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1.
Medicine (Baltimore) ; 103(29): e38858, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39029072

RESUMO

Bladder cancer (BC) is fatal during muscle invasion and treatment progress is limited. In this study, we aimed to construct and validate basement membrane (BM)-associated gene prognosis to predict BC progression and tumor immune infiltration correlation. We choreographed BM-related genes in the Cancer Genome Atlas (TCGA) database using COX regression and least absolute shrinkage and selection operator (LASSO) analysis, and the predictive value of BM-related genes was further validated by the GSE32548, GSE129845, and immunohistochemistry staining. All analyses were performed with R-version 4.2.2, and its appropriate packages. Three genes were identified to construct a gene signature to predictive of BC prognosis. We divided the TCGA database into 2 groups, and patients in the high-risk group had worse overall survival (OS) than those in the low-risk group. In GSE32548, we confirmed that patients in the high-risk group had a poorer prognosis compared to those in the low-risk group in terms of OS. Immunohistochemical staining of EPEMP1, GPC2, and ITGA3 showed significantly higher expression at the protein level in BC tissues than in normal tissues. The Spearman analysis showed risk score was positively correlated with B cell naïve, Macrophages M2, and Mast cells resting. stromal score, immune score, and ESTIMATE scores were significantly higher in the high-risk group. drugs sensitivity analysis showed IC50 of Cisplatin, Gemcitabine, and Methotrexate in the high-risk group was significantly higher than that in the low-risk group. We identified 3 prognostic genes from a novel perspective of BM genes as effective risk stratification tools for BC patients.


Assuntos
Membrana Basal , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/imunologia , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/patologia , Prognóstico , Membrana Basal/imunologia , Membrana Basal/patologia , Masculino , Feminino , Biomarcadores Tumorais/genética , Pessoa de Meia-Idade , Idoso , Regulação Neoplásica da Expressão Gênica
2.
Environ Toxicol ; 39(6): 3367-3380, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38445432

RESUMO

AIMS: Basement membrane-related genes (BMs) participate in regulating cell polarity, invasion, metastasis, and survival across different tumor types. Nevertheless, the specific functions of BMs in colorectal cancer (CRC) remain uncertain. METHODS: To investigate the clinical relevance of BMs in CRC, we retrieved both gene expression and clinical data from The Cancer Genome Atlas (TCGA) datasets for subsequent analysis. The Kaplan-Meier (K-M) survival curve was employed to evaluate prognosis in high- and low-risk groups. Furthermore, additional analyses, including nomogram construction, functional enrichment, examination of the tumor immune microenvironment, prediction of small-molecule drugs, and more, were conducted to delve into the significance of BM-related signatures in CRC. Single-cell data from seven CRC patients were obtained from the TISCH2 database, and expression validation and cell source exploration of BM-related signatures were performed. Lastly, the expression and function of TIMP1, a key gene in BMs that may play a role in the progression of CRC, was validated in vitro through a series of basic experiments. RESULTS: We constructed a seven BMs-based model to categorize CRC patients into high-risk and low-risk groups. K-M survival analysis indicated a poorer prognosis for high-risk CRC patients. Cox regression analysis further identified the risk score as an independent prognostic factor for CRC patients. The nomogram model exhibited superior discrimination and calibration abilities of CRC patients. Based on the results from GO/KEGG and GSEA, genes in the high-risk subgroup were implicated in immune-related pathways and exhibited a positive correlation with immune checkpoints. In single-cell data, we found that TIMP1 is highly expressed in many cells, especially in malignant tumor cells. We also observed up-regulation of TIMP1 in CRC cell lines, promoting cancer invasion and migration in vitro. CONCLUSIONS: Our study has discovered a novel prognostic index derived from BM-related genes in CRC patients. Specifically, the new model enables patient stratification, improving the selection of individuals likely to benefit from immunotherapy.


Assuntos
Membrana Basal , Neoplasias Colorretais , Análise de Célula Única , Inibidor Tecidual de Metaloproteinase-1 , Humanos , Neoplasias Colorretais/genética , Neoplasias Colorretais/imunologia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/mortalidade , Inibidor Tecidual de Metaloproteinase-1/genética , Prognóstico , Membrana Basal/imunologia , Análise de Sequência de RNA , Microambiente Tumoral/imunologia , Regulação Neoplásica da Expressão Gênica , Linhagem Celular Tumoral
4.
Eur J Haematol ; 106(3): 340-345, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33197297

RESUMO

INTRODUCTION: Patients with AL amyloidosis and immunoglobulin deposition diseases (IDD) are vulnerable during the COVID-19 pandemic due to the immune compromise from the plasma cell disorder and therapy-related immune defects. We describe a local experience in providing care for patients with AL amyloidosis and IDD. METHOD: Patient treatment and disease status since the beginning of the pandemic on March 11, 2020, as declared by WHO, were collected and analyzed. RESULTS: Ninety-six patients with AL amyloidosis and IDD were included. Four patients with IDD and 22 patients with systemic AL amyloidosis were receiving treatment during the pandemic. Since the pandemic, patients' treatments were discontinued if they achieved VGPR or better postinduction. Seven patients discontinued all treatment after achieving VGPR, and others required treatment modifications. 28 patients have been tested for COVID-19, and all tests have been negative. Three patients died since the pandemic, two from organ complications of systemic AL amyloidosis and one from an unrelated cause. CONCLUSION: The management of AL amyloidosis and IDD must be individualized on the clinical characteristics, centers' access to care under the pandemic restrictions, and the epidemiological aspects of the outbreak.


Assuntos
COVID-19 , Cadeias Leves de Imunoglobulina/análise , Amiloidose de Cadeia Leve de Imunoglobulina/tratamento farmacológico , Pandemias , Paraproteinemias/tratamento farmacológico , SARS-CoV-2 , Idoso , Alberta/epidemiologia , Anticorpos Monoclonais/uso terapêutico , Membrana Basal/imunologia , Membrana Basal/patologia , Bortezomib/uso terapêutico , COVID-19/diagnóstico , COVID-19/epidemiologia , Teste para COVID-19/estatística & dados numéricos , Ciclofosfamida/uso terapêutico , Dexametasona/uso terapêutico , Gerenciamento Clínico , Suscetibilidade a Doenças , Quimioterapia Combinada , Feminino , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina/mortalidade , Estimativa de Kaplan-Meier , Lenalidomida/uso terapêutico , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Neoplasia Residual , Paraproteinemias/mortalidade , Medicina de Precisão , Estudos Retrospectivos , Telemedicina
5.
Mol Immunol ; 128: 195-204, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33142137

RESUMO

Membranous nephropathy (MN) is an immune complex mediated disease. Although limited to the kidney, in up to 20% of patients MN is associated with other autoimmune, infectious or malignant diseases. The initial pathogenetic event in what is still considered "primary" MN is the binding of circulating autoantibodies to proteins (autoantigens) expressed in glomerular podocytes. This antibody binding leads to the formation of immune complexes in the glomerular basement membrane. There is clinical and experimental evidence that these immune deposits lead to the activation of the complement system. Experimental studies in the MN model of Heymann's nephritis show that the terminal membrane attack complex (MAC) of the complement system induces a disturbance of the glomerular filtration barrier and leads to proteinuria, the clinical hallmark of MN. After the discovery of the phospholipase A2 receptor 1 and thrombospondin type 1 domain containing protein 7A as endogenous antigens, it is assumed that IgG4 antibodies directed against these proteins induce MN in over 85% of patients with primary MN. As a result, the role of complement in the pathogenesis of MN needs to be defined in light of these developments. In this review we describe the current knowledge on the function of the complement system in primary MN and discuss the open questions, which have to be solved for a better understanding of the potential role of complement in the pathophysiology of primary MN.


Assuntos
Proteínas do Sistema Complemento/imunologia , Glomerulonefrite Membranosa/imunologia , Animais , Complexo Antígeno-Anticorpo/imunologia , Autoanticorpos/imunologia , Autoantígenos/imunologia , Membrana Basal/imunologia , Complexo de Ataque à Membrana do Sistema Complemento/imunologia , Humanos , Imunoglobulina G/imunologia , Rim/imunologia , Glomérulos Renais/imunologia , Podócitos/imunologia , Receptores da Fosfolipase A2/imunologia , Trombospondinas/imunologia
6.
Pathol Int ; 70(7): 463-469, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32419249

RESUMO

A 70-year-old Japanese man with diabetes mellitus was referred to our hospital for treatment of renal dysfunction. Renal biopsy revealed that the tubular basement membrane (TBM) showed extreme thickening histologically, and selective polyclonal immunoglobulin G deposition on the thickened TBM, whereas no immunoglobulin deposition was found in the glomeruli in an immunofluorescence study. In electron microscopy, a powdery type of electron dense material, which was similar to that seen in Randall-type monoclonal immunoglobulin deposition disease (MIDD), was observed on the tubular epithelial side of the TBM. However, the present case was differentiated from MIDD, because polyclonal deposition with both kappa and lambda deposition on the TBM was observed. Moreover, there was no noticeable glomerular deposition, which is usually found in cases of MIDD. Anti-TBM disease was also considered as a differential diagnosis, in which polyclonal immunoglobulin deposits selectively on the TBM. However, in the present case, prominent interstitial nephritis was not observed. A similar case with a history of diabetes mellitus has been reported, which was diagnosed as Polyclonal Immunoglobulin G Deposition Disease. No further reports of this case have emerged thereafter; we present this case as the second report supporting this article.


Assuntos
Membrana Basal/imunologia , Nefropatias Diabéticas/imunologia , Nefropatias Diabéticas/patologia , Imunoglobulina G/imunologia , Túbulos Renais/imunologia , Idoso , Membrana Basal/patologia , Humanos , Túbulos Renais/patologia , Masculino
7.
FASEB J ; 34(6): 8044-8056, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32307751

RESUMO

Islet transplantation in man is limited by multiple factors including islet availability, islet cell damage caused by collagenase during isolation, maintenance of islet function between isolation and transplantation, and allograft rejection. In this study, we describe a new approach for preparing islets that enhances islet function in vitro and reduces immunogenicity. The approach involves culture on native decellularized 3D bone marrow-derived extracellular matrix (3D-ECM), which contains many of the matrix components present in pancreas, prior to islet transplantation. Compared to islets cultured on tissue culture plastic (TCP), islets cultured on 3D-ECM exhibited greater attachment, higher survival rate, increased insulin content, and enhanced glucose-stimulated insulin secretion. In addition, culture of islets on 3D-ECM promoted recovery of vascular endothelial cells within the islets and restored basement membrane-related proteins (eg, fibronectin and collagen type VI). More interestingly, culture on 3D-ECM also selectively decontaminated islets of "passenger" cells (co-isolated with the islets) and restored basement membrane-associated type VI collagen, which were associated with an attenuation in islet immunogenicity. These results demonstrate that this novel approach has promise for overcoming two major issues in human islet transplantation: (a) poor yield of islets from donated pancreas tissue and (b) the need for life-long immunosuppression.


Assuntos
Membrana Basal/fisiologia , Medula Óssea/fisiologia , Matriz Extracelular/fisiologia , Tolerância Imunológica/fisiologia , Ilhotas Pancreáticas/imunologia , Ilhotas Pancreáticas/fisiologia , Animais , Membrana Basal/imunologia , Membrana Basal/metabolismo , Medula Óssea/imunologia , Medula Óssea/metabolismo , Colágeno Tipo VI/imunologia , Colágeno Tipo VI/metabolismo , Matriz Extracelular/imunologia , Matriz Extracelular/metabolismo , Fibronectinas/imunologia , Fibronectinas/metabolismo , Glucose/imunologia , Glucose/metabolismo , Tolerância Imunológica/imunologia , Insulina/imunologia , Insulina/metabolismo , Secreção de Insulina/imunologia , Secreção de Insulina/fisiologia , Ilhotas Pancreáticas/metabolismo , Transplante das Ilhotas Pancreáticas/métodos , Masculino , Ratos , Ratos Endogâmicos F344 , Ratos Endogâmicos Lew , Ratos Endogâmicos WF
8.
Am J Ophthalmol ; 216: 1-6, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32067959

RESUMO

PURPOSE: To investigate if there is an association between the location of the conjunctival biopsy site (lesional, perilesional, or nonaffected) and the result of the direct immunofluorescence (DIF) test in patients with suspected mucous membrane pemphigoid (MMP) involving the ocular surface. DESIGN: Retrospective case series. METHODS: Records of patients with clinically suspected ocular MMP were reviewed to determine the location of the conjunctival biopsy. Conjunctival biopsy locations were defined as "lesional," "perilesional," and "nonaffected" conjunctiva. The DIF was considered positive when there was deposition of at least 1 of either IgM, IgG, IgA, or C3 at the basement membrane of the specimen; nondiagnostic when only fibrinogen was found at the same location; and negative when none of these features were present. RESULTS: The records of 41 patients were analyzed. Of these, 32 were eligible to be included in the study. Biopsies were lesional in 22% of cases (7/32), perilesional in 22% (7/32), and from nonaffected conjunctiva in 56% (18/32). DIF results were positive in 14% of lesional biopsies, in 86% of perilesional biopsies, and in 17% of those from nonaffected conjunctiva (P = .003). Perilesional biopsies gave higher positive DIF than lesional biopsies (P = .029). CONCLUSIONS: Perilesional conjunctival biopsies are associated with an increase in positive DIF results. These results support the need to sample perilesional conjunctival tissue in patients with suspected MMP.


Assuntos
Autoanticorpos/metabolismo , Túnica Conjuntiva/patologia , Penfigoide Mucomembranoso Benigno/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Membrana Basal/imunologia , Biópsia , Complemento C3/imunologia , Túnica Conjuntiva/imunologia , Feminino , Fibrinogênio/metabolismo , Técnica Direta de Fluorescência para Anticorpo/métodos , Seguimentos , Humanos , Imunoglobulina A/imunologia , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Masculino , Pessoa de Meia-Idade , Mucosa/imunologia , Mucosa/patologia , Penfigoide Mucomembranoso Benigno/imunologia , Estudos Retrospectivos
9.
Ocul Immunol Inflamm ; 28(4): 703-707, 2020 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-31268817

RESUMO

Ectodermal dysplasia (ED) is a group of several genetic conditions with absence or dysgenesis of at least two ectodermal derivatives: teeth, skin and its appendages including hair, nails, eccrine and sebaceous glands. The most important clinical findings in patients with ED are hypodontia, hypotrichosis, and hypohidrosis, which can lead to episodes of hyperthermia. Few reports have focused on the progressive keratopathy in ED. Cicatrizing conjunctivitis associated with anti-basement membrane autoantibodies has been described. We report a series of three ectodermal dysplasia patients with an ocular phenotype typically seen in ocular mucous membrane pemphigoid; conjunctival immunohistopathology revealed anti-basement membrane autoantibodies in all of them, and systemic immunosuppression proved to be effective in improving symptoms and helping to stabilize ocular surface disease.


Assuntos
Autoanticorpos/imunologia , Membrana Basal/imunologia , Túnica Conjuntiva/patologia , Displasia Ectodérmica/imunologia , Penfigoide Mucomembranoso Benigno/diagnóstico , Membrana Basal/patologia , Túnica Conjuntiva/imunologia , Displasia Ectodérmica/diagnóstico , Displasia Ectodérmica/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Penfigoide Mucomembranoso Benigno/complicações , Penfigoide Mucomembranoso Benigno/imunologia
10.
Nephrol Dial Transplant ; 34(4): 711-717, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30124906

RESUMO

BACKGROUND: Tubular basement membrane immune deposits (TBMID) has rarely been observed in renal allografts. It is usually found in BK virus nephropathy and immune complex glomerulonephritis; however, its significance is not well understood. We conducted a retrospective clinicopathological study on monoclonal immunoglobulin G (IgG) TBMID. METHODS: We studied 7177 renal allograft biopsy specimens obtained from Tokyo Women's Medical University from 2007 to 2015 and performed light microscopic, electron microscopic and immunofluorescence studies. RESULTS: Tubular basement membrane (TBM) deposits of IgG were found in 73 biopsies from 61 patients and the IgG subclass was obtained in 31 biopsies. There were no cases of monoclonal IgA or IgM TBMID. In total, 13 biopsies from 10 patients showed monoclonal IgG TBMID. Of these, seven showed monoclonal IgG1κ TBMID and one each showed monoclonal IgG2κ, IgG2λ and IgG3κ TBMID. Conversely, eight patients showed polyclonal IgG TBMID. In electron microscopy, large granular electron-dense deposits (EDDs) in the TBM were detected in all patients with monoclonal IgG1κ TBMID. EDDs were absent in TBM in patients with monoclonal IgG2κ, IgG2λ or IgG3κ TBMID. Progression of interstitial fibrosis and tubular atrophy (IFTA) was significantly higher in patients with monoclonal IgG1κ TBMID than in those with polyclonal IgG TBMID (P < 0.05). There were no significant differences in the other clinical parameters between monoclonal IgG1κ and polyclonal IgG TBMID. CONCLUSIONS: This is the first study of patients with monoclonal IgG TBMID in renal allografts. We found that monoclonal IgG1κ TBMID was associated with EDD formation in TBM and IFTA progression.


Assuntos
Anticorpos Monoclonais/imunologia , Membrana Basal/imunologia , Glomerulonefrite/imunologia , Imunoglobulina G/imunologia , Transplante de Rim/métodos , Nefrite Intersticial/imunologia , Adolescente , Adulto , Idoso , Aloenxertos , Anticorpos Monoclonais/metabolismo , Membrana Basal/metabolismo , Criança , Feminino , Glomerulonefrite/metabolismo , Glomerulonefrite/patologia , Humanos , Imunoglobulina G/metabolismo , Masculino , Pessoa de Meia-Idade , Nefrite Intersticial/metabolismo , Nefrite Intersticial/patologia , Prognóstico , Estudos Retrospectivos , Adulto Jovem
11.
Nephrol Dial Transplant ; 34(2): 193-199, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30124958

RESUMO

A kidney biopsy is done to determine the etiology of the glomerulonephritis (GN) and the severity of the lesion, to identify whether other lesions, related to or not related to the GN, are present on the kidney biopsy and finally to ascertain the extent of chronicity of the GN. The etiology of GN is based on the classification of GN into five groups: immune complex-mediated GN, antineutrophil cytoplasmic antibody (ANCA)-associated GN, anti-glomerular basement membrane (GBM) GN, monoclonal immunoglobulin-mediated GN and C3 glomerulopathy. Immune complex GN includes multiple specific diseases such as lupus nephritis, IgA nephropathy, infection-related GN and fibrillary GN. ANCA GN, anti-GBM GN and C3 glomerulopathy are specific diseases in themselves, while monoclonal Ig GN includes proliferative GN with monoclonal Ig deposits and monoclonal Ig deposition disease. Thus identification of the class of GN and within it the specific disease determines the etiology of GN. Ancillary studies may be required to confirm the etiology of GN. The severity of the GN is revealed by the pattern of injury, such as crescentic, necrotizing, diffuse proliferative, exudative, membranoproliferative, mesangial proliferative or a sclerosing GN. Secondary diagnosis either related or unrelated to the GN, such as diabetic glomerulosclerosis, acute tubular necrosis or thrombotic microangiopathy, may also be present. The secondary diagnosis may sometimes be the reason for the kidney biopsy. The chronicity of GN is determined by evaluating the extent of glomerulosclerosis, tubular atrophy and interstitial fibrosis and vascular sclerosis present on the biopsy. This review summarizes the approach to standardizing a kidney biopsy report that includes these components in a logical and sequential manner.


Assuntos
Anticorpos Anticitoplasma de Neutrófilos/análise , Biópsia/normas , Glomerulonefrite por IGA/classificação , Glomerulonefrite/classificação , Nefrologia/normas , Membrana Basal/imunologia , Complemento C3/imunologia , Glomerulonefrite/diagnóstico , Glomerulonefrite/patologia , Glomerulonefrite por IGA/diagnóstico , Humanos , Imunoglobulinas/imunologia , Glomérulos Renais/fisiopatologia , Nefrite Lúpica/classificação , Nefrite Lúpica/diagnóstico
12.
J Invest Dermatol ; 138(7): 1473-1480, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29410066

RESUMO

Vancomycin (VCM) is known to induce linear IgA bullous dermatosis (LAD). However, in contrast to conventional LAD, in which circulating IgA autoantibodies against basement membrane proteins are commonly detected, patient sera from VCM-induced LAD yields negative results in indirect immunofluorescence microscopy, and the targeted autoantigen remains undetermined. By using sera from a typical patient with VCM-induced LAD, we identified that co-incubation of sera with VCM resulted in linear IgA deposition at the basement membrane zone by indirect immunofluorescence. Patient sera reacted with the dermal side of 1 mol/L NaCl-split skin and with the recombinant noncollagenous (i.e., NC1) domain of type VII collagen by both immunoblot and ELISA in the presence of VCM. The investigation of an additional 13 patients with VCM-induced LAD showed that 10 out of the 14 sera (71.4%) reacted with the NC1 domain of type VII collagen by ELISA when spiked with VCM, whereas only 4 (28.6%) tested positive without it. The enhancement of reactivity to NC1 by VCM, as determined by optical density via ELISA, was observed in 10 out of the 14 sera (71.4%). These findings indicate that type VII collagen is a target autoantigen in VCM-induced LAD and that VCM mediates IgA autoreactivity against type VII collagen, providing an insight into mechanisms involved in drug-induced autoimmune disease.


Assuntos
Antibacterianos/efeitos adversos , Imunoglobulina A/imunologia , Dermatose Linear Bolhosa por IgA/imunologia , Úlcera Cutânea/tratamento farmacológico , Vancomicina/efeitos adversos , Idoso , Autoanticorpos/sangue , Autoantígenos/imunologia , Autoimunidade/efeitos dos fármacos , Membrana Basal/imunologia , Biópsia , Calcinose/tratamento farmacológico , Calcinose/etiologia , Colágeno Tipo VII/sangue , Colágeno Tipo VII/imunologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina A/sangue , Dermatose Linear Bolhosa por IgA/sangue , Dermatose Linear Bolhosa por IgA/induzido quimicamente , Dermatose Linear Bolhosa por IgA/patologia , Doença Mista do Tecido Conjuntivo/complicações , Doença Mista do Tecido Conjuntivo/tratamento farmacológico , Prednisolona/uso terapêutico , Testes Sorológicos/métodos , Pele/citologia , Pele/imunologia , Pele/patologia , Úlcera Cutânea/etiologia
13.
Clin J Am Soc Nephrol ; 13(1): 63-72, 2018 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-29162595

RESUMO

BACKGROUND AND OBJECTIVES: Large studies on long-term kidney outcome in patients with anti-glomerular basement membrane (anti-GBM) GN are lacking. This study aimed to identify clinical and histopathologic parameters that predict kidney outcome in these patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This retrospective analysis included a total of 123 patients with anti-GBM GN between 1986 and 2015 from six centers worldwide. Their kidney biopsy samples were classified according to the histopathologic classification for ANCA-associated GN. Clinical data such as details of treatment were retrieved from clinical records. The primary outcome parameter was the occurrence of ESRD. Kidney survival was analyzed using the log-rank test and Cox regression analyses. RESULTS: The 5-year kidney survival rate was 34%, with an improved rate observed among patients diagnosed after 2007 (P=0.01). In patients with anti-GBM GN, histopathologic class and kidney survival were associated (P<0.001). Only one of 15 patients with a focal class biopsy sample (≥50% normal glomeruli) developed ESRD. Patients with a sclerotic class biopsy sample (≥50% globally sclerotic glomeruli) and patients with 100% cellular crescents did not recover from dialysis dependency at presentation. In multivariable analysis, dialysis dependency at presentation (hazard ratio [HR], 3.17; 95% confidence interval [95% CI], 1.59 to 6.32), percentage of normal glomeruli (HR, 0.97; 95% CI, 0.95 to 0.99), and extent of interstitial infiltrate (HR, 2.02; 95% CI, 1.17 to 3.50) were predictors of ESRD during follow-up. CONCLUSIONS: Dialysis dependency, low percentage of normal glomeruli, and large extent of interstitial infiltrate are associated with poor kidney outcome in anti-GBM GN. Kidney outcome has improved during recent years; the success rate doubled after 2007. PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2017_11_21_CJASNPodcast_18_1_v.mp3.


Assuntos
Doença Antimembrana Basal Glomerular/imunologia , Autoanticorpos/imunologia , Membrana Basal/imunologia , Glomérulos Renais/imunologia , Adulto , Idoso , Doença Antimembrana Basal Glomerular/diagnóstico , Doença Antimembrana Basal Glomerular/fisiopatologia , Doença Antimembrana Basal Glomerular/terapia , Biópsia , Progressão da Doença , Feminino , Humanos , Falência Renal Crônica/imunologia , Falência Renal Crônica/patologia , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Glomérulos Renais/patologia , Glomérulos Renais/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Diálise Renal , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Adulto Jovem
14.
J Cell Mol Med ; 21(3): 543-551, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27704726

RESUMO

Spontaneous tumour regression after high-dose therapy and autologous stem cell transplantation is associated with the aplastic anaemia-like syndrome and the presence of polyclonal autoantibodies against carbonic anhydrase I (CA I). When tumour cells were grown in vitro in the presence of patients' sera positive for anti-CA I autoantibodies, their morphological pattern was altered. These changes were accompanied by modifications in the gene expression profile. We observed downregulation of genes of the basal lamina assembly (collagen type IV alpha 4, the laminin subunit gamma 2), the extracellular matrix (collagen type I alpha 1), the cytoskeleton (keratin 14 type I), the collagen triple helix repeat containing 1 and the proto-oncogene WNT7B. On the other hand, the expression of the CA 1 gene was increased in the tumour cells. It was also noticed that the presence of anti-CA I autoantibodies did not impair tumour cell proliferation and cell viability in vitro. These findings were observed only in the presence of patients' sera positive for anti-CA I autoantibodies.


Assuntos
Autoanticorpos/sangue , Autoanticorpos/imunologia , Anidrase Carbônica I/imunologia , Proteínas da Matriz Extracelular/metabolismo , Matriz Extracelular/metabolismo , Neoplasias/sangue , Neoplasias/imunologia , Adulto , Idoso , Especificidade de Anticorpos/imunologia , Membrana Basal/imunologia , Membrana Basal/metabolismo , Anidrase Carbônica I/metabolismo , Proliferação de Células/fisiologia , Sobrevivência Celular/imunologia , Colágeno/imunologia , Colágeno/metabolismo , Cadeia alfa 1 do Colágeno Tipo I , Citoesqueleto/imunologia , Citoesqueleto/metabolismo , Regulação para Baixo/imunologia , Matriz Extracelular/imunologia , Proteínas da Matriz Extracelular/imunologia , Feminino , Expressão Gênica/genética , Expressão Gênica/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/metabolismo , Proto-Oncogene Mas
15.
Br J Dermatol ; 177(1): 152-157, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27943257

RESUMO

BACKGROUND: Linear IgA bullous dermatosis (LABD) is a heterogeneous disease. Different diagnostic criteria have been used in different reports. OBJECTIVES: To reappraise the characteristic features of LABD with only IgA deposition at the basement membrane zone (BMZ) with direct immunofluorescence (DIF). METHODS: We retrospectively collected data from 101 patients from our archival records from 1 January 1996 to 31 December 2014 who had: (i) blisters on the skin and/or mucous membranes; (ii) subepidermal blisters in a biopsy specimen; and (iii) linear IgA deposition along the BMZ with/without linear C3 deposition at the BMZ with DIF. Most patients were referred for serological evaluation. Patients who showed concurrent linear IgG and/or IgM deposition at the BMZ under DIF were excluded. Clinical manifestations and serological findings were analysed. RESULTS: Heterogeneity of autoantigens in LABD was confirmed. Fifty-four of 101 patients (53%) had IgG antibodies detected either by indirect immunofluorescence, immunoblotting or enzyme-linked immunosorbent assays (ELISA). No statistical difference in clinical manifestations was found between patients in the IgG antibody-possessing group and patients in the other group. CONCLUSIONS: An association of IgG anti-BMZ antibodies with LABD may increase if new IgG immunoblotting or ELISA techniques become available. Consensus for diagnostic criteria for LABD is desired for prospective data storage, although it may be arbitrary.


Assuntos
Membrana Basal/imunologia , Imunoglobulina A/metabolismo , Dermatose Linear Bolhosa por IgA/imunologia , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Técnica Direta de Fluorescência para Anticorpo , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
J Clin Invest ; 126(11): 4125-4139, 2016 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-27701149

RESUMO

Neutrophils need to penetrate the perivascular basement membrane for successful extravasation into inflamed tissue, but this process is incompletely understood. Recent findings have associated mammalian sterile 20-like kinase 1 (MST1) loss of function with a human primary immunodeficiency disorder, suggesting that MST1 may be involved in immune cell migration. Here, we have shown that MST1 is a critical regulator of neutrophil extravasation during inflammation. Mst1-deficient (Mst1-/-) neutrophils were unable to migrate into inflamed murine cremaster muscle venules, instead persisting between the endothelium and the basement membrane. Mst1-/- neutrophils also failed to extravasate from gastric submucosal vessels in a murine model of Helicobacter pylori infection. Mechanistically, we observed defective translocation of VLA-3, VLA-6, and neutrophil elastase from intracellular vesicles to the surface of Mst1-/- neutrophils, indicating that MST1 is required for this crucial step in neutrophil transmigration. Furthermore, we found that MST1 associates with the Rab27 effector protein synaptotagmin-like protein 1 (JFC1, encoded by Sytl1 in mice), but not Munc13-4, thereby regulating the trafficking of Rab27-positive vesicles to the cellular membrane. Together, these findings highlight a role for MST1 in vesicle trafficking and extravasation in neutrophils, providing an additional mechanistic explanation for the severe immune defect observed in patients with MST1 deficiency.


Assuntos
Fator de Crescimento de Hepatócito/imunologia , Neutrófilos/imunologia , Proteínas Proto-Oncogênicas/imunologia , Vesículas Secretórias/imunologia , Migração Transendotelial e Transepitelial/imunologia , Músculos Abdominais/irrigação sanguínea , Músculos Abdominais/imunologia , Animais , Membrana Basal/imunologia , Transporte Biológico Ativo/genética , Transporte Biológico Ativo/imunologia , Mucosa Gástrica/química , Mucosa Gástrica/imunologia , Fator de Crescimento de Hepatócito/genética , Humanos , Síndromes de Imunodeficiência/genética , Síndromes de Imunodeficiência/imunologia , Integrina alfa3beta1/genética , Integrina alfa3beta1/imunologia , Integrina alfa6beta1/genética , Integrina alfa6beta1/imunologia , Elastase de Leucócito/genética , Elastase de Leucócito/imunologia , Proteínas de Membrana/genética , Proteínas de Membrana/imunologia , Camundongos , Camundongos Knockout , Proteínas Proto-Oncogênicas/genética , Vesículas Secretórias/genética , Migração Transendotelial e Transepitelial/genética , Vênulas/imunologia , Proteínas de Transporte Vesicular
17.
Clin Immunol ; 170: 39-52, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27464450

RESUMO

Laminins are ubiquitous constituents of the basement membranes with major architectural and functional role as supported by the fact that absence or mutations of laminins lead to either lethal or severely impairing phenotypes. Besides genetic defects, laminins are involved in a wide range of human diseases including cancer, infections, and inflammatory diseases, as well as autoimmune disorders. A growing body of evidence implicates several laminin chains as autoantigens in blistering skin diseases, collagenoses, vasculitis, or post-infectious autoimmunity. The current paper reviews the existing knowledge on autoimmunity against laminins referring to both experimental and clinical data, and on therapeutic implications of anti-laminin antibodies. Further investigation of relevant laminin epitopes in pathogenic autoimmunity would facilitate the development of appropriate diagnostic tools for thorough characterization of patients' antibody specificities and should decisively contribute to designing more specific therapeutic interventions.


Assuntos
Autoanticorpos/imunologia , Autoantígenos/imunologia , Autoimunidade/imunologia , Laminina/imunologia , Animais , Autoantígenos/genética , Autoimunidade/genética , Membrana Basal/imunologia , Humanos , Laminina/genética , Mutação/imunologia , Neoplasias/genética , Neoplasias/imunologia , Neoplasias/patologia , Dermatopatias/genética , Dermatopatias/imunologia
18.
Mol Immunol ; 76: 123-33, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27450516

RESUMO

Autoantibodies mediate organ destruction in multiple autoimmune diseases, yet their origins in patients remain poorly understood. To probe the genetic origins and structure of disease-associated autoantibodies, we engrafted immunodeficient mice with human CD34+ hematopoietic stem cells and immunized with the non-collagenous-1 (NC1) domain of the alpha3 chain of type IV collagen. This antigen is expressed in lungs and kidneys and is targeted by autoantibodies in anti-glomerular basement membrane (GBM) nephritis and Goodpasture syndrome (GPS), prototypic human organ-specific autoimmune diseases. Using Epstein Barr virus transformation and cell fusion, six human anti-alpha3(IV)NC1 collagen monoclonal autoantibodies (mAb) were recovered, including subsets reactive with human kidney and with epitopes recognized by patients' IgG. Sequence analysis reveals a long to exceptionally long heavy chain complementarity determining region3 (HCDR3), the major site of antigen binding, in all six mAb. Mean HCDR3 length is 25.5 amino acids (range 20-36), generated from inherently long DH and JH genes and extended regions of non-templated N-nucleotides. Long HCDR3 are suited to forming noncontiguous antigen contacts and to binding recessed, immunologically silent epitopes hidden from conventional antibodies, as seen with self-antigen crossreactive broadly neutralizing anti-HIV Ig (bnAb). The anti-alpha3(IV)NC1 collagen mAb also show preferential use of unmutated variable region genes that are enriched among human chronic lymphocytic leukemia antibodies that share features with natural polyreactive Ig. Our findings suggest unexpected relationships between pathogenic anti-collagen Ig, bnAb, and autoreactive Ig associated with malignancy, all of which arise from B cells expressing unconventional structural elements that may require transient escape from tolerance for successful expansion.


Assuntos
Autoanticorpos/imunologia , Membrana Basal/imunologia , Colágeno Tipo IV/imunologia , Motivos de Aminoácidos/genética , Motivos de Aminoácidos/imunologia , Animais , Anticorpos Monoclonais/genética , Anticorpos Monoclonais/imunologia , Autoanticorpos/genética , Autoantígenos/imunologia , Regiões Determinantes de Complementaridade/genética , Regiões Determinantes de Complementaridade/imunologia , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Humanos , Imuno-Histoquímica , Camundongos
19.
In Vitro Cell Dev Biol Anim ; 51(8): 827-34, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25977076

RESUMO

The cornea functions as the major refractive interface for vision and protects the internal eye from insult. Current understanding of innate immune responses to corneal infection derives from a synthesis of in vitro and in vivo analyses. However, monolayer cell cultures and mouse models do not accurately duplicate all aspects of innate immunity in human patients. Here, we describe a three-dimensional culture system that incorporates human cells and extracellular matrix to more completely simulate the human cornea for studies of infection. Human corneal stromal fibroblasts were mixed with type I collagen in 3-µm pore size transwell inserts, and overlayed with Matrigel to simulate a human corneal stroma and epithelial basement membrane. These were then infected with a cornea-tropic adenovirus, and exposed on their inferior side to leukocytes derived from human peripheral blood. Subsequent analyses were performed with histology, confocal microscopy, ELISA, and fluorescence-activated cell sorting (FACS). CXCL8, a neutrophil chemokine shown previously as the first cytokine induced in infection of human corneal cells, increased upon adenovirus infection of facsimiles in a dose-responsive fashion. Myeloperoxidase-positive cells infiltrated infected corneal facsimiles in a sub-Matrigel location, possibly due to CXCL8 colocalization with heparan sulfate, a Matrigel constituent. Cellular infiltration was significantly inhibited by treatment with chemical inhibitors of p38 MAPK and Src kinase, both constituents of a signaling cascade previously suggested to regulate inflammation after adenovirus infection. FACS analysis determined that both virus and corneal fibroblasts were necessary for the induction of leukocyte migration into the facsimiles. The corneal facsimile, literally a cornea in a test tube, permits mechanistic studies on human tissue in a highly tractable system.


Assuntos
Doenças da Córnea/imunologia , Imunidade Inata/fisiologia , Infecções por Adenovirus Humanos/imunologia , Membrana Basal/imunologia , Córnea/citologia , Córnea/imunologia , Córnea/virologia , Doenças da Córnea/virologia , Ceratócitos da Córnea/imunologia , Ceratócitos da Córnea/fisiologia , Substância Própria/citologia , Substância Própria/imunologia , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Humanos , Microscopia Confocal , Modelos Imunológicos
20.
Bull Exp Biol Med ; 157(1): 56-61, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24915947

RESUMO

We analyzed local reactions of immune homeostasis in the human skin, in particular, effector immune cells CD68 responsible for antigen presentation, during human papillomavirus infection. Under conditions of long-term papillomavirus infection, CD68 markers were identifi ed only in the connective tissue of the skin (derma) and were completely absent in the epidermis, where they were found during physiological and reparative regeneration after thermal injury. We concluded that hypertrophy of the epidermis and connective tissue of the dermal papillary layer in human papillomavirus infection is related to the absence of CD68 immune cells in the epithelial plate and their accumulation in the connective tissue adjacent to the basement membrane of the epidermis. The possibility of epithelium contamination with the virus depends on local immune homeostasis. Therefore, induction of proper CD68 distribution in appropriate structures can contribute to normalization of epithelial-connective tissue interactions.


Assuntos
Células Apresentadoras de Antígenos/patologia , Membrana Basal/patologia , Tecido Conjuntivo/patologia , Derme/patologia , Epiderme/patologia , Infecções por Papillomavirus/patologia , Células Apresentadoras de Antígenos/imunologia , Células Apresentadoras de Antígenos/virologia , Antígenos CD/imunologia , Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/imunologia , Antígenos de Diferenciação Mielomonocítica/metabolismo , Membrana Basal/imunologia , Membrana Basal/virologia , Biomarcadores/metabolismo , Diferenciação Celular , Tecido Conjuntivo/imunologia , Tecido Conjuntivo/virologia , Derme/imunologia , Derme/virologia , Epiderme/imunologia , Epiderme/virologia , Humanos , Imunofenotipagem , Papillomaviridae/fisiologia , Infecções por Papillomavirus/imunologia , Infecções por Papillomavirus/virologia , Técnicas de Cultura de Tecidos
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