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Results for “AUTOIMMUNE DISEASES”

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PubMed1998

[Interferon-gamma, the Th1/Th2 paradigm and autoimmune diseases].

Autoimmune diseases originate from a rupture in physiological immune tolerance towards self antigens. However, the formation of autoantibodies and autoreactive inflammatory cells is also regulated by the cytokine network, in which interferon-gamma (IFN-gamma), produced by NK and T lymphocytes, occupies a central position. IFN-gamma influences the function of all cell types involved in immune-mediated inflammatory reactions: antigen-presenting cells, cytotoxic and regulatory T lymphocytes, antibody-producing B lymphocytes, endothelial cells and mononuclear phagocytes. Experimental manipulations which affect the production or action of IFN-gamma invariably affect the course of experimentally induced autoimmune diseases in animals, but do so in divergent directions. A current explanatory framework for these actions of IFN-gamma invokes the T helper-1/T helper-2 (Th1/Th2) concept. According to this concept, autoimmune diseases, like other immune reactions, fall apart in two categories depending on whether the T helper lymphocytes assume a Th1 or Th2 profile. IFN-gamma is assumed to fulfill the function of a promotor and effector of the Th1 profile and is associated with inflammation and tissue damage typical for cell-mediated hypersensitivity reactions. Accordingly, IFN-gamma should boost autoimmune diseases of the Th1 type. However, experimental testing of this prediction contradicts this implication and necessitates revision of the function assigned to IFN-gamma in the Th1/Th2 concept.

Autoimmune Diseases↗

PubMed2002

Millennium Award. Proteomics for the development of DNA tolerizing vaccines to treat autoimmune disease.

Autoimmune disease affects 3% of the world population, yet current therapies that globally suppress immune function are inadequate. Tremendous need exists for specific and curative therapies, and we describe a strategy for development of antigen-specific therapies that inactivate pathogenic lymphocytes causing tissue injury. Major barriers to development of antigen-specific therapies for T-cell-mediated autoimmune diseases, such as multiple sclerosis, rheumatoid arthritis, and autoimmune diabetes, include (i) lack of knowledge of the specificity of autoimmune responses, for which proteomic technologies represent powerful tools to identify the self-protein targets of the autoimmune response, and (ii) lack of methods to induce specific immune tolerance, for which DNA tolerizing vaccines represent a promising strategy. We termed our approach Reverse Genomics: use of the proteomics-determined specificity of the autoantibody response to develop and select DNA tolerizing vaccines. Studies performed using animal models for multiple sclerosis and autoimmune diabetes support our Reverse Genomics approach. Through integration of proteomics with specific tolerizing therapies, we are developing a comprehensive approach to treat human autoimmune disease.

Animals↗

PubMed1992

[Autoimmunization and autoimmune diseases].

Autoimmunization is understood as a type of immune reactions to the unchanged autoantigens only. Autoimmune processes can be subdivided into the physiological ("sanitary" and regulatory) and pathological ones. Physiological processes are of importance in supporting natural immunological tolerance while pathological processes develop on the basis of the physiological ones in presence of various defects of suppressive mechanisms of the immune system. Pathological processes are the basis of the autoimmune diseases and diseases with secondary autoimmune disturbances. The distinction between organo-specific and organo-nonspecific autoimmune diseases can be taken as their preliminary tentative classification.

Antigen-Antibody Reactions↗

PubMed2006

Gene therapy strategies towards immune tolerance to treat the autoimmune diseases.

Autoimmune diseases such as type 1 diabetes and multiple sclerosis pose a significant health burden on our society. As a whole, autoimmune diseases affect approximately 6% of the population and are the third largest disease burden after heart disease and cancer. Such pathologic manifestations arise by way of damaging reactions of B-cell derived antibodies and/or T-cells to self-antigens and are triggered by genetic and environmental factors. Currently there is no known cure, with treatment restricted to toxic, long-term immunosuppressive regimes, replacement therapy and in intractable cases, transplantation of autologous or allogeneic haematopoietic stem cells. In experimental models of autoimmunity, gene therapeutic approaches have demonstrated promise in treating the autoimmune diseases. These include delivery of anti-inflammatory cytokines and exploitation of regulatory T cells. However, none of these approaches provide lasting, long-term benefit. We hypothesise that therapeutically transduced haematopoietic stem cells followed by transplantation is an alternative strategy to establish permanent immune tolerance that can not only prevent autoimmunity but also cure these diseases. Our approach is focused on directing autoimmune disease-specific autoantigen expression in the thymus by genetic manipulation of haematopoietic stem cells to establish molecular chimeras. Our hypothesis originates from experimental studies with a mouse model of experimental autoimmune gastritis (EAG) and more recently with the non-obese diabetic (NOD) mouse model for type 1 diabetes (T1D).

Animals↗

PubMed2004

Any increased risk of autoimmune disease?

Autoimmune diseases such as systemic lupus erythematosus (SLE) are known to have a strong genetic component, therefore the risk of autoimmune disease might be increased in family members of patients with SLE. However, there are currently no data that support a higher incidence of autoimmune disorders in the offspring of SLE patients. Babies with neonatal lupus are not at increased risk to develop SLE in later life, but a continued follow-up is suggested, especially prior to adolescence and if the mother herself has an autoimmune disease.

Autoimmune Diseases↗

PubMed1999

Anticytokine therapy in autoimmune diseases.

Autoimmune reaction and inflammation observed in autoimmune diseases may be caused by the deregulated production of cytokines. Interleukin-6 (IL-6) is a pleiotropic cytokine with a wide range of biological activities such as support of hematopoiesis, regulation of acute phase reactions, and generation of immune responses. Uncontrolled hyperproduction of IL-6 causes plasmacytosis, hyper-gamma-globulinemia, thrombocytosis, mesangial cell proliferation of the kidney as well as inflammatory symptoms which are frequently observed in autoimmune diseases. Thus, interference with IL-6 signal transduction may be useful for autoimmune disease therapy. The pathogenic significance of IL-6 in autoimmune disorders and new therapeutic approaches involving blocking of IL-6 signal transduction are discussed.

Animals↗

PubMed1997

New autoantibodies and their antigens in autoimmune diseases.

Autoimmune diseases are caused by failure to distinguish between host and foreign (e.g. microbial) antigens. We do not know why autoimmune disease occurs and what the relevant pathogenic mechanisms are. Autoantibodies might be considered as diagnostic markers, e.g. as "witnesses" to or "messengers" of autoimmune disease. Therefore, older and newer autoantibodies, as well as results on their respective antigens, will be considered.

Animals↗

PubMed2004

Sex, MHC and complement C4 in autoimmune diseases.

Autoimmune diseases are estimated to affect 10-50 million people in the United States, and untold millions worldwide. Nearly 80% of all people with autoimmune diseases are women, and a strong association of these diseases with MHC genes has been known for some time. However, very little is known about what causes autoimmune diseases or the factors that lead to disease recurrence. The sex-associated differences in multiple sclerosis (MS) and the mouse model of MS, experimental autoimmune encephalomyelitis (EAE), are associated with MHC genetic background, sex hormone levels and cytokine production. The implication of these factors has aided the identification of new autosomal genetic susceptibility loci. Complete deficiencies of early complement components are strongly associated with systemic lupus erythematosus (SLE) but the role of complement proteins in SLE is not yet clear. Recent data suggest that quantitative and qualitative diversities of the MHC-linked complement C4 among different ethnic groups can be important in the susceptibility and disease severity of SLE.

Animals↗

PubMed1995

Genetic background and environment contribute synergistically to the onset of autoimmune diseases.

Autoimmune diseases result from the breakdown of "self" tolerance. Environmental factors appear to be responsible for triggering this errant immune response, directed against self-tissue determinants, only when a susceptible genetic background is present in an individual. Autoimmune diseases, normally characterized by their association with certain HLA alleles, also share other features: the presence of autoantibodies, autoreactive T lymphocytes, and an intermittent clinical course of exacerbations and remissions. In cases of organ-specific diseases, as well as in cases of multi-system autoimmune diseases, viruses are increasingly implicated as such environmental triggers. Current molecular biology techniques have permitted a fine dissection of the genetic background of susceptible individuals and have enabled a more complete characterization of the immunocompetent cells involved in this autoaggression. Molecular approaches will soon allow us to pinpoint the characteristics of the environmental stimuli, so that protective strategies could be formulated to spare susceptible individuals from their ill effects.

Autoimmune Diseases↗

PubMed2003

The epidemiology of autoimmune diseases.

Autoimmune diseases are among the leading causes of death among young and middle-aged women in the United States. Incidence rates vary among the autoimmune diseases, with estimates ranging from less than one newly-diagnosed case of systemic sclerosis to more than 20 cases of adult-onset rheumatoid arthritis per 100,000 person-years. Prevalence rates range from less than 5 per 100,000 (e.g. chronic active hepatitis, uveitis) to more than 500 per 100,000 (Grave disease, rheumatoid arthritis, thyroiditis). At least 85% of thyroiditis, systemic sclerosis, systemic lupus erythematosus, and Sjögren disease patients are female. Although most diseases can occur at any age, some diseases primarily occur in childhood and adolescence (e.g. type 1 diabetes), in the mid-adult years (e.g. myasthenia gravis, multiple sclerosis), or among older adults (e.g. rheumatoid arthritis, primary systemic vasculitis). Ethnic and geographic differences in incidence of specific autoimmune diseases have been documented, but specific groups may be at higher risk for some diseases and lower risk for other diseases. The incidence of type 1 diabetes increased but the rates of rheumatoid arthritis declined over the past 40 years. Thus although there are commonalities, there are also important demographic differences between diseases. Disease-specific research, as well as studies that focus on potentially related diseases, needs to be conducted.

Adult↗

PubMed2002

Adoptive cellular gene therapy of autoimmune disease.

Autoimmune disorders represent inappropriate immune responses directed at self-tissue. Because CD4+ T cells are important mediators in the pathogenesis of autoimmune disease, they are ideal candidates for cell-based gene therapy. Using retrovirally-transduced cells and luciferase bioluminescence, we have demonstrated that primary T cells and hybridomas, rapidly and preferentially home to the sites of inflammation in organ-specific autoimmune disease. These cells, transduced with retroviral vectors to drive expression of various 'regulatory proteins', such as IL-4, IL-10 and IL-12p40, deliver these immunoregulatory proteins to the inflamed lesions, providing therapy for experimental models of autoimmune disease such as EAE, CIA and NOD mice. This technique was originally developed in our lab in the murine model of multiple sclerosis, EAE, where T cell hybridomas reactive with myelin basic protein (MBP) were transduced to express and used to deliver the modulatory cytokine, IL-4. Recently we have observed that the cytokine receptor antagonist, IL-12p40 transduced anti-myelin basic protein (MBP) TCR-transgenic T cells (but not CII-reactive T cells) were effective in preventing EAE whereas the CII-reactive, but not MBP-reactive T cells, transduced to express IL-12p40, would treat CIA.

Adoptive Transfer↗

PubMed2003

[Pathological roles of oxidative stress in autoimmune diseases].

Autoimmune diseases are complex diseases in which both genetic and environmental factors are involved. Excessive oxidative stress is thought to have an important role in the pathogenesis of autoimmune diseases by enhancing the inflammation, inducing apoptotic cell death, and breaking down the immunological tolerance. When the state of oxidative stress was investigated in patients with rheumatoid arthritis(RA), systemic lupus erythematosus(SLE), and Sjögren's syndrome(SS) by oxidative stress profile(OSP), most subjects were in excessive oxidative stress or in defective antioxidant potentials. The thioredoxin(TRX) level in peripheral blood was significantly higher in these patients than in healthy subjects. Urinary excretion of 8-hydroxy-guanosine was also significantly increased in these patients compared with healthy subjects. We have proven that oxidative stress as well as UV irradiation induced the expression of SS-A/Ro52 autoantigen on the cell surface of keratinocytes. Oxidative stress not only injures the cellular components but also induces cellular responses, including apoptosis and gene activation. We also identified that GSTM1 null genotype was a candidate gene for susceptibility to SS and was associated with SS-A/Ro autoantibody production. In the synovial fluid of RA patients, TRX was abundantly detected and was produced in the lining layer of synovial tissue, indicating that TRX might protect synovial tissue from oxidative stress. Infections, UV irradiation, coldness, and emotional stress have been clinically well known as developing and exacerbating factors for autoimmune diseases. These environmental factors are closely related to oxidative stress. It is very important to develop reliable test methods to detect the state of oxidative stress and antioxidants.

Arthritis, Rheumatoid↗

PubMed1996

TCR gene polymorphisms and autoimmune disease.

Autoimmunity may result from abnormal regulation within the immune system. As the T cell is the principal regulator of the immune system and its normal function depends on immune recognition or self/non-self discrimination, abnormalities of the idiotypic T-cell receptor (TCR) may be one cause of autoimmune disease. The TCR is a clonally distributed, cell-surface heterodimer which binds peptide antigen when complexed with HLA molecules. In order to recognize the variety of antigens it may possibly encounter, the TCR, by necessity, is a diverse structure. As with immunoglobulin, it is the variable domain of the TCR which interacts with antigen and exhibits the greatest amount of amino acid variability. The underlying genetic basis for this structural diversity is similar to that described for immunoglobulin, with TCR diversity relying on the somatic recombination, in a randomly imprecise manner, of smaller gene segments to form a functional gene. There are a large number of gene segments to choose from (particularly the TCRAV, TCRAJ and TCRBV gene segments) and some of these also exhibit allelic variation. Finally, polymorphisms in non-coding regions of TCR genes, leading to biased recombination or expression, are also beginning to be recognized. All these factors contribute to the polymorphic nature of the TCR, in terms of both structure and repertoire formation. It follows that inherited abnormalities in either coding or regulatory regions of TCR genes may predispose to aberrant T-cell function and autoimmune disease. This review will outline the genomic organization of the TCR genes, the genetic mechanisms responsible for the generation of diversity, and the results of investigations into the association between germline polymorphisms and autoimmune disease.

Alleles↗

PubMed1999

Imaging of autoimmune diseases.

Autoimmune diseases represent a heterogeneous group of pathologies with a wide range of immunological changes and clinical presentations. The clinical onset of the disease commonly occurs when signs and symptoms of target tissue hypofunction appear; complications can also be present. The aim of an imaging diagnostic technique in this context is to correctly evaluate the disease extent and severity for appropriate treatment and to follow up the efficacy of therapy. In addition, identification of subjects at risk and the preclinical diagnosis may allow disease prevention. Ultrasound (US), conventional radiology and computed tomography (CT) are often used for a detailed morphological study of tissues involved; magnetic resonance (MRI) may also demonstrate biochemical and structural tissue changes. Nuclear medicine techniques are known for their sensitivity and specificity and in recent years an expanding field is represented by the development of radiolabelled receptor ligands. New radiopharmaceuticals able to bind in vivo to specific receptors have been introduced allowing the non invasive detection of changes in affected tissues. The relevant criteria to choose different diagnostic approaches in several autoimmune diseases are discussed in this review. In particular the role and contribution of nuclear medicine for the study of autoimmune diseases have been described.

Antibodies, Monoclonal↗

PubMed2002

Cutting edge: molecular portrait of human autoimmune disease.

Autoimmune diseases affect 3-5% of the population, are mediated by the immune response to self-Ags, and are characterized by the site of tissue destruction. We compared expression levels of >4,000 genes in PBMC of control individuals before and after immunization to those of individuals with four distinct autoimmune diseases. The gene expression profile of the normal immune response exhibits coordinate changes in expression of genes with related functions over time. In contrast, each individual from all autoimmune diseases displays a similar gene expression profile unrelated to the pattern of the immunized group. To our surprise, genes with a distinct expression pattern in autoimmunity are not necessarily "immune response" genes, but are genes that encode proteins involved in apoptosis, cell cycle progression, cell differentiation, and cell migration.

Adult↗

PubMed2006

Anti-TNF-alpha antibody therapies in autoimmune diseases.

Autoimmune diseases affect about 3% of the world population, more frequently women than men, and their incidence is attributed to an immune response of a genetically predisposed individual to an environmental pathogen, under the influence of inadequate immuno-regulatory mechanisms. Advances in understanding the cellular activity pathways and cytokine expression profiles have led to new therapeutic regiments, like soluble receptors, monoclonal antibodies and molecular mimetics that have been employed to enhance or replace conventional immunosuppressive therapies. Among new biologicals that have been developed to target defined pathways of the adaptive immune response are TNF-alpha inhibitors. TNF-alpha is a proinflammatory cytokine elevated in many autoimmune lesions, and its deregulation characterizes many autoimmune diseases. TNF-alpha seems to exhibit an immunoregulatory role that can alter the balance of T regulatory cells and orchestrate acute immunological responses. More than half a million autoimmune patients have received therapy with anti-TNF-alpha antibodies, usually because they were refractory to conventional treatments. This review offers an update on TNF-alpha-targeted therapies used in patients suffering from various autoimmune diseases, based on the current knowledge of disease pathogenesis, with emphasis on the efficacy and safety that clinical trials have shown until now.

Animals↗

PubMed1998

Cell biology of autoimmune diseases.

Autoimmune diseases such as insulin-dependent diabetes mellitus, rheumatoid arthritis, and multiple sclerosis are common in the western world and are often devastating diseases which pose serious health problems. The key feature of such diseases is the development and persistence of inflammatory processes in the apparent absence of pathogens, leading to chronic breakdown of selected tissues. To date, no comprehensive explanation can be given for the onset or persistence of autoimmunity. As a rule, the chronic activation of helper T lymphocytes reactive against self proteins appears to be crucial for fueling the destructive autoimmune process, but why this occurs remains to be established. In this review, we present an overview on the rules that govern activation of T lymphocytes and on the factors that control it. The contribution of both genetic and environmental factors are discussed, clarifying that most autoimmune disease are of multifactorial origin. Special emphasis is given to the contribution of infectious events and the role of stress proteins in the process. In attempts to dissect the mechanisms involved in autoimmunity and to develop ways of blocking disease, experimental animal models are widely employed. We describe the various experimental models that exist for the study of multiple sclerosis, diabetes, and other autoimmune diseases and on the experience that has been gained in such models with experimental therapies to block the activation of self-reactive T lymphocytes. The lessons that can be drawn from these studies provide hope that continued efforts will lead to the successful development of antigen-specific strategies which block the development of autoimmunity also in humans.

Animals↗

PubMed1999

[Immunosuppressive therapy in autoimmune diseases].

Autoimmune diseases play an increasing role in daily practise. Advanced understanding of the pathogenesis and pathophysiology enables an outcome orientated therapy leading to a far better prognosis. Immunosuppressive drugs are essential for the treatment. The therapeutical concepts are adopted to the individual character and stage of the disease. In the meantime, therapeutical regimes combine certain drugs. Although it is not possible to cure these autoimmune diseases, a remission can be achieved in most cases. Further developments will concentrate on more selective strategies and the potentials of gene therapy.

Arthritis, Rheumatoid↗