ABSTRACT
The IgG-type neutralizing GM-CSF autoantibody (GMAb) is known to be the causative agent for autoimmune pulmonary alveolar proteinosis (APAP). Previous studies report that serum levels of IgG-GMAb are approximately 50-fold higher in APAP patients than in healthy subjects (HS). Serum levels of IgM-GMAb are also higher in APAP patients than in HS, but this has been assumed to be an etiological bystander. However, the mechanism for the excessive production of IgG-GMAb in APAP remains unclear. To investigate this, we detected putative GMAb-producing B cells (PGMPB) by inoculated B cells from the peripheral blood of APAP patients, HS, and umbilical cord blood mononuclear cells (UCBMNs) with Epstein-Barr virus. Both ELISA and ELISPOT assays showed that IgM-type GMAb was consistently and frequently present in all three groups, whereas IgG-type GMAb was high only in APAP patients, in whom it was exclusively produced in memory B cells and not in naive B cells. Since PGMPB in UCBMNs produced IgM-GMAb, but not IgG-GMAb, to the same extent as in HS and APAP patients, most IgM-GMAb reacted with GM-CSF in a non-specific manner. The memory B cell pool of APAP patients contain higher frequency of PGMPB than that of healthy subjects.
Subject(s)
Autoantibodies/immunology , Autoantigens/immunology , B-Lymphocytes/immunology , Granulocyte-Macrophage Colony-Stimulating Factor/immunology , Immunologic Memory , Pulmonary Alveolar Proteinosis/immunology , Adolescent , Adult , Antibodies, Neutralizing/blood , Antibodies, Neutralizing/immunology , Antibodies, Neutralizing/metabolism , Autoantibodies/blood , Autoantibodies/metabolism , B-Lymphocytes/metabolism , Enzyme-Linked Immunospot Assay , Female , Fetal Blood/immunology , Healthy Volunteers , Herpesvirus 4, Human/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin G/metabolism , Infant, Newborn , Male , Middle Aged , Pulmonary Alveolar Proteinosis/blood , Recombinant Proteins , Young AdultABSTRACT
Previous studies demonstrated that antigranulocyte colony-stimulating factor autoantibody (GMAb) was consistently present in patients with autoimmune pulmonary alveolar proteinosis (aPAP), and, thus, represented candidature as a reliable diagnostic marker. However, our large cohort study suggested that the concentration of this antibody was not correlated with disease severity in patients. We found that the κ/λ ratio of GMAb was significantly correlated with the degree of hypoxemia. The proportion of λ-type GMAb per total λ-type IgG was significantly higher in severely affected patients than those in mildly affected patients, but the proportion of κ-type was unchanged. The κ/λ ratio was significantly correlated with both KL-6 and SP-D, which have been previously reported as disease severity markers. Thus, the light chain isotype usage of GMAb may not only be associated with the severity of aPAP, but may also represent a useful disease severity marker.
Subject(s)
Autoantibodies/blood , Autoimmune Diseases/immunology , Granulocyte-Macrophage Colony-Stimulating Factor/immunology , Immunoglobulin kappa-Chains/blood , Immunoglobulin lambda-Chains/blood , Pulmonary Alveolar Proteinosis/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Autoimmune Diseases/blood , Autoimmune Diseases/diagnosis , Autoimmune Diseases/pathology , Biomarkers/blood , Female , Granulocyte-Macrophage Colony-Stimulating Factor/antagonists & inhibitors , Granulocyte-Macrophage Colony-Stimulating Factor/blood , Humans , Immunoglobulin kappa-Chains/immunology , Immunoglobulin lambda-Chains/immunology , Male , Middle Aged , Mucin-1/blood , Pulmonary Alveolar Proteinosis/blood , Pulmonary Alveolar Proteinosis/diagnosis , Pulmonary Alveolar Proteinosis/pathology , Pulmonary Surfactant-Associated Protein D/blood , Severity of Illness IndexABSTRACT
We have previously demonstrated that a novel protein ZYG1 induces sexual cell fusion (zygote formation) of Dictyostelium cells. In the process of cell fusion, involvements of signal transduction pathways via Ca(2+) and PKC (protein kinase C) have been suggested because zygote formation is greatly enhanced by PKC activators. In fact, there are several deduced sites phosphorylated by PKC in ZYG1 protein. Thereupon, we designed the present work to examine whether or not ZYG1 is actually phosphorylated by PKC and localized at the regions of cell-cell contacts where cell fusion occurs. These were ascertained, suggesting that ZYG1 might be the target protein for PKC. A humanized version of zyg1 cDNA (mzyg1) was introduced into myoblasts to know if ZYG1 is also effective in cell fusion of myoblasts. Quite interestingly, enforced expression of ZYG1 in myoblasts was found to induce markedly their cell fusion, thus strongly suggesting the existence of a common signaling pathway for cell fusion beyond the difference of species.
ABSTRACT
The granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibody (GMAb) is the causative agent underlying autoimmune pulmonary alveolar proteinosis (aPAP). It consists primarily of the IgG isotype. At present, information on other isotypes of the autoantibody is limited. We detected serum the IgM isotype of GMAb (IgM-GMAb) in more than 80% of patients with aPAP and 22% of healthy subjects, suggesting that a continuous antigen pressure may be present in most patients. Levels of the IgM isotype were weakly correlated with IgG-GMAb levels but not IgA-GMAb, suggesting that its production may be associated with that of IgG-GMAb. The mean binding avidity to GM-CSF of the IgM isotype was 100-fold lower than the IgG-GMAb isotype, whereas the IC(50) value for neutralizing capacity was 20,000-fold higher than that of IgG-GMAb, indicating that IgM-GMAb is only a very weak neutralizer of GM-CSF. In bronchoalveolar lavage fluid from nine patients, IgG-GMAb was consistently detected, but IgM-GMAb was under the detection limit in most patients, confirming that IgM-GMAb is functionally a bystander in the pathogenesis of aPAP. It rather may be involved in the mechanism for development of IgG-GMAb in vivo.
Subject(s)
Autoantibodies/blood , Autoimmune Diseases/immunology , Granulocyte-Macrophage Colony-Stimulating Factor/immunology , Immunoglobulin G/biosynthesis , Immunoglobulin M/blood , Pulmonary Alveolar Proteinosis/immunology , Adolescent , Adult , Aged , Antibody Formation , Autoantibodies/chemistry , Autoantibodies/physiology , Bronchoalveolar Lavage Fluid/chemistry , Case-Control Studies , Cell Count , Child , Female , Granulocyte-Macrophage Colony-Stimulating Factor/chemistry , Humans , Immunoglobulin A/blood , Immunoglobulin G/blood , Immunoglobulin G/chemistry , Immunoglobulin M/chemistry , Immunoglobulin M/physiology , Leukocytes, Mononuclear/cytology , Leukocytes, Mononuclear/metabolism , Male , Middle Aged , Protein Binding , Young AdultABSTRACT
BACKGROUND: Autoimmune pulmonary alveolar proteinosis (aPAP) is caused by granulocyte/macrophage-colony stimulating factor (GM-CSF) autoantibodies in the lung. Previously, we reported that GM-CSF inhalation therapy improved alveolar-arterial oxygen difference and serum biomarkers of disease severity in these patients. It is plausible that inhaled GM-CSF improves the dysfunction of alveolar macrophages and promotes the clearance of the surfactant. However, effect of the therapy on components in bronchoalveolar lavage fluid (BALF) remains unclear. OBJECTIVES: To figure out changes in surfactant clearance during GM-CSF inhalation therapy. METHODS: We performed retrospective analyses of BALF obtained under a standardized protocol from the same bronchus in each of 19 aPAP patients before and after GM-CSF inhalation therapy (ISRCTN18931678, JMA-IIA00013; total dose 10.5-21 mg, duration 12-24 weeks). For evaluation, the participants were divided into two groups, high responders with improvement in alveolar-arterial oxygen difference ≥13 mmHg (n = 10) and low responders with that < 13 mmHg (n = 9). RESULTS: Counts of both total cells and alveolar macrophages in BALF did not increase during the therapy. However, total protein and surfactant protein-A (SP-A) were significantly decreased in high responders, but not in low responders, suggesting that clearance of surfactant materials is correlated with the efficacy of the therapy. Among 94 biomarkers screened in bronchoalveolar lavage fluid, we found that the concentration of interleukin-17 and cancer antigen-125 were significantly increased after GM-CSF inhalation treatment. CONCLUSIONS: GM-CSF inhalation decreased the concentration of total protein and SP-A in BALF, and increase interleukin-17 and cancer antigen-125 in improved lung of autoimmune pulmonary alveolar proteinosis.
Subject(s)
Bronchoalveolar Lavage Fluid , Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use , Lung/metabolism , Pulmonary Alveolar Proteinosis/metabolism , Pulmonary Surfactant-Associated Protein A/metabolism , Pulmonary Surfactants/metabolism , Respiratory Therapy , Administration, Inhalation , Autoantibodies/immunology , Bronchoalveolar Lavage Fluid/immunology , Evidence-Based Medicine , Female , Granulocyte-Macrophage Colony-Stimulating Factor/immunology , Humans , Immunohistochemistry , Interleukin-17/immunology , Lung/immunology , Lung/pathology , Macrophages, Alveolar/drug effects , Male , Middle Aged , Pilot Projects , Pulmonary Alveolar Proteinosis/drug therapy , Pulmonary Alveolar Proteinosis/immunology , Pulmonary Alveolar Proteinosis/pathology , Pulmonary Surfactant-Associated Protein A/immunology , Pulmonary Surfactants/immunology , Respiratory Therapy/methods , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUNDS: Previously, we demonstrated that neutralizing capacity but not the concentration of GM-CSF autoantibody was correlated with the disease severity in patients with autoimmune pulmonary alveolar proteinosis (PAP)¹â»³. As abrogation of GM-CSF bioactivity in the lung is the likely cause for autoimmune PAP4â»5, it is promising to measure the neutralizing capacity of GM-CSF autoantibodies for evaluating the disease severity in each patient with PAP. Until now, neutralizing capacity of GM-CSF autoantibodies has been assessed by evaluating the growth inhibition of human bone marrow cells or TF-1 cells stimulated with GM-CSF6â»8. In the bioassay system, however, it is often problematic to obtain reliable data as well as to compare the data from different laboratories, due to the technical difficulties in maintaining the cells in a constant condition. OBJECTIVE: To mimic GM-CSF binding to GM-CSF receptor on the cell surface using cell-free receptor-binding-assay. METHODS: Transgenic silkworm technology was applied for obtaining a large amount for recombinant soluble GM-CSF receptor alpha (sGMRα) with high purity9⻹³. The recombinant sGMRα was contained in the hydrophilic sericin layers of silk threads without being fused to the silk proteins, and thus, we can easily extract from the cocoons in good purity with neutral aqueous solutions¹4(,)¹5. Fortunately, the oligosaccharide structures, which are critical for binding with GM-CSF, are more similar to the structures of human sGMRα than those produced by other insects or yeasts. RESULTS: The cell-free assay system using sGMRα yielded the data with high plasticity and reliability. GM-CSF binding to sGMRα was dose-dependently inhibited by polyclonal GM-CSF autoantibody in a similar manner to the bioassay using TF-1 cells, indicating that our new cell-free assay system using sGMRα is more useful for the measurement of neutralizing activity of GM-CSF autoantibodies than the bioassay system using TF-1 cell or human bone marrow cells. CONCLUSIONS: We established a cell-free assay quantifying the neutralizing capacity of GM-CSF autoantibody.
Subject(s)
Antibodies, Neutralizing/analysis , Autoantibodies/analysis , Cell-Free System , Granulocyte-Macrophage Colony-Stimulating Factor/immunology , Receptors, Granulocyte-Macrophage Colony-Stimulating Factor/immunology , Amino Acid Sequence , Animals , Animals, Genetically Modified , Antibodies, Neutralizing/immunology , Antibodies, Neutralizing/metabolism , Autoantibodies/immunology , Autoantibodies/metabolism , Base Sequence , Binding, Competitive , Bombyx , Granulocyte-Macrophage Colony-Stimulating Factor/metabolism , Humans , Molecular Sequence Data , Pancreatitis-Associated Proteins , Receptors, Granulocyte-Macrophage Colony-Stimulating Factor/metabolism , Recombinant Proteins/immunology , Recombinant Proteins/metabolismABSTRACT
The aim of the project is to develop a novel method estimating granulocyte-macrophage colony-stimulating factor (GM-CSF) neutralizing capacity with high-throughput and good reproducibility. For that purpose, we designed a cell-free receptor binding assay consisting of a solid-phase recombinant soluble GM-CSF receptor alpha (GMRalpha) and a biotinylated GM-CSF (bGM-CSF). Using this system, competitive inhibition of bGM-CSF binding to soluble GM-CSF receptor alpha (sGMRalpha) by GM-CSF autoantibody or IgG fractions from the sera of patients with pulmonary alveolar proteinosis was examined, resulting in excellent reproducibility. Binding inhibition was correlated with growth inhibition of TF-1 cells, a GM-CSF dependent cell line. These results suggest that our cell-free system can be applied to estimate the neutralizing capacity of GM-CSF autoantibodies ex vivo.
Subject(s)
Autoantibodies/metabolism , Binding, Competitive/drug effects , Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology , Pulmonary Alveolar Proteinosis/immunology , Autoantibodies/isolation & purification , Binding, Competitive/immunology , Biotin/metabolism , Cell Line , Cell Proliferation/drug effects , Cell-Free System , Granulocyte-Macrophage Colony-Stimulating Factor/immunology , High-Throughput Screening Assays , Humans , Pulmonary Alveolar Proteinosis/blood , Pulmonary Alveolar Proteinosis/diagnosis , Receptors, Granulocyte-Macrophage Colony-Stimulating Factor/metabolism , Reproducibility of ResultsABSTRACT
Elution of metals from Ni- and Fe-based alloy (i.e. Inconel 625 and SUS 316) under hydrothermal conditions was investigated. Results showed that metals could be eluted even in a short contact time. At subcritical conditions, a significant amount of Cr was extracted from SUS 316, while only traces of Ni, Fe, Mo, and Mn were eluted. In contrast, Ni was removed in significant amounts compared to Cr when Inconel 625 was tested. Several factors including temperature and contact time were found to affect elution behavior. The presence of air in the fluid even promoted elution under subcritical conditions.