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Biomedical subjects

N Talal

Publications and source records attributed to N Talal.

At least 91 records · Page 5Linked to original sources
PubMed1990

Practical use of immunosuppressive drugs in autoimmune rheumatic diseases.

Immunosuppressive drugs are frequently used in the treatment of autoimmune rheumatic diseases when more conventional therapy, including corticosteroids, fail to control the manifestations of disease. The practical use of these drugs in rheumatoid arthritis, systemic lupus erythematosus, and vasculitis (including Wegener's granulomatosis and Sjögren's syndrome) are reviewed. The focus is on the indications for the administration of these agents and proper monitoring of their effect on disease activity.

Arthritis, Rheumatoid↗
PubMed1990

Sex hormone involvement in the induction of experimental systemic lupus erythematosus by a pathogenic anti-DNA idiotype in naive mice.

The effect of sex hormones on the induction of experimental systemic lupus erythematosus (SLE) with a human anti-DNA (16/6 Id +) antibody, was studied. We found that injection of the pathogenic idiotype to BALB/c females and orchiectomized males treated with estrogen caused a rapid outburst of the disease 3 months after immunization, while nonestrogen treated mice developed the disease 5 months after immunization. The flare of SLE disease was characterized by raised levels of autoantibodies in the sera to dsDNA, histones, cardiolipin, Sm, RNP, SSA (Ro), SSB (La) and an emergence of high titers of mouse antibody carrying the 16/6 Id. These enhanced antibody levels were associated with an increase in erythrocyte sedimentation rate, proteinuria and leukopenia. Immunofluorescent studies confirmed the existence of immune complexes in the afflicted kidneys. Testosterone treated BALB/c females and orchiectomized males developed a classical response to the human anti-DNA antibody (16/6 Id +), but failed to develop fulminant SLE-like disease. Our data demonstrate the importance of sex hormones on the induction of experimental SLE-like disease in mice with no genetic tendency to autoimmunity.

Animals↗
PubMed1989

Ig VH gene family repertoire of plasma cells derived from lupus-prone MRL/lpr and MRL/++ mice.

VH gene family usage was determined in both spontaneous, in vivo activated plasma cells and LPS-induced plasma cells from individual MRL/lpr mice by using in situ hybridization. It was found that VH gene family expression in spontaneous plasma cells varied from mouse to mouse. Some mice expressed VH families in an apparently random manner similar to that obtained with polyclonal activation. Other mice showed an exaggerated expression of particular VH gene families. VH J558 was overrepresented most frequently, but overrepresentation of VH 7183, Q52, and 36-60 was also observed. Importantly, LPS-induced VH gene family expression in these same mice displaying biased VH family usage in spontaneous plasma cells, appeared normal with no evidence for similar biases in the LPS-induced repertoire. Anti-DNA antibody concentrations and the degree of glomerulonephritis were determined for each mouse to measure the severity of disease. The level of expression of the J558 family was positively correlated with disease severity. The results suggest that the initial autoantibody response is highly diverse but becomes more restricted as the disease progresses.

Animals↗
PubMed1989

Estrogen induces normal murine CD5+ B cells to produce autoantibodies.

Females have better humoral immune responses and are more susceptible to autoimmune diseases than males. Normal female mice (C57BL/6J, C3H/HeJ, and NZW) have significantly increased spontaneous autoimmune plaque-forming cells (APFC) to mouse erythrocytes pretreated with bromelain (Br-ME) in spleen, peritoneal exudate cell, and bone marrow compared to their male counterparts. A minor subpopulation of B cells, CD5+ B, is thought to produce this autoantibody. As determined by dual color flow cytometry, increased APFC to Br-ME in females is not due to quantitative increase of CD5+ B cells. Rather, it is due to increased numbers or percentages) of CD5+ B cells producing these autoantibodies, because CD5+ B cells from females produced greater numbers of APFC to Br-ME than equal numbers of cells derived from males. The increased autoantibody production in females can be attributed to the effect of estrogen on the immune response because this hormone markedly augments APFC to Br-ME in intact or orchidectomized males. Male hormone had little effect. Importantly, estrogen did not increase the numbers of B or CD5+ B cells but augmented the ability of B cells to produce this response. This was verified when a T cell-depleted B cell fraction or fluorescence-activated cell sorter purified CD5+ B cells from estrogen-treated mice proved more efficient in the production of APFC to Br-ME. These results suggest that the number of CD5+ B cells committed to produce autoantibodies to Br-ME is increased under the influence of estrogen. This is the first demonstration that estrogen can augment the production of natural autoantibodies in normal mice. The overall augmented humoral immune responses in females and the B cell hyperactivity in female predominant autoimmune diseases appears to be due to estrogen.

Animals↗
PubMed1989

VH sequence of a human anti-Sm autoantibody. Evidence that autoantibodies can be unmutated copies of germline genes.

The utilization of germline genes for the synthesis of autoantibodies has been suspected for many years based on the presence of cross-reactive idiotypes among patients as well as in some healthy first-degree relatives of patients with several autoimmune diseases including SLE. One such system of idiotypes involves anti-Sm antibodies, which are highly specific for SLE. To definitively establish the utilization of germline genes in the Sm system, we produced human-human B cell hybridomas from a patient with SLE who had circulating anti-Sm antibodies. One stable hybridoma designated 4B4 secretes an IgM-kappa mAb that binds Sm and shares idiotypic determinants with other anti-Sm antibodies. A second anti-Sm antibody (3C3), isolated from the same patient was also studied. Oligo(dT) priming was used to produce cDNA corresponding to full length IgM. Sequence analysis revealed that the VH gene segment (1-96) of 4B4 is identical to a VH sequence previously detected in a fetal liver cDNA library by Schroeder and his co-workers as well as a germline VH recently described by Berman and his associates. The identity of a lupus mAb and sequences derived from unrelated individuals provides strong evidence that this autoantibody is a direct copy of a germline gene.

Amino Acid Sequence↗
PubMed1989

Polyamine oxidation down-regulates IL-2 production by human peripheral blood mononuclear cells.

Polyamine biosynthesis by mononuclear cells (MNC) appears to regulate T cell activity since 1) inhibition of polyamine biosynthesis increases IL-2 production and 2) H2O2 (a product of polyamine oxidase, PAO), suppresses lymphocyte proliferation. We investigated this immunoregulatory mechanism and find that catalase, an H2O2 inhibitor, also enhances IL-2 production by MNC. The addition of PAO, but only in the presence of either endogenous or exogenous spermidine (a polyamine), decreases IL-2 production; this effect is catalase inhibitable. Pre-incubation with spermidine, but not any of three diamines tested, suppresses PHA-stimulated IL-2 production and this effect requires monocytes. Three PAO inhibitors have an enhancing effect on IL-2 production which is again monocyte dependent. These results suggest that: 1) H2O2 produced by PHA-activated PBMC down-regulates IL-2 production; 2) products of the interaction between PAO and spermidine inhibit IL-2 production and H2O2 is essential but apparently not sufficient to mediate this effect; 3) human PBMC contain PAO activity. This polyamine-PAO-dependent inhibitory mechanism might constitute a feedback loop that limits human T cell proliferation and, consequently, also the immune responses mediated by these cells.

Adult↗
PubMed1989

The expression and function of CD3 and CD5 in patients with primary Sjögren's syndrome.

We studied the expression and function of 2 cell surface markers that induce T cell activation, CD3 and CD5, in 19 patients with primary Sjögren's syndrome (SS). The expression of CD3+ lymphocytes was normal, but CD3 function was moderately reduced, as measured by anti-CD3-induced T cell proliferation. Anti-CD3-induced stimulation of T cell help for Ig production and non-major histocompatibility complex-restricted (natural) killing were normal. In contrast, there was reduced expression and function of the CD5 molecule on peripheral blood lymphocytes of the SS patients. The ratio of CD5+ to CD3+ lymphocytes was 0.45 in SS patients compared with 0.85 in normal subjects, indicating that the CD3+ cells are relatively CD5-deficient in SS patients. Anti-CD5 monoclonal antibody did not augment suboptimal anti-CD3 stimulation of whole peripheral blood lymphocytes or of purified T lymphocytes from SS patients, which indicated impaired functioning of the CD5 molecule. A significant impairment in proliferation was found in response to phorbol myristate acetate and to ionomycin in combination, suggesting defective intracellular signaling. Findings from serial studies of individual patients suggested that normal or low expression of CD5 on T cells can be stable over periods as long as 2 years. However, in 2 patients who required systemic therapy, a correction of the CD5 lymphocyte abnormality occurred in association with clinical remission, which suggests the potential reversibility of this condition. Our findings suggest a possible defect in intracellular signaling in primary SS, related in part to the CD5 molecule, which may provide a molecular explanation for the T cell hyporesponsiveness that is characteristic of this disease.

Antigens, Differentiation↗
PubMed1989

Autostimulatory growth factors produced by Sjögren's syndrome B cell lines.

Sjögren's syndrome (SS) is a systemic autoimmune disorder characterized by polyclonal hypergammaglobulinemia, autoantibody formation, and intense tissue infiltration by lymphoid and plasma cells. These patients have a predisposition to the development of monoclonal immunoglobulins and B cell lymphomas. To study the role of B cells in this disease, we established B cell lines from three patients with benign primary SS. These B cell lines grew spontaneously without any stimulation and expressed EBV nuclear antigen. The lines secreted an autostimulatory factor which had properties of a B cell growth factor. Peripheral blood B cells from SS patients, after culture for 3 days, secreted a similar factor which stimulated the proliferation of established SS B cell lines. These results suggest that circulating B cells in SS produce an autocrine growth factor that may contribute to lymphoproliferation and ultimately to the emergence of B cell lymphomas.

B-Lymphocytes↗
PubMed1989

Characterization of the IL-2-receptor on rheumatoid arthritis synovial fluid T cells.

We studied the hypoproliferative response of synovial fluid (SF) T cells in rheumatoid arthritis (RA) using a mitogenic monoclonal antibody (MoAb) specific for the T-cell antigen receptor-associated CD3 complex. RASF T cells are defective in their proliferative response and in the induction of the Tac (p55) component of the IL-2-receptor (IL-2-R) when stimulated with anti-CD3 monoclonal antibody (MoAb). However, fresh RASF T cells bear demonstrable IL-2-R in cross-linking experiments which are not seen in unstimulated peripheral blood (PB). These receptors are functional since RASF T cells proliferate in response to recombinant IL-2 (rIL-2) better than fresh PB T cells from either normal or RA patients. Scatchard analysis indicates increased (4-fold) numbers of high affinity IL-2-R on (phytohaemagglutinin) PHA-activated RASF T cells as compared with comparably activated RAPB T cells. Phorbol myristate acetate (PMA) induces Tac antigen expression in RASF but does not lead to proliferation. The hyporesponsiveness of RASF T cells does not appear to result from lack of IL-2-R, lack of IL-2-R inducibility, or proliferative potential.

Adult↗
PubMed1989

The goals of immunologic intervention in autoimmune disease.

Autoimmune diseases represent disorders of immunologic regulation for which specifically targeted immunologic intervention offers great therapeutic promise, superior to highly toxic and totally non-specific conventional therapy currently in use. The cellular and cytokine targets for this new approach and the various concepts underlying their deployment are discussed in this article.

Animals↗
PubMed1989

Epitope specificity of anti-La antibodies from patients with Sjögren's syndrome.

To investigate patterns of autoreactivity in Sjögren's syndrome, the epitope specificity of anti-La antibodies was determined using recombinant antigens bearing sequences of the amino, middle, and carboxyl portions of the La molecule. Sera from patients with primary as well as secondary Sjögren's syndrome reacted with all three fragments, although the magnitude of the responses varied markedly among individuals. Furthermore, the proportion of antibody binding directed to the different La epitopes showed considerable individual variations, but these patterns were not correlated with specific clinical manifestations. These results suggest that quantitative and qualitative aspects of anti-La responses in Sjögren's syndrome are determined by factors distinct from those determining the clinical expression of disease.

Antibodies↗
PubMed1989

Autostimulatory factor produced by B-cell lines from patients with Sjögren's syndrome.

Sjögren's syndrome (SS) is an autoimmune disease with a predisposition to transform into a B-cell lymphoma. Stable B-cell lines were established (without exogenous stimulation other than fetal bovine serum) from the peripheral blood of three SS patients. These cell lines secreted immunoglobulin (either IgG, IgM or both) and expressed cytoplasmic immunoglobulin. They were positive for the B-cell markers Leu 12 and Leu 16, and also for HLA-DR and the transferrin receptor. The cells lacked CD3 and the IL-2 receptor. Supernatants from these cell lines had autostimulatory activity. When 24-h culture supernatants were added to freshly cultured peripheral blood mononuclear cells, the proliferation index was 2-3 times higher as compared to cells cultured with HB101 medium alone. This autostimulatory activity can be attributed to a B-cell growth factor since these supernatants were also able (1) to support the growth of BD9 cells and (2) to augment the proliferation of PB B cells preactivated with S. aureus Cowan strain I. Furthermore, the supernatants did not contain IL-1, IL-2, or gamma-interferon. Thus, B cells that grow spontaneously from the peripheral blood of SS patients spontaneously produce a B-cell growth factor. This factor could contribute importantly to the autoantibody production, tissue lymphoid infiltration and B-cell lymphoma seen in this disease.

B-Lymphocytes↗
PubMed1989

Estrogen induces the development of autoantibodies and promotes salivary gland lymphoid infiltrates in normal mice.

There are important bidirectional interactions between the immune and the endocrine system. Sex hormones influence the immune system throughout life including postnatal and prenatal stages. For example, we find that administration of estrogen to normal mice markedly augments the ability of CD5+ B cells to express their autoimmune potential by producing increased numbers of plaque-forming cells (APFC) to bromelain-treated mouse erythrocytes (Br-ME). The effect of sex hormones on immune function at the most critical stage of development, the prenatal period, remains unstudied. We hypothesize that an imbalance of the in utero sex hormone microenvironment critically influences the fetal immune system. We have termed this influence immunological imprinting. After birth this imprinting could contribute to immune-mediated disorders. To test this hypothesis, we developed a mouse model in which normal mice were prenatally exposed to estrogens. In preliminary experiments, these mice produced higher numbers of APFC to Br-ME, particularly in the peritoneal cavity cell exudates. Furthermore, mice prenatally exposed to estrogens had accelerated development of autoimmune salivary gland lesions indistinguishable from Sjögren's syndrome (SS) in humans. Further experiments are warranted to confirm these findings. The prenatal effects of estrogen may have relevance for familial and neonatal autoimmune syndromes.

Animals↗
PubMed1989

Increased polyamines may downregulate interleukin 2 production in rheumatoid arthritis.

Polyamines downregulate immune reactivity. RA is associated with decreased IL 2 production. In this study, we present evidence to suggest that excessive polyamines can contribute to the IL 2 deficiency in RA. Blocking polyamine production with inhibitors of ornithine decarboxylase results in increased IL 2 production by RA PBMC. Moreover, polyamine oxidase (PAO) inhibitors and catalase also increase IL 2 production by RA PBMC. This effect of PAO inhibition is monocyte mediated. After 3 d in culture, RA PBMC produce three times more IL 2 than do normal PBMC. This rise is prevented by exogenous spermidine but only in the presence of monocytes. The concentration of polyamines in RA PBMC and synovial fluid MNC is 2-20-fold higher than in normal cells. Thus, polyamines and their oxidation products downregulate IL 2 production by RA PBMC and may account for the decreased T cell effector function seen in this disease.

Adult↗
PubMed1989

Sex hormones and autoimmune rheumatic disorders.

It has now been recognized that there are complex interactions between the gonadal endocrine and the immune systems. The action of sex hormones on the immune system has important physiological and pathological consequences. The preponderance in women of autoimmune diseases in humans and in experimental animals has a basis in sex hormones. Hypoandrogenic/hyperestrogenic states are thought to contribute to the disease process. This article presents evidence for the action of sex hormones in various experimental animal models of autoimmune diseases and discusses several mechanisms of sex hormone action on the immune system. These mechanisms remain complex and it is to be hoped that the recent advances in immunology, endocrinology, pharmacology, and molecular biology will enable the description and clarification of these mechanisms of action.

Animals↗