lewis-x-antigen and Autoimmune-Diseases

Immune complexes are present in the circulation of healthy individuals and the formation of such complexes is part of a normal immune process. During some pathological conditions, significant amounts of immune complexes are formed and deposited in the kidney and other tissues, causing severe injury. Since the levels of immune complexes can provide valuable prognostic information, dozens of methods have been developed to detect and quantify these complexes. However, many of these methods are non-specific, not quantitative, and give false-positive results. Methods based on detecting the antigen portion of immune complexes can yield more precise information about circulating immune complexes. We have used a quantitative dot-blot assay, which permits detection of antigen even if buried, to determine the levels of antigen in circulating immune complexes. In healthy donors, significant amounts of immune complexes containing DNA and beta(2)-glycoprotein I were detected (natural immune complexes). Natural immune complexes with Lewis X antigen were also observed in the circulation of healthy persons. In experimentally induced murine systemic lupus erythematosus (SLE) and SLE patients, there was a correlation between the clinical manifestations and the levels of DNA in the circulating immune complexes. At severe SLE flares, the level of DNA in circulating immune complexes decreased, probably due to tissue deposition of immune complexes. The low levels of DNA in immune complexes circulating in SLE patients correlated with low serum concentrations of the complement component C1q. No direct correlation was found between the levels of circulating anti-dsDNA antibodies and DNA in immune complexes. Thus, quantitation of antigen levels in circulating immune complexes can be used to determine the prognosis of autoimmune diseases.

Topics: Adult; Animals; Antigen-Antibody Complex; Antigens; Autoantibodies; Autoimmune Diseases; beta 2-Glycoprotein I; DNA; Glycoproteins; Humans; Immunity, Innate; Immunoblotting; Lewis X Antigen; Lupus Erythematosus, Systemic; Mice; Prognosis

Giant cell arteritis (GCA) is a common form of primary systemic vasculitis in adults, with no reliable indicators of prognosis or treatment responses. We used single cell technologies to comprehensively map immune cell populations in the blood of patients with GCA and identified the CD66b+CD15+CD10lo/-CD64- band neutrophils and CD66bhiCD15+CD10lo/-CD64+/bright myelocytes/metamyelocytes to be unequivocally associated with both the clinical phenotype and response to treatment. Immature neutrophils were resistant to apoptosis, remained in the vasculature for a prolonged period of time, interacted with platelets, and extravasated into the tissue surrounding the temporal arteries of patients with GCA. We discovered that immature neutrophils generated high levels of extracellular reactive oxygen species, leading to enhanced protein oxidation and permeability of endothelial barrier in an in vitro coculture system. The same populations were also detected in other systemic vasculitides. These findings link functions of immature neutrophils to disease pathogenesis, establishing a clinical cellular signature of GCA and suggesting different therapeutic approaches in systemic vascular inflammation.

Topics: Aged; Antigens, CD; Antigens, Surface; Apoptosis; Autoimmune Diseases; Cell Adhesion Molecules; Cell Line; Cell Lineage; Coculture Techniques; Female; Giant Cell Arteritis; GPI-Linked Proteins; Granulocyte Precursor Cells; Humans; Leukocyte Count; Lewis X Antigen; Male; Middle Aged; Neprilysin; Neutrophils; Oxidation-Reduction; Prognosis; Reactive Oxygen Species; Single-Cell Analysis; Systemic Vasculitis; Temporal Arteries; Vascular Diseases

Iatrogenic immunodeficiency-associated lymphoproliferative disorders are rare. A small subset of these lesions resembles classical Hodgkin lymphoma (CHL), but there are few data in the literature about these lesions. We describe 10 patients with autoimmune diseases treated with immunomodulator therapeutic agents who developed CHL. The autoimmune diseases included rheumatoid arthritis (n=5), systemic lupus erythematosus (n=2), dermatomyositis (n=1), autoimmune hepatitis (n=1), and Crohn disease (n=1), and the immunomodulatory therapies were methotrexate, azathioprine, tumor necrosis factor-α inhibitors, and thalidomide alone or in various combinations. The study group included 9 women and 1 man with a median age of 50 years (range, 25 to 77 y). The histologic features supported CHL in all cases with Reed-Sternberg (RS) and Hodgkin (H) cells in an inflammatory cell background, although the neoplasm could only be subclassified in 3 patients: 2 nodular sclerosis and 1 mixed cellularity. Immunohistochemical analysis supported the diagnosis of CHL. In all cases the RS-H cells were CD30. Nine of 10 cases were CD15, whereas CD20 was expressed variably in 4/10 cases. CD45/LCA was negative in 8 cases assessed. In situ hybridization for Epstein-Barr virus-encoded RNA was positive in the RS-H cells in 8/10 cases. The microenvironment of these lesions depicted a predominance of T-regulatory cells and M2 histiocytes. Clinical follow-up data were available for 7 patients, with a median posttreatment period of 27 months (range, 12 mo to 7 y). In all 7 patients immunomodulatory drug therapy was discontinued, and chemotherapy for CHL was administered; 2 patients also received local radiation. All 7 patients achieved complete remission and are alive. We conclude that iatrogenic immunodeficiency-associated CHL is highly associated with Epstein-Barr virus infection, and patients usually have a good outcome after discontinuation of immunomodulatory agents and chemotherapy for CHL.

Topics: Adult; Aged; Antigens, CD20; Autoimmune Diseases; Biomarkers, Tumor; Female; Fucosyltransferases; Herpesvirus 4, Human; Histiocytes; Hodgkin Disease; Humans; Iatrogenic Disease; Immunocompromised Host; Immunohistochemistry; Immunosuppressive Agents; In Situ Hybridization; Lewis X Antigen; Male; Middle Aged; Reed-Sternberg Cells; Remission Induction; RNA, Viral; T-Lymphocytes, Regulatory; Time Factors; Treatment Outcome; Tumor Microenvironment

Occurrence of monocytoid B-lymphocytes (MBL) in extranodal organs in various inflammatory diseases was examined. MBL were present in 5 (11.4%) of 44 patients with Graves' disease, 11 (36.7%) of 30 with Hashimoto's thyroiditis, 1 (8.3%) of 12 with lymphoid follicular hyperplasia (LFH) of stomach, 1 (10%) of 10 with cutaneous LFH, and 0 of 5 with LFH of lung. The MBL presented as irregularly shaped nodular collections of cells, directly surrounding secondary follicles. Immunohistochemistry revealed a B-cell nature of these cells which expressed the following antigens; CD3-, CD 15-, CD45RA+, CD45Ro-, CDw 75+, CD74+, Mx-PanB+, MB-1+, EMA-. There were no immunoglobulin light chain restriction among infiltrating lymphoid cells. MBL in 2 of 18 cases showed positive reaction for CD43. The patients with MBL were older than those without MBL in each organ site, though the difference was not statistically significant. These findings showed that the MBL could appear in nonlymphoid organs affected by long-standing inflammation. High frequency of the appearance of the MBL in Hashimoto's thyroiditis suggest that MBL proliferation correlates with an impaired immune status.

Topics: Adult; Aged; Antigens, CD; Antigens, Differentiation, B-Lymphocyte; Antigens, Differentiation, Myelomonocytic; Autoimmune Diseases; B-Lymphocytes; CD3 Complex; Cell Movement; Female; Graves Disease; Histocompatibility Antigens Class II; Humans; Hyperplasia; Immunohistochemistry; Incidence; Leukocyte Common Antigens; Leukosialin; Lewis X Antigen; Lung Diseases; Male; Middle Aged; Sialoglycoproteins; Skin Diseases; Stomach Diseases; Thyroiditis, Autoimmune