Immunological Tolerance and Regulating Immune Responses

Total Page:16

File Type:pdf, Size:1020Kb

Immunological Tolerance and Regulating Immune Responses 1 Immunological tolerance and regulating immune responses Shiv Pillai, MD PhD Massachusetts General Hospital 2 Lecture outline • Mechanisms of central and peripheral immune tolerance B cell tolerance T cell tolerance • Regulatory T cells • Lymphocyte Exhaustion • Autoimmunity • Integration and Summary GOD Self Non-Self Recognition 4 CENTRAL LYMPHOID ORGANS PERIPHERY Y Y Receptor Mature Central Naïve assembly Tolerance Cells EDIT OR ELIMINATE SELF- REACTIVE CELLS Pos. and Neg. Selection of Lymphocytes Abbas, Lichtman, and Pillai. Cellular and Molecular Immunology, 7th edition. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Germline Organization of Human Ig Loci Abbas, Lichtman, and Pillai. Cellular and Molecular Immunology, 7th edition. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. Checkpoints during B cell development 7 8 Distant segments are recombined during receptor assembly 9 Receptor editing is the major mechanism of central B cell tolerance Multivalent high Oligovalent high affinity Low affinity self reactive B cells affinity self induces may persist - potentially dangerous self induces receptor editing anergy (and maybe deletion) Y Y Y BONE PERIPHERY: MARROW ANERGIZED B CELLS NEED BAFF Self-antigen Self-reactive B Edited B cell cell Receptor editing occurs in the bone marrow 11 ONE STEP L-CHAIN REARRANGEMENT DRIVES RECEPTOR EDITING Anergy Clonal Ignorance Deletion Tregs Mature B cell Somatically mutated Pathogenic IgG memory B cell MULTIPLE MECHANISMS OF PERIPHERAL B CELL TOLERANCE An overview of T cell development 13 14 Selection Events in Double and Single Positive Thymocytes 15 Consequences of self antigen recognition in thymus From: Abbas. Pillai & Lichtman, Cellular & Molecular Immunology 8th ed 2014 Deletion of self-reactive T cells in the thymus: 16 how are self antigens expressed in the thymus? AIRE (autoimmune regulator) is a regulator of transcription that stimulates expression of many self antigens in the medullary epithelial cells of the thymus, required for deletion of self-reactive thymocytes Mechanisms of peripheral T cell tolerance 17 T cell anergy- no Signal Two and role for CTLA-4 18 Inhibitory Receptors Dampen Immune Responses 19 They help mediate: 1.Peripheral Tolerance 2.Lymphocyte Exhaustion 3.Activation Induced Cell Death CTLA-4, PD-1, TIM-3 etc 20 Balancing lymphocyte activation and control Activation Inhibition Effector T cells Regulatory T cells, Anergy, AICD, Exhausted T cells Normal: reactions against pathogens No response to self Pathologic: inflammatory Controlled response to disease, e.g. caused by pathogens reactions against self or pathogens 21 Properties of regulatory T cells • Phenotype: CD4+, high IL-2 receptor (CD25), low IL-7 receptor, Foxp3 transcription factor; other markers • Significance: Foxp3 mutations --> autoimmune disease (IPEX); many autoimmune diseases may be associated with defects in or resistance to Tregs • Mechanisms of action: multiple – secretion of immune-suppressive cytokines (TGF, IL-10; IL-35?) – inhibition of APC function (role of CTLA-4?) 22 Regulatory T cells Inhibition of Self-reactive Peipheral B cells 23 Autoimmune diseases: failure of control Failure of tolerance Tolerance Lymphocyte activation Effector T cells Normal Inflammatory disease, e.g. reactions against self tissues Pathogenesis of autoimmunity Genetic defects Epigenetic Changes Break in tolerance and in immune Enhanced inflammation cells Microbes, microbial metabolites Availability of B and T cell clones in IgG4-RD subjects may facilitate studies on epigenetic alterations Pathogenesis of organ-specific autoimmunity 25 Abbas, Lichtman and Pillai. Cellular and Molecular Immunology, 7th edition, 2011 c Elsevier Model for the Pathogenesis of SLE Abbas, Lichtman, and Pillai. Cellular and Molecular Immunology, 7th edition. Copyright © 2011Copyright by © Saunders,2011 by Saunders, an an imprint imprint of ofElsevier Elsevier Inc. Inc. 27 A game of dice…......
Recommended publications
  • Primary Sjogren Syndrome: Focus on Innate Immune Cells and Inflammation
    Review Primary Sjogren Syndrome: Focus on Innate Immune Cells and Inflammation Chiara Rizzo 1, Giulia Grasso 1, Giulia Maria Destro Castaniti 1, Francesco Ciccia 2 and Giuliana Guggino 1,* 1 Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Section, University of Palermo, Piazza delle Cliniche 2, 90110 Palermo, Italy; [email protected] (C.R.); [email protected] (G.G.); [email protected] (G.M.D.C.) 2 Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 7, 80138 Naples, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-091-6552260 Received: 30 April 2020; Accepted: 29 May 2020; Published: 3 June 2020 Abstract: Primary Sjogren Syndrome (pSS) is a complex, multifactorial rheumatic disease that mainly targets salivary and lacrimal glands, inducing epithelitis. The cause behind the autoimmunity outbreak in pSS is still elusive; however, it seems related to an aberrant reaction to exogenous triggers such as viruses, combined with individual genetic pre-disposition. For a long time, autoantibodies were considered as the hallmarks of this disease; however, more recently the complex interplay between innate and adaptive immunity as well as the consequent inflammatory process have emerged as the main mechanisms of pSS pathogenesis. The present review will focus on innate cells and on the principal mechanisms of inflammation connected. In the first part, an overview of innate cells involved in pSS pathogenesis is provided, stressing in particular the role of Innate Lymphoid Cells (ILCs). Subsequently we have highlighted the main inflammatory pathways, including intra- and extra-cellular players.
    [Show full text]
  • Autoimmunity and Organ Damage in Systemic Lupus Erythematosus
    REVIEW ARTICLE https://doi.org/10.1038/s41590-020-0677-6 Autoimmunity and organ damage in systemic lupus erythematosus George C. Tsokos ✉ Impressive progress has been made over the last several years toward understanding how almost every aspect of the immune sys- tem contributes to the expression of systemic autoimmunity. In parallel, studies have shed light on the mechanisms that contribute to organ inflammation and damage. New approaches that address the complicated interaction between genetic variants, epigen- etic processes, sex and the environment promise to enlighten the multitude of pathways that lead to what is clinically defined as systemic lupus erythematosus. It is expected that each patient owns a unique ‘interactome’, which will dictate specific treatment. t took almost 100 years to realize that lupus erythematosus, strongly to the heterogeneity of the disease. Several genes linked to which was initially thought to be a skin entity, is a systemic the immune response are regulated through long-distance chroma- Idisease that spares no organ and that an aberrant autoimmune tin interactions10,11. Studies addressing long-distance interactions response is involved in its pathogenesis. The involvement of vital between gene variants in SLE are still missing, but, with the advent organs and tissues such as the brain, blood and the kidney in most of new technologies, such studies will emerge. patients, the vast majority of whom are women of childbearing age, Better understanding of the epigenome is needed to under- impels efforts to develop diagnostic tools and effective therapeu- stand how it supplements the genetic contribution to the dis- tics. The prevalence ranges from 20 to 150 cases per 100,000 peo- ease.
    [Show full text]
  • Pathophysiology of Immune Thrombocytopenic Purpura: a Bird's-Eye View
    Egypt J Pediatr Allergy Immunol 2014;12(2):49-61. Review article Pathophysiology of immune thrombocytopenic purpura: a bird's-eye view. Amira Abdel Moneam Adly Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt ABSTRACT and B lymphocytes (including T-helper, T- Immune thrombocytopenic purpura (ITP) is a cytotoxic, and T-regulatory lymphocytes) 6. common autoimmune disorder resulting in isolated The triggering event for ITP is unknown7, but thrombocytopenia. It is a bleeding disorder continued research is providing new insights into characterized by low platelet counts due to decreased the underlying immunopathogenic processes as well platelet production as well as increased platelet as the cellular and molecular mechanisms involved destruction by autoimmune mechanisms. ITP can in megakaryocytopoiesis and platelet turnover. present either alone (primary) or in the setting of other Although historically ITP-associated thrombo- conditions (secondary) such as infections or altered cytopenia was attributed solely to increased rates of immune states. ITP is associated with a loss of destruction of antibody- coated platelets, it has tolerance to platelet antigens and a phenotype of become evident that suboptimal platelet production accelerated platelet destruction and impaired platelet also plays a role 8. production. Although the etiology of ITP remains Bleeding is due to decreased platelet production unknown, complex dysregulation of the immune as well as accelerated platelet destruction mediated system is observed in ITP patients. Antiplatelet in part by autoantibody-based destruction antibodies mediate accelerated clearance from the mechanisms9. Most autoantibodies in ITP are circulation in large part via the reticuloendothelial isotype switched and harbor somatic mutations10, (monocytic phagocytic) system.
    [Show full text]
  • B Cell Activation and Escape of Tolerance Checkpoints: Recent Insights from Studying Autoreactive B Cells
    cells Review B Cell Activation and Escape of Tolerance Checkpoints: Recent Insights from Studying Autoreactive B Cells Carlo G. Bonasia 1 , Wayel H. Abdulahad 1,2 , Abraham Rutgers 1, Peter Heeringa 2 and Nicolaas A. Bos 1,* 1 Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, 9713 Groningen, GZ, The Netherlands; [email protected] (C.G.B.); [email protected] (W.H.A.); [email protected] (A.R.) 2 Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, 9713 Groningen, GZ, The Netherlands; [email protected] * Correspondence: [email protected] Abstract: Autoreactive B cells are key drivers of pathogenic processes in autoimmune diseases by the production of autoantibodies, secretion of cytokines, and presentation of autoantigens to T cells. However, the mechanisms that underlie the development of autoreactive B cells are not well understood. Here, we review recent studies leveraging novel techniques to identify and characterize (auto)antigen-specific B cells. The insights gained from such studies pertaining to the mechanisms involved in the escape of tolerance checkpoints and the activation of autoreactive B cells are discussed. Citation: Bonasia, C.G.; Abdulahad, W.H.; Rutgers, A.; Heeringa, P.; Bos, In addition, we briefly highlight potential therapeutic strategies to target and eliminate autoreactive N.A. B Cell Activation and Escape of B cells in autoimmune diseases. Tolerance Checkpoints: Recent Insights from Studying Autoreactive Keywords: autoimmune diseases; B cells; autoreactive B cells; tolerance B Cells. Cells 2021, 10, 1190. https:// doi.org/10.3390/cells10051190 Academic Editor: Juan Pablo de 1.
    [Show full text]
  • Mechanisms Governing Anaphylaxis: Inflammatory Cells, Mediators
    International Journal of Molecular Sciences Review Mechanisms Governing Anaphylaxis: Inflammatory Cells, Mediators, Endothelial Gap Junctions and Beyond Samantha Minh Thy Nguyen 1, Chase Preston Rupprecht 2, Aaisha Haque 3, Debendra Pattanaik 4, Joseph Yusin 5 and Guha Krishnaswamy 1,3,* 1 Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27106, USA; [email protected] 2 The Rowan School of Osteopathic Medicine, Stratford, NJ 08084, USA; [email protected] 3 The Bill Hefner VA Medical Center, Salisbury, NC 27106, USA; [email protected] 4 Division of Allergy and Immunology, UT Memphis College of Medicine, Memphis, TN 38103, USA; [email protected] 5 The Division of Allergy and Immunology, Greater Los Angeles VA Medical Center, Los Angeles, CA 90011, USA; [email protected] * Correspondence: [email protected] Abstract: Anaphylaxis is a severe, acute, life-threatening multisystem allergic reaction resulting from the release of a plethora of mediators from mast cells culminating in serious respiratory, cardiovascular and mucocutaneous manifestations that can be fatal. Medications, foods, latex, exercise, hormones (progesterone), and clonal mast cell disorders may be responsible. More recently, novel syndromes such as delayed reactions to red meat and hereditary alpha tryptasemia have been described. Anaphylaxis manifests as sudden onset urticaria, pruritus, flushing, erythema, Citation: Nguyen, S.M.T.; Rupprecht, angioedema (lips, tongue, airways, periphery), myocardial dysfunction (hypovolemia, distributive
    [Show full text]
  • Eosinophil Extracellular Traps and Inflammatory Pathologies—Untangling the Web!
    REVIEW published: 26 November 2018 doi: 10.3389/fimmu.2018.02763 Eosinophil Extracellular Traps and Inflammatory Pathologies—Untangling the Web! Manali Mukherjee 1*, Paige Lacy 2 and Shigeharu Ueki 3 1 Department of Medicine, McMaster University and St Joseph’s Healthcare, Hamilton, ON, Canada, 2 Department of Medicine, Alberta Respiratory Centre, University of Alberta, Edmonton, AB, Canada, 3 Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan Eosinophils are an enigmatic white blood cell, whose immune functions are still under intense investigation. Classically, the eosinophil was considered to fulfill a protective role against parasitic infections, primarily large multicellular helminths. Although eosinophils are predominantly associated with parasite infections, evidence of a role for eosinophils in mediating immunity against bacterial, viral, and fungal infections has been recently reported. Among the mechanisms by which eosinophils are proposed to exert their protective effects is the production of DNA-based extracellular traps (ETs). Remarkably, Edited by: DNA serves a role that extends beyond its biochemical function in encoding RNA and Moncef Zouali, protein sequences; it is also a highly effective substance for entrapment of bacteria Institut National de la Santé et de la and other extracellular pathogens, and serves as valuable scaffolding for antimicrobial Recherche Médicale (INSERM), France mediators such as granule proteins from immune cells. Extracellular
    [Show full text]
  • Of T Cell Tolerance
    cells Review Strength and Numbers: The Role of Affinity and Avidity in the ‘Quality’ of T Cell Tolerance Sébastien This 1,2,† , Stefanie F. Valbon 1,2,†, Marie-Ève Lebel 1 and Heather J. Melichar 1,3,* 1 Centre de Recherche de l’Hôpital Maisonneuve-Rosemont, Montréal, QC H1T 2M4, Canada; [email protected] (S.T.); [email protected] (S.F.V.); [email protected] (M.-È.L.) 2 Département de Microbiologie, Immunologie et Infectiologie, Université de Montréal, Montréal, QC H3C 3J7, Canada 3 Département de Médecine, Université de Montréal, Montréal, QC H3T 1J4, Canada * Correspondence: [email protected] † These authors contributed equally to this work. Abstract: The ability of T cells to identify foreign antigens and mount an efficient immune response while limiting activation upon recognition of self and self-associated peptides is critical. Multiple tolerance mechanisms work in concert to prevent the generation and activation of self-reactive T cells. T cell tolerance is tightly regulated, as defects in these processes can lead to devastating disease; a wide variety of autoimmune diseases and, more recently, adverse immune-related events associated with checkpoint blockade immunotherapy have been linked to a breakdown in T cell tolerance. The quantity and quality of antigen receptor signaling depend on a variety of parameters that include T cell receptor affinity and avidity for peptide. Autoreactive T cell fate choices (e.g., deletion, anergy, regulatory T cell development) are highly dependent on the strength of T cell receptor interactions with self-peptide. However, less is known about how differences in the strength Citation: This, S.; Valbon, S.F.; Lebel, of T cell receptor signaling during differentiation influences the ‘function’ and persistence of anergic M.-È.; Melichar, H.J.
    [Show full text]
  • Tolerance to Allergens: How It Develops and How It Can Be Induced
    Session 2101 Plenary: Immunotherapy: Mechanism, Outcomes and Markers Tolerance to Allergens: How it Develops and How it Can be Induced Cezmi A. Akdis, MD Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland Corresponding author: Cezmi A. Akdis, MD Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos Address E-mail: [email protected] Tel.: + 41 81 4100848 Fax: + 41 81 4100840 Acknowledgments: The authors' laboratories are supported by the Swiss National Foundation grant 320030_132899 and Christine Kühne Center for Allergy Research and Education (CK-CARE). ABSTRACT The induction of immune tolerance and specific immune suppression are essential processes in the control of immune responses. Allergen immunotherapy induces early desensitization and peripheral T cell tolerance to allergens associated with development of Treg and Breg cells, and downregulation of several allergic and inflammatory aspects of effector subsets of T cells, B cells, basophils, mast cells and eosinophils. Similar molecular and cellular mechanisms have been observed in subcutaneous and sublingual AIT as well as natural tolerance to high doses of allergen exposure. In allergic disease, the balance between allergen-specific Treg and disease-promoting T helper 2 cells (Th2) appears to be decisive in the development of an allergic versus a non-disease promoting or “healthy” immune response against allergen. Treg specific for common environmental allergens represent the dominant subset in healthy individuals arguing for a state of natural tolerance to allergen in these individuals. In contrast, there is a high frequency of allergen-specific Th2 cells in allergic individuals. Treg function appears to be impaired in active allergic disease.
    [Show full text]
  • B Cell Checkpoints in Autoimmune Rheumatic Diseases
    REVIEWS B cell checkpoints in autoimmune rheumatic diseases Samuel J. S. Rubin1,2,3, Michelle S. Bloom1,2,3 and William H. Robinson1,2,3* Abstract | B cells have important functions in the pathogenesis of autoimmune diseases, including autoimmune rheumatic diseases. In addition to producing autoantibodies, B cells contribute to autoimmunity by serving as professional antigen- presenting cells (APCs), producing cytokines, and through additional mechanisms. B cell activation and effector functions are regulated by immune checkpoints, including both activating and inhibitory checkpoint receptors that contribute to the regulation of B cell tolerance, activation, antigen presentation, T cell help, class switching, antibody production and cytokine production. The various activating checkpoint receptors include B cell activating receptors that engage with cognate receptors on T cells or other cells, as well as Toll-like receptors that can provide dual stimulation to B cells via co- engagement with the B cell receptor. Furthermore, various inhibitory checkpoint receptors, including B cell inhibitory receptors, have important functions in regulating B cell development, activation and effector functions. Therapeutically targeting B cell checkpoints represents a promising strategy for the treatment of a variety of autoimmune rheumatic diseases. Antibody- dependent B cells are multifunctional lymphocytes that contribute that serve as precursors to and thereby give rise to acti- cell- mediated cytotoxicity to the pathogenesis of autoimmune diseases
    [Show full text]
  • B Lymphocytes in Neuromyelitis Optica
    VIEWS & REVIEWS B lymphocytes in neuromyelitis optica Jeffrey L. Bennett, MD, ABSTRACT PhD Neuromyelitis optica (NMO) is an inflammatory autoimmune disorder of the CNS that predomi- ’ Kevin C. O Connor, PhD nantly affects the spinal cord and optic nerves. A majority (approximately 75%) of patients with Amit Bar-Or, MD, FRCP NMO are seropositive for autoantibodies against the astrocyte water channel aquaporin-4 Scott S. Zamvil, MD, (AQP4). These autoantibodies are predominantly IgG1, and considerable evidence supports their PhD pathogenicity, presumably by binding to AQP4 on CNS astrocytes, resulting in astrocyte injury Bernhard Hemmer, MD and inflammation. Convergent clinical and laboratory-based investigations have indicated that Thomas F. Tedder, PhD B cells play a fundamental role in NMO immunopathology. Multiple mechanisms have been H.-Christian von hypothesized: AQP4 autoantibody production, enhanced proinflammatory B cell and plasmablast Büdingen, MD activity, aberrant B cell tolerance checkpoints, diminished B cell regulatory function, and loss of Olaf Stuve, MD, PhD B cell anergy. Accordingly, many current off-label therapies for NMO deplete B cells or modulate Michael R. Yeaman, PhD their activity. Understanding the role and mechanisms whereby B cells contribute to initiation, Terry J. Smith, MD maintenance, and propagation of disease activity is important to advancing our understanding Christine Stadelmann, of NMO pathogenesis and developing effective disease-specific therapies. Neurol Neuroimmunol MD Neuroinflamm 2015;2:e104;
    [Show full text]
  • Difference Between Hypersensitivity and Autoimmunity Key Difference – Hypersensitivity Vs Autoimmunity
    Difference Between Hypersensitivity and Autoimmunity www.differencebetwee.com Key Difference – Hypersensitivity vs Autoimmunity Autoimmunity is an adaptive immune response mounted against self-antigens. In simple terms, when your body is acting against its own cells and tissues, this is called an autoimmune reaction. An exaggerated and inappropriate immune response to an antigenic stimulus is defined as a hypersensitivity reaction. Unlike autoimmune reactions that are triggered only by the endogenous antigens, hypersensitivity reactions are triggered by both endogenous and exogenous antigens. This is the key difference between hypersensitivity and autoimmunity. What is Hypersensitivity? An exaggerated and inappropriate immune response to an antigenic stimulus is defined as a hypersensitivity reaction. The first exposure to a particular antigen activates the immune system and, antibodies are produced as a result. This is called sensitization. Subsequent exposures to the same antigen give rise to hypersensitivity. Few important facts regarding the hypersensitivity reactions are given below They can be elicited by both exogenous and endogenous agents. They are a result of an imbalance between the effector mechanisms and the countermeasures that are there to control any inappropriate execution of an immune response. The presence of a genetic susceptibility increases the likelihood of hypersensitivity reactions. The manner in which hypersensitivity reactions harm our body is similar to the way that the pathogens are destroyed by immune reactions. Figure 01: Allergy According to the Coombs and Gell classification, there are four main types of hypersensitivity reactions. Type I- Immediate Type/ Anaphylactic Mechanism Vasodilation, edema, and contraction of smooth muscles are the pathological changes that take place during the immediate phase of the reaction.
    [Show full text]
  • 2 Allergy, Immunodeficiency, Autoimmunity and COVID-19
    2 Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination Frequently Asked Questions (FAQ) 17 February 2021 This information has been developed by ASCIA, the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand, to answer questions regarding COVID-19 vaccination in relation to allergy, immunodeficiency and autoimmunity. ASCIA will update this FAQ when new information is available. 1. Why is the COVID-19 vaccination program important? Vaccination is an important way to reduce the risk of developing infectious diseases which can easily spread. This includes COVID-19, which is caused by infection with the SARS-CoV-2 coronavirus. Immunity occurs after the vaccine stimulates a person’s immune system to make antibodies (immunoglobulins) to help protect the body from future infections. This means that if a person is vaccinated, they will be less likely to get COVID-19. Even if a person does get infected, it is likely to be a milder illness. Public health measures and restrictions that were implemented by the Australian and New Zealand governments since March 2020 have been successful in controlling the spread of COVID-19 in our countries. However, the COVID-19 pandemic has been a major cause of illness and deaths in other countries. This means that vaccination programs are required throughout the world, including Australia and New Zealand. 2. Which COVID-19 vaccines have been approved in Australia and New Zealand? Pfizer/BioNTech COMIRNATY mRNA-based COVID-19 vaccine has been provisionally approved by the Therapeutic Goods Administration (TGA), part of the Australian Government Department of Health, and by Medsafe in New Zealand for people 16 years and older.
    [Show full text]