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1.
EMBO J ; 39(19): e105071, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32840892

RESUMO

Inflammasomes execute a unique type of cell death known as pyroptosis. Mostly characterized in myeloid cells, caspase-1 activation downstream of an inflammasome sensor results in the cleavage and activation of gasdermin D (GSDMD), which then forms a lytic pore in the plasma membrane. Recently, CARD8 was identified as a novel inflammasome sensor that triggers pyroptosis in myeloid leukemia cells upon inhibition of dipeptidyl-peptidases (DPP). Here, we show that blocking DPPs using Val-boroPro triggers a lytic form of cell death in primary human CD4 and CD8 T cells, while other prototypical inflammasome stimuli were not active. This cell death displays morphological and biochemical hallmarks of pyroptosis. By genetically dissecting candidate components in primary T cells, we identify this response to be dependent on the CARD8-caspase-1-GSDMD axis. Moreover, DPP9 constitutes the relevant DPP restraining CARD8 activation. Interestingly, this CARD8-induced pyroptosis pathway can only be engaged in resting, but not in activated T cells. Altogether, these results broaden the relevance of inflammasome signaling and associated pyroptotic cell death to T cells, central players of the adaptive immune system.


Assuntos
Proteínas Adaptadoras de Sinalização CARD/imunologia , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Inflamassomos/imunologia , Ativação Linfocitária , Proteínas de Neoplasias/imunologia , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/imunologia , Proteínas de Ligação a Fosfato/imunologia
3.
Diabetologia ; 63(4): 825-836, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31873789

RESUMO

AIMS/HYPOTHESIS: Type 1 diabetes is characterised by a progressive decline in beta cell mass. This is also observed following implantation of pancreatic islet allografts, but there is no reliable information regarding the time course of beta cell loss. This is due to the limited availability of non-invasive pancreatic islet imaging techniques. We have previously described that dipeptidyl peptidase 6 (DPP6) is an alpha and beta cell-specific biomarker, and developed a camelid antibody (nanobody '4hD29') against it. We demonstrated the possibility to detect DPP6-expressing cells by single-photon emission computed tomography (SPECT)/ computed tomography (CT), but the correlation between the number of cells grafted and the SPECT signal was not assessed. Here, we investigate whether the 4hD29 nanobody allows us to detect different amounts of human pancreatic islets implanted into immune-deficient mice. In addition, we also describe the adaptation of the probe for use with positron emission tomography (PET). METHODS: DPP6 expression was assessed in human samples using tissue arrays and immunohistochemistry. The effect of the 4hD29 nanobody on cell death and glucose-stimulated insulin secretion was measured in EndoC-ßH1 cells and in human islets using Hoechst/propidium iodide staining and an anti-insulin ELISA, respectively. We performed in vivo SPECT imaging on severe combined immunodeficient (SCID) mice transplanted with different amounts of EndoC-ßH1 cells (2 × 106, 5 × 106 and 10 × 106 cells), human islets (1000 and 3000) or pancreatic exocrine tissue using 99mTc-labelled 4hD29 nanobody. This DPP6 nanobody was also conjugated to N-chlorosuccinimide (NCS)-1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA), radiolabelled with either 67Ga (SPECT) or 68Ga (PET) and used in a proof-of-principle experiment to detect DPP6-expressing cells (Kelly neuroblastoma) grafted in SCID mice. RESULTS: The DPP6 protein is mainly expressed in pancreatic islets. Importantly, the anti-DPP6 nanobody 4hD29 allows non-invasive detection of high amounts of EndoC-ßH1 cells or human islets grafted in immunodeficient mice. This suggests that the probe must be further improved to detect lower numbers of islet cells. The 4hD29 nanobody neither affected beta cell viability nor altered insulin secretion in EndoC-ßH1 cells and human islets. The conversion of 4hD29 nanobody into a PET probe was successful and did not alter its specificity. CONCLUSIONS/INTERPRETATION: These findings suggest that the anti-DPP6 4hD29 nanobody may become a useful tool for the quantification of human islet grafts in mice and, pending future development, islet mass in individuals with diabetes.


Assuntos
Rastreamento de Células/métodos , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Células Secretoras de Insulina/metabolismo , Transplante das Ilhotas Pancreáticas , Ilhotas Pancreáticas/diagnóstico por imagem , Anticorpos de Domínio Único/farmacologia , Animais , Contagem de Células , Células Cultivadas , Dipeptidil Peptidases e Tripeptidil Peptidases/antagonistas & inibidores , Feminino , Radioisótopos de Gálio/análise , Radioisótopos de Gálio/farmacocinética , Xenoenxertos , Humanos , Células Secretoras de Insulina/citologia , Ilhotas Pancreáticas/citologia , Ilhotas Pancreáticas/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos SCID , Camundongos Transgênicos , Imagem Molecular/métodos , Compostos de Organotecnécio/química , Compostos de Organotecnécio/farmacocinética , Traçadores Radioativos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Anticorpos de Domínio Único/análise , Anticorpos de Domínio Único/química
4.
PLoS One ; 14(8): e0220866, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31390378

RESUMO

Dipeptidyl amino-peptidase 3 (DPP3) is an aminopeptidase involved in peptide degradation, including hormone peptides as angiotensin II and enkephalins. DPP3 plasma activity increases in septic patients and correlates with mortality risk. However, the exact physiological role of DPP3 remains unclear and animal studies are necessary to reveal the function of DPP3 in vivo. To this demand, we developed a two-step purification procedure for isolation of native human DPP3 from blood cell lysate (BCL) that is suitable for in vivo applications. With the use of monoclonal antibodies coupled to beads in combination with an ion-exchange chromatography, we recovered 68% of human DPP3 activity from BCL with a purity of ≥ 95%. Purified human DPP3 was assayed for activity and protein concentration using recently published DPP3-activity- and immunoassays. Additionally, protein stability and storage in relevant buffers were tested. Our results provide a promising strategy for fast and efficient isolation of human DPP3. The purified human DPP3 represents the native state of DPP3, suitable for future in vivo applications to investigate the physiological role of DPP3 and its involvement in pathophysiological conditions.


Assuntos
Células Sanguíneas/enzimologia , Dipeptidil Peptidases e Tripeptidil Peptidases/isolamento & purificação , Anticorpos Monoclonais , Cromatografia por Troca Iônica , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Humanos , Preservação Biológica , Estabilidade Proteica
6.
Neurogastroenterol Motil ; 31(10): e13611, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31016817

RESUMO

BACKGROUND: The identification of autoantibodies directed against neuronal antigens has led to the recognition of a wide spectrum of neurological autoimmune disorders (NAD). With timely recognition and treatment, many patients with NAD see rapid improvement. Symptoms associated with NAD can be diverse and are determined by the regions of the nervous system affected. In addition to neurological symptoms, a number of these disorders present with prominent gastrointestinal (GI) manifestations such as nausea, diarrhea, weight loss, and gastroparesis prompting an initial evaluation by gastroenterologists. PURPOSE: This review provides a general overview of autoantibodies within the nervous system, focusing on three scenarios in which nervous system autoimmunity may initially present with gut symptoms. A general approach to evaluation and treatment, including antibody testing, will be reviewed.


Assuntos
Doenças Autoimunes do Sistema Nervoso/fisiopatologia , Gastroenteropatias/fisiopatologia , Adulto , Idoso , Anticorpos Antinucleares/imunologia , Anticorpos Antineoplásicos , Aquaporina 4/imunologia , Área Postrema/fisiopatologia , Autoanticorpos/imunologia , Doenças Autoimunes do Sistema Nervoso/complicações , Doenças Autoimunes do Sistema Nervoso/tratamento farmacológico , Doenças Autoimunes do Sistema Nervoso/imunologia , Doenças do Sistema Nervoso Autônomo/complicações , Doenças do Sistema Nervoso Autônomo/tratamento farmacológico , Doenças do Sistema Nervoso Autônomo/imunologia , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Encéfalo/diagnóstico por imagem , Diarreia/etiologia , Diarreia/imunologia , Diarreia/fisiopatologia , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Feminino , Gastroenteropatias/etiologia , Gastroenteropatias/imunologia , Gastroparesia/etiologia , Gastroparesia/imunologia , Gastroparesia/fisiopatologia , Humanos , Imunossupressores/uso terapêutico , Pseudo-Obstrução Intestinal/complicações , Pseudo-Obstrução Intestinal/tratamento farmacológico , Pseudo-Obstrução Intestinal/imunologia , Pseudo-Obstrução Intestinal/fisiopatologia , Masculino , Pessoa de Meia-Idade , Náusea/etiologia , Náusea/imunologia , Náusea/fisiopatologia , Proteínas do Tecido Nervoso/imunologia , Neuromielite Óptica/complicações , Neuromielite Óptica/tratamento farmacológico , Neuromielite Óptica/imunologia , Neuromielite Óptica/fisiopatologia , Síndromes Paraneoplásicas do Sistema Nervoso/complicações , Síndromes Paraneoplásicas do Sistema Nervoso/tratamento farmacológico , Síndromes Paraneoplásicas do Sistema Nervoso/imunologia , Síndromes Paraneoplásicas do Sistema Nervoso/fisiopatologia , Canais de Potássio/imunologia , Redução de Peso
7.
Clin Immunol ; 197: 68-76, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30205177

RESUMO

Treatment with intracerebroventricular (ICV)-delivered cerliponase alfa enzyme replacement therapy (ERT) in a Phase 1/2 study of 24 subjects with CLN2 disease resulted in a meaningful preservation of motor and language (ML) function and was well tolerated. Treatment was associated with anti-drug antibody (ADA) production in the cerebrospinal fluid (CSF) of 6/24 (25%) and in the serum of 19/24 (79%) of clinical trial subjects, respectively, over a mean exposure of 96.4 weeks (range 0.1-129 weeks). Neutralizing antibodies (NAb) were not detected in the CSF of any of the subjects. No events of anaphylaxis were reported. Neither the presence of serum ADA nor drug-specific immunoglobulin E was associated with the incidence or severity of hypersensitivity adverse events. Serum and CSF ADA titers did not correlate with change in ML score. Therefore, the development of an ADA response to cerliponase alfa is not predictive of an adverse safety profile or poor treatment outcome.


Assuntos
Anticorpos/imunologia , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Terapia de Reposição de Enzimas , Lipofuscinoses Ceroides Neuronais/tratamento farmacológico , Proteínas Recombinantes/imunologia , Adolescente , Anticorpos Neutralizantes/imunologia , Criança , Pré-Escolar , Dipeptidil Peptidases e Tripeptidil Peptidases/uso terapêutico , Progressão da Doença , Hipersensibilidade a Drogas/epidemiologia , Hipersensibilidade a Drogas/imunologia , Feminino , Humanos , Imunoglobulina E/imunologia , Infusões Intraventriculares , Masculino , Proteínas Recombinantes/uso terapêutico , Tripeptidil-Peptidase 1
8.
Neurology ; 88(14): 1340-1348, 2017 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-28258082

RESUMO

OBJECTIVE: To report the main syndrome of dipeptidyl-peptidase-like protein 6 (DPPX) antibody-associated encephalitis, immunoglobulin G (IgG) subclass, and the antibody effects on DPPX/Kv4.2 potassium channels. METHODS: A retrospective analysis of new patients and cases reported since 2013 was performed. IgG subclass and effects of antibodies on cultured neurons were determined with described techniques. RESULTS: Nine new patients were identified (median age 57 years, range 36-69 years). All developed severe prodromal weight loss or diarrhea followed by cognitive dysfunction (9), memory deficits (5), CNS hyperexcitability (8; hyperekplexia, myoclonus, tremor, or seizures), or brainstem or cerebellar dysfunction (7). The peak of the disease was reached 8 months (range 1-54 months) after onset. All patients had both IgG4 and IgG1 DPPX antibodies. In cultured neurons, the antibodies caused a decrease of DPPX clusters and Kv4.2 protein that was reversible on removal of the antibodies. Considering the current series and previously reported cases (total 39), 67% developed the triad: weight loss (median 20 kg; range 8-53 kg)/gastrointestinal symptoms, cognitive-mental dysfunction, and CNS hyperexcitability. Outcome was available from 35 patients (8 not treated with immunotherapy): 60% had substantial or moderate improvement, 23% had no improvement (most of them not treated), and 17% died. Relapses occurred in 8 of 35 patients (23%) and were responsive to immunotherapy. CONCLUSIONS: DPPX antibodies are predominantly IgG1 and IgG4 and associate with cognitive-mental deficits and symptoms of CNS hyperexcitability that are usually preceded by diarrhea, other gastrointestinal symptoms, and weight loss. The disorder is responsive to immunotherapy, and this is supported by the reversibility of the antibody effects in cultured neurons.


Assuntos
Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Dipeptidil Peptidases e Tripeptidil Peptidases/metabolismo , Encefalite , Imunoglobulina G/uso terapêutico , Proteínas do Tecido Nervoso/imunologia , Proteínas do Tecido Nervoso/metabolismo , Canais de Potássio/imunologia , Canais de Potássio/metabolismo , Adulto , Idoso , Animais , Células Cultivadas , Relação Dose-Resposta a Droga , Eletroencefalografia , Embrião de Mamíferos , Encefalite/diagnóstico por imagem , Encefalite/fisiopatologia , Encefalite/terapia , Feminino , Seguimentos , Hipocampo/citologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/classificação , Imunoglobulina G/farmacologia , Imunoterapia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neurônios/efeitos dos fármacos , Agregados Proteicos/efeitos dos fármacos , Ratos , Estudos Retrospectivos , Canais de Potássio Shal/imunologia , Canais de Potássio Shal/metabolismo , Fatores de Tempo
9.
Cell Physiol Biochem ; 41(2): 423-438, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28214886

RESUMO

BACKGROUND: Chronic hepatitis B virus (HBV) infection is associated with a weak but specific cellular immune response of the host to HBV. Tripeptidyl peptidaseⅡ (TPPⅡ), an intracellular macromolecule and proteolytic enzyme, plays an important complementary and compensatory role for the proteasome during viral protein degradation and major histocompatibility complex class I antigen presentation by inducing a specific cellular immune response in vivo. Based on a previous study, we aimed to explore the role of MHC class I antigen presentation in vivo and the mechanisms that may be involved. METHODS: In this study, recombinant adenoviral vectors harboring the hepatitis B core antigen (HBcAg) and the TPPII gene were constructed (Adv-HBcAg and Adv-HBcAg-TPPII), and H-2Kd HBV-transgenic BALB/c mice and HLA-A2 C57BL/6 mice were immunized with these vectors, respectively. We evaluated the specific immune responses induced by Adv-HBcAg-TPPII in the HBV transgenic BALB/c mice and HLA-A2 C57BL/6 mice as well as the anti-viral ability of HBV transgenic mice, and we explored the underlying mechanisms. RESULTS: We found that immunization with Adv-HBcAg-TPPII induced the secretion of the cytokines interleukin-2 (IL-2), interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) as well as the activities of IFN-γ-secreting CD8+ T cells and CD4+ T cells. In addition, HBcAg-specific CTL activity in C57/BL mice and HBV transgenic animals was significantly enhanced in the Adv-HBcAg-TPPII group. Furthermore, Adv-HBcAg-TPPII decreased the hepatitis B surface antigen (HBsAg) and HBV DNA levels and the amount of HBsAg and HBcAg in liver tissues. Moreover, Adv-HBcAg-TPPII enhanced the expression of T-box transcription factor (T-bet) and downregulated GATA-binding protein 3 (GATA-3) while increasing the expression levels of JAK2, STAT1, STAT4 and Tyk2. CONCLUSIONS: These results suggested that the JAK/STAT signaling pathway participates in the CTL response that is mediated by the adenoviral vector encoding TPPII. Adv-HBcAg-TPPII could therefore break immune tolerance and stimulate HBV-specific cytotoxic T lymphocyte activity and could have a good therapeutic effect in transgenic mice.


Assuntos
Adenoviridae/genética , Aminopeptidases/metabolismo , Dipeptidil Peptidases e Tripeptidil Peptidases/metabolismo , Vetores Genéticos/metabolismo , Antígenos do Núcleo do Vírus da Hepatite B/metabolismo , Imunidade Celular , Serina Endopeptidases/metabolismo , Alanina Transaminase/sangue , Aminopeptidases/genética , Aminopeptidases/imunologia , Animais , Aspartato Aminotransferases/sangue , Linfócitos T CD4-Positivos/citologia , Linfócitos T CD4-Positivos/metabolismo , Linfócitos T CD8-Positivos/citologia , Linfócitos T CD8-Positivos/metabolismo , Citocinas/metabolismo , DNA Viral/sangue , Dipeptidil Peptidases e Tripeptidil Peptidases/genética , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Fator de Transcrição GATA3/metabolismo , Vetores Genéticos/genética , Antígenos do Núcleo do Vírus da Hepatite B/genética , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/genética , Interferon gama/metabolismo , Janus Quinase 2/genética , Janus Quinase 2/metabolismo , Fígado/metabolismo , Fígado/patologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , RNA Mensageiro/metabolismo , Fator de Transcrição STAT1/genética , Fator de Transcrição STAT1/metabolismo , Fator de Transcrição STAT4/genética , Fator de Transcrição STAT4/metabolismo , Serina Endopeptidases/genética , Serina Endopeptidases/imunologia
10.
Blood ; 125(5): 741-2, 2015 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-25634610

RESUMO

In this issue of Blood, Stepensky et al provide an astute description of immunosenescence arising from deficiency in tripeptidyl peptidase II (TPPII). Senescence of T and B lymphocytes is a striking finding, which has recently come into the limelight because it can be linked to primary immunodeficiency syndromes with autoimmunity.


Assuntos
Envelhecimento/imunologia , Aminopeptidases/imunologia , Anemia Hemolítica Autoimune/genética , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Mutação da Fase de Leitura , Síndromes de Imunodeficiência/genética , Serina Endopeptidases/imunologia , Trombocitopenia/genética , Animais , Feminino , Humanos , Masculino
11.
Blood ; 125(5): 753-61, 2015 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-25414442

RESUMO

Autoimmune cytopenia is a frequent manifestation of primary immunodeficiencies. Two siblings presented with Evans syndrome, viral infections, and progressive leukopenia. DNA available from one patient showed a homozygous frameshift mutation in tripeptidyl peptidase II (TPP2) abolishing protein expression. TPP2 is a serine exopeptidase involved in extralysosomal peptide degradation. Its deficiency in mice activates cell death programs and premature senescence. Similar to cells from naïve, uninfected TPP2-deficient mice, patient cells showed increased major histocompatibility complex I expression and most CD8(+) T-cells had a senescent CCR7-CD127(-)CD28(-)CD57(+) phenotype with poor proliferative responses and enhanced staurosporine-induced apoptosis. T-cells showed increased expression of the effector molecules perforin and interferon-γ with high expression of the transcription factor T-bet. Age-associated B-cells with a CD21(-) CD11c(+) phenotype expressing T-bet were increased in humans and mice, combined with antinuclear antibodies. Moreover, markers of senescence were also present in human and murine TPP2-deficient fibroblasts. Telomere lengths were normal in patient fibroblasts and granulocytes, and low normal in lymphocytes, which were compatible with activation of stress-induced rather than replicative senescence programs. TPP2 deficiency is the first primary immunodeficiency linking premature immunosenescence to severe autoimmunity. Determination of senescent lymphocytes should be part of the diagnostic evaluation of children with refractory multilineage cytopenias.


Assuntos
Envelhecimento/imunologia , Aminopeptidases/imunologia , Anemia Hemolítica Autoimune/genética , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Mutação da Fase de Leitura , Síndromes de Imunodeficiência/genética , Serina Endopeptidases/imunologia , Trombocitopenia/genética , Aminopeptidases/deficiência , Aminopeptidases/genética , Anemia Hemolítica Autoimune/complicações , Anemia Hemolítica Autoimune/imunologia , Anemia Hemolítica Autoimune/patologia , Animais , Apoptose , Sequência de Bases , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/patologia , Criança , Pré-Escolar , Consanguinidade , Dipeptidil Peptidases e Tripeptidil Peptidases/deficiência , Dipeptidil Peptidases e Tripeptidil Peptidases/genética , Feminino , Fibroblastos/imunologia , Fibroblastos/metabolismo , Fibroblastos/patologia , Expressão Gênica , Humanos , Síndromes de Imunodeficiência/complicações , Síndromes de Imunodeficiência/imunologia , Síndromes de Imunodeficiência/patologia , Masculino , Camundongos , Camundongos Knockout , Dados de Sequência Molecular , Perforina/genética , Perforina/imunologia , Serina Endopeptidases/deficiência , Serina Endopeptidases/genética , Irmãos , Proteínas com Domínio T/genética , Proteínas com Domínio T/imunologia , Linfócitos T/imunologia , Linfócitos T/metabolismo , Linfócitos T/patologia , Trombocitopenia/complicações , Trombocitopenia/imunologia , Trombocitopenia/patologia
12.
Mol Genet Metab ; 114(2): 281-93, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25257657

RESUMO

The CLN2 form of neuronal ceroid lipofuscinosis, a type of Batten disease, is a lysosomal storage disorder caused by a deficiency of the enzyme tripeptidyl peptidase-1 (TPP1). Patients exhibit progressive neurodegeneration and loss of motor, cognitive, and visual functions, leading to death by the early teenage years. TPP1-null Dachshunds recapitulate human CLN2 disease. To characterize the safety and pharmacology of recombinant human (rh) TPP1 administration to the cerebrospinal fluid (CSF) as a potential enzyme replacement therapy (ERT) for CLN2 disease, TPP1-null and wild-type (WT) Dachshunds were given repeated intracerebroventricular (ICV) infusions and the pharmacokinetic (PK) profile, central nervous system (CNS) distribution, and safety were evaluated. TPP1-null animals and WT controls received 4 or 16mg of rhTPP1 or artificial cerebrospinal fluid (aCSF) vehicle every other week. Elevated CSF TPP1 concentrations were observed for 2-3 days after the first ICV infusion and were approximately 1000-fold higher than plasma levels at the same time points. Anti-rhTPP1 antibodies were detected in CSF and plasma after repeat rhTPP1 administration, with titers generally higher in TPP1-null than in WT animals. Widespread brain distribution of rhTPP1 was observed after chronic administration. Expected histological changes were present due to the CNS delivery catheters and were similar in rhTPP1 and vehicle-treated animals, regardless of genotype. Neuropathological evaluation demonstrated the clearance of lysosomal storage, preservation of neuronal morphology, and reduction in brain inflammation with treatment. This study demonstrates the favorable safety and pharmacology profile of rhTPP1 ERT administered directly to the CNS and supports clinical evaluation in patients with CLN2 disease.


Assuntos
Aminopeptidases/administração & dosagem , Dipeptidil Peptidases e Tripeptidil Peptidases/administração & dosagem , Terapia de Reposição de Enzimas , Lipofuscinoses Ceroides Neuronais/tratamento farmacológico , Serina Proteases/administração & dosagem , Aminopeptidases/efeitos adversos , Aminopeptidases/imunologia , Aminopeptidases/farmacocinética , Animais , Anticorpos/sangue , Anticorpos/líquido cefalorraquidiano , Encéfalo/patologia , Encéfalo/ultraestrutura , Dipeptidil Peptidases e Tripeptidil Peptidases/efeitos adversos , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Dipeptidil Peptidases e Tripeptidil Peptidases/farmacocinética , Progressão da Doença , Cães , Avaliação Pré-Clínica de Medicamentos , Genótipo , Infusões Intraventriculares , Lipofuscinoses Ceroides Neuronais/patologia , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/farmacocinética , Serina Proteases/efeitos adversos , Serina Proteases/imunologia , Serina Proteases/farmacocinética , Tripeptidil-Peptidase 1
14.
Neurology ; 83(20): 1797-803, 2014 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-25320100

RESUMO

OBJECTIVE: To describe the detection frequency and clinical associations of immunoglobulin G (IgG) targeting dipeptidyl-peptidase-like protein-6 (DPPX), a regulatory subunit of neuronal Kv4.2 potassium channels. METHODS: Specimens from 20 patients evaluated on a service basis by tissue-based immunofluorescence yielded a synaptic immunostaining pattern consistent with DPPX-IgG (serum, 20; CSF, all 7 available). Transfected HEK293 cell-based assay confirmed DPPX specificity in all specimens. Sixty-nine patients with stiff-person syndrome and related disorders were also evaluated by DPPX-IgG cell-based assay. RESULTS: Of 20 seropositive patients, 12 were men; median symptom onset age was 53 years (range, 13-75). Symptom onset was insidious in 15 and subacute in 5. Twelve patients reported prodromal weight loss. Neurologic disorders were multifocal. All had one or more brain or brainstem manifestations: amnesia (16), delirium (8), psychosis (4), depression (4), seizures (2), and brainstem disorders (15; eye movement disturbances [8], ataxia [7], dysphagia [6], dysarthria [4], respiratory failure [3]). Nine patients reported sleep disturbance. Manifestations of central hyperexcitability included myoclonus (8), exaggerated startle (6), diffuse rigidity (6), and hyperreflexia (6). Dysautonomia involved the gastrointestinal tract (9; diarrhea [6], gastroparesis, and constipation [3]), bladder (7), cardiac conduction system (3), and thermoregulation (1). Two patients had B-cell neoplasms: gastrointestinal lymphoma (1), and chronic lymphocytic leukemia (1). Substantial neurologic improvements followed immunotherapy in 7 of 11 patients with available treatment data. DPPX-IgG was not detected in any of the stiff-person syndrome patients. CONCLUSIONS: DPPX-IgG is a biomarker for an immunotherapy-responsive multifocal neurologic disorder of the central and autonomic nervous systems.


Assuntos
Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Imunoglobulina G/sangue , Imunoglobulina G/líquido cefalorraquidiano , Proteínas do Tecido Nervoso/imunologia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/fisiopatologia , Canais de Potássio/imunologia , Adolescente , Corticosteroides/uso terapêutico , Adulto , Idoso , Sistema Nervoso Autônomo/patologia , Encéfalo/patologia , Feminino , Gastroenteropatias/etiologia , Células HEK293 , Humanos , Imunoterapia , Imageamento por Ressonância Magnética , Masculino , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/metabolismo , Doenças do Sistema Nervoso/terapia , Transtornos do Sono-Vigília/etiologia , Transfecção , Redução de Peso/fisiologia , Adulto Jovem
15.
Curr Opin Neurol ; 27(3): 361-8, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24792345

RESUMO

PURPOSE OF REVIEW: This review describes the main types of autoimmune encephalitis with special emphasis on those associated with antibodies against neuronal cell surface or synaptic proteins, and the differential diagnosis with infectious encephalitis. RECENT FINDINGS: There is a continuous expansion of the number of cell surface or synaptic proteins that are targets of autoimmunity. The most recently identified include the metabotropic glutamate receptor 5 (mGluR5), dipeptidyl-peptidase-like protein-6 (DPPX), and γ-aminobutyric acid-A receptor (GABAAR). In these and previously known types of autoimmune encephalitis [N-methyl-D-aspartate receptor (NMDAR), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), γ-aminobutyric acid-B receptor (GABABR), leucine-rich glioma inactivated protein 1 (LGI1), contactin-associated protein-like 2 (CASPR2)], the prodromal symptoms or types of presentations often suggest a viral encephalitis. We review here clues that help in the differential diagnosis with infectious encephalitis. Moreover, recent investigations indicate that viral encephalitis (e.g., herpes simplex) can trigger synaptic autoimmunity. In all these disorders, immunotherapy is usually effective. SUMMARY: Autoimmune encephalitis comprises an expanding group of potentially treatable disorders that should be included in the differential diagnosis of any type of encephalitis. VIDEO ABSTRACT: http://links.lww.com/CONR/A25,


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Encefalopatias/diagnóstico , Encéfalo/patologia , Encefalite/diagnóstico , Doença de Hashimoto/diagnóstico , Tuberculose do Sistema Nervoso Central/diagnóstico , Encefalite Antirreceptor de N-Metil-D-Aspartato/imunologia , Autoanticorpos/imunologia , Encefalopatias/imunologia , Diagnóstico Diferencial , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Encefalite/imunologia , Encefalite por Herpes Simples/diagnóstico , Encefalite por Herpes Simples/imunologia , Doença de Hashimoto/imunologia , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Imageamento por Ressonância Magnética , Proteínas de Membrana/imunologia , Proteínas do Tecido Nervoso/imunologia , Canais de Potássio/imunologia , Proteínas/imunologia , Receptor de Glutamato Metabotrópico 5/imunologia , Receptores de GABA-A/imunologia , Receptores de Glutamato/imunologia , Tuberculose do Sistema Nervoso Central/imunologia
16.
Neurology ; 82(17): 1521-8, 2014 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-24696508

RESUMO

OBJECTIVE: To describe a novel and distinct variant of progressive encephalomyelitis with rigidity and myoclonus (PERM) associated with antibodies directed against dipeptidyl peptidase-like protein 6 (DPPX), a regulatory subunit of the Kv4.2 potassium channels on the surface of neurons. METHODS: Case series describing the clinical, paraclinical, and serologic features of 3 patients with PERM. A recombinant, cell-based indirect immunofluorescence assay with DPPX-expressing HEK293 cells was used to detect DPPX antibodies in conjunction with mammalian tissues. RESULTS: All patients presented with a distinct syndrome involving hyperekplexia, prominent cerebellar ataxia with marked eye movement disorder, and trunk stiffness of variable intensity. Additional symptoms comprised allodynia, neurogenic pruritus, and gastrointestinal symptoms. Symptoms began insidiously and progressed slowly. An inflammatory CSF profile with mild pleocytosis and intrathecal immunoglobulin G synthesis was found in all patients. High DPPX antibody titers were detected in the patients' serum and CSF, with specific antibody indices suggestive of intrathecal synthesis of DPPX antibodies. Response to immunotherapy was good, but constant and aggressive treatment may be required. CONCLUSION: These cases highlight the expanding spectrum of both PERM and anti-neuronal antibodies. Testing for DPPX antibodies should be considered in the diagnostic workup of patients with acquired hyperekplexia, cerebellar ataxia, and stiffness, because such patients might benefit from immunotherapy. Further studies are needed to elucidate both the entire clinical spectrum associated with DPPX antibodies and their role in pathogenesis.


Assuntos
Anticorpos/sangue , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Encefalomielite/sangue , Rigidez Muscular/sangue , Mioclonia/sangue , Proteínas do Tecido Nervoso/imunologia , Canais de Potássio/imunologia , Adolescente , Adulto , Anticorpos/líquido cefalorraquidiano , Encéfalo/metabolismo , Encéfalo/patologia , Eletromiografia , Encefalomielite/complicações , Encefalomielite/tratamento farmacológico , Encefalomielite/imunologia , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Masculino , Rigidez Muscular/complicações , Rigidez Muscular/tratamento farmacológico , Rigidez Muscular/imunologia , Mioclonia/complicações , Mioclonia/tratamento farmacológico , Mioclonia/imunologia , Adulto Jovem
17.
J Clin Invest ; 123(11): 4755-68, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24216478

RESUMO

Cross-priming of CD8+ T cells and generation of effector immune responses is pivotal for tumor immunity as well as for successful anticancer vaccination and therapy. Dead and dying cells produce signals that can influence Ag processing and presentation; however, there is conflicting evidence regarding the immunogenicity of necrotic cell death. We used a mouse model of sterile necrosis, in which mice were injected with sterile primary necrotic cells, to investigate a role of these cells in priming of CD8+ T cells. We discovered a molecular mechanism operating in Ag donor cells that regulates cross-priming of CD8+ T cells during primary sterile necrosis and thereby controls adaptive immune responses. We found that the cellular peptidases dipeptidyl peptidase 3 (DPP-3) and thimet oligopeptidase 1 (TOP-1), both of which are present in nonimmunogenic necrotic cells, eliminated proteasomal degradation products and blocked Ag cross-presentation. While sterile necrotic tumor cells failed to induce CD8+ T cell responses, their nonimmunogenicity could be reversed in vitro and in vivo by inactivation of DPP-3 and TOP-1. These results indicate that control of cross-priming and thereby immunogenicity of primary sterile necrosis relies on proteasome-dependent oligopeptide generation and functional status of peptidases in Ag donor cells.


Assuntos
Apresentação Cruzada , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Metaloendopeptidases/imunologia , Necrose/imunologia , Linfócitos T/enzimologia , Linfócitos T/imunologia , Imunidade Adaptativa , Animais , Linhagem Celular Tumoral , Dipeptidil Peptidases e Tripeptidil Peptidases/antagonistas & inibidores , Dipeptidil Peptidases e Tripeptidil Peptidases/genética , Feminino , Metaloendopeptidases/antagonistas & inibidores , Metaloendopeptidases/genética , Camundongos , Camundongos Endogâmicos C57BL , Modelos Imunológicos , Ovalbumina/imunologia , RNA Interferente Pequeno/genética
18.
Ann Neurol ; 73(1): 120-8, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23225603

RESUMO

OBJECTIVE: To report a novel cell surface autoantigen of encephalitis that is a critical regulatory subunit of the Kv4.2 potassium channels. METHODS: Four patients with encephalitis of unclear etiology and antibodies with a similar pattern of neuropil brain immunostaining were selected for autoantigen characterization. Techniques included immunoprecipitation, mass spectrometry, cell-base experiments with Kv4.2 and several dipeptidyl-peptidase-like protein-6 (DPPX) plasmid constructs, and comparative brain immunostaining of wild-type and DPPX-null mice. RESULTS: Immunoprecipitation studies identified DPPX as the target autoantigen. A cell-based assay confirmed that all 4 patients, but not 210 controls, had DPPX antibodies. Symptoms included agitation, confusion, myoclonus, tremor, and seizures (1 case with prominent startle response). All patients had pleocytosis, and 3 had severe prodromal diarrhea of unknown etiology. Given that DPPX tunes up the Kv4.2 potassium channels (involved in somatodendritic signal integration and attenuation of dendritic back-propagation of action potentials), we determined the epitope distribution in DPPX, DPP10 (a protein homologous to DPPX), and Kv4.2. Patients' antibodies were found to be specific for DPPX, without reacting with DPP10 or Kv4.2. The unexplained diarrhea led to a demonstration of a robust expression of DPPX in the myenteric plexus, which strongly reacted with patients' antibodies. The course of neuropsychiatric symptoms was prolonged and often associated with relapses during decreasing immunotherapy. Long-term follow-up showed substantial improvement in 3 patients (1 was lost to follow-up). INTERPRETATION: Antibodies to DPPX are associated with a protracted encephalitis characterized by central nervous system hyperexcitability (agitation, myoclonus, tremor, seizures), pleocytosis, and frequent diarrhea at symptom onset. The disorder is potentially treatable with immunotherapy.


Assuntos
Autoanticorpos/biossíntese , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Encefalite/imunologia , Proteínas do Tecido Nervoso/imunologia , Canais de Potássio/imunologia , Canais de Potássio Shal/metabolismo , Idoso , Animais , Reações Antígeno-Anticorpo/imunologia , Autoanticorpos/química , Encefalite/enzimologia , Encefalite/patologia , Feminino , Células HEK293 , Humanos , Masculino , Camundongos , Camundongos Knockout , Pessoa de Meia-Idade , Canais de Potássio Shal/química , Canais de Potássio Shal/imunologia
19.
Clin Vaccine Immunol ; 18(9): 1568-76, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21734068

RESUMO

Aspergillus terreus has been difficult to identify in cases of aspergillosis, and clinical identification has been restricted to the broad identification of aspergillosis lesions in affected organs or the detection of fungal carbohydrates. As a result, there is a clinical need to identify species-specific biomarkers that can be used to detect invasive A. terreus disease. Monoclonal antibodies (MAbs) were developed to a partially purified preparation of cytolytic hyphal exoantigens (HEA) derived from A. terreus culture supernatant (CSN). Twenty-three IgG1 isotype murine MAbs were developed and tested for cross-reactivity against hyphal extracts of 54 fungal species. Sixteen MAbs were shown to be specific for A. terreus. HEA were detected in conidia, hyphae, and in CSN of A. terreus. HEA were expressed in high levels in the hyphae during early stages of A. terreus growth at 37°C, whereas at room temperature the expression of HEA peaked by days 4 to 5. Expression kinetics of HEA in CSN showed a lag, with peak levels at later time points at room temperature and 37°C than in hyphal extracts. Serum spiking experiments demonstrated that human serum components do not inhibit detection of the HEA epitopes by MAb enzyme-linked immunosorbent assay (ELISA). Immunoprecipitation and proteomic analysis demonstrated that MAbs 13E11 and 12C4 immunoprecipitated a putative uncharacterized leucine aminopeptidase (Q0CAZ7), while MAb 19B2 recognized a putative dipeptidyl-peptidase V (DPP5). Studies using confocal laser scanning microscopy showed that the uncharacterized leucine aminopeptidase mostly localized to extracellular matrix structures while dipeptidyl-peptidase V was mostly confined to the cytoplasm.


Assuntos
Anticorpos Antifúngicos , Anticorpos Monoclonais , Antígenos de Fungos/imunologia , Aspergilose/diagnóstico , Aspergillus/imunologia , Hifas/imunologia , Infecções Oportunistas/diagnóstico , Animais , Anticorpos Antifúngicos/biossíntese , Anticorpos Antifúngicos/imunologia , Anticorpos Monoclonais/biossíntese , Anticorpos Monoclonais/imunologia , Antígenos de Fungos/análise , Aspergilose/imunologia , Aspergilose/microbiologia , Aspergillus/classificação , Dipeptidil Peptidases e Tripeptidil Peptidases/análise , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoprecipitação , Leucil Aminopeptidase/análise , Leucil Aminopeptidase/imunologia , Camundongos , Microscopia Confocal , Infecções Oportunistas/imunologia , Infecções Oportunistas/microbiologia , Proteômica , Coelhos , Especificidade da Espécie
20.
Eur J Immunol ; 41(6): 1583-93, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21469121

RESUMO

Dipeptidyl peptidase 2 (DPP2) is an N-terminal dipeptidase, required for maintaining lymphocytes in a resting state. Mutant mice with T-cell-specific knock-down (kd) of DPP2 (lck-DPP2 kd) were generated and analyzed for their phenotype. Normal thymocyte development and a modest increase in the proportions of peripheral T cells were observed in these mice compared with littermate controls. Interestingly, the peripheral T cells were hyperactive upon TCR stimulation in vitro, although they did not express any activation markers. Furthermore, CD3-crosslinking in the naïve CD4(+) and CD8(+) T cells of lck-DPP2 kd mice resulted mainly in IL-17 production. Similarly, the mutant T cells secreted primarily IL-17 after in vivo priming and in vitro antigen-specific restimulation. These data suggest that IL-17 production is the default program for T-cell differentiation in the absence of DPP2. Thus, DPP2 seems to impose a threshold for quiescent T cells, preventing them from drifting into cell cycle.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Dipeptidil Peptidases e Tripeptidil Peptidases/metabolismo , Células Th17/metabolismo , Animais , Complexo CD3/imunologia , Diferenciação Celular/genética , Proliferação de Células , Células Cultivadas , Dipeptidil Peptidases e Tripeptidil Peptidases/genética , Dipeptidil Peptidases e Tripeptidil Peptidases/imunologia , Imunização , Interleucina-17/imunologia , Interleucina-17/metabolismo , Ativação Linfocitária/genética , Camundongos , Camundongos Knockout , Receptores de Antígenos de Linfócitos T alfa-beta/imunologia , Células Th17/imunologia , Células Th17/patologia
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