RESUMEN
BACKGROUND: Exposure to environmental hormones, such as alkylphenols, has been suggested to be associated with the development of asthma, but the mechanism of action remains unclear. OBJECTIVE: This study examined the effect of 4-nonylphenol (NP), one of the most important alkylphenols, on conventional dendritic cells (cDCs) and adaptive T-cell responses. It also explored the role of aryl hydrocarbon receptor (AhR) in NP's effect. METHODS: NP-conditioned bone marrow-derived DCs (BM-DCs) and splenic CD11c(+) cDCs were assessed regarding function in a murine model under conditions relevant to route and level of exposure in humans. RESULTS: Our results showed that splenic cDCs from NP-exposed mice have potent Th2-skewing ability and secrete increased levels of IL-6 and TNF-α, but not IL-10 and IL-12, at baseline and after stimulation with LPS. Further, bone marrow-derived DCs were cultured in the presence of NP and showed similar cytokine pattern and influenced the antigen-specific T cells secreting significantly less IFN-γ. Importantly, NP-exposed mice developed more severe OVA-induced allergic lung inflammation compared with control group. Interestingly, in a congenic strain of mice carrying low-affinity, ligand-binding mutant AhR (AhR(d) ), NP's effect on DC functions and lung inflammation was not observed in vitro and in vivo. CONCLUSION: These results suggested that NP may disturb physiologic function of DCs through, in part, AhR-dependent mechanisms, supporting the importance of NP exposure on the regulation of DC functions and allergic inflammation.
Asunto(s)
Asma/inducido químicamente , Contaminantes Ambientales/toxicidad , Fenoles/toxicidad , Inmunidad Adaptativa/efectos de los fármacos , Animales , Asma/inmunología , Asma/metabolismo , Biomarcadores/metabolismo , Linfocitos T CD4-Positivos/efectos de los fármacos , Linfocitos T CD4-Positivos/metabolismo , Citocinas/metabolismo , Células Dendríticas/efectos de los fármacos , Células Dendríticas/inmunología , Células Dendríticas/metabolismo , Pulmón/inmunología , Pulmón/metabolismo , Pulmón/patología , Ratones , Ratones Endogámicos BALB C , Receptores de Hidrocarburo de Aril/metabolismoRESUMEN
Foxp3, a member of the forkhead transcription factor family, is a master gene that controls the development and function of CD4(+)CD25(+) regulatory T (Treg) cells. It is thought to contribute to pathogenesis of many different tumors, including ovarian carcinoma and pancreatic, breast and pancreatic ductal adenocarcinoma. Selectively depleted Foxp3-expressing cells with anit-CD25 antibodies or vaccination of Foxp3 mRNA-transfected dendritic cells engender protective immunity against tumor. This study targeted silencing Foxp3 gene expression using RNA interference (RNAi) delivered by a lentiviral vector to evaluate the therapeutic role of Foxp3 short-hairpin RNAs (shRNAs) in a murine model of leukemia. RLmale symbol1, a mouse CD4(+)CD25(+) leukemia cell with Foxp3 expression, was used as the leukemia animal model. By infecting RLmale symbol1 cells with Lenti-Foxp3-siRNA, we reduced Foxp3 gene expression and the suppressive function of CD4(+)CD25(-) effector cells stimulated with ConA. Moreover, lentiviral-mediated Foxp3 RNAi transduced into RLmale symbol1 cell or injected into the tumor showed suppressive effects on tumor growth and prolonged the survival of tumor-transplanted mice. However, this suppressive effect was abrogated in NOD-SCID mice transplanted with Lenti-Foxp3-siRNA-infected RLmale symbol1 cells. In conclusion, inhibiting Foxp3 gene expression by shRNAs effectively decreases tumor growth of Treg cell-like leukemia. The results may provide a novel strategy for future immunotherapy against cancers.
Asunto(s)
Factores de Transcripción Forkhead/antagonistas & inhibidores , Lentivirus/genética , Leucemia Experimental/terapia , Leucemia de Células T/terapia , Interferencia de ARN , Animales , Línea Celular Tumoral , Terapia Genética , Leucemia Experimental/genética , Leucemia de Células T/genética , Masculino , Ratones , Ratones Endogámicos BALB C , Estabilidad del ARNRESUMEN
Plasmacytoid dendritic cells (pDCs) are critical in controlling adaptive immunity, but the mechanisms governing cytokine expression remain incompletely defined. Analogues of prostaglandin (PG)I(2), such as iloprost, can modulate functions of myeloid dendritic cells, but their involvement in the regulation of human pDCs remains unknown. To this end, the regulatory role of PGI(2) analogues on cytokine expression in pDCs was investigated. Circulating pDCs were magnetically sorted with BDCA-4 cell isolation kits from human peripheral blood mononuclear cells and treated with varying concentrations of iloprost with or without the addition of Toll-like receptor agonists, or an I prostanoid (IP) receptor antagonist, CAY10449. The levels of tumour necrosis factor (TNF)-alpha, interferon (IFN)-alpha and interleukin (IL)-10 were measured by ELISA. Iloprost induced IL-10 expression, but suppressed CpG oligodeoxynucleotide- (or imiquimod-) induced TNF-alpha and IFN-alpha production in pDCs. This effect was reversed by the addition of CAY10449. Forskolin, a cyclic adenosine monophosphate activator, conferred a similar modulating effect to that noted in iloprost-treated pDCs, although a higher concentration of forskolin was required to exert the same effect. Iloprost enhanced interleukin-10 and suppressed Toll-like receptor-mediated tumour necrosis factor-alpha and interferon-alpha production of human plasmacytoid dendritic cells via the I prostanoid receptor and, in part, the cyclic adenosine monophosphate pathway.
Asunto(s)
Citocinas/biosíntesis , Células Dendríticas/citología , Epoprostenol/análogos & derivados , Regulación de la Expresión Génica , Benzofenonas/farmacología , Colforsina/farmacología , AMP Cíclico/metabolismo , Ensayo de Inmunoadsorción Enzimática , Humanos , Iloprost/farmacología , Imidazoles/farmacología , Interferón-alfa/metabolismo , Interleucina-10/metabolismo , Oligonucleótidos/química , Inhibidores de Agregación Plaquetaria/farmacología , Transducción de Señal , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
Programmed cell death (apoptosis) is a process involved in the development of various tissues and suggested to be critical in the elimination of self-reactive immature T and B lymphocytes when they first encounter self antigens. To investigate further the role of apoptosis in the pathogenesis of autoimmune disease, the apoptotic phenomena of spleen cells and peritoneal cells of NZB/W F1 mice or nonautoimmune BALB/c mice were studied. Spleen cells and peritoneal cells were isolated and analyzed for their apoptotic phenomenon with the method of DNA staining. The data showed: 1) freshly isolated-spleen cells from BALB/c and NZB/W F1 mice showed little apoptosis as assessed by quantitative DNA flow cytometry, and had a significant increase with age (p < 0.001); 2) and data also showed that spleen cells of NZB/W F1 have higher spontaneous apoptotic rate than those of BALB/c mice (p < 0.05); 3) the apoptotic rate of dexamethasone (DEX)-treated spleen cells was lower in NZB/W F1 mice compared to that of nonautoimmune mice; 4) peritoneal cells showed little apoptosis when cells were freshly isolated and also had a striking increase with age (p < 0.05); 5) the apoptotic rate of DEX-treated peritoneal cells increased dramatically with age in BALB/c (p < 0.05), but not in NZB/W F1 mice. Our data showed quite clearly that splenic cells are much different from peritoneal cells according to their apoptotic responses. Furthermore, the apoptotic phenomenon of immune effector cells was also different between those of autoimmune and normal mice.
Asunto(s)
Apoptosis , Enfermedades Autoinmunes/patología , Linfocitos/patología , Animales , Enfermedades Autoinmunes/inmunología , Dexametasona/farmacología , Femenino , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos NZB , Bazo/patologíaRESUMEN
OBJECTIVES: Systemic lupus erythematosus (SLE) is characterized by the presence of autoantibodies (autoAbs) directed against the nuclear structure. Previous studies have demonstrated that dendritic cells (DCs) can process and present self-antigens (Ags) from apoptotic cells (ACs) in lupus. However, there is no direct evidence demonstrating that ACs provide self-Ags, such as histones, to stimulate autoreactive T-cells in lupus. METHODS: AC-pulsed bone marrow-derived DCs (AC-BMDCs) were used to stimulate autoreactive T-cells in vitro and in vivo. RESULTS: In our study, we found that AC-BMDCs could induce the proliferation of CD4+ T-cells from unprimed NZB x NZW F1 (BWF1) mice, which spontaneously develop SLE, but not CD4+ T-cells, from non-autoimmune DBA-2 x NZW F1 (DWF1) mice. In addition, AC-BMDCs could induce significant proliferative responses to certain histone peptide-specific T-cells. Furthermore, these AC-BMDCs could induce a considerable anti-DNA Ab response in vivo after adoptive transfer into DWF1 mice, suggesting that AC-BMDCs can break tolerance in normal mice and initiate an autoimmune response. CONCLUSION: Our study provides a direct link between self-epitopes from ACs presented by DCs and autoreactive T-cell activation, and demonstrates that ACs are critical for the induction of autoimmunity in vivo.
Asunto(s)
Traslado Adoptivo/métodos , Linfocitos T CD4-Positivos/inmunología , Células Dendríticas/trasplante , Lupus Eritematoso Sistémico/terapia , Activación de Linfocitos , Animales , Apoptosis , Autoanticuerpos/inmunología , Autoinmunidad , Línea Celular , Proliferación Celular , Citocinas/inmunología , ADN/inmunología , Femenino , Citometría de Flujo , Inmunoglobulina G/inmunología , Glomérulos Renales/inmunología , Ratones , Ratones Mutantes , Modelos Animales , FagocitosisRESUMEN
Systemic lupus erythematosus (SLE) is a chronic, systemic autoimmune disease characterized by the loss of tolerance to self-antigen. Because it is currently not known if regulatory T (T(reg)) cells are involved in the pathogenesis, we determined the frequency of CD4(+)CD25(+) T cells and assayed the related gene expression levels in CD4(+)CD25(+) T cells isolated from both lupus mice (NZB/NZW F(1)) and normal control mice (DBA2/NZW F(1)). The results showed that the frequency of CD4(+)CD25(+) T cells in lupus mice was lower than that of normal mice. Except for the high expression level of interleukin (IL)-10 mRNA, CD4(+)CD25(+) T cells from lupus mice expressed normal forkhead box P3 (Foxp3) and transforming growth factor (TGF)-beta mRNA, and exerted suppressive functions. Furthermore, we depleted CD25(+) T(reg) cells of non-autoimmune mice with anti-CD25 antibody and broke their tolerance with apoptotic cell-pulsed dendritic cells for the follow-up of autoantibody levels. The mice in the CD25(+) cell-depleted group had higher titres of anti-double-strand/single-strand DNA antibodies than those of the isotype control antibody-treated group. These findings indicated that CD4(+)CD25(+) T cells might be involved in the regulatory mechanism of autoantibody production.
Asunto(s)
Autoanticuerpos/inmunología , Linfocitos T CD4-Positivos/inmunología , Lupus Eritematoso Sistémico/inmunología , Receptores de Interleucina-2/inmunología , Animales , Apoptosis , Autoanticuerpos/sangre , Células Dendríticas/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Citometría de Flujo , Factores de Transcripción Forkhead/genética , Expresión Génica , Terapia de Inmunosupresión , Interleucina-10/genética , Ratones , Ratones Endogámicos NZB , ARN Mensajero/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factor de Crecimiento Transformador beta/genéticaRESUMEN
Humic acid (HA), a potential toxin that has penetrated the drinking well water of blackfoot disease-endemic areas in Taiwan, has been implicated as an etiological factor of this disease. In this study, we investigated the effects of HA on the generation of reactive oxygen species (ROS) in cultured human umbilical vein endothelial cells (HUVECs). The generation of ROS was monitored by flow cytometry. Pretreatment of HUVECs with HA induced reactive oxygen species in a dose- and time-dependent manner. Xanthine oxidase inhibitor (Allopurinol), NADPH oxidase inhibitor (diphenylene iodomium) and calcium chelator (BAPTA) could not reduce the generation of ROS. Protein kinase C inhibitor (H7) could reduce the generation of ROS slightly, but the intracellular antioxidant glutathione monoethyl ester and the iron chelator desferrioxamine (DFO) could inhibit the generation of ROS completely. HA also enhanced the expression of ferritin and induced intracellular chelatable iron; however, HA reduced the expression of transferrin receptor. Pretreatment with DFO inhibited HA-mediated increases of ferritin synthesis and intracellular chelatable iron, but caused recovery of the inhibitory effect on transferrin receptor. Cotreatment with iron and HA induced more ROS and intracellular chelatable iron than iron or HA treatment alone. Furthermore, HA enhanced the accumulation of iron in endothelial cells. These data demonstrate that HA can increase the generation of ROS through enhancing the accumulation of intracellular iron. Taken together, our findings suggest that iron mediates HA-associated oxidative stress in endothelial cells, which may be a possible mechanism leading to atherothrombotic vascular injury observed for patients with blackfoot disease.
Asunto(s)
Arteriopatías Oclusivas/inducido químicamente , Sustancias Húmicas/farmacología , Hierro/metabolismo , Estrés Oxidativo , Arteriopatías Oclusivas/metabolismo , Células Cultivadas , Ferritinas/metabolismo , Humanos , Quelantes del Hierro/metabolismo , Receptores de Transferrina/metabolismoRESUMEN
Programmed cell death (apoptosis) is an essential process in the development of various tissues and its involvement has been proposed for the elimination of self-reactive immature T and B lymphocytes when self antigens are first encountered. In order to further investigate the role of apoptosis in the pathogenesis of autoimmune disease, the apoptosis of lipopolysaccharide (LPS)-activated B cells, peritoneal cells from NZB x NZW F1 (NZB/W F1) mice and nonautoimmune BALB/c mice were assayed using an in vitro culture system. Splenic B cells were isolated and then stimulated with LPS before further activated with crosslinking antimu antibody. In addition, the apoptosis of peritoneal cells induced by crosslinking antimu antibody was also analyzed. The data revealed that the specific apoptosis of both activated B cells and peritoneal cells induced by crosslinking antimu antibody was very similar comparing NZB/W F1 and nonautoimmune BALB/c mice. This activation-induced B-cells apoptosis could be rescued, however, with the addition of cytokines such as interleukin (IL)-5 or IL-10, to the culture. The results suggest that there is no endogenous defect in the apoptosis of activated B cells for autoimmune NZB/W F1 comparing nonautoimmune BALB/c mice. Notably, however, abnormally high levels of the type 2 T helper (Th2)-related cytokines such as IL-5 or IL-10 may play an important role in the abnormal expansion of activated B cells in autoimmune NZB/W F1 mice.
Asunto(s)
Apoptosis , Linfocitos B/citología , Citocinas/farmacología , Lupus Eritematoso Sistémico/patología , Animales , Anticuerpos/inmunología , Células Cultivadas , Femenino , Inmunoglobulina M/inmunología , Interleucina-10/farmacología , Interleucina-5/farmacología , Lipopolisacáridos/farmacología , Activación de Linfocitos , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos NZB , Cavidad Peritoneal/citologíaRESUMEN
Previous study suggested that MRL-lpr/lpr mice treated with tamoxifen (TAM) had less severe proteinuria, reduced serum titre of anti-dsDNA autoantibodies and an increased survival rate. To investigate further the regulatory mechanisms of TAM on MRL-lpr/lpr female mice, a total dose of 200 microg per mice (5.5 mg/kg) was given every 2 weeks subcutaneously, while the control mice were injected with oil only. After being treated with TAM four times, the mice were killed and cellular functions were evaluated. The TAM-treated groups had smaller sized spleen and lymph nodes. Flow cytometric analysis of splenocytes had a significantly lower percentage of cell number of T cells and double negative T cells (CD4- CD8- T cells). There was no difference in cytokine production (interleukin (IL)-2, IL-4, IL-5, IL-10 and interferon-gamma (IFN-gamma)) from splenocytes stimulated with concanavalin A (Con A) or cytokines (IL-6) secreted by peritoneal exudate cells when stimulated with lipopolysaccharide (LPS). However, IL-2 from lymph node cells was significantly higher on TAM-treated mice. Finally, splenocytes or purified T cells stimulated with anti-CD3 antibody plus cross-linking immunoglobulin G (IgG) of the TAM-treated group had higher 3H-incorporation of proliferation assay compared with that of control groups. In vitro study further demonstrated that IL-2-activated proliferation of lymph node double negative (DN) T cells can be inhibited by TAM treatment in a dose-dependent manner. Our finding demonstrated that TAM may potentially influence T cells and modulate the immune function, which offers a novel approach to explore the feasibility of hormone therapy for autoimmune diseases.
Asunto(s)
Enfermedades Autoinmunes/tratamiento farmacológico , Antagonistas de Estrógenos/uso terapéutico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Subgrupos de Linfocitos T/efectos de los fármacos , Tamoxifeno/uso terapéutico , Animales , Antígenos de Superficie/metabolismo , Líquido Ascítico/inmunología , Enfermedades Autoinmunes/inmunología , Técnicas de Cultivo de Célula , División Celular/efectos de los fármacos , División Celular/inmunología , Relación Dosis-Respuesta Inmunológica , Femenino , Interleucina-2/inmunología , Lupus Eritematoso Sistémico/inmunología , Ganglios Linfáticos/inmunología , Ratones , Proteinuria/tratamiento farmacológico , Bazo/inmunología , Tasa de Supervivencia , Subgrupos de Linfocitos T/inmunologíaRESUMEN
Polyclonal B-cell activation is the central theme in the production of autoantibodies and possible activation of autoreactive T cells in both human and murine lupus. The abnormal expansion of CD5+ B cells in murine lupus has been suggested, in particular, to be one of the most characteristic findings in these mice. Activated B cells can be separated from the B cells of resting stage by the difference in cell density. The aim of this study was to investigate the characteristics of different densities of the spleen cells separated by gradient density. Furthermore, the ability of anti-DNA antibody secretion in each percoll gradient fraction of B cells was also analysed. The results showed: a higher percentage of CD5+ B cells, which corresponded to the activated B-cell population, in percoll gradient 1 and 2 fractions; that splenic B cells of NZB/W F1 mice had proliferative response to interleukin (IL)-4 or IL-5 but not to IL-10 or interferon-gamma (IFN-gamma); and that B cells isolated by percoll gradient produced anti-DNA antibody after stimulation with lipopolysaccharide (LPS) plus IL-5 and IFN-gamma, but not IL-4 and IL-10. These data suggest that B cells at different stages of activation express differential characteristics and functions.
Asunto(s)
Linfocitos B/inmunología , Nefritis Lúpica/inmunología , Activación de Linfocitos/inmunología , Animales , Anticuerpos Antinucleares/inmunología , Autoinmunidad/inmunología , Linfocitos B/efectos de los fármacos , Antígenos CD5/análisis , División Celular , Centrifugación por Gradiente de Densidad , Citocinas/inmunología , Citocinas/farmacología , ADN de Cadena Simple/inmunología , Modelos Animales de Enfermedad , Femenino , Humanos , Inmunofenotipificación , Nefritis Lúpica/sangre , Masculino , Ratones , Ratones Endogámicos NZB , Ratones Endogámicos , Povidona , Dióxido de Silicio , Bazo/citología , Bazo/inmunologíaRESUMEN
Systemic lupus erythematosus (SLE) is characterized by the existence of a heterogeneous group of autoantibodies directed against nuclear intact structures, such as nucleosomes and small nuclear ribonucleoproteins (snRNPs). Autoantibodies against snRNPs are of special interest because they are detectable in the majority of SLE patients. Although the B-cell antigenic determinants have been well characterized, very limited data have been reported in regard to the T-cell epitopes of snRNPs. Furthermore, several studies have demonstrated that determination of the auto-T-cell epitopes recognized by freshly isolated T cells is difficult from unprimed lupus mice when self-antigen-pulsed B cells or macrophages are used as antigen-presenting cells (APCs) in vitro. In the present study, we showed a novel approach for determining the auto-T-cell epitopes, using bone marrow-derived dendritic cells (BMDCs) pulsed with the murine U1A protein - an immunodominant antigen of the U1 snRNPs - which is capable of activating freshly isolated T cells from unprimed (NZB x NZW) F1 (BWF1) mice in vitro. The T-cell epitope area was found to be located at the C-terminus of U1A, overlapping the T-cell epitope of human U1A that has been reported in human SLE. Identification of the autoreactive T-cell epitope(s) in snRNPs will help to elucidate how reciprocal T-B determinant spreading of snRNPs emerges in lupus. The results presented here also indicate that it is feasible to use this approach to further explore strategies to design immunotherapy for patients with lupus.
Asunto(s)
Autoinmunidad/inmunología , Células Dendríticas/inmunología , Epítopos de Linfocito T/inmunología , Lupus Eritematoso Sistémico/inmunología , Ribonucleoproteína Nuclear Pequeña U1/inmunología , Animales , Autoanticuerpos/biosíntesis , Células de la Médula Ósea/inmunología , Técnicas de Cultivo de Célula , División Celular/inmunología , Citocinas/biosíntesis , Relación Dosis-Respuesta Inmunológica , Femenino , Antígenos de Histocompatibilidad Clase II/inmunología , Activación de Linfocitos/inmunología , Ratones , Ratones Endogámicos DBA , Ratones Endogámicos NZB , Ratones Endogámicos , Proteínas de Unión al ARN/inmunología , Subgrupos de Linfocitos T/inmunologíaRESUMEN
It has been documented that sex hormone may play a role in the pathogenesis of murine lupus. To determine the effect of tamoxifen (TAM) on NZB/W F1 female mice, a total dose of 800 microg (22 mg/kg body weight) of TAM was administered subcutaneously every 2 weeks. The control mice were injected with peanut oil only. After treatment with TAM for 5 months, the mice were killed and immunological parameters were evaluated. The results suggest that NZB/W F1 mice treated with TAM had less severe proteinuria and increased survival rate compared to controls. Flow cytometric analysis of splenocytes revealed a significantly lower percentage of B cells and CD5+ B cells in the TAM-treated group. There was a significantly lower serum level of soluble tumour necrosis factor (TNF) receptor I and II molecules in the TAM-treated mice. Immunohistological study showed that control mice had severe immune complex deposition in the kidney. In contrast, TAM-treated mice had much less pathological change. In summary, this study demonstrated that TAM treatment might be able to alleviate the symptoms of lupus nephritis, influence B-cell count, modulate the expression of cytokine receptors and thereby subsequently affect immune function. Further studies to determine the cellular mechanisms in lupus nephritis may increase our understanding of this complex disease and provide additional targets for therapeutic intervention.
Asunto(s)
Moduladores de los Receptores de Estrógeno/uso terapéutico , Nefritis Lúpica/tratamiento farmacológico , Tamoxifeno/uso terapéutico , Animales , Anticuerpos Antinucleares/sangre , Linfocitos B/inmunología , Citocinas/biosíntesis , ADN/inmunología , Femenino , Inmunofenotipificación , Riñón/patología , Ratones , Ratones Endogámicos NZB , Proteinuria/mortalidad , Receptores del Factor de Necrosis Tumoral/sangreRESUMEN
Humic acid (HA), a potential toxin when penetrating the drinking well water of blackfoot disease-endemic areas in Taiwan, has been implicated as one of the etiological factors of this disease. In this study, we investigated the effects of HA on the expression of human vascular endothelial-leukocyte adhesion molecules and the activation of nuclear factor kappa B (NF-kappaB) in cultured human umbilical vein endothelial cells (HUVECs). The expression of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin was monitored by flow cytometry. Pretreatment of HUVECs with HA inhibited the lipopolysaccharide (LPS)-induced expression of these three adhesion molecules in a dose- and time-dependent manner. Since NF-kappaB can regulate the expression of these adhesion molecules, NF-kappaB activation was assessed by electrophoretic mobility shift assay (EMSA). Our results reveal that the activation of NF-kappaB by LPS is suppressed by HA in a dose- and time-dependent manner. Furthermore, HA reduces NF-kappaB binding to DNA slightly, but completely inhibits the degradation of IkappaBalpha at a concentration of 100 microg/ml. Thus, all our data demonstrate that HA can inhibit the LPS-induced expression of adhesion molecules through the inhibition of NF-kappaB activation. HA may also suppress the immune or inflammatory reaction of HUVECs responsible for endotoxin, which could be one possible explanation for the causes of the infection and inflammation observed for patients with blackfoot disease. Our results also suggest that immune or inflammatory disturbance occurs for patients with blackfoot disease and that NF-kappaB may be a critical molecule in the pathogenesis of this disease.