PubMed · 15925530
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J-Y Muller. 2005. [TRALI].. https://doi.org/10.1016/j.tracli.2005.04.026
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Tumor necrosis factor alpha (TNFalpha), with the potential to destroy tissue, is likely to be tightly regulated. A major regulatory step is the translational repression of TNFalpha. This study evaluates whether endogenous inhibitory cytokines account for this repression. Two cell populations were isolated from peripheral blood using techniques that minimized activation, one composed primarily of monocytes and the other containing T-cells and NK-cells. When cultured without a stimulus in the presence of Abs neutralizing IL-4, IL-10, or TGFbeta, each population released large amounts of TNFalpha, reaching levels induced by PHA or LPS. Their actions were at the post-translational level since the numbers of transcripts did not change, and inhibitors of protein or RNA synthesis had no effects. When inhibitors of 38 MAP kinase and ERK were added, T-cell release of TNFalpha proved to involve both pathways while monocytes were dependent on p38 but not ERK. Changes in soluble TNF receptor levels or cell uptake of TNFalpha were not involved. This study shows that low TNFalpha secretion by resting T-cells and monocytes is maintained by endogenous inhibitors that suppress post-translational processing of TNFalpha by MAP kinases. Keeping TNFalpha levels low is critical to the non-inflammatory steady-state.
Post kala-azar dermal leishmaniasis (PKDL) is a dermatosis caused by persistence of Leishmania donovani parasites in the skin following apparently successful treatment of visceral leishmaniasis. The distribution of PKDL lesions in Sudanese patients often mirrors the clothing habits of those affected. It is most severe in or confined to the sun-exposed parts of the skin. It is well established that elimination of Leishmania parasites requires activation of parasitised macrophages by a Th1 immune response and that the latter is depressed by ultraviolet light (UVB). In this paper, we hypothesized that UVB light might be a key player in the pathogenesis of PKDL. This paper links observations made in the field with immunological data that are compatible with this hypothesis. We therefore investigated patients with PKDL immunologically for a possible role of UVB exposure in the pathogenesis of this condition. We marshal evidence that the changes in the tissues are compatible with the effects of UVB light and it is probable that UVB appears to be a key factor in the pathogenesis of PKDL. Immunopathologically the lesions were characterized by an influx of various inflammatory cells. The number of CD1a (Langerhans' cells) was decreased, they lost their dendrites, their HLA-DR and B7-1 expression was down regulated while B7-2 was expressed. Others have shown that Langerhans' cells with these features result from UVB exposure and that such cells are unable to present antigen to Th1 cells while retaining the capacity to present antigen to Th2 cells. Various cytokines known to be induced by UVB radiation could be demonstrated in PKDL lesions. Of these IL-10, TGF-beta, IL-12, IL-4 and TNF-alpha were found in different quantities. The Th-1 cytokine IFN-gamma was constantly present. The tissue origin of the Th-1 cells in PKDL is unknown. We believe that the antagonistic action of the different cytokines is the cause of the inflammation and chronicity of PKDL.
Acute viral myocarditis is the main cause of cardiac failure in young patients and accounts for up to 60% of "idiopathic" dilated cardiomyopathy. The clinical course of viral myocarditis is mostly insidious with limited cardiac inflammation and dysfunction. However, overwhelming inflammation may occur in a subset of patients, leading to fulminant cardiac injury, whereas others develop chronic heart failure due to autoimmune myocarditis. Today, little effective treatment exists for patients, apart from general supportive therapy and antifailure regimens. Urokinase-type plasminogen activator (u-PA) and matrix metalloproteinases (MMP) have been implicated in cardiac inflammation, matrix remodeling, and wound healing after cardiac injury. The present review will assess the mechanism by which these proteinases mediate cardiac dilatation, fibrosis, and dysfunction after cardiac stress or injury, in order to understand how inhibition of proteinases may provide a novel therapeutic tool to prevent cardiac dilatation and failure during viral myocarditis.