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Effect of opioid receptor antagonist on mitigating tumor necrosis factor-like weak inducer of apoptosis (TWEAK)-induced apoptolysis in pemphigus pathogenesis 阿片受体拮抗剂对减轻肿瘤坏死因子样细胞凋亡弱诱导剂(TWEAK)诱导的天疱疮发病机制中细胞凋亡的影响
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-09-13 DOI: 10.1016/j.jaut.2024.103307
Xueting Peng , Sijia Wang , Kunyi Wu , Christopher Cook , Liang Li , Zhao Wang , Hanjiang Gu , Mei Lu , Guanglei Hu , Kaixuan Ren , Gang Hu , Weihui Zeng , Yumin Xia , Yale Liu

Pemphigus is a severe autoimmune blistering disease characterized by acantholysis triggered by autoantibodies against desmoglein 1 and 3 (DSG1/3). Apoptosis plays a pivotal role in facilitating acantholysis, yet the precise underlying mechanism remains obscure. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is known to promote apoptosis and disrupt cell junctions, although its involvement in pemphigus pathogenesis remains ambiguous. Our study observed decreased DSG1/3 expression alongside increased TWEAK/fibroblast growth factor-inducible 14 (Fn14) expression and keratinocyte apoptosis in both lesional and perilesional skin. In vitro experiments revealed that TWEAK-stimulated keratinocytes exhibited enhanced apoptosis, STAT1 phosphorylation, and reduced intercellular DSG1/3 expression. Notably, bulk-RNA sequencing unveiled that CASPASE-3 was responsible for mediating the DSG1/3 depletion, as confirmed by direct interaction with DSG1/3 in a co-immunoprecipitation assay. Naloxone, known for preserving cellular adhesion and preventing cell death, effectively reduced apoptosis and restored DSG1/3 levels in TWEAK-stimulated keratinocytes. The anti-apoptotic properties of naloxone were further validated in a murine pemphigus model. Our findings elucidate that TWEAK facilitates keratinocyte apoptosis by augmenting caspase-3 activity, leading to DSG1/3 depletion and apoptosis in pemphigus. Importantly, naloxone can counter TWEAK-induced apoptosis in pemphigus pathogenesis, offering a potential therapeutic intervention.

丘疹性荨麻疹是一种严重的自身免疫性水疱病,其特征是由针对去疱疹素 1 和 3(DSG1/3)的自身抗体引发的棘层溶解。细胞凋亡在促进棘层溶解方面起着关键作用,但其确切的内在机制仍不清楚。众所周知,肿瘤坏死因子样细胞凋亡弱诱导因子(TWEAK)可促进细胞凋亡并破坏细胞连接,但它在丘疹性荨麻疹发病机制中的作用仍不明确。我们的研究观察到,DSG1/3表达减少的同时,TWEAK/成纤维细胞生长因子诱导14(Fn14)表达增加,病变和周围皮肤的角质细胞凋亡也增加。体外实验显示,TWEAK 刺激的角质形成细胞表现出更强的凋亡、STAT1 磷酸化和细胞间 DSG1/3 表达减少。值得注意的是,大量 RNA 测序揭示了 CASPASE-3 负责介导 DSG1/3 的消耗,在共沉淀试验中与 DSG1/3 的直接相互作用也证实了这一点。纳洛酮以保持细胞粘附性和防止细胞死亡而闻名,它能有效减少细胞凋亡,并恢复 TWEAK 刺激的角质形成细胞中 DSG1/3 的水平。纳洛酮的抗凋亡特性在小鼠丘疹性荨麻疹模型中得到了进一步验证。我们的研究结果阐明,TWEAK 通过增强 caspase-3 的活性促进角质形成细胞的凋亡,从而导致丘疹性荨麻疹中 DSG1/3 的耗竭和细胞凋亡。重要的是,纳洛酮可以对抗TWEAK在丘疹性荨麻疹发病机制中诱导的细胞凋亡,从而提供一种潜在的治疗干预。
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引用次数: 0
Alternative splicing and intron retention: Their profiles and roles in cutaneous fibrosis of systemic sclerosis 替代剪接和内含子保留:它们在系统性硬化症皮肤纤维化中的概况和作用
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-09-12 DOI: 10.1016/j.jaut.2024.103306
Shasha Xie , Ding Bao , Yizhi Xiao , Hongdong Li , Muyao Guo , Bingying Dai , Sijia Liu , Jing Huang , Muyuan Li , Liqing Ding , Qiming Meng , Chun-Liu Lv , Jörg H.W. Distler , Hui Luo , Honglin Zhu

Background

Alternative splicing (AS) and intron retention (IR) implicated in multiple pathophysiological processes, have rarely been reported in systemic sclerosis (SSc).

Methods

We integrated bulk RNA-seq and 4D label-free mass spectrometry to perform a multi-omics analysis of AS and IR in SSc skin tissue and fibroblasts. RMATS and iREAD were used to identify AS and IR, which were validated by real-time PCR. Spearman correlation and the LASSO method were employed to assess correlations among clinical features, introns, splicing factors (regulators of AS) and proteins.

Findings

AS profiles showed distinct alterations in SSc skin tissue, with the most pronounced changes occurring in IR. AS and IR were associated with total modified Rodnan skin score (mRSS) and local skin score. Upon TGF-β stimulation, fibroblasts exhibited significant alterations in IR profiles, affecting genes related to fibroblast proliferation and collagen fibril organization. A comprehensive integrated analysis of introns, exons, and proteome profiles revealed that IR exerted a negative impact on protein expression, with certain changes being under intronic control. RT-PCR confirmed the presence of intron and exon-derived sequences of CTTN, OGA, MED16 and PHYKPL. Additionally, notable changes were observed in the regulatory network of splicing factors in SSc skin tissues. These factors are also involved in fibrosis pathways and correlated with clinical features.

Conclusion

Totally, abnormal AS, IR profiles and splicing factors were identified in SSc, altered IRs and splicing factors participated in fibrosis-related pathways. IR exerted a negative impact on protein expression in TGF-β-stimulated fibroblasts. Clarification of the IR mechanisms will provide new insights into the pathophysiology of SSc.

背景与多种病理生理过程有关的另类剪接(AS)和内含子保留(IR)在系统性硬化症(SSc)中鲜有报道。方法我们整合了大容量RNA-seq和4D无标记质谱,对SSc皮肤组织和成纤维细胞中的AS和IR进行了多组学分析。RMATS和iREAD用于鉴定AS和IR,并通过实时PCR进行验证。研究结果AS图谱在SSc皮肤组织中显示出明显的改变,最明显的改变发生在IR中。AS和IR与改良罗德南皮肤总评分(mRSS)和局部皮肤评分相关。在TGF-β刺激下,成纤维细胞的IR谱发生了显著变化,影响了与成纤维细胞增殖和胶原纤维组织相关的基因。对内含子、外显子和蛋白质组图谱的综合分析表明,IR 对蛋白质表达产生了负面影响,某些变化受内含子控制。RT-PCR 证实了 CTTN、OGA、MED16 和 PHYKPL 内含子和外显子序列的存在。此外,在 SSc 皮肤组织中还观察到剪接因子调控网络的显著变化。结论总体而言,在 SSc 中发现了异常的 AS、IR 图谱和剪接因子,改变的 IR 和剪接因子参与了纤维化相关途径。IR对TGF-β刺激的成纤维细胞的蛋白表达有负面影响。阐明IR机制将为了解SSc的病理生理学提供新的视角。
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引用次数: 0
Therapeutic potentials of adoptive cell therapy in immune-mediated neuropathy 免疫介导的神经病变中采用细胞疗法的治疗潜力
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-09-11 DOI: 10.1016/j.jaut.2024.103305
Siqi Shang , Chongbo Zhao , Jie Lin

Immune-mediated neuropathy (IMN) is a group of heterogenous neuropathies caused by intricate autoimmune responses. For now, known mechanisms of different IMN subtypes involve the production of autoantibodies, complement activation, enhanced inflammation and subsequent axonal/demyelinating nerve damages. Recent therapeutic studies mainly focus on specific antibodies and small molecule inhibitors previously approved in rheumatoid diseases. Initial strategies based on the pathophysiologic features of IMN should be explored. Adoptive cell therapy (ACT) refers to the emerging immunotherapies in which circulating immunocytes are collected from peripheral blood and modified with killing and immunomodulatory capacities. It consists of chimeric antigen receptor-T cell therapy, T cell receptor-engineered T cell, CAR-Natural killer cell therapy, and others. In the last decade, ACT has demonstrated extraordinary potentials in treating cancers, infectious diseases and autoimmune diseases. Versatile combinations of targets, chimeric domains and effector cells greatly empower ACT to treat complicated immune disorders. In this review, we summarized the advances of ACT and envisioned suitable strategies for different IMN subtypes.

免疫介导的神经病(IMN)是一组由复杂的自身免疫反应引起的异质性神经病。目前,已知的不同 IMN 亚型的发病机制包括自身抗体的产生、补体激活、炎症增强以及随后的轴突/脱髓鞘神经损伤。最近的治疗研究主要集中在特异性抗体和以前批准用于类风湿病的小分子抑制剂上。应探索基于 IMN 病理生理学特征的初步策略。采用性细胞疗法(ACT)是指从外周血中收集循环免疫细胞并对其进行改造,使其具有杀伤和免疫调节能力的新兴免疫疗法。它包括嵌合抗原受体-T 细胞疗法、T 细胞受体工程化 T 细胞、CAR-自然杀伤细胞疗法等。在过去十年中,ACT 在治疗癌症、传染病和自身免疫性疾病方面展现出了非凡的潜力。靶点、嵌合结构域和效应细胞的多种组合大大增强了 ACT 治疗复杂免疫疾病的能力。在这篇综述中,我们总结了 ACT 的进展,并设想了针对不同 IMN 亚型的合适策略。
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引用次数: 0
Lupus-prone NZM2328 mice exhibit enhanced UV-induced myeloid cell recruitment and activation in a type I interferon dependent manner 红斑狼疮易感 NZM2328 小鼠表现出紫外线诱导的髓细胞募集和活化增强,其方式依赖于 I 型干扰素。
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-09-05 DOI: 10.1016/j.jaut.2024.103296
Mitra P. Maz , Alayka L. Reddy , Celine C. Berthier , Lam C. Tsoi , Deborah J. Colesa , Sonya J. Wolf , Hong Shi , Shannon N. Loftus , Rezvan Moallemian , Rachael Bogle , Matthias Kretzler , Chaim O. Jacob , Johann E. Gudjonsson , J. Michelle Kahlenberg

Though the exact causes of systemic lupus erythematosus (SLE) remain unknown, exposure to ultraviolet (UV) light is one of the few well-known triggers of cutaneous inflammation in SLE. However, the precise cell types which contribute to the early cutaneous inflammatory response in lupus, and the ways that UV dosing and interferons modulate these findings, have not been thoroughly dissected. Here, we explore these questions using the NZM2328 spontaneous murine model of lupus. In addition, we use iNZM mice, which share the NZM2328 background but harbor a whole-body knockout of the type I interferon (IFN) receptor, and wild-type BALB/c mice. 10-13-week-old female mice of each strain were treated with acute (300 mJ/cm2 x1), chronic (100 mJ/cm2 daily x5 days), or no UVB, and skin was harvested and processed for bulk RNA sequencing and flow cytometry. We identify that inflammatory pathways and gene signatures related to myeloid cells – namely neutrophils and monocyte-derived dendritic cells – are a shared feature of the acute and chronic UVB response in NZM skin greater than iNZM and wild-type skin. We also verify recruitment and activation of these cells by flow cytometry in both acutely and chronically irradiated NZM and WT mice and demonstrate that these processes are dependent on type I IFN signaling. Taken together, these data indicate a skewed IFN-driven inflammatory response to both acute and chronic UVB exposure in lupus-prone skin dominated by myeloid cells, suggesting both the importance of type I IFNs and myeloid cells as therapeutic targets for photosensitive patients and highlighting the risks of even moderate UV exposure in this patient population.

尽管系统性红斑狼疮(SLE)的确切病因仍然不明,但紫外线照射是系统性红斑狼疮皮肤炎症的少数几个众所周知的诱因之一。然而,导致红斑狼疮早期皮肤炎症反应的确切细胞类型,以及紫外线剂量和干扰素调节这些结果的方式尚未得到彻底研究。在这里,我们使用 NZM2328 自发性狼疮小鼠模型来探讨这些问题。此外,我们还使用了iNZM小鼠和野生型BALB/c小鼠,iNZM小鼠与NZM2328小鼠背景相同,但全身I型干扰素(IFN)受体被敲除。对每个品系 10-13 周大的雌性小鼠分别进行急性(300 mJ/cm2 x1)、慢性(100 mJ/cm2 每天 x5 天)或无 UVB 处理,然后采集皮肤并进行大量 RNA 测序和流式细胞术处理。我们发现,与骨髓细胞(即中性粒细胞和单核细胞衍生树突状细胞)相关的炎症通路和基因特征是 NZM 皮肤对急性和慢性 UVB 反应的共同特征,其程度高于 iNZM 和野生型皮肤。我们还通过流式细胞术验证了这些细胞在急性和慢性辐照的 NZM 和 WT 小鼠中的招募和活化,并证明这些过程依赖于 I 型 IFN 信号。总之,这些数据表明,在红斑狼疮易发皮肤中,髓系细胞主导的急性和慢性 UVB 暴露会导致 IFN 驱动的偏斜炎症反应,这表明 I 型 IFN 和髓系细胞作为光敏感患者治疗靶点的重要性,同时也凸显了即使是适度的紫外线暴露也会给这类患者带来的风险。
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引用次数: 0
Amelioration of immunoglobulin A vasculitis by suppression of the pathological expansion of T follicular helper 17 cells 通过抑制 T 滤泡辅助 17 细胞的病理性扩增来改善免疫球蛋白 A 血管炎
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-09-03 DOI: 10.1016/j.jaut.2024.103304
Qinglian Jiang , Xuyang Chi , Tong Wei , Shingo Nakayamada , Yu Shan , Yini Sun , Xing Zhao , Jieqing Zhou , Yan Fan , Jia Gu , Hong Jiang , Xiaoxue Ma

The main pathogenic features of immunoglobulin A vasculitis (IgAV) are overactive B cells and elevated production of IgA, which requires help from T follicular helper 17 (Tfh17) cells. To evaluate the pathological role of Tfh17 cells in IgAV, we investigated the mechanism responsible for Tfh17 differentiation and explored how to ameliorate IgAV by modulating Tfh17 generation.

Peripheral blood mononuclear cells from IgAV patients were analyzed by flow cytometry. In vitro culture was performed to assess the modulation of cytokine-induced phenotypes. IgAV rats were used to explore the therapeutic effects of IL-6 blockade and the regulatory functions of IL-6 in Tfh17 cells. Serum cytokine and IgA levels were measured by ELISA while histopathological changes were evaluated by H&E,PAS or immunofluorescence staining.

Frequency of CD4+CXCR5+CCR6+ Tfh17 cells were increased in IgAV patients and associated with disease severity. There was also a significant infiltration of Tfh17 cells in the kidney of human IgAV nephritis patients. IL-6 promoted the dendritic cell production of TGF-β and Tfh17 differentiation. In IgAV rats, the in vivo blockade of IL-6 signaling inhibited Tfh17 differentiation, resulting in reduction of the germinal center and IgA production. Suppression of Tfh17 cells using IL-6 blockade greatly ameliorated clinical symptoms such as hemorrhagic rash and bloody stool and decreased IgA deposition and mesangial proliferation in the kidney in IgAV rats.

Our findings suggest that suppression of Tfh17 differentiation can alleviate IgA-mediated vasculitis and may permit the development of tailored medicines for treating IgAV.

免疫球蛋白A血管炎(IgAV)的主要致病特征是B细胞过度活跃和IgA生成增加,而这需要T滤泡辅助细胞17(Tfh17)的帮助。为了评估Tfh17细胞在IgAV中的病理作用,我们研究了Tfh17分化的机制,并探讨了如何通过调节Tfh17的生成来改善IgAV。通过流式细胞术分析了 IgAV 患者的外周血单核细胞,并进行了体外培养,以评估细胞因子诱导表型的调节情况。用 IgAV 大鼠来探讨 IL-6 阻断的治疗效果以及 IL-6 在 Tfh17 细胞中的调节功能。用ELISA法测定血清细胞因子和IgA水平,用H&E、PAS或免疫荧光染色法评估组织病理学变化。在人类IgAV肾炎患者的肾脏中也有明显的Tfh17细胞浸润。IL-6促进树突状细胞产生TGF-β和Tfh17分化。在IgAV大鼠体内阻断IL-6信号传导可抑制Tfh17分化,导致生殖中心和IgA生成减少。我们的研究结果表明,抑制Tfh17分化可以缓解IgA介导的血管炎,并可能开发出治疗IgAV的定制药物。
{"title":"Amelioration of immunoglobulin A vasculitis by suppression of the pathological expansion of T follicular helper 17 cells","authors":"Qinglian Jiang ,&nbsp;Xuyang Chi ,&nbsp;Tong Wei ,&nbsp;Shingo Nakayamada ,&nbsp;Yu Shan ,&nbsp;Yini Sun ,&nbsp;Xing Zhao ,&nbsp;Jieqing Zhou ,&nbsp;Yan Fan ,&nbsp;Jia Gu ,&nbsp;Hong Jiang ,&nbsp;Xiaoxue Ma","doi":"10.1016/j.jaut.2024.103304","DOIUrl":"10.1016/j.jaut.2024.103304","url":null,"abstract":"<div><p>The main pathogenic features of immunoglobulin A vasculitis (IgAV) are overactive B cells and elevated production of IgA, which requires help from T follicular helper 17 (Tfh17) cells. To evaluate the pathological role of Tfh17 cells in IgAV, we investigated the mechanism responsible for Tfh17 differentiation and explored how to ameliorate IgAV by modulating Tfh17 generation.</p><p>Peripheral blood mononuclear cells from IgAV patients were analyzed by flow cytometry. In vitro culture was performed to assess the modulation of cytokine-induced phenotypes. IgAV rats were used to explore the therapeutic effects of IL-6 blockade and the regulatory functions of IL-6 in Tfh17 cells. Serum cytokine and IgA levels were measured by ELISA while histopathological changes were evaluated by H&amp;E,PAS or immunofluorescence staining.</p><p>Frequency of CD4<sup>+</sup>CXCR5<sup>+</sup>CCR6<sup>+</sup> Tfh17 cells were increased in IgAV patients and associated with disease severity. There was also a significant infiltration of Tfh17 cells in the kidney of human IgAV nephritis patients. IL-6 promoted the dendritic cell production of TGF-β and Tfh17 differentiation. In IgAV rats, the in vivo blockade of IL-6 signaling inhibited Tfh17 differentiation, resulting in reduction of the germinal center and IgA production. Suppression of Tfh17 cells using IL-6 blockade greatly ameliorated clinical symptoms such as hemorrhagic rash and bloody stool and decreased IgA deposition and mesangial proliferation in the kidney in IgAV rats.</p><p>Our findings suggest that suppression of Tfh17 differentiation can alleviate IgA-mediated vasculitis and may permit the development of tailored medicines for treating IgAV.</p></div>","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"149 ","pages":"Article 103304"},"PeriodicalIF":7.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety of biologic immunosuppressants in pregnant women with immune-mediated inflammatory diseases. 患有免疫介导的炎症性疾病的孕妇使用生物免疫抑制剂的安全性。
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-16 DOI: 10.1016/j.jaut.2024.103301
Martínez-Sánchez N, J Álvarez-Troncoso, Á Robles-Marhuenda, M De la Calle Fernández-Miranda, M L Muner Hernando, J L Bartha
<p><strong>Background: </strong>Immune-mediated inflammatory diseases (IMIDs) typically affect women of childbearing age. One of the challenges in treating these women during pregnancy is to manage the disease while minimizing or avoiding the use of disease-modifying antirheumatic drugs (DMARDs) that may increase the risk to the mother or fetus. Biologic therapy has transformed the management of these patients. This study aimed to evaluate the maternal-fetal safety and perinatal outcomes in pregnant women with IMID exposed to biologic DMARDs either preconceptionally or during pregnancy and compare them with women using conventional DMARDs and a group of healthy pregnant women.</p><p><strong>Methods: </strong>We conducted a retrospective study with prospective follow-up of pregnant women with IMID at a single center. We analyzed baseline maternal demographic characteristics, diseases, DMARDs, and maternal-fetal outcomes.</p><p><strong>Results: </strong>A cohort of 244 pregnancies was studied. One hundred twenty-eight patients met classificatory criteria for rheumatic and musculoskeletal diseases (RMD) or inflammatory bowel disease (IBD), and 116 pregnancies of healthy women were evaluated from the same study period. One hundred and one pregnancies in IMID patients (89.84 %) occurred under immunosuppressive treatment, 78.91 % of IMID pregnancies were under cDMARD (33.59 % exclusive cDMARD), 56.25 % under bDMARD, and 27.34 % under oral glucocorticoids. Anti-TNF was the most frequent (88.88 %) bDMARD and was used in 50.78 % of the IMIDs. There was at least one flare in 37.10 % of the IMID pregnancies, and 9.38 % experienced more than one. Among flares, 43.48 % happened in the first trimester, 34.78 % in the second trimester, and 19.57 % in the third. Flares were more frequent in the RMD patients compared with IBD (p = 0.041; OR 2.15, 95%CI: 1.03-4.52). Flare was associated with discontinuation of bDMARD before the eighth week of gestation (p = 0.016), but especially in the second (p = 0.042) and third trimester (p = 0.012). Maternal infections were an infrequent complication overall (7.66 %), although more frequent in patients with IMIDs (p = 0.004) but were not associated with cDMARD or bDMARD. IMID patients needed assisted reproductive techniques (ART) more often (p = 0.001, OR 2.83, 95%CI: 1.02-7.90). More cesarean sections were performed in gestations under treatment with bDMARD (p = 0.020) and especially in those under treatment with anti-TNF. Aneuploidies calculation risk and fetal malformations were not correlated with DMARDs (cDMARDs, bDMARDs, or its combination) nor with any of the DMARDs individually preconcepcionally or during gestation. Small for gestational age (SGA) newborns were higher in patients with IMIDs however, it was not associated with DMARD use.</p><p><strong>Discussion: </strong>In general, patients with IMIDs who require treatment with bDMARDs have a more severe or refractory disease prior to gestation. In our cohort, we fou
背景:免疫介导的炎症性疾病(IMID)通常会影响育龄妇女。妊娠期妇女在治疗这些疾病时面临的挑战之一是在控制疾病的同时尽量减少或避免使用可能会增加母亲或胎儿风险的改善病情抗风湿药(DMARDs)。生物疗法改变了这些患者的治疗方法。本研究旨在评估在孕前或孕期使用生物 DMARDs 的 IMID 孕妇的母胎安全性和围产期结局,并将其与使用传统 DMARDs 的孕妇和一组健康孕妇进行比较:我们在一个中心对患有IMID的孕妇进行了回顾性研究和前瞻性随访。我们分析了孕妇的基线人口特征、疾病、DMARDs 和母胎结局:研究对象包括 244 名孕妇。其中 128 名患者符合风湿和肌肉骨骼疾病(RMD)或炎症性肠病(IBD)的分类标准,在同一研究期间还对 116 名健康孕妇进行了评估。IMID患者中有101例(89.84%)妊娠是在免疫抑制治疗下发生的,78.91%的IMID妊娠是在cDMARD治疗下发生的(33.59%为独家cDMARD),56.25%是在bDMARD治疗下发生的,27.34%是在口服糖皮质激素治疗下发生的。抗肿瘤坏死因子(Anti-TNF)是最常用的 bDMARD(88.88%),在 50.78% 的 IMID 中使用。37.10%的IMID妊娠至少出现过一次复发,9.38%的妊娠出现过一次以上复发。其中,43.48%的复发发生在妊娠前三个月,34.78%发生在妊娠后三个月,19.57%发生在妊娠后三个月。与 IBD 相比,RMD 患者的复发率更高(P = 0.041;OR 2.15,95%CI:1.03-4.52)。复发与妊娠第 8 周前停用 bDMARD 有关(p = 0.016),尤其是在妊娠第 2 周(p = 0.042)和第 3 周(p = 0.012)。产妇感染是一种不常见的并发症(7.66%),但在IMID患者中更为常见(p = 0.004),但与cDMARD或bDMARD无关。IMID患者更经常需要辅助生殖技术(ART)(p = 0.001,OR 2.83,95%CI:1.02-7.90)。在使用 bDMARD 治疗的妊娠中,剖宫产率更高(p = 0.020),尤其是在使用抗肿瘤坏死因子治疗的妊娠中。非整倍体计算风险和胎儿畸形与DMARDs(cDMARDs、bDMARDs或其组合)无关,也与孕前或妊娠期间单独使用的任何DMARDs无关。IMIDs患者的新生儿胎龄小(SGA)率较高,但这与使用DMARD无关:讨论:一般来说,需要使用bDMARDs治疗的IMIDs患者在妊娠前病情较重或难治。在我们的队列中,我们发现使用 bDMARDs 的患者病情复发的风险较高,尤其是早期停药的患者。在孕产妇结局中,我们发现 IMID 患者需要抗逆转录病毒疗法的次数更多。这可能首先与产妇的年龄有关。在胎儿结局方面,IMID 患者和健康患者的先天性畸形没有差异,也与 DMARDs 无关:结论:使用 bDMARDs 可以有效控制疾病,从母婴角度来看也是安全的,不会增加早产、SGA、畸形或感染。
{"title":"Safety of biologic immunosuppressants in pregnant women with immune-mediated inflammatory diseases.","authors":"Martínez-Sánchez N, J Álvarez-Troncoso, Á Robles-Marhuenda, M De la Calle Fernández-Miranda, M L Muner Hernando, J L Bartha","doi":"10.1016/j.jaut.2024.103301","DOIUrl":"10.1016/j.jaut.2024.103301","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Immune-mediated inflammatory diseases (IMIDs) typically affect women of childbearing age. One of the challenges in treating these women during pregnancy is to manage the disease while minimizing or avoiding the use of disease-modifying antirheumatic drugs (DMARDs) that may increase the risk to the mother or fetus. Biologic therapy has transformed the management of these patients. This study aimed to evaluate the maternal-fetal safety and perinatal outcomes in pregnant women with IMID exposed to biologic DMARDs either preconceptionally or during pregnancy and compare them with women using conventional DMARDs and a group of healthy pregnant women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective study with prospective follow-up of pregnant women with IMID at a single center. We analyzed baseline maternal demographic characteristics, diseases, DMARDs, and maternal-fetal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A cohort of 244 pregnancies was studied. One hundred twenty-eight patients met classificatory criteria for rheumatic and musculoskeletal diseases (RMD) or inflammatory bowel disease (IBD), and 116 pregnancies of healthy women were evaluated from the same study period. One hundred and one pregnancies in IMID patients (89.84 %) occurred under immunosuppressive treatment, 78.91 % of IMID pregnancies were under cDMARD (33.59 % exclusive cDMARD), 56.25 % under bDMARD, and 27.34 % under oral glucocorticoids. Anti-TNF was the most frequent (88.88 %) bDMARD and was used in 50.78 % of the IMIDs. There was at least one flare in 37.10 % of the IMID pregnancies, and 9.38 % experienced more than one. Among flares, 43.48 % happened in the first trimester, 34.78 % in the second trimester, and 19.57 % in the third. Flares were more frequent in the RMD patients compared with IBD (p = 0.041; OR 2.15, 95%CI: 1.03-4.52). Flare was associated with discontinuation of bDMARD before the eighth week of gestation (p = 0.016), but especially in the second (p = 0.042) and third trimester (p = 0.012). Maternal infections were an infrequent complication overall (7.66 %), although more frequent in patients with IMIDs (p = 0.004) but were not associated with cDMARD or bDMARD. IMID patients needed assisted reproductive techniques (ART) more often (p = 0.001, OR 2.83, 95%CI: 1.02-7.90). More cesarean sections were performed in gestations under treatment with bDMARD (p = 0.020) and especially in those under treatment with anti-TNF. Aneuploidies calculation risk and fetal malformations were not correlated with DMARDs (cDMARDs, bDMARDs, or its combination) nor with any of the DMARDs individually preconcepcionally or during gestation. Small for gestational age (SGA) newborns were higher in patients with IMIDs however, it was not associated with DMARD use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;In general, patients with IMIDs who require treatment with bDMARDs have a more severe or refractory disease prior to gestation. In our cohort, we fou","PeriodicalId":15245,"journal":{"name":"Journal of autoimmunity","volume":"148 ","pages":"103301"},"PeriodicalIF":7.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High throughput screening identifies repurposable drugs for modulation of innate and acquired immune responses 高通量筛选确定可用于调节先天和后天免疫反应的药物
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-08-19 DOI: 10.1016/j.jaut.2024.103302
Saeedeh Ghorbanalipoor , Kazuko Matsumoto , Natalie Gross , Linda Heimberg , Malin Krause , Wendelien Veldkamp , Moritz Magens , Johannes Zanken , Kerstin J. Neuschutz , David A. De Luca , Khalaf Kridin , Gestur Vidarsson , Lenche Chakievska , Remco Visser , Sven Kunzel , Andreas Recke , Yask Gupta , Katharina Boch , Artem Vorobyev , Kathrin Kalies , Ralf J. Ludwig

A balanced immune system is essential to maintain adequate host defense and effective self-tolerance. While an immune system that fails to generate appropriate response will permit infections to develop, uncontrolled activation may lead to autoinflammatory or autoimmune diseases. To identify drug candidates capable of modulating immune cell functions, we screened 1200 small molecules from the Prestwick Chemical Library for their property to inhibit innate or adaptive immune responses. Our studies focused specifically on drug interactions with T cells, B cells, and polymorphonuclear leukocytes (PMNs). Candidate drugs that were validated in vitro were examined in preclinical models to determine their immunomodulatory impact in chronic inflammatory diseases, here investigated in chronic inflammatory skin diseases. Using this approach, we identified several candidate drugs that were highly effective in preclinical models of chronic inflammatory disease. For example, we found that administration of pyrvinium pamoate, an FDA-approved over-the-counter anthelmintic drug, suppressed B cell activation in vitro and halted the progression of B cell-dependent experimental pemphigoid by reducing numbers of autoantigen-specific B cell responses. In addition, in studies performed in gene-deleted mouse strains provided additional insight into the mechanisms underlying these effects, for example, the receptor-dependent actions of tamoxifen that inhibit immune-complex-mediated activation of PMNs. Collectively, our methods and findings provide a vast resource that can be used to identify drugs that may be repurposed and used to promote or inhibit cellular immune responses.

平衡的免疫系统对于维持适当的宿主防御和有效的自我耐受至关重要。如果免疫系统不能产生适当的反应,就会导致感染,而不受控制的激活则可能导致自身炎症或自身免疫性疾病。为了找出能够调节免疫细胞功能的候选药物,我们从普雷斯威克化学库中筛选了 1200 种小分子药物,研究它们抑制先天性或适应性免疫反应的特性。我们的研究特别关注药物与 T 细胞、B 细胞和多形核白细胞(PMN)的相互作用。在体外验证的候选药物在临床前模型中进行了检验,以确定它们对慢性炎症性疾病的免疫调节作用。通过这种方法,我们确定了几种在慢性炎症疾病临床前模型中非常有效的候选药物。例如,我们发现,服用美国食品及药物管理局批准的非处方抗蠕虫药物帕莫酸吡维尼,可抑制体外 B 细胞活化,并通过减少自身抗原特异性 B 细胞反应的数量,阻止 B 细胞依赖性实验性丘疹性荨麻疹的发展。此外,在基因缺失的小鼠品系中进行的研究为了解这些作用的机制提供了更多信息,例如他莫昔芬抑制免疫复合物介导的 PMNs 激活的受体依赖性作用。总之,我们的方法和发现提供了一个巨大的资源库,可用于确定可重新用于促进或抑制细胞免疫反应的药物。
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引用次数: 0
Telitacicept: A novel horizon in targeting autoimmunity and rheumatic diseases 泰利昔普针对自身免疫和风湿性疾病的新视野
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-08-14 DOI: 10.1016/j.jaut.2024.103291
Liuting Zeng , Kailin Yang , Yang Wu , Ganpeng Yu , Yexing Yan , Moujia Hao , Tian Song , Yuwei Li , Junpeng Chen , Lingyun Sun

BLyS and APRIL have the capability to bind to B cells within the body, allowing these cells to evade elimination when they should naturally be removed. While BLyS primarily plays a role in B cell development and maturation, APRIL is linked to B cell activation and the secretion of antibodies. Thus, in theory, inhibiting BLyS or APRIL could diminish the population of aberrant B cells that contribute to SLE and reduce disease activity in patients. Telitacicept functions by binding to and neutralizing the activities of both BLyS and APRIL, thus hindering the maturation and survival of plasma cells and fully developed B cells. The design of telitacicept is distinctive; it is not a monoclonal antibody but a TACI-Fc fusion protein generated through recombinant DNA technology. This fusion involves merging gene segments of the TACI protein, which can target BLyS/APRIL simultaneously, with the Fc gene segment of the human IgG protein. The TACI-Fc fusion protein exhibits the combined characteristics of both proteins. Currently utilized for autoimmune disease treatment, telitacicept is undergoing clinical investigations globally to assess its efficacy in managing various autoimmune conditions. This review consolidates information on the mechanistic actions, dosing regimens, pharmacokinetics, efficacy, and safety profile of telitacicept—a dual-targeted biological agent. It integrates findings from prior experiments and pharmacokinetic analyses in the treatment of RA and SLE, striving to offer a comprehensive overview of telitacicept's research advancements.

BLyS 和 APRIL 能够与体内的 B 细胞结合,使这些本应自然清除的细胞得以逃避清除。BLyS 主要作用于 B 细胞的发育和成熟,而 APRIL 则与 B 细胞的活化和抗体的分泌有关。因此,从理论上讲,抑制BLyS或APRIL可以减少导致系统性红斑狼疮的异常B细胞数量,减轻患者的疾病活动。替立肽通过与 BLyS 和 APRIL 结合并中和它们的活性,从而阻碍浆细胞和发育完全的 B 细胞的成熟和存活。替立替塞普的设计与众不同;它不是单克隆抗体,而是通过 DNA 重组技术生成的 TACI-Fc 融合蛋白。这种融合涉及将 TACI 蛋白的基因片段与人类 IgG 蛋白的 Fc 基因片段合并,TACI 蛋白可同时靶向 BLyS/APRIL。TACI-Fc 融合蛋白具有两种蛋白的综合特性。泰利他赛普目前用于治疗自身免疫性疾病,正在全球范围内开展临床研究,以评估其在治疗各种自身免疫性疾病方面的疗效。本综述整合了有关替立替塞普(telitacicept)--一种双靶向生物制剂--的作用机理、给药方案、药代动力学、疗效和安全性的信息。它整合了之前治疗RA和系统性红斑狼疮的实验结果和药代动力学分析,力求全面概述替立替塞普特的研究进展。
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引用次数: 0
WTAP promotes the progression of ulcerative colitis by silencing the expression of CES2 through m6A modification WTAP 通过 m6A 修饰抑制 CES2 的表达,从而促进溃疡性结肠炎的进展
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-08-13 DOI: 10.1016/j.jaut.2024.103295
Xiaoran Xie , Sha Cheng , Xiong Chen , Xia Wang

Objective

This study will explore the function of WTAP, the critical segment of m6A methyltransferase complex, in UC and its regulation on immune response.

Methods

The expression levels of key proteins were detected in colon tissues which were derived from UC patients and mice. Macrophage polarization and CD4+ T cell infiltration were detected by flow cytometry and IF staining. ELISA assay was utilized to analyze the level of the inflammatory cytokines. m6A-RIP-PCR, actinomycin D test, and RIP assays were utilized to detect the m6A level, stability, and bound proteins of CES2 mRNA. A dual luciferase reporter assay was conducted to confirm the transcriptional interactions between genes. A co-culture system of intestinal epithelium-like organs was constructed to detect the primary mouse intestinal epithelial cells (PMIEC) differentiation. The interaction between proteins was detected via Co-IP assay.

Results

The expression of WTAP and CES2 in UC tissues was increased and decreased, respectively. Knockdown of WTAP inhibited the progression of UC in mice by inhibiting M1 macrophage polarization and CD4+ T cell infiltration. WTAP combined YTHDF2 to promote the m6A modification of CES2 mRNA and inhibited its expression. CES2 co-expressed with EPHX2 and overexpression of CES2 promoted the differentiation of PMIEC. The inhibitory effect of WTAP knockdown on the progress of UC was partially abrogated by CES2 knockdown.

Conclusion

WTAP/YTHDF2 silences CES2 by promoting its m6A modification and then promotes the progression of UC. WTAP could be a promoting therapy target of UC.

方法 在 UC 患者和小鼠的结肠组织中检测关键蛋白的表达水平。采用流式细胞术和 IF 染色法检测巨噬细胞极化和 CD4+ T 细胞浸润。m6A-RIP-PCR、放线菌素 D 试验和 RIP 试验用于检测 CES2 mRNA 的 m6A 水平、稳定性和结合蛋白。为了证实基因之间的转录相互作用,还进行了双荧光素酶报告实验。构建了肠上皮样器官共培养系统,以检测小鼠原代肠上皮细胞(PMIEC)的分化情况。结果WTAP和CES2在UC组织中的表达分别增加和减少。敲除 WTAP 可抑制 M1 巨噬细胞极化和 CD4+ T 细胞浸润,从而抑制小鼠 UC 的恶化。WTAP与YTHDF2结合可促进CES2 mRNA的m6A修饰并抑制其表达。CES2与EPHX2共表达,过表达CES2可促进PMIEC的分化。结论 WTAP/YTHDF2通过促进CES2的m6A修饰沉默CES2,进而促进UC的进展。WTAP可能是促进UC治疗的靶点。
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引用次数: 0
Antigen-specific T cells and autoimmunity 抗原特异性 T 细胞与自身免疫
IF 7.9 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-08-13 DOI: 10.1016/j.jaut.2024.103303
Manuel Rojas , Yeny Acosta-Ampudia , Luke S. Heuer , Weici Zang , Diana M Monsalve , Carolina Ramírez-Santana , Juan-Manuel Anaya , William M Ridgway , Aftab A Ansari , M. Eric Gershwin

Autoimmune diseases (ADs) showcase the intricate balance between the immune system's protective functions and its potential for self-inflicted damage. These disorders arise from the immune system's erroneous targeting of the body's tissues, resulting in damage and disease. The ability of T cells to distinguish between self and non-self-antigens is pivotal to averting autoimmune reactions. Perturbations in this process contribute to AD development. Autoreactive T cells that elude thymic elimination are activated by mimics of self-antigens or are erroneously activated by self-antigens can trigger autoimmune responses. Various mechanisms, including molecular mimicry and bystander activation, contribute to AD initiation, with specific triggers and processes varying across the different ADs. In addition, the formation of neo-epitopes could also be implicated in the emergence of autoreactivity. The specificity of T cell responses centers on the antigen recognition sequences expressed by T cell receptors (TCRs), which recognize peptide fragments displayed by major histocompatibility complex (MHC) molecules. The assortment of TCR gene combinations yields a diverse array of T cell populations, each with distinct affinities for self and non-self antigens. However, new evidence challenges the traditional notion that clonal expansion solely steers the selection of higher-affinity T cells. Lower-affinity T cells also play a substantial role, prompting the “two-hit” hypothesis. High-affinity T cells incite initial responses, while their lower-affinity counterparts perpetuate autoimmunity. Precision treatments that target antigen-specific T cells hold promise for avoiding widespread immunosuppression. Nevertheless, detection of such antigen-specific T cells remains a challenge, and multiple technologies have been developed with different sensitivities while still harboring several drawbacks. In addition, elements such as human leukocyte antigen (HLA) haplotypes and validation through animal models are pivotal for advancing these strategies. In brief, this review delves into the intricate mechanisms contributing to ADs, accentuating the pivotal role(s) of antigen-specific T cells in steering immune responses and disease progression, as well as the novel strategies for the identification of antigen-specific cells and their possible future use in humans. Grasping the mechanisms behind ADs paves the way for targeted therapeutic interventions, potentially enhancing treatment choices while minimizing the risk of systemic immunosuppression.

自身免疫性疾病(ADs)展示了免疫系统的保护功能与其自我造成损害的潜力之间错综复杂的平衡。这些疾病源于免疫系统对人体组织的错误定位,从而导致损伤和疾病。T 细胞区分自身抗原和非自身抗原的能力是避免自身免疫反应的关键。这一过程的紊乱会导致注意力缺失症的发生。躲过胸腺清除的自身反应性T细胞被自身抗原的模拟物激活,或被自身抗原错误激活,都会引发自身免疫反应。包括分子模仿和旁观者激活在内的各种机制都会导致自身免疫性疾病的发生,不同的自身免疫性疾病的具体诱因和过程各不相同。此外,新表位的形成也可能与自身反应的出现有关。T 细胞反应的特异性以 T 细胞受体(TCR)表达的抗原识别序列为中心,TCR 可识别主要组织相容性复合体(MHC)分子显示的肽片段。各种 TCR 基因组合产生了多种多样的 T 细胞群,每种细胞群对自身和非自身抗原都有不同的亲和力。然而,新的证据挑战了克隆扩增只引导高亲和力 T 细胞选择的传统观念。亲和力较低的 T 细胞也发挥了重要作用,从而提出了 "两击 "假说。高亲和力T细胞激发最初的反应,而低亲和力T细胞则使自身免疫永久化。针对抗原特异性 T 细胞的精准治疗有望避免广泛的免疫抑制。然而,检测这种抗原特异性 T 细胞仍是一项挑战,目前已开发出多种技术,灵敏度各不相同,但仍存在一些缺陷。此外,人类白细胞抗原(HLA)单倍型和动物模型验证等因素也是推进这些策略的关键。简而言之,这篇综述深入探讨了导致ADs的复杂机制,强调了抗原特异性T细胞在引导免疫反应和疾病进展中的关键作用,以及鉴定抗原特异性细胞的新策略及其未来可能在人类中的应用。掌握抗原特异性细胞背后的机制为有针对性的治疗干预铺平了道路,从而有可能增加治疗选择,同时最大限度地降低全身免疫抑制的风险。
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引用次数: 0
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Journal of autoimmunity
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