scholarly journals Innate and Adaptive Immunity in Giant Cell Arteritis

2021 ◽  
Vol 11 ◽  
Author(s):  
Mitsuhiro Akiyama ◽  
Shozo Ohtsuki ◽  
Gerald J. Berry ◽  
David H. Liang ◽  
Jörg J. Goronzy ◽  
...  

Autoimmune diseases can afflict every organ system, including blood vessels that are critically important for host survival. The most frequent autoimmune vasculitis is giant cell arteritis (GCA), which causes aggressive wall inflammation in medium and large arteries and results in vaso-occlusive wall remodeling. GCA shares with other autoimmune diseases that it occurs in genetically predisposed individuals, that females are at higher risk, and that environmental triggers are suspected to beget the loss of immunological tolerance. GCA has features that distinguish it from other autoimmune diseases and predict the need for tailored diagnostic and therapeutic approaches. At the core of GCA pathology are CD4+ T cells that gain access to the protected tissue niche of the vessel wall, differentiate into cytokine producers, attain tissue residency, and enforce macrophages differentiation into tissue-destructive effector cells. Several signaling pathways have been implicated in initiating and sustaining pathogenic CD4+ T cell function, including the NOTCH1-Jagged1 pathway, the CD28 co-stimulatory pathway, the PD-1/PD-L1 co-inhibitory pathway, and the JAK/STAT signaling pathway. Inadequacy of mechanisms that normally dampen immune responses, such as defective expression of the PD-L1 ligand and malfunction of immunosuppressive CD8+ T regulatory cells are a common theme in GCA immunopathology. Recent studies are providing a string of novel mechanisms that will permit more precise pathogenic modeling and therapeutic targeting in GCA and will fundamentally inform how abnormal immune responses in blood vessels lead to disease.

Author(s):  
Christine N. Noto ◽  
Stella G. Hoft ◽  
Richard J. DiPaolo

Mast cells are an essential part of the immune system and are best known as important modulators of allergic and anaphylactic immune responses. Upon activation, mast cells release a multitude of inflammatory mediators with various effector functions that can be both protective and damage-inducing. Mast cells can have an anti-inflammatory or pro-inflammatory immunological effect and play important roles in regulating autoimmune diseases including rheumatoid arthritis, type 1 diabetes, and multiple sclerosis. Importantly, chronic inflammation and autoimmunity are linked to the development of specific cancers including pancreatic cancer, prostate cancer, colorectal cancer, and gastric cancer. Inflammatory mediators released from activated mast cells regulate immune responses and promote vascular permeability and the recruitment of immune cells to the site of inflammation. Mast cells are present in increased numbers in tissues affected by autoimmune diseases as well as in tumor microenvironments where they co-localize with T regulatory cells and T effector cells. Mast cells can regulate immune responses by expressing immune checkpoint molecules on their surface, releasing anti-inflammatory cytokines, and promoting vascularization of solid tumor sites. As a result of these immune modulating activities, mast cells have disease-modifying roles in specific autoimmune diseases and cancers. Therefore, determining how to regulate the activities of mast cells in different inflammatory and tumor microenvironments may be critical to discovering potential therapeutic targets to treat autoimmune diseases and cancer.


2021 ◽  
Vol 12 ◽  
Author(s):  
Payal Grover ◽  
Peeyush N. Goel ◽  
Mark I. Greene

T regulatory cells suppress a variety of immune responses to self-antigens and play a role in peripheral tolerance maintenance by limiting autoimmune disorders, and other pathological immune responses such as limiting immune reactivity to oncoprotein encoded antigens. Forkhead box P3 (FOXP3) expression is required for Treg stability and affects functional activity. Mutations in the master regulator FOXP3 and related components have been linked to autoimmune diseases in humans, such as IPEX, and a scurfy-like phenotype in mice. Several lines of evidence indicate that Treg use a variety of immunosuppressive mechanisms to limit an immune response by targeting effector cells, including secretion of immunoregulatory cytokines, granzyme/perforin-mediated cell cytolysis, metabolic perturbation, directing the maturation and function of antigen-presenting cells (APC) and secretion of extracellular vesicles for the development of immunological tolerance. In this review, several regulatory mechanisms have been highlighted and discussed.


Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1582
Author(s):  
Chloe O’Neill ◽  
Féaron C. Cassidy ◽  
Donal O’Shea ◽  
Andrew E. Hogan

Mucosal associated invariant T (MAIT) cells are a population of unconventional T cells which can bridge the innate and adaptive immune systems. Well-described roles for MAIT cells include host protection against invading bacteria, fungi and viruses. Upon activation, MAIT cells become prolific effector cells, capable of producing a range of cytokines and lytic molecules. In addition to their anti-microbial role, MAIT cells have been implicated in immune responses to cancer, with opposing beneficial and pathogenic roles reported. On the one hand, MAIT cells can home to the site of the tumour in many human cancers and can produce anti-tumour molecules. On the other, MAIT cells can display defective phenotypes in certain cancers and produce pro-tumour molecules. In this review, we discuss the current literature on the diverse roles for MAIT cells in cancer, outlining their frequencies, functions and associations with N staging and prognosis. We also discuss potential mechanisms underpinning cancer-related alterations in MAIT cells and highlight therapeutic approaches to harness or target MAIT cells in cancer.


2021 ◽  
pp. 15-18
Author(s):  
Jesica Gallo ◽  
Eduardo Henares ◽  
Sergio Paira

Calciphylaxis is characterized by intense deposition of calcium in small blood vessels, skin, and other organs, described mainly in patients with chronic renal insufficiency, renal transplant of parathyroid dysfunction. To date, there are only seven cases described in literature of calciphylaxis mimicking giant cell arteritis (GCA). In this review, we present the eighth case pathologically documented.


Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1392
Author(s):  
Peter Lawrence Smith ◽  
Katarzyna Piadel ◽  
Angus George Dalgleish

Cancer vaccination and immunotherapy revolutionised the treatment of cancer, a result of decades of research into the immune system in health and disease. However, despite recent breakthroughs in treating otherwise terminal cancer, only a minority of patients respond to cancer immunotherapy and some cancers are largely refractive to immunotherapy treatment. This is due to numerous issues intrinsic to the tumour, its microenvironment, or the immune system. CD4+ and CD8+ αβ T-cells emerged as the primary effector cells of the anti-tumour immune response but their function in cancer patients is often compromised. This review details the mechanisms by which T-cell responses are hindered in the setting of cancer and refractive to immunotherapy, and details many of the approaches under investigation to direct T-cell function and improve the efficacy of cancer vaccination and immunotherapy.


2021 ◽  
Vol 12 ◽  
Author(s):  
David A. Horwitz ◽  
Sean Bickerton ◽  
Antonio La Cava

Autoimmune diseases are disorders of immune regulation where the mechanisms responsible for self-tolerance break down and pathologic T cells overcome the protective effects of T regulatory cells (Tregs) that normally control them. The result can be the initiation of chronic inflammatory diseases. Systemic lupus erythematosus (SLE) and other autoimmune diseases are generally treated with pharmacologic or biological agents that have broad suppressive effects. These agents can halt disease progression, yet rarely cure while carrying serious adverse side effects. Recently, nanoparticles have been engineered to correct homeostatic regulatory defects and regenerate therapeutic antigen-specific Tregs. Some approaches have used nanoparticles targeted to antigen presenting cells to switch their support from pathogenic T cells to protective Tregs. Others have used nanoparticles targeted directly to T cells for the induction and expansion of CD4+ and CD8+ Tregs. Some of these T cell targeted nanoparticles have been formulated to act as tolerogenic artificial antigen presenting cells. This article discusses the properties of these various nanoparticle formulations and the strategies to use them in the treatment of autoimmune diseases. The restoration and maintenance of Treg predominance over effector cells should promote long-term autoimmune disease remission and ultimately prevent them in susceptible individuals.


2021 ◽  
Vol 19 ◽  
pp. 205873922110476
Author(s):  
Na Zhang ◽  
Ze-Ming Zhang ◽  
Xiao-Fei Wang

Basophils are the rarest blood cell population and have not been extensively studied. Our understanding of the functions of basophils is limited to their roles as the main effector cells in hypersensitivity reactions. Similar to mast cells, basophils express high-affinity IgE receptor (FcεRI), contain granules, and release hypersensitivity-associated mediators (such as histamine). The roles of basophils have not been fully elucidated; however, with the rapid development of monoclonal techniques, high-purity cell sorting techniques, and basophil-deficient mouse models, understanding of the functions and phenotypes of basophils has increased. This facilitates further investigations on the relationships between basophils and host immunity. Basophils are not only involved in mediating the generation of allergic reactions but also play important roles in immunomodulation and are responsible for the onset of infectious, allergic, and autoimmune diseases. In this review, we summarize the progress in understanding the roles of basophils in mediating immune responses with an emphasis on autoimmune diseases, particularly systemic lupus erythematosus and rheumatoid arthritis.


1974 ◽  
Vol 139 (5) ◽  
pp. 1303-1316 ◽  
Author(s):  
John W. Schrader

Specific immunological unresponsiveness was induced using thymus-dependent antigens in congenitally athymic (nu/nu) mice, in which no T-cell function has been demonstrated. The tolerance was induced in vivo by the injection of 5–10 mg of either FGG or DNP-HGG. Spleen cells from treated mice were tested in vitro for the ability to mount thymus-independent immune responses against FGG in the presence of polymerized flagellin POL, and the DNP determinant conjugated to POL. A specific deficiency in either the in vitro anti-FGG or anti-DNP response was demonstrated, depending on the antigen used for treatment of the spleen cell donor. Athymic mice treated with FGG were also tested by in vivo challenge with FGG given with POL as an adjuvant and were found to be hyporesponsive. Unresponsiveness to in vitro challenge was established by 24 h after the in vivo injection of FGG. It was found that the injection of POL with the FGG prevented the development of unresponsiveness, but not if the POL was given 24 h or more after the FGG. The unresponsiveness could not be overcome by confrontation with allogeneic spleen cells from CBA mice, although the presence of allogeneic spleen cells had a large amplifying effect on the response of control spleen cells. These experiments demonstrate a mechanism for the tolerization of bone marrow-derived cells by thymus-dependent antigens in the absence of the thymus.


Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_3) ◽  
pp. iii17-iii27
Author(s):  
Maria C Cid ◽  
Roberto Ríos-Garcés ◽  
Nekane Terrades-García ◽  
Georgina Espígol-Frigolé

Abstract For decades, the treatment of GCA has relied on glucocorticoids. Work over the past two decades has supported a modest efficacy of MTX but no clear benefit from anti-TNF-based therapies. More recently, the therapeutic armamentarium for GCA has expanded. The availability of agents targeting specific cytokines, cytokine receptors or signalling pathways, along with a better, although still limited, understanding of the immunopathology of GCA, are opening further therapeutic possibilities. Blocking IL-6 receptor with tocilizumab has been effective in maintaining remission and reducing glucocorticoid exposure and tocilizumab has been approved for the treatment of GCA. However, nearly half of the patients do not benefit from tocilizumab and additional options need to be investigated. This review focuses on standard therapeutic approaches and on targeted therapies that have been or are currently under investigation.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. SCI-2-SCI-2 ◽  
Author(s):  
Thomas F. Tedder

Abstract B cells have been historically characterized as positive regulators of immune responses, but can also influence immune responses through numerous mechanisms other than antibody production. In one example, we and others have functionally identified a rare but specific subset of IL-10-competent regulatory B cells in humans and mice by their ability to secrete IL-10. We have labeled these B cells as “B10 cells” to identify them as the exclusive source of B-cell IL-10. The capacity of B10 cells to produce IL-10 is central to their ability to negatively regulate inflammation and autoimmune disease, as well as adaptive and innate immune responses. Rare B10 cell numbers often increase during inflammation and autoimmunity, particularly in some patients with active disease and autoimmune-prone mice. Nonetheless, the in vivo expansion of B10 cells in mice and patients responding to inflammation is inadequate to effectively control disease. However, the adoptive transfer of 1-2x105 spleen B10 cells from naïve or antigen-primed mice significantly inhibits disease initiation in mouse models of inflammation, autoimmune disease, and contact hypersensitivity. B10 cells are not overtly immunosuppressive, but instead have antigen-specific regulatory functions. Appropriate B-cell antigen receptor specificity and signals are required to drive B10 cell development and acquisition of IL-10 competence under physiological conditions in vivo. Following antigen-specific B10 cell development, their maturation into functional IL-10-secreting effector cells in vivo requires IL-21 and CD40-dependent cognate interactions with antigen-specific T cells. These critical checkpoints are likely to direct localized B10 cell IL-10 production to blunt antigen-specific T-cell responses during cognate B10:T cell interactions. These findings likely explain how antigen-specific B10 cell-effector function can exert such potent in vivo effects and selectively inhibit antigen-specific T-cell function during inflammation and autoimmunity without untoward immunosuppression. Human B10 cells are likely to have similar in vivo regulatory activities. In support of this, collaborative studies with Brice Weinberg and others have shown that human blood B10 cells and malignant cells from 90 percent of patients with chronic lymphocytic leukemia (CLL) share similar cell surface phenotypes and the capacity to express IL-10. Mouse B10 cells and malignant cells in the Tcl-1 transgenic mouse model of CLL also share similar phenotypes and the capacity to express IL-10. Of importance, CLL cell production of IL-10 appears to be dynamically regulated in mice and CLL patients are frequently immunosuppressed with abnormalities in both humoral and cellular immunity. Thus, B10 cells and CLL cells share regulatory properties. Insights into the molecular pathways that regulate antigen-specific B10 cell function in vivo have led to the development of an in vitro culture system that expands functionally-active mouse B10 cells (B10 effector cells) ex vivo by 4 million-fold. B10 effector cells resulting from this culture system secrete IL-10, retain their antigen-specific regulatory functions, and have demonstrated potent anti-inflammatory effects that effectively treat mice with established autoimmune disease. In mice, this culture system allows the generation of sufficient B10 effector cells from one mouse to treat 21,000 syngeneic mice with established disease. Thus, autologous B10 effector cells may eventually provide a new therapy that successfully treats patients with severe and refractory autoimmune disease, particularly those individuals for whom effective drugs have not been identified, as well as those who experience transplant rejection. Disclosures: Tedder: Angelica Therapeutics, Inc.: Consultancy, Equity Ownership; National Institutes of Health grants AI56363 and AI057157: Research Funding; Lymphoma Research Foundation: Research Funding.


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