An immunological insight into the origins of pre-eclampsia.

BACKGROUND: Pre-eclampsia is a syndrome of heterogeneous origin characterized by deficient placentation due to the inability of the cytotrophoblast to acquire an invasive phenotype and to remodel the uterine spiral arteries. One of the main problems observed early in pre-eclampsia is an altered regulation of the immune system, where the shift toward a Th2 cytokine profile observed in normal pregnancies, does not occur. In pre-eclampsia, high interferon (IFN)-gamma concentrations are present, along with transforming growth factor-beta cytokines, which retard migration of cytotrophoblasts. METHODS: A review of the scientific literature was performed on the immunological factors associated with the origins of pre-eclampsia. The various components of the immune system that may be participating in the aberrant immune activation that pathologically affect early pregnancy events and inhibit cytotrophoblast invasion were identified. RESULTS AND CONCLUSIONS: Cells and their signaling and regulatory molecules have been implicated in the immunological alterations found in the placental microenvironment of patients who develop pre-eclampsia. One of the main differences found in pre-eclampsia is a shift toward Th1 responses and the production of IFN-gamma. The origin of IFN-gamma is not clearly identified and could be the uterine natural killer cells, the placental dendritic cells modulating Th responses, alterations in synthesis of or response to regulatory molecules, or changes in the function of regulatory T cells in pregnancy. Aberrant immune responses promoting pre-eclampsia may also be due to an altered fetal allorecognition or to inflammatory triggers. Understanding the immunological basis for pre-eclampsia will expand knowledge regarding other adverse pregnancy outcomes.

Current concepts in autoimmune hepatitis.

Autoimmune hepatitis has a global occurrence, diverse clinical phenotype, and evolving treatment options. The goals of this report are to review the codified diagnostic criteria, spectrum of clinical presentations, proposed pathogenic mechanisms, conventional treatment strategies, and promising interventions. The literature published in English from 1980-2005 was reviewed and an updated current perspective provided. Autoimmune hepatitis affects all ages, may be asymptomatic, frequently has an acute onset, and can present as fulminant hepatitis. Perivenular (zone 3) necrosis is within the histological spectrum. Autoimmune hepatitis can recur or develop de novo after liver transplantation. CD4+ T-helper cells and natural killer T cells have been implicated in the pathogenesis, and molecular mimicry may break self-tolerance. DRB1*0301 and DRB1*0401 are the susceptibility alleles among white North Americans and northern Europeans, whereas diverse alleles of HLA DR4 have been associated with the disease in Japan, mainland China, and Mexico. DRB1*1301 is associated with autoimmune hepatitis in South American children, and it may predispose to an indigenous etiologic agent. Antibodies to soluble liver antigen/liver pancreas may have prognostic importance, and cyclosporine and mycophenolate mofetil must be assessed by clinical trial before incorporation into management algorithms. Site-specific interventions are feasible, and they require a confident experimental animal model for evaluation. Variant syndromes lack diagnostic and therapeutic guidelines. In conclusion, autoimmune hepatitis must be considered in all patients with acute and chronic liver disease and those with allograft dysfunction after transplantation. New immunosuppressive agents and site-specific interventions promise to improve care.

Role of cytokines and major histocompatibility complex restriction in mouse resistance to infection with a natural recombinant strain (type I-III) of Toxoplasma gondii.

Herein we characterized various genetic markers and the biological behavior of a natural recombinant strain of Toxoplasma gondii (P-Br). From nine genetic markers analyzed, three (B1, ROP1, and SAG1) and three (cS10-A6, GRA6, and SAG3) markers belong to parasites from the type I and type III lineages, respectively. The SAG2 and L363 loci were shown to be type I-III chimera alleles. The cB2l-4 microsatellite marker showed a unique haplotype. The P-Br strain presented low virulence in the acute phase of infection and was cystogenic during the chronic infection. The interleukin 12/gamma interferon axis and inducible nitric oxide synthase were main determinants of resistance during the acute infection with the P-Br strain. As opposed to infection with the type II strain of T. gondii (ME-49), peroral infection with the P-Br strain led only to a light inflammatory infiltrate and no major lesions in the intestine of the C57BL/6 mice. In addition, the BALB/c (resistant to ME-49) and C57BL/6 (susceptible to ME-49) mice were shown, respectively, to be more susceptible and more resistant to cyst formation and toxoplasmic encephalitis when infected with the P-Br strain. Further, the C57BL/KsJ and DBA2/J congenic strains containing major histocompatibility complex (MHC) haplotype "d" were more resistant than the parental strains (C57BL/6 and DBA1/J), when infected with the ME-49 but not with the P-Br strain. Together, our results indicate that resistance to cyst formation and toxoplasmic encephalitis induced during infection with P-Br is not primarily controlled by the MHC haplotype d, as previously reported for type II strains of T. gondii.

A method for multiple sequential analyses of macrophage functions using a small single cell sample.

Microbial pathogens such as bacillus Calmette-Guérin (BCG) induce the activation of macrophages. Activated macrophages can be characterized by the increased production of reactive oxygen and nitrogen metabolites, generated via NADPH oxidase and inducible nitric oxide synthase, respectively, and by the increased expression of major histocompatibility complex class II molecules (MHC II). Multiple microassays have been developed to measure these parameters. Usually each assay requires 2-5 x 10(5) cells per well. In some experimental conditions the number of cells is the limiting factor for the phenotypic characterization of macrophages. Here we describe a method whereby this limitation can be circumvented. Using a single 96-well microassay and a very small number of peritoneal cells obtained from C3H/HePas mice, containing as little as <=2 x 10(5) macrophages per well, we determined sequentially the oxidative burst (H2O2), nitric oxide production and MHC II (IAk) expression of BCG-activated macrophages. More specifically, with 100 micro l of cell suspension it was possible to quantify H2O2 release and nitric oxide production after 1 and 48 h, respectively, and IAk expression after 48 h of cell culture. In addition, this microassay is easy to perform, highly reproducible and more economical.

MHC allele-specific binding of a malaria peptide makes it become promiscuous on fitting a glycine residue into pocket 6.

Peptide 1585 (EVLYLKPLAGVYRSLKKQLE) has a highly conserved amino-acid sequence located in the Plasmodium falciparum main merozoite surface protein (MSP-1) C-terminal region, required for merozoite entry into human erythrocytes and therefore represents a vaccine candidate for P. falciparum malaria. Original sequence-specific binding to five HLA DRB1* alleles (0101, 0102, 0401, 0701, and 1101) revealed this peptide's specific HLA DRB1*0102 allele binding. This peptide's allele-specific binding to HLA DRB1*0102 took on broader specificity for the DRB1*0101, -0401, and -1101 alleles when lysine was replaced by glycine in position 17 (peptide 5198: EVLYLKPLAGVYRSLKG(17)QLE). Binding of the identified G(10)VYRSLKGQLE(20) C-terminal register to these alleles suggests that peptide promiscuous binding relied on fitting Y(12), L(15), and G(17) into P-1, P-4, and P-6, respectively. The implications of the findings and the future of this synthetic vaccine candidate are discussed.

Regulation of T cell response to leishmania antigens by determinants of histocompatibility leukocyte class I and II molecules

It has been shown that HLA class I molecules play a significant role in the regulation of the proliferation of T cells activated by mitogens and antigens. We evaluated the ability of mAb to a framework determinant of HLA class I molecules to regulate T cell proliferation and interferon gamma (IFN-g) production against leishmania, PPD, C. albicans and tetanus toxoid antigens in patients with tegumentary leishmaniasis and healthy subjects. The anti-major histocompatibility complex (MHC) mAb (W6/32) suppressed lymphocyte proliferation by 90 percent in cultures stimulated with aCD3, but the suppression was variable in cultures stimulated with leishmania antigen. This suppression ranged from 30-67 percent and was observed only in 5 of 11 patients. IFN-g production against leishmania antigen was also suppressed by anti-HLA class I mAb. In 3 patients IFN-g levels were suppressed by more than 60 percent, while in the other 2 cultures IFN-g levels were 36 and 10 percent lower than controls. The suppression by HLA class I mAb to the proliferative response in leishmaniasis patients and in healthy controls varied with the antigens and the patients or donors tested. To determine whether the suppression is directed at antigen presenting cells (APCs) or at the responding T cells, experiments with antigen-primed non-adherent cells, separately incubated with W6/32, were performed. Suppression of proliferation was only observed when the W6/32 mAb was added in the presence of T cells. These data provide evidence that a mAb directed at HLA class I framework determinants can suppress proliferation and cytokine secretion in response to several antigens

El Complejo Mayor de Histocompatibilidad en Malaria: Implicaciones en el Desarrollo de Vacunas

El estudio de péptidos antigémicos candidatos al desarrollo de una vacuna contra la malaria por Plasmodium falciparum, ha mostrado la influencia del complejo mayor de histocompatibilidad humano en la respuesta inmune a determinados epítopes parásitarios. El estudio de la asociación entre el Antígeno Leucocitario Humano-B-53 (HLA) y la protección contra malaria severa ha permitido la caracterización de los péptidos presentados por esta molécula definiendo un epítope reconocido por los linfocitos T citotóxicos de los individuos protegidos. A pesar de que existen muchos hallazgos contradictorios, se sugiere la evaluación de este péptido como componente de una vacuna sintética. Otros hallazgos indican que algunas moléculas HLA clase II modifican la respuesta inmune humoral a antígenos parasitarios específicos mostrándose por ejemplo, una asociación positiva entre los portadores del alelo DQw2 y la respuesta de anticuerpos a la secuencia repetitiva (EENV)6 del antígeno Pf155/RESA o una asociación negativa entre los individuos homocigotos al antígeno HLA-DR4 y la respuesta inmune humoral al péptido sintético Spf66. Es importante estudiar los mecanismos por los cuales operan estas asociaciones para definir nuevos péptidos antigénicos potencialmente protectores, verificar el papel de otros genes cuyo locus está ubicado en la región HLA en el desarrollo de susceptibilidad o de resistencia a la infección y aumentar nuestro conocimiento sobre los procesos de selección natural de las moléculas HLA en las poblaciones considerando que el polimorfismo de estas moléculas ha surgido fundamentalmente por el encuentro con diferentes patógenos

Histocompatibilidad / Histocompatibility

El Complejo Mayor de Histocompatibilidad humano consiste en una serie de genes fuertemente enlazados presentes en el brazo corto del cromosoma 6, normalmente heredados en bloque y constituyen el haplotipo HLA. La mayoría presenta alto polimorfismo, lo que permite la presencia de numerosas variantes alélicas. La herencia de este segmento puede seguirse dentro de una familia por tipificación de ADN celular o de los antígenos HLA expresados en las membranas celulares, permitiendo estudios de filiación o poblacionales. La función más importante es el reconocimiento de la identidad: las células se reconocen entre sí como propias de un individuo. Juegan un papel esencial en la selección clonal de linfocitos, en la presentación antigénica y en la regulación del sistema inmune. El estudio de su asociación con enfermedades representó un importante avance en la Inmunología clínica. En la actualidad numerosos trabajos reafirman su papel en los procesos autoinmunes, en la respuesta inmune según la interacción del sitio de unión del HLA y el epitope antigénico presentado y probablemente en la susceptibilidad a determinados tumores. Objetivos: Introducir al conocimiento del Sistema Mayor de Histocompatibilidad y su aplicación clínica, comprender los fundamentos de los estudios más frecuentes fomentando la autoevaluación y educación continua (AU)

Histocompatibilidad / Histocompatibility

El Complejo Mayor de Histocompatibilidad humano consiste en una serie de genes fuertemente enlazados presentes en el brazo corto del cromosoma 6, normalmente heredados en bloque y constituyen el haplotipo HLA. La mayoría presenta alto polimorfismo, lo que permite la presencia de numerosas variantes alélicas. La herencia de este segmento puede seguirse dentro de una familia por tipificación de ADN celular o de los antígenos HLA expresados en las membranas celulares, permitiendo estudios de filiación o poblacionales. La función más importante es el reconocimiento de la identidad: las células se reconocen entre sí como propias de un individuo. Juegan un papel esencial en la selección clonal de linfocitos, en la presentación antigénica y en la regulación del sistema inmune. El estudio de su asociación con enfermedades representó un importante avance en la Inmunología clínica. En la actualidad numerosos trabajos reafirman su papel en los procesos autoinmunes, en la respuesta inmune según la interacción del sitio de unión del HLA y el epitope antigénico presentado y probablemente en la susceptibilidad a determinados tumores. Objetivos: Introducir al conocimiento del Sistema Mayor de Histocompatibilidad y su aplicación clínica, comprender los fundamentos de los estudios más frecuentes fomentando la autoevaluación y educación continua

Artritis reumatoide de casos múltiples: estudio de una familia mexicana / Multiple rheumatoid arthritis. Study of one mexican family

La artritis reumatoide(AR) es una enfermedad inflamatoria crónica de etiología desconocida y en donde numerosos estudios han encontrado asociación con los genes clase I y clase II del complejo principal de histocompatibilidad (CPH), principalmente en los locus del HLA-B y el HLA-DR y el desarrollo de AR. En este reporte se estudió una familia mexicana con AR en donde 4 mujeres estaban afectadas. El haplotipo estrechamente estrechamente asociado con est enfermedad fue el HLA-A1, B5, DR4, DRB1*0404, DQ3, DRw53. En conclusión, estos resultados confirman el papael directo que tiene los genes calse II del CPH en la susceptibilidad al desarrollo de AR y se discute la gran heterogeneidad genética localizada en el locus HLA-B, la cual varía de acuerdo al grupo étnico que se estudie

[MHC-dependent molecular mechanisms of susceptibility and protection in type I diabetes in Mexicans]. / Los mecanismos moleculares de susceptibilidad y de protección dependientes del MHC en la diabetes tipo I en Mexicanos.

MHC class II genes play an important role in the autoimmune destruction of the pancreatic b-cell occurring in IDDM. The genetic pattern of the disease was investigated in Mexican Mestizos. The serological findings of HLA antigens showed a significant association of DR3, DR4, DQ2 and DQ8 and a protective effect of DR11, DR15, DQ5, DQ6 and DQ7. With these results, DNA analysis of HLA-DRB1, B3, B4, DQA1, DQB1, DPA1, DPB1 genes was performed using PCR with allele specific oligotyping. Among the patients, 92.78 carry DQA1 alleles that have ARG in position 52 of DQa chain, and 78.2% are ASP- in DQ5-57. The RR for homozygotes is 32.8 and 5.6, respectively. The main haplotype involved is DRB1*0405, DQA1*0301, DQB1*0302. Thus, DQa and DQb form a relevant recognition site for the "diabetogenic peptidett which induces the autoimmune destruction. Positions 57 and 74 of DRB1 locus contribute highly to the expression and severity of IDDM in Mestizos and other ethnic groups, but not in Caucasians or Blacks.