Current directions in autoimmunity最新文献

A functional immune system is dependent on the generation and selection of a lymphocyte repertoire that is sufficiently diverse to respond to innumerable foreign antigens yet be adequately self-tolerant to avoid the development of autoimmunity. Programmed cell death by a process known as apoptosis is responsible for negative selection of nonreactive leukocyte precursors and autoreactive thymocytes, killing of infected and transformed cells by cytotoxic lymphocytes and deletion of superfluous activated lymphocytes by activation-induced cell death (AICD) and peripheral deletion at the termination of an immune response. Mitochondrial respiration is required to meet the energy requirements of activated and proliferating peripheral lymphocytes. Several mitochondrial proteins have been implicated as regulators of apoptosis in the immune system that are required for prevention of autoimmunity. Recent discoveries have shed light on mitochondrial functions as they relate to cell death, including caspase-dependent and -independent apoptosis, mitochondrial death substrates and events that disable mitochondrial functions during apoptosis. These discoveries, taken with reports that the specific manner by which a cell dies greatly impacts on the nature of subsequent immune responses, highlight an exciting era of research on mitochondrial function and its role in apoptosis and the effects on immune responses.

Glomerulonephritis (GN) is a form of autoimmunity in which apoptosis may be a double-edged sword. Resolution of GN can be promoted by apoptosis of infiltrating leucocytes and excess resident glomerular cells, leading to efficient anti-inflammatory clearance by macrophages and mesangial cells. However, unscheduled apoptosis in glomerular cells, especially epithelial cells ('podocytes') may drive progression of GN to hypocellular, nonfunctional scar. Defects in clearance of apoptotic cells may also have deleterious local effects, in addition to promoting autoimmunity itself. Nevertheless, there is strong promise for novel therapies based on new knowledge of apoptosis in GN, especially in regulation of leucocyte clearance from the inflamed glomerulus.

The current studies of apoptosis in rheumatoid arthritis (RA) suggest that the TNF ligand-receptor superfamily (TNFRsF) molecules, downstream pathways (activation of proapoptosis or anti-apoptosis pathway), cell types (lymphocytes and synovial fibroblast), and the mechanism that triggers apoptosis (tolerance induction-related, downmodulation of inflammation-related, or DNA damage-related) all exhibit a capability to determine the induction or prevention of RA. This series of defects at different levels and in different cells have been shown to lead to T cell and synovial hyperproliferation, defective apoptosis, excessive apoptosis, or bone erosion. In this chapter, we summarize the available knowledge of the regulation of TNFRsF and their likely pathogenic roles in RA to help identify candidate target cells and target molecules for delivery of gene constructs to modulate apoptosis to prevent the development of RA in both humans and mice.

Systemic lupus erythematosus (SLE) is characterized by a diverse array of autoantibodies, particularly against nuclear antigens, thought to derive from apoptotic and necrotic cells. Impaired clearance functions for dying cells may explain accumulation of apoptotic cells in SLE tissues, and secondary necrosis of these cells may contribute to the chronic inflammation in this disease. The exposure of phosphatidylserine (PS) and altered carbohydrates on dying cells are important recognition signals for macrophages. Furthermore, serum factors such as complement, DNase I, pentraxins (e.g. C-reactive protein) and IgM contribute to efficient opsonization and uptake of apoptotic and necrotic cells. Defects in these factors may impact the development of SLE in humans and mice in a variety of ways. We observed impaired clearance of apoptotic cells in lymph nodes and skin biopsies of humans with lupus, as well as intrinsic defects of macrophages differentiated in vitro from SLE patients' CD34+ stem cells, demonstrating that apoptotic cells are not properly cleared in a subgroup of patients with SLE. This altered mechanism for the clearance of dying cells may represent a central pathogenic process in the development and acceleration of this autoimmune disease.

Death receptors belong to the TNF (tumor necrosis factor)/NGF (nerve growth factor) receptor superfamily. Signaling via death receptors plays a distinct role, e.g. in the immune system, where it contributes to regulation of the adaptive immune response in various ways, most notably by triggering activation-induced cell death (AICD) of T cells. Thus, dysregulation of death receptor signaling, either allowing too much or too little apoptosis, can lead to autoimmune disorders and also impacts on tumorigenesis or other diseases. In this chapter we address components, molecular mechanisms and regulation of death receptor signaling with particular focus on CD95 (APO-1, Fas). We discuss the role of death receptor-mediated AICD in regulation of the adaptive immune response against foreign and self antigens in comparison to cytokine deprivation-mediated death by neglect. Finally, the contribution of dysregulated death receptor/ligand systems to autoimmune diseases such as diabetes, multiple sclerosis and Hashimoto's thyroiditis is discussed.

The collagenous C-type lectin family (collectins) members are humoral molecules found in the serum and on certain mucosal surfaces. In humans the family of collectins include the mannose-binding lectin, surfactant protein A and surfactant protein D. They demonstrate broad ligand specificity for both pathogenic bacteria and viruses. Over the past 5 years data have emerged indicating that these molecules are able to bind self-derived ligands in the form of apoptotic cells and regulate inflammatory responses. Furthermore, exciting new data from murine models have begun to define the in vivo importance of these molecules as regulators of inflammation and immunity. Here will discuss our current understanding of the process of collectin recognition of dying and damaged cells and its implications for autoimmune and inflammatory diseases.

The death receptor Fas/TNFRSF6 is a key player in lymphocyte apoptosis induction. Patients lacking a functional Fas/TNFRSF6 receptor develop a chronic lymphoproliferation termed Autoimmune LymphoProliferative Syndrome (ALPS), characterized by a benign tumoral syndrome, autoimmune cytopenias, hyperglobulinemia (G and A) and accumulation of TCRalphaBeta CD4-CD8- cells (called double-negative, or DN, T cells). Inherited mutations in the TNFRSF6 gene are responsible for most ALPS cases (ALPS-I). Caspase 10 gene mutations are found in a few of the remaining cases (ALPS-II). In a third group of patients (ALPS-III), somatic mosaicism of Fas/TNFRSF6 mutations as found in sporadic cases. Consequences of this finding will be discussed in terms of functional and molecular diagnosis as well as in the understanding of the pathophysiological basis of ALPS.

To prevent autoimmunity, it is critical that tolerance mechanisms block autoantibody production from self-reactive B cells. B cell tolerance is maintained through mechanisms that can reversibly or irreversibly silence autoreactive B cells. Of these mechanisms, those that lead to B cell death offer the most reliable form of tolerance to prevent autoimmunity. In many cases, death of autoreactive B cells is regulated by the cell intrinsic, or mitochondrial pathway of cell death. The pro-apoptotic Bcl-2 family proteins, Bak, Bax, and Bim have been shown to be required for disruption of mitochondria and intrinsic cell death of self-reactive B cells whereas the anti-apoptotic Bcl-2, Bcl-xL, and Mcl-1 can prevent cell death by interfering with the action of Bax and Bak. Bcl-2 and Bcl-xL have also been shown to regulate the autophagic cell death pathway that may also play a role in B cell tolerance. Even after mitochondrial disruption, mechanisms exist that may impede activation of caspases and death of autoreactive B cells. Together, understanding of cell death mechanisms and how they may affect B cell tolerance has made significant recent advances and it is now important to incorporate alternate and post-mitochondrial cell death mechanisms into B cell tolerance models.

Apoptosis is essential for the development, function and homeostasis of the immune system. Experiments with transgenic and gene knock-out mice have shown that defects in the control of apoptosis in the hematopoietic system can promote the development of autoimmunity or hematological malignancy. In contrast, excessive apoptosis of normally long-lived hemopoietic cells can lead to lymphopenia and immunodeficiency. In mammals, cell death in response to developmental cues and many cell stress signals is regulated by the opposing factions of the Bcl-2 family of proteins. In particular, the pro-apoptotic subgroup called BH3-only proteins, which includes Bim, is critical in the initiation of apoptosis in response to many death stimuli. Bim has been found to be an important regulator of the negative selection of B lymphocytes in the bone marrow and of T lymphocytes both in the thymus and the periphery. Mice lacking Bim accumulate self-reactive lymphocytes, develop autoantibodies and on certain genetic backgrounds succumb to SLE-like autoimmune disease. Abnormalities in Bim expression and the thymic deletion of auto-reactive lymphocytes have also been implicated as a component of the complex, polygenic predisposition to autoimmune diabetes seen in NOD mice. Bim is also an essential regulator of T lymphocyte apoptosis during the termination of an immune response. This chapter focuses on the role of Bim in the development and function of the immune system and its potential role in autoimmunity. Degenerative disorders due to increased apoptosis mediated by Bim are also discussed.