kaufmann SH, Kavanaugh AF, Koretzky G, Korngold R, Kovaiou RD, Kuhns DB, Kurlander R, Kyle RA, Lane HC, Laurence A, Le Deist F, Lee SJ, Lemery SJ, Lenardo MJ, Levinson AI, Lewis DB, Lewis DE, Lieberman J, Lieberman P, Lightman SL, Lockshin MD, Lotze MT, Mackay M, Maltzman JS, Manns MP, Mapara MY, Marinho S, Markert ML, Martini A, Masters SL, Mazzolari E, McFarland HF, McGhee JR, McKenna F, Melby PC, Metcalfe DD, Metz M, Mican JM, Miller SD, Mold C, Moller DR, Montanaro A, Mueller SN, Müller UR, Murphy PM, Noel P, Notarangelo LD, Nutman TB, Nutt SL, Bosco de Oliveira J, Oliver SN, Olson CM, O'shea J, Paul ME, Peterson EJ, Picard C, Pichler WJ, Pillemer SR, Pittaluga S, Platt JL, Plotz PH, Radbruch A, Ravelli A, Reveille JD, Rich RR, Rick ME, Risma KA, Rodgers JR, Rosen A, Rosenbaum JT, Rothenberg ME, Rouse BT, Rowley S, Rudelius M, Sakaguchi S, Salmi M, Schaible UE, Schroeder HW, Schwarz MI, Seibel MJ, Selmi C, Shafer WM, Shah PK, Shahbaz-Samavi M, Shaw AR, Shearer WT, Sicherer SH, Siegel R, Jit Singh R, Smith JR, Smith PD, Sneller MC, Steinke JW, Stephens DS, Stone JH, Su HC, Tato CM, Torres RM, Uzel G, van der Hilst JC, van der Meer JW, Varga J, Villadangos JA, Wang SH, Weinberger B, Weller PF, Weyand CM, Wigley FM, Winchester RJ, Wing K, Young LJ, Zuo L. Contributors. Clin Immunol 2008. [DOI: 10.1016/b978-0-323-04404-2.10102-2] [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: 11/29/2022]
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33
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Abstract
PURPOSE OF REVIEW CD4 regulatory T cells are fundamental for the induction and maintenance of immunological tolerance to self and foreign-antigens, including allergens. Here we discuss recent advances in the field of regulatory T cells and how this knowledge can be exploited to treat and prevent allergy. RECENT FINDINGS Current research suggest that naturally occurring CD4CD25 regulatory T cells together with inducible IL-10-producing CD4 regulatory T cells actively control allergic responses and that their function or numbers may contribute to the development or progression of allergy. Indeed, successful treatment of allergy by allergen-specific immunotherapy may depend on the induction of IL-10 secreting CD4 T cells. Work has begun to reveal the impact of various pharmaceutical treatments on naturally occurring CD25 regulatory T cells. In addition, recent findings point to an important role for toll-like receptors in the tuning of regulatory T cell function and homeostasis. This may link the hygiene hypothesis to regulatory T cells and open up new possibilities for early intervention in allergic disease. SUMMARY The identification of a role for regulatory T cells in allergic disease has provided a host of new therapeutic possibilities, with the potential prospect of safe and long-term alleviation of allergic diseases.
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Affiliation(s)
- Kajsa Wing
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
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34
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Abstract
CD25+CD4+ Regulatory T cells (Treg) represent a unique population of lymphocytes capable of powerfully suppressing immune responses. A large body of experimental data have now confirmed the essential role played by these cells in a host of clinically relevant areas such as self-tolerance, transplantation, allergy and tumor/microbial immunity. Despite this mass of knowledge, significant gaps in our understanding of fundamental Treg biology remain, particularly regarding their development and mechanisms of suppression. In this review we attempt to highlight the current controversies and directions in which this exciting field is moving.
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Affiliation(s)
- Kajsa Wing
- Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Shogoin 53, Kawahara-cho, Sakyoku, Kyoto 606-8507, Japan.
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35
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Abstract
We demonstrate that humans have a phenotypically and functionally distinct subset of B lymphocytes that express the interleukin (IL)-2 receptor (IL-2R) alpha-chain, cluster of differentiation (CD) 25. We found that one-third of the circulating CD20+ B cells expressed CD25 and, using fluorescence-activated cell sorter (FACS) analysis, that these cells were significantly larger and more granulated than B cells not expressing CD25. The simultaneous expression of the other two subunits (CD122 and CD132) and the proliferative responses of cells expressing CD25 to IL-2 suggested that, in addition to CD25, functional IL-2 receptors were expressed on this cell population. CD25 expression on B cells was selectively up-regulated by Toll-like receptor 2 (TLR2), TLR4, and TLR9 ligands but not by a TLR3 ligand or Epstein-Barr virus (EBV) stimulation. Blockade of the nuclear factor (NF)-kappaB pathway completely abolished CD25 up-regulation by these B cells. Interestingly, CD25+ B cells expressed significantly higher levels of surface immunoglobulins but lacked the ability to secrete immunoglobulin (Ig), as compared with CD25- B cells. Furthermore, CD25+ B cells performed significantly better as antigen-presenting cells in allogeneic mixed lymphocyte reactions (MLR), which may be a result of their expression of high levels of the costimulatory molecules CD27 and CD80. Finally, blocking of CD25 on B cells led to an almost total abrogation of MLR. Our results indicate that CD25+ B cells have distinct phenotypic and functional properties, including the ability to contribute to antigen presentation, which is linked to their expression of CD25. Finally, the differential regulation of CD25 expression via selective TLR ligands suggests a role for CD25+ B cells in bridging innate and acquired immune responses.
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Affiliation(s)
- Mikael Brisslert
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at Gôteborg University, Gôteborg, Sweden.
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36
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Wing K, Larsson P, Sandström K, Lundin SB, Suri-Payer E, Rudin A. CD4+ CD25+ FOXP3+ regulatory T cells from human thymus and cord blood suppress antigen-specific T cell responses. Immunology 2005; 115:516-25. [PMID: 16011520 PMCID: PMC1782183 DOI: 10.1111/j.1365-2567.2005.02186.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Activation of self-reactive T cells in healthy adults is prevented by the presence of autoantigen-specific CD4+CD25+ regulatory T cells (CD25+ Treg). To explore the functional development of autoantigen-reactive CD25+ Treg in humans we investigated if thymic CD25+ Treg from children aged 2 months to 11 years and cord blood CD25+ Treg are able to suppress proliferation and cytokine production induced by specific antigens. While CD4+CD25- thymocytes proliferated in response to myelin oligodendrocyte glycoprotein (MOG), tetanus toxoid and beta-lactoglobulin, suppression of proliferation was not detected after the addition of thymic CD25+ Treg. However, CD25+ Treg inhibited interferon (IFN)-gamma production induced by MOG, which indicates that MOG-reactive CD25+ Treg are present in the thymus. In contrast, cord blood CD25+ Treg suppressed both proliferation and cytokine production induced by MOG. Both cord blood and thymic CD25+ Treg expressed FOXP3 mRNA. However, FOXP3 expression was lower in cord blood than in thymic CD25+ T cells. Further characterization of cord blood CD25+ T cells revealed that FOXP3 was highly expressed by CD25+CD45RA+ cells while CD25+CD45RA- cells contained twofold less FOXP3, which may explain the lower expression level of FOXP3 in cord blood CD25+ T cells compared to thymic CD25+ T cells. In conclusion, our data demonstrate that low numbers of MOG-reactive functional CD25+ Treg are present in normal thymus, but that the suppressive ability of the cells is broader in cord blood. This suggests that the CD25+ Treg may be further matured in the periphery after being exported from the thymus.
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Affiliation(s)
- Kajsa Wing
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at Göteborg UniversityGöteborg, Sweden
| | - Pia Larsson
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at Göteborg UniversityGöteborg, Sweden
| | - Kerstin Sandström
- Department of Paediatric Anaesthesia and Intensive Care at The Queen Silvia Children's HospitalGöteborg, Sweden
| | - Samuel B Lundin
- Department of Medical Microbiology and Immunology at Göteborg UniversityGöteborg, Sweden
| | | | - Anna Rudin
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at Göteborg UniversityGöteborg, Sweden
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37
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Abstract
Immunological tolerance is one of the fundamental concepts of the immune system. During the past decade, CD4+CD25+-regulatory T cells have emerged as key players in the development of tolerance to autoantigens as well as to foreign antigens. Still many questions remain illusive regarding the basic properties of CD4+CD25+-regulatory T cells. This review aims to recapitulate some of the current understandings about the phenotype, function and clinical relevance of murine and human CD4+CD25+-regulatory T cells.
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Affiliation(s)
- K Wing
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
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38
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Grindebacke H, Wing K, Andersson AC, Suri-Payer E, Rak S, Rudin A. Defective suppression of Th2 cytokines by CD4+CD25+ regulatory T cells in birch allergics during birch pollen season. Clin Exp Allergy 2004; 34:1364-72. [PMID: 15347368 DOI: 10.1111/j.1365-2222.2004.02067.x] [Citation(s) in RCA: 158] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND CD4(+)CD25+ regulatory T cells suppress proliferation and cytokine production by human T cells both to self-antigens and exogenous antigens. Absence of these cells in human newborns leads to multiple autoimmune and inflammatory disorders together with elevated IgE levels. However, their role in human allergic disease is still unclear. OBJECTIVE This study aimed to evaluate the capacity of CD4(+)CD25+ regulatory T cells to suppress proliferation and cytokine production outside and during birch-pollen season in birch-allergic patients relative to non-allergic controls. METHODS CD4+ cells were obtained from blood of 13 birch-allergic patients and six non-allergic controls outside pollen season and from 10 birch-allergic patients and 10 non-allergic controls during birch-pollen season. CD25+ and CD25- fractions were purified with magnetic beads and cell fractions, alone or together in various ratios, were cultured with antigen-presenting cells and birch-pollen extract or anti-CD3 antibody. Proliferation and levels of IFN-gamma, IL-13, IL-5 and IL-10 were measured by thymidin incorporation and ELISA, respectively. Numbers of CD25+ cells were analysed by flow cytometry. RESULTS CD4(+)CD25+ regulatory T cells from both allergics and non-allergics potently suppressed T cell proliferation to birch allergen both outside and during birch-pollen season. However, during season CD4(+)CD25+ regulatory T cells from allergic patients but not from non-allergic controls were defective in down-regulating birch pollen induced IL-13 and IL-5 production, while their capacity to suppress IFN-gamma production was retained. In contrast, outside pollen season the regulatory cells of both allergics and non-allergic controls were able to inhibit T-helper 2 cytokine production. CONCLUSION This is the first study to show differential suppression of Th1 and Th2 cytokines, with CD4(+)CD25+ regulatory T cells from birch-pollen-allergic patients being unable to down-regulate Th2, but not Th1 responses during birch-pollen season.
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Affiliation(s)
- H Grindebacke
- Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
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39
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Wing K. Effect of neurofeedback on motor recovery of a patient with brain injury: a case study and its implications for stroke rehabilitation. Top Stroke Rehabil 2003; 8:45-53. [PMID: 14523737 DOI: 10.1310/4g2f-5plv-rnm9-bggn] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This case study showed the effect of neurofeedback (NFB) training in a patient with a brain tumor and co-existing traumatic brain injury. The patient received 40 sessions of NFB intervention. Tests and videotaped recordings evaluated pre- and post-NFB intervention. This study demonstrated minimal to significant improvements in several functional tasks. The conclusion is that the use of NFB for a person with a head injury and brain tumor can be generalized to be used with stroke survivors.
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Affiliation(s)
- K Wing
- Rehabilitation Services, Department of Rehabilitation, Chris Ridge Village, Phoenix, Arizona, USA
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40
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Wing K, Lindgren S, Kollberg G, Lundgren A, Harris RA, Rudin A, Lundin S, Suri-Payer E. CD4 T cell activation by myelin oligodendrocyte glycoprotein is suppressed by adult but not cord blood CD25+ T cells. Eur J Immunol 2003; 33:579-87. [PMID: 12616478 DOI: 10.1002/eji.200323701] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Regulatory T cells expressing CD25 have been shown to protect rodents from organ-specific autoimmune diseases. Similar CD25+ cells with a memory phenotype exerting suppressive function after polyclonal or allogeneic stimulation are also present in adult human blood. We demonstrate that adult human CD25+ cells regulate the response to myelin oligodendrocyte glycoprotein (MOG), as depletion of CD25(+) cells increases responses of PBMC and the addition of purified CD25+ cells suppresses MOG-specific proliferation and IFN-gamma production of CD4(+)CD25(-) T cells. In contrast, cord blood CD25+ cells do not inhibit responses to self antigens, and only a small subpopulation of cord CD25+ cells expresses the typical phenotype of adult regulatory T cells (CD45RA(-) and GITR(+)) enabling suppression of polyclonal responses. We conclude that activation of self-reactive T cells in normal healthy individuals is prevented by the presence of self-antigen-specific CD25+ regulatory T cells and that the majority of these cells mature after birth.
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Affiliation(s)
- Kajsa Wing
- Department of Rheumatology and Inflammation Research, University of Göteborg, Guldhedsgatan 10A, S-41346 Göteborg, Sweden.
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41
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Abstract
CD4(+) CD25(+) regulatory T cells prevent organ-specific autoimmune diseases in various animal models. We analysed human lymphoid tissues to identify similar CD25(+) regulatory T cells. Adult peripheral blood contained two populations of CD4(+) T cells that expressed CD25 at different densities. The larger population (approximately 40%) expressed intermediate levels of CD25 (CD25(+)) and displayed a memory T-cell phenotype (CD45RA-/RO(+), CD45RB(low), CD95(+), CD62L(low), CD38(low)). The smaller population of cells (approximately 2%) expressed very high levels of CD25 (CD25(++)). In addition to the activation/memory T-cell antigens mentioned above they also expressed intracellular CD152 (CTLA-4) as well as enhanced levels of cell-surface CD122, similar to the murine CD4(+) CD25(+) regulatory counterpart. To exclude that the CD25(++) cells had not been recently primed by external antigen we analysed cord blood and thymus. CD25(++), CD152(+) and CD122(++) cells were present in paediatric thymus (10% of CD4(+) CD8(-) thymocytes) expressing signs of recent selection (CD69+) and in cord blood (5% of CD4(+) cells) where they showed a naive phenotype. In addition, cord blood contained a small population of CD25(+) cells (approximately 2% of CD4 T cells) that were CD152(-) and CD122(low) and displayed signs of activation. Together with published data that CD25(+) CD25(++) cells from the thymus and peripheral blood are regulatory, our results suggest that regulatory CD25(+) T cells leave the thymus in a naïve state and become activated in the periphery.
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Affiliation(s)
- Kajsa Wing
- Department of Rheumatology, Göteborg University, Göteborg, Sweden
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42
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Hickling TP, Bright H, Wing K, Gower D, Martin SL, Sim RB, Malhotra R. A recombinant trimeric surfactant protein D carbohydrate recognition domain inhibits respiratory syncytial virus infection in vitro and in vivo. Eur J Immunol 1999; 29:3478-84. [PMID: 10556802 DOI: 10.1002/(sici)1521-4141(199911)29:11<3478::aid-immu3478>3.0.co;2-w] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The pulmonary collectin, lung surfactant protein D (SP-D), plays a role in host defense mediated by the interaction of surface carbohydrates of inhaled pathogens with the lectin domains of SP-D. Respiratory syncytial virus (RSV), the most important viral pathogen of neonates and infants, encodes a highly glycosylated attachment protein, G. Binding studies were performed with G protein from RSV (human, A2 strain) and both native and recombinant human SP-D. The effect of recombinant trimeric SP-D lectin domains (rSP-D) on the interaction between RSV and host cells was determined by two methods: an infectivity study with monolayers of Hep-2C cells and in vivo infections in BALB/c mice. These studies show that full-length and recombinant SP-D bind to RSV G protein in a concentration-dependent manner. Both EDTA and mannan inhibited binding of full-length SP-D. These results indicate that binding occurs via the carbohydrate recognition domain of the SP-D. The recombinant SP-D inhibited RSV infectivity in cell culture in a dose-dependent manner, giving 100% inhibition of replication. Intranasal administration of recombinant SP-D to RSV-infected mice inhibited replication of the virus in the lungs, reducing levels of lung virus by 80%. These results suggest that SP-D plays a major role in clearing RSV from the lungs.
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Affiliation(s)
- T P Hickling
- GlaxoWellcome Medicines Research Centre, Stevenage, GB.
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43
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Tidehag P, Hallmans G, Wing K, Sjöström R, Agren G, Lundin E, Zhang JX. A comparison of iron absorption from single meals and daily diets using radioFe (55Fe, 59Fe). Br J Nutr 1996; 75:281-9. [PMID: 8785204 DOI: 10.1079/bjn19960130] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The purpose of the present study was to compare two measures of Fe absorption, one from single meals and the other from daily diets. Ten ileostomy subjects were given the same low-fibre composite diet for all three meals each day for five consecutive days. After 3 weeks the experiment was repeated with a high-fibre diet. The morning meal constituted one-seventh of the total daily diet intake, the mid-day meal two-sevenths and the evening meal four-sevenths of the total daily diet intake. On days 4 and 5 of each diet period the morning meal was labelled with 55Fe and all three meals were labelled with 59Fe. The activities retained in the subjects 19 d later showed the Fe absorption from the low-fibre diet measured from the morning meals to be almost 80% greater than the average Fe absorption measured from all meals during the same 2 d. With the high-fibre diet the absorption from the morning meals was less than 50% greater than the average for all meals but the difference was not significant. We suggest that all meals of the day should be labelled with radioFe in order to avoid inflating the measures of Fe absorption.
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Affiliation(s)
- P Tidehag
- Department of Nutritional Research, Umeå University, Sweden
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Tidehag P, Sandberg AS, Hallmans G, Wing K, Türk M, Holm S, Grahn E. Effect of milk and fermented milk on iron absorption in ileostomy subjects. Am J Clin Nutr 1995; 62:1234-8. [PMID: 7491886 DOI: 10.1093/ajcn/62.6.1234] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
This study was undertaken to determine whether milk with its high calcium content adversely affects the absorption of nonheme iron from the diet as greatly as single-meal studies indicate. Nine ileostomy subjects ate a low-fiber, low-phytate diet for 8 consecutive weeks. During the first and eight weeks they drank a 250-mL soft drink with three main meals and an evening snack each day (0.16 g Ca/d). During the two intervening 3-wk periods, they drank the same amount of low-fat milk or fermented low-fat milk (Verum; Hälsofil, Norrmejerier, Umeä, Sweden) according to a formally randomized crossover design (1.4 g Ca/d). During the last 2 d in each of the four periods, apparent iron absorption (balance) from a test diet together with that period's beverage was measured and the plasma ferritin concentration was determined. There was no decrease in apparent iron absorption during the milk diet periods.
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Affiliation(s)
- P Tidehag
- Biophysics Laboratory, Umeä University, Sweden
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Abstract
A new system for direct digital intraoral radiography, Sens-A-Ray, is presented. This system is based on a detector with a charge-coupled device that was designed especially for direct exposure to x-ray radiation. The system also includes interface electronics and an IBM AT-compatible personal computer with a digital I/O with frame memory, a super VGA graphics board, a high-resolution monitor, and software for the exposure, capture, storage, and enhancement of images. An external optical mass storage device is used for permanent storage of images in digital format. A video printer may be used to create hard copies. The system produces radiographic images at a significantly lower exposure than required for E-speed intraoral film. Applications of the system are exemplified, and its basic properties are discussed.
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Affiliation(s)
- P Nelvig
- Regam Medical Systems AB, University of Umeå, Karolinska Institutet, Stockholm, Sweden
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Abstract
The purpose of this study was to compare three measures of the availability of dietary Zn and Fe in order to test their validity. Thirty-six 5-wk-old rats were fed deionized water and wheat crispbread made from endosperm flour, whole-grain flour, or endosperm flour supplemented with Zn and Fe to the whole-grain levels ad libitum for 14 d. The retention of 65Zn and 59Fe from test meals of the same breads after 1 wk and the sum of the excretion of endogenous Zn and Fe (injected 65Zn and 59Fe) with the Zn and Fe balances, respectively, were used as independent measures of Zn and Fe absorption. Measurements of Zn absorption, Zn balance, and serum Zn concentration gave quite different results with regard to the availability of Zn in the three breads, presumably because of the homeostatic regulation of the absorption and excretion of Zn when the Zn in the diet is in excess of the body's needs. Measurements of Fe absorption, Fe balance, and Fe concentrations in liver and serum were consistent in demonstrating overloading of Fe in the group given wheat-endosperm crispbread supplemented with Zn and Fe, but there was evidence that the isotope retention method overestimated iron absorption.
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Affiliation(s)
- K Wing
- Department of Oral Radiology, University of Umeå, Sweden
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Moberg Wing A, Wing K, Tholin K, Sjöström R, Sandström B, Hallmans G. The relation of the accumulation of cadmium in human placenta to the intake of high-fibre grains and maternal iron status. Eur J Clin Nutr 1992; 46:585-95. [PMID: 1327741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Exposure to cadmium via the diet is known to depend to a large extent on the intake of cereal grains, particularly the high-fibre fractions of wheat. Subjects with low iron status absorb more cadmium than those with better iron status. The purpose of the present study was to determine to what extent cadmium accumulation in human placenta is affected by the intake of grain fibre and maternal iron status during pregnancy. Thirty-nine pregnant women participated in the study. In each trimester the women were requested to complete a dietary history and to allow blood samples to be taken for haemoglobin, serum ferritin and serum thiocyanate determinations, the latter as a marker for smoking. At delivery the whole placenta was taken for the determination of the cadmium concentration. The 32 women who had serum thiocyanate levels less than 70 mumol/l, who had completed at least one dietary history and from whom a blood sample was obtained in the third trimester, were included in the final statistical analyses. In the group of women who consumed less than the median intake of grain fibre and had more than 15 micrograms ferritin/l serum in the third trimester, the placenta cadmium concentration was nearly half that in the placentae of women who had consumed more grain fibre or had lower iron status in late pregnancy.
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Affiliation(s)
- A Moberg Wing
- Department of Nutritional Research, University of Umeå, Sweden
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Abstract
The influence of various factors that may affect the outcome of root canal therapy was evaluated in 356 patients 8 to 10 yr after the treatment. The results of treatment were directly dependent on the preoperative status of the pulp and periapical tissues. The rate of success for cases with vital or nonvital pulps but having no periapical radiolucency exceeded 96%, whereas only 86% of the cases with pulp necrosis and periapical radiolucency showed apical healing. The possibility of instrumenting the root canal to its full length and the level of root filling significantly affected the outcome of treatment. Of all of the periapical lesions present on previously root-filled teeth, only 62% healed after retreatment. The predictability from clinical and radiographic signs of the treatment-outcome in individual cases with preoperative periapical lesions cases was found to be low. Thus, factors which were not measured or identified may be critical to the outcome of endodontic treatment.
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Tidehag P, Hallmans G, Sjöström R, Sunzel B, Wetter L, Wing K. The extent of coprophagy in rats with differing iron status and its effect on iron absorption. Lab Anim 1988; 22:313-9. [PMID: 3230866 DOI: 10.1258/002367788780746250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The purpose of this study was to determine the prevalence of coprophagy in rats with differing iron status and its effect on the measurement of iron absorption from test meals with and without bran. Two experiments were performed using radioisotope-labelled microspheres added as a non-digestible marker for the ingested faeces and the diet and 59Fe added as a marker for the nonhaem iron in the test meal. In this study, coprophagy occurred at group mean rates of between 5 and 22% and was independent of the iron status of the rats or the presence or absence of bran in the diet. The relative absorption of iron, measured as the retention of 59Fe from a single meal, was affected to the same extent in groups with the same iron status, if it was affected at all. Thus comparisons of iron absorption from diets with and without bran should not be affected by coprophagy.
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Affiliation(s)
- P Tidehag
- Biophysics Laboratory, University of Umeå, Sweden
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Hallmans G, Nilsson U, Sjöström R, Wetter L, Wing K. The importance of the body's need for zinc in determining Zn availability in food: a principle demonstrated in the rat. Br J Nutr 1987; 58:59-64. [PMID: 3620438 DOI: 10.1079/bjn19870069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
1. The hypothesis that the availability of zinc in a food is limited by factors in the food was tested against the hypothesis that Zn absorption is homeostatically regulated by the body according to its need for Zn. 2. The experimental model used was the short-term administration to rats of a parenteral nutrition solution with no added Zn in an attempt to increase their need for Zn in an anabolic phase. 3. The absorption and retention of 65Zn from a piece of endosperm-wheat crisp-bread in rats injected intraperitoneally with the parenteral nutrition solution was more than 40% higher than that in a control group injected with physiological saline (9 g sodium chloride/l). 4. The results indicate that the availability of Zn in the bread is not fixed but variable and dependent on the body's need for Zn.
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