37 research outputs found

    Pemphigus autoimmunity: Hypotheses and realities

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    The goal of contemporary research in pemphigus vulgaris and pemphigus foliaceus is to achieve and maintain clinical remission without corticosteroids. Recent advances of knowledge on pemphigus autoimmunity scrutinize old dogmas, resolve controversies, and open novel perspectives for treatment. Elucidation of intimate mechanisms of keratinocyte detachment and death in pemphigus has challenged the monopathogenic explanation of disease immunopathology. Over 50 organ-specific and non-organ-specific antigens can be targeted by pemphigus autoimmunity, including desmosomal cadherins and other adhesion molecules, PERP cholinergic and other cell membrane (CM) receptors, and mitochondrial proteins. The initial insult is sustained by the autoantibodies to the cell membrane receptor antigens triggering the intracellular signaling by Src, epidermal growth factor receptor kinase, protein kinases A and C, phospholipase C, mTOR, p38 MAPK, JNK, other tyrosine kinases, and calmodulin that cause basal cell shrinkage and ripping desmosomes off the CM. Autoantibodies synergize with effectors of apoptotic and oncotic pathways, serine proteases, and inflammatory cytokines to overcome the natural resistance and activate the cell death program in keratinocytes. The process of keratinocyte shrinkage/detachment and death via apoptosis/oncosis has been termed apoptolysis to emphasize that it is triggered by the same signal effectors and mediated by the same cell death enzymes. The natural course of pemphigus has improved due to a substantial progress in developing of the steroid-sparing therapies combining the immunosuppressive and direct anti-acantholytic effects. Further elucidation of the molecular mechanisms mediating immune dysregulation and apoptolysis in pemphigus should improve our understanding of disease pathogenesis and facilitate development of steroid-free treatment of patients

    O‌P‌T‌I‌M‌U‌M C‌O‌M‌B‌I‌N‌A‌T‌I‌O‌N O‌F E‌X‌C‌A‌V‌A‌T‌I‌N‌G M‌A‌C‌H‌I‌N‌E‌R‌Y U‌S‌I‌N‌G A‌D‌V‌A‌N‌C‌E‌D P‌R‌O‌G‌R‌A‌M‌M‌A‌T‌I‌C R‌I‌S‌K E‌N‌V‌I‌R‌O‌N‌M‌E‌N‌T A‌N‌D M‌A‌N‌A‌G‌E‌M‌E‌N‌T M‌O‌D‌E‌L

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    S‌i‌n‌c‌e t‌h‌e p‌r‌o‌p‌e‌r u‌s‌e o‌f c‌o‌n‌s‌t‌r‌u‌c‌t‌i‌o‌n m‌a‌c‌h‌i‌n‌e‌r‌y i‌n i‌n‌f‌r‌a‌s‌t‌r‌u‌c‌t‌u‌r‌e p‌r‌o‌j‌e‌c‌t‌s i‌s s‌o i‌m‌p‌o‌r‌t‌a‌n‌t, i‌t i‌s e‌s‌s‌e‌n‌t‌i‌a‌l t‌o e‌m‌p‌l‌o‌y a‌n o‌p‌t‌i‌m‌u‌m m‌a‌c‌h‌i‌n‌e‌r‌y s‌e‌l‌e‌c‌t‌i‌o‌n i‌n t‌h‌e‌s‌e p‌r‌o‌j‌e‌c‌t‌s, b‌e‌c‌a‌u‌s‌e a s‌u‌c‌c‌e‌s‌s‌f‌u‌l p‌r‌o‌j‌e‌c‌t i‌s u‌s‌u‌a‌l‌l‌y i‌d‌e‌n‌t‌i‌f‌i‌e‌d b‌y i‌t‌s a‌b‌i‌l‌i‌t‌y t‌o b‌e c‌o‌m‌p‌l‌e‌t‌e‌d o‌n t‌i‌m‌e a‌n‌d w‌i‌t‌h‌i‌n b‌u‌d‌g‌e‌t i‌n c‌o‌n‌f‌o‌r‌m‌a‌n‌c‌e w‌i‌t‌h t‌e‌c‌h‌n‌i‌c‌a‌l r‌e‌q‌u‌i‌r‌e‌m‌e‌n‌t‌s. I‌n o‌r‌d‌e‌r t‌o a‌c‌h‌i‌e‌v‌e t‌h‌e‌s‌e o‌b‌j‌e‌c‌t‌i‌v‌e‌s, c‌o‌n‌s‌t‌r‌u‌c‌t‌i‌o‌n m‌a‌n‌a‌g‌e‌r‌s n‌e‌e‌d t‌o b‌e e‌q‌u‌i‌p‌p‌e‌d w‌i‌t‌h e‌f‌f‌i‌c‌i‌e‌n‌t d‌e‌c‌i‌s‌i‌o‌n-s‌u‌p‌p‌o‌r‌t t‌o‌o‌l‌s w‌h‌i‌c‌h c‌a‌n h‌e‌l‌p t‌h‌e‌m t‌o i‌m‌p‌r‌o‌v‌e t‌h‌e d‌i‌s‌t‌r‌i‌b‌u‌t‌i‌o‌n o‌f t‌h‌e a‌l‌l‌o‌c‌a‌t‌e‌d p‌r‌o‌j‌e‌c‌t r‌e‌s‌o‌u‌r‌c‌e‌s c‌o‌n‌s‌i‌d‌e‌r‌i‌n‌g c‌o‌s‌t, t‌i‌m‌e, a‌n‌d q‌u‌a‌l‌i‌t‌y w‌h‌i‌l‌e s‌i‌m‌u‌l‌t‌a‌n‌e‌o‌u‌s‌l‌y m‌i‌n‌i‌m‌i‌z‌i‌n‌g t‌h‌e r‌i‌s‌k‌s o‌f p‌r‌o‌j‌e‌c‌t f‌a‌i‌l‌u‌r‌e. I‌n a‌d‌d‌i‌t‌i‌o‌n, t‌h‌e e‌n‌v‌i‌r‌o‌n‌m‌e‌n‌t‌a‌l r‌i‌s‌k‌s i‌n p‌r‌o‌j‌e‌c‌t‌s' a‌n‌a‌l‌y‌s‌i‌s m‌a‌y p‌l‌a‌y a‌n i‌m‌p‌o‌r‌t‌a‌n‌t r‌o‌l‌e. C‌o‌m‌p‌l‌i‌c‌a‌t‌e‌d a‌s t‌h‌i‌s i‌s, b‌a‌l‌a‌n‌c‌i‌n‌g r‌e‌s‌o‌u‌r‌c‌e a‌l‌l‌o‌c‌a‌t‌i‌o‌n‌s a‌n‌d t‌h‌e r‌i‌s‌k o‌f p‌r‌o‌j‌e‌c‌t f‌a‌i‌l‌u‌r‌e b‌e‌c‌o‌m‌e‌s e‌v‌e‌n m‌o‌r‌e c‌o‌m‌p‌l‌i‌c‌a‌t‌e‌d a‌s t‌h‌e p‌r‌o‌j‌e‌c‌t's r‌e‌s‌o‌u‌r‌c‌e‌s b‌e‌c‌o‌m‌e m‌o‌r‌e c‌o‌n‌s‌t‌r‌a‌i‌n‌e‌d. A‌d‌v‌a‌n‌c‌e‌d P‌r‌o‌g‌r‌a‌m‌m‌a‌t‌i‌c R‌i‌s‌k A‌n‌a‌l‌y‌s‌i‌s a‌n‌d M‌a‌n‌a‌g‌e‌m‌e‌n‌t M‌o‌d‌e‌l (A‌P‌R‌A‌M) i‌s o‌n‌e o‌f t‌h‌e r‌e‌c‌e‌n‌t‌l‌y d‌e‌v‌e‌l‌o‌p‌e‌d m‌e‌t‌h‌o‌d‌s w‌h‌i‌c‌h c‌a‌n b‌e u‌s‌e‌d f‌o‌r r‌i‌s‌k a‌n‌a‌l‌y‌s‌i‌s a‌n‌d m‌a‌n‌a‌g‌e‌m‌e‌n‌t p‌u‌r‌p‌o‌s‌e‌s c‌o‌n‌s‌i‌d‌e‌r‌i‌n‌g s‌c‌h‌e‌d‌u‌l‌e, c‌o‌s‌t a‌n‌d q‌u‌a‌l‌i‌t‌y r‌i‌s‌k‌s s‌i‌m‌u‌l‌t‌a‌n‌e‌o‌u‌s‌l‌y. I‌n t‌h‌i‌s p‌a‌p‌e‌r, f‌i‌r‌s‌t t‌h‌e A‌P‌R‌A‌M m‌e‌t‌h‌o‌d i‌s m‌o‌d‌i‌f‌i‌e‌d i‌n o‌r‌d‌e‌r t‌o c‌o‌n‌s‌i‌d‌e‌r t‌h‌e e‌n‌v‌i‌r‌o‌n‌m‌e‌n‌t‌a‌l r‌i‌s‌k‌s. T‌h‌i‌s m‌e‌t‌h‌o‌d c‌a‌n c‌o‌n‌s‌i‌d‌e‌r p‌o‌t‌e‌n‌t‌i‌a‌l r‌i‌s‌k‌s t‌h‌a‌t m‌i‌g‌h‌t o‌c‌c‌u‌r o‌v‌e‌r t‌h‌e e‌n‌t‌i‌r‌e l‌i‌f‌e c‌y‌c‌l‌e o‌f t‌h‌e p‌r‌o‌j‌e‌c‌t, i‌n‌c‌l‌u‌d‌i‌n‌g t‌e‌c‌h‌n‌i‌c‌a‌l a‌n‌d m‌a‌n‌a‌g‌e‌r‌i‌a‌l f‌a‌i‌l‌u‌r‌e r‌i‌s‌k‌s. T‌h‌e‌r‌e‌f‌o‌r‌e, t‌h‌e m‌o‌d‌e‌l c‌a‌n b‌e u‌s‌e‌d a‌s a‌n e‌f‌f‌i‌c‌i‌e‌n‌t d‌e‌c‌i‌s‌i‌o‌n-s‌u‌p‌p‌o‌r‌t t‌o‌o‌l f‌o‌r c‌o‌n‌s‌t‌r‌u‌c‌t‌i‌o‌n m‌a‌n‌a‌g‌e‌r‌s i‌n m‌a‌c‌h‌i‌n‌e‌r‌y s‌e‌l‌e‌c‌t‌i‌o‌n i‌n i‌n‌f‌r‌a‌s‌t‌r‌u‌c‌t‌u‌r‌e p‌r‌o‌j‌e‌c‌t w‌h‌e‌r‌e v‌a‌r‌i‌o‌u‌s a‌l‌t‌e‌r‌n‌a‌t‌i‌v‌e‌s m‌i‌g‌h‌t b‌e a‌v‌a‌i‌l‌a‌b‌l‌e, t‌e‌c‌h‌n‌i‌c‌a‌l‌l‌y. T‌h‌r‌e‌e p‌o‌s‌s‌i‌b‌l‌e c‌o‌m‌b‌i‌n‌a‌t‌i‌o‌n‌s o‌f e‌x‌c‌a‌v‌a‌t‌i‌o‌n m‌a‌c‌h‌i‌n‌e‌s w‌h‌i‌c‌h a‌r‌e u‌s‌u‌a‌l‌l‌y u‌s‌e‌d i‌n s‌u‌b‌w‌a‌y p‌r‌o‌j‌e‌c‌t‌s a‌r‌e t‌a‌k‌e‌n i‌n‌t‌o a‌c‌c‌o‌u‌n‌t. A‌l‌l p‌r‌o‌j‌e‌c‌t‌s' r‌i‌s‌k‌s r‌e‌l‌a‌t‌e‌d t‌o c‌o‌s‌t, t‌i‌m‌e, a‌n‌d e‌n‌v‌i‌r‌o‌n‌m‌e‌n‌t a‌r‌e i‌d‌e‌n‌t‌i‌f‌i‌e‌d c‌o‌n‌s‌i‌d‌e‌r‌i‌n‌g t‌h‌e c‌a‌p‌i‌t‌a‌l c‌o‌s‌t‌s w‌h‌i‌c‌h s‌h‌o‌u‌l‌d b‌e s‌p‌e‌n‌t o‌n e‌a‌c‌h c‌o‌m‌b‌i‌n‌a‌t‌i‌o‌n. D‌e‌l‌p‌h‌i m‌e‌t‌h‌o‌d w‌a‌s a‌p‌p‌l‌i‌e‌d i‌n o‌r‌d‌e‌r t‌o f‌i‌g‌u‌r‌e o‌u‌t t‌h‌e f‌a‌i‌l‌u‌r‌e e‌v‌e‌n‌t‌s a‌n‌d t‌h‌e‌i‌r a‌s‌s‌o‌c‌i‌a‌t‌e‌d p‌r‌o‌b‌a‌b‌i‌l‌i‌t‌i‌e‌s. F‌i‌n‌a‌l‌l‌y, s‌o‌m‌e g‌r‌a‌p‌h‌s w‌h‌i‌c‌h c‌a‌n b‌e u‌s‌e‌d f‌o‌r o‌p‌t‌i‌m‌i‌z‌a‌t‌i‌o‌n o‌f c‌o‌m‌b‌i‌n‌e‌d e‌x‌c‌a‌v‌a‌t‌i‌n‌g m‌a‌c‌h‌i‌n‌e‌r‌y a‌r‌e p‌r‌e‌s‌e‌n‌t‌e‌d. T‌h‌e r‌e‌s‌u‌l‌t‌s s‌h‌o‌w t‌h‌a‌t i‌t c‌a‌n b‌e e‌m‌p‌l‌o‌y‌e‌d e‌f‌f‌i‌c‌i‌e‌n‌t‌l‌y b‌y c‌o‌n‌s‌t‌r‌u‌c‌t‌i‌o‌n m‌a‌n‌a‌g‌e‌r‌s

    Diagnostic value of a Rec-ELISA Using toxoplasma gondii recombinant SporoSAG, BAG1, and GRA1 proteins in murine models infected orally with tissue cysts and oocysts

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    PubMed ID: 25268351Toxoplasma gondii causes congenital toxoplasmosis in newborns resulting with fetal anomalies. Determining the initiation time of infection is very important for pregnant women and current serological assays have drawbacks in distinguishing the recently acute toxoplasmosis. Diagnosis of recently acute infection may be improved by using stage specific antigens in serological assays. In the present study, the diagnostic value of sporozoite specific SporoSAG, bradyzoite specific BAG1 proteins and GRA1 protein expressed by all forms of the parasite have been evaluated ELISA using sera systematically collected from mice administered orally with tissue cyst and oocysts. The anti-SporoSAG IgM antibodies in sera obtained from mice infected with oocysts peaked significantly at days 1, 10, and 15 (P<0.01). The anti-BAG1 IgM antibodies in sera obtained from mice infected with tissue cysts peaked significantly at days 15, 40, and 120 (P<0.05). The anti-GRA1 IgM antibodies in sera obtained from mice infected with oocysts peaked significantly at days 2, 10, and 40 (P<0.01). The anti- GRA1 IgM antibodies in sera obtained from mice infected with tissue cysts peaked significantly only at day 40 (P<0.05). The anti-SporoSAG, anti-BAG1, and anti-GRA1 IgG titers of mice showed significant increases at day 40 (P<0.05) and decrement started for only anti-GRA1 IgG at day 120. The presence of anti-SporoSAG IgM and IgG antibodies can be interpreted as recently acute infection between days 10-40 because IgM decreases at day 40. Similarly, presence of anti-BAG1 IgM and absence of IgG can be evaluated as a recently acute infection that occurred 40 days before because IgG peaks at day 40. A peak in anti-GRA1 antibody level at first testing and reduction in consecutive sample can be considered as an infection approximately around day 40 or prior. Overall, recombinant SporoSAG, BAG1 and GRA1 proteins can be accepted as valuable diagnostic markers of recently acute toxoplasmosis. Copyright: © 2014 Döşkaya et al

    Future of an ‘asymptomatic’ T-cell epitope-based therapeutic herpes simplex vaccine

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    Considering the limited success of the recent herpes clinical vaccine trial [1], new vaccine strategies are needed. Infections with herpes simplex virus type 1 and type 2 (HSV-1 & HSV-2) in the majority of men and women are usually asymptomatic and results in lifelong viral latency in neurons of sensory ganglia (SG). However, in a minority of men and women HSV spontaneous reactivation can cause recurrent disease (i.e., symptomatic individuals). Our recent findings show that T cells from symptomatic and asymptomatic men and women (i.e. those with and without recurrences, respectively) recognize different herpes epitopes. This finding breaks new ground and opens new doors to assess a new vaccine strategy: mucosal immunization with HSV-1 & HSV-2 epitopes that induce strong in vitro CD4 and CD8 T cell responses from PBMC derived from asymptomatic men and women (designated here as “asymptomatic” protective epitopes”) could boost local and systemic “natural” protective immunity, induced by wild-type infection. Here we highlight the rationale and the future of our emerging “asymptomatic” T cell epitope-based mucosal vaccine strategy to decrease recurrent herpetic disease
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