B和T淋巴细胞衰减因子(BTLA)在类风湿关节炎滑膜组织的表达

目的:探讨CD28家族共抑制分子B和T淋巴细胞衰减因子在类风湿关节炎(RA)患者滑膜组织内的表达。方法:免疫组化法检测RA患者滑膜组织BTLA的表达;并使用免疫荧光法检测BTLA的细胞定位及分布。结果:免疫组化结果证实,RA患者滑膜组织中有大量的BTLA阳性细胞,形态观察提示这些阳性的细胞主要是淋巴结处的淋巴细胞及巨噬细胞;免疫荧光分析进一步表明这些BTLA+细胞主要为CD3+T细胞及CD68+巨噬细胞,少数CD31+内皮细胞也表达BTLA。此外,对比其他B7家族共刺激分子在滑膜组织中的分布,免疫荧光发现BTLA共表达于B7-H1+,B7-H4+及HVEM+细胞,但不表达于B7-DC+及B7-H3+细胞。结论:关节炎滑膜组织内有大量BTLA阳性细胞,提示BTLA有可能参与并调节了关节炎的病理进程。     

Expansion of a unique macrophage subset in rheumatoid arthritis synovial lining layer

The Z39Ig protein (complement receptor for C3b and iC3b) is expressed on resident tissue macrophages in various tissues. This study was undertaken to examine the distribution of Z39Ig+cells and their phenotypic features in rheumatoid arthritis (RA) synovium, in comparison with those of osteoarthritis (OA) and psoriatic arthritis (PsA) synovium. Monoclonal anti-Z39Ig antibody was produced by immunizing Z39Ig transfected murine pre B cells and used for the identification of Z39Ig+cells. Z39Ig+cells were further stained with antibodies to macrophages, fibroblast-like synoviocytes, complement receptors and dendritic cells by using the double immunostaining method in normal, RA, OA and PsA synovium. RA synovial mononuclear cells were double-stained using anti-Z39Ig and anti-CD11c antibodies and sorted into Z39Ig+CD11c+cells and Z39Ig+CD11c-cells. These cell populations were then analysed by electron microscopy. The expression of the Z39Ig protein was limited to intimal macrophages in normal, RA, OA and PsA synovium. The numbers of Z39Ig+CD11c+cells and the ratios of Z39Ig+CD11c+cells to Z39Ig+cells were increased in the synovial lining layer of RA as compared with those of OA and PsA. The ultrastructural analysis of Z39Ig+CD11c+cells showed the character of macrophages with many secondary lysosomes and swelling of mitochondria. Z39Ig+ cells appeared to be useful for identification of resident tissue macrophages in normal synovium and the corresponding macrophages in the synovial lining layer of inflammatory arthritis. Expansion of Z39Ig+CD11c+cells was characteristic of RA synovial lining layer.     

Expression and functional role of 1F7 (CD26) antigen on peripheral blood and synovial fluid T cells in rheumatoid arthritis patients.

The expression and the functional role of the CD26 (1F7) T cell surface molecule, an ectoenzyme which seems to represent a functional collagen receptor of T lymphocytes and to have a role in T cell activation, were analysed in both peripheral blood (PB) and synovial fluid (SF) T cell samples from patients with active and inactive rheumatoid arthritis (RA). Although patients with active disease displayed higher percentages of PB CD26+ CD4+ T cells than inactive RA and control subjects, CD26 antigen expression on RA SF T lymphocytes was low. The anti-1F7 binding to the T cell surface, that led to CD26 antigen modulation and enhancement of both IL-2 synthesis by, and 3H-TdR incorporation of, anti-CD3- or anti-CD2-triggered PB T cells in RA and control subjects, was unable to affect significantly both expression and functional activity of RA SF T lymphocytes. Since the 1F7 antigen spontaneously reappeared on the surface of unstimulated SF T cells after 2-5 days of culturing, the low 1F7 antigen expression of anti-1F7 in the SF T cell compartment may be the result of in vivo molecule modulation exerted by the natural ligand in the joint, with important implications for T cell activation and lymphokine synthesis.     

B7-H3在类风湿关节炎患者滑膜组织内的表达及分布研究

探讨B7家族共刺激分子B7-H3在类风湿关节炎(RA)患者滑膜组织内的表达及分布。方法:使用免疫组化法检测RA患者滑膜组织B7-H3的表达,并使用免疫荧光法检测B7-H3在细胞中的定位及分布。结果:免疫组化结果证实,RA患者滑膜组织中有大量的B7-H3阳性细胞,形态观察提示这些阳性的细胞主要为毛细血管细胞、滑膜细胞、局部淋巴结处的T细胞及巨噬细胞;免疫荧光分析进一步表明这些B7-H3+细胞主要为CD68+巨噬细胞,CD31+内皮细胞及CK-18+上皮细胞。此外,对比其他B7家族共刺激分子在滑膜组织中的分布,免疫荧光发现B7-H3共表达于B7-DC+及HVEM+血管,但不表达于B7-H1+及B7-H4+细胞。类风湿关节炎滑膜组织内有大量B7-H3阳性细胞,提示B7-H3有可能参与并调节关节炎的病理进程。     

衰变加速因子及其所在膜微区在T淋巴细胞信号传递中的作用

低温抽提Jurkat细胞膜去污剂抗性的膜成分(DIG),检测Src家族酪氨酸激酶(PTK)及衰变加速因子(DAF)的分布情况。共聚焦扫描显微技术检测Jurkat细胞静息与交联状态下DAF分子对去污剂Triton-X100的抗溶性,以探讨其在Jur-kat细胞免疫识别中的作用,结果显示静息状态CD3对去污剂无抗溶性,而DAF与Lck有抗溶性。单抗交联后CD3对去污剂抗性有所增加。静息状态DAF与Src家族PTK特异分布于膜微区中,交联CD3可诱导CD3与膜微区特异性聚集,DAF所在的膜微区可能促进T细胞的免疫识别和信号传递作用。     

Polyreactivity of human IgG Fc-binding phage antibodies constructed from synovial fluid CD38+ B cells of patients with rheumatoid arthritis

Recent data indicate that rheumatoid factors (RFs) that occur in patients with rheumatoid arthritis (RA) are derived from Ig-producing terminally differentiated CD20-, CD38+ plasma cells present in synovial fluids (SFs). Phage antibody display libraries were constructed using CD38+ plasma cells isolated from SFs of two RF-seropositive RA patients. The libraries were enriched for phage antibodies (Phabs) binding to human IgG (HuIgG) Fc fragments and the sequences of their V genes were analysed. These data provided further evidence for an Ag-driven immune response in patients with RA, including expansion of clonally related B cells, selection and isotype switching, all hallmarks of a germinal center reaction. In the present study, the functional characteristics of these HuIgG Fc-binding monoclonal (mo) Phabs were further analysed in order to provide more insight into the specificity of HuIgG Fc-binding Phabs. Remarkably, all HuIgG Fc-binding moPhabs tested (n=48; derived from four different libraries) displayed polyreactivity. Structural analysis of the CDR3 regions revealed characteristic features of polyreactive Igs. Most H chain CDR3 regions harboured tryptophan/tyrosine-rich parts and approximately 60% of the L chain CDR3 regions of both RA patients displayed an identical stretch of amino acids (W/Y-D-S-S). Supportive for a dominant role of VH in specificity, exchange of VL regions with a single VH region yielded moPhabs with similar specificities. All together, the data suggest the presence of an Ag-driven process in the joints of patients with RA, including somatic mutation and clonal selection entailing isotype switching, resulting in the differentiation of B cells into polyreactive RF-secreting plasma cells.     

树突状细胞在类风湿关节炎中的研究进展

类风湿关节炎(RA)是以关节滑膜炎为主要特征的全身性、炎性反应自身免疫病。目前认为RA的发生是由抗原提呈细胞(APC)对自身抗原的异常提呈所引起的。树突状细胞(DC)是已知功能最强的APC,它能处理并提呈抗原,引发免疫应答;同时它还具有诱导免疫耐受的功能,这一特点使其可能成为临床治疗RA的新途径。     

The immunohistology of synovial lining cells in normal and inflamed synovium

The immunohistology of synovial lining cells (SLCs) in normal and inflamed hyperplastic synovium was investigated using monoclonal antibodies directed against leucocyte common antigen (LCA) HLA-DR and other macrophage components. We found that some SLCs in normal synovium express LCA, HLA-DR, and monocyte/macrophage-associated antigens. The number of SLCs expressing these antigens is increased in hyperplastic osteoarthritic (OA) and rheumatoid (RA) synovium. Some SLCs which did not react for LCA or other macrophage markers but were positive for HLA-DR were also noted in normal synovium and some segments of hyperplastic OA synovium. SLCs which are positive for LCA, HLA-DR, and macrophage markers contribute to the intimal hyperplasia in RA where they account for the majority of SLCs in the synovial intima. In OA synovium, the distribution of SLCs showing this pattern of reactivity was less uniform with numerous SLCs which were positive for HLA-DR but negative for LCA and other macrophage markers also present in the synovial intima. These findings indicate that there are some SLCs of bone marrow origin in normal and hyperplastic synovium. They also suggest that recruitment of SLCs of marrow origin is important in the production of intimal hyperplasia in both RA and OA and that there is also a significant local proliferation of non-marrow derived SLCs in OA.     

Contrasting levels of in vitro cytokine production by rheumatoid synovial tissues demonstrating different patterns of mononuclear cell infiltration.

Synovial membrane samples obtained at knee arthroplasty from 22 patients with rheumatoid arthritis (RA) were characterized histologically. Two groups were identified. Tissue samples from 15 patients demonstrated multiple focal lymphoid aggregates of mononuclear cells (group A). Samples from the remaining seven patients demonstrated diffuse mononuclear cell infiltration (group B). Samples of each synovial membrane (0.25 g) were cultured for cytokine production. The highest levels of IL-1 beta and IL-6 were produced by group A tissues: 19.1 +/- 19.6 ng/ml IL-1 beta (mean +/- s.d.) and 264.4 +/- 301.9 ng/ml IL-6, versus 3.8 +/- 6.6 ng/ml and 54.7 +/- 42.6 ng/ml respectively. Small quantities of IL-2 and IL-4 were measured in both groups: the levels of IL-2 in group A cultures were highest (P = 0.04). Moreover, using MoAbs, the most intense cytokine staining in the tissues was detected in group A. Similar total numbers of each cell subpopulation and similar quantities of immunoglobulin and rheumatoid factor synthesis were measured in both groups. It is suggested that the presence of multiple focal lymphoid aggregates associated with higher levels of cytokine production observed in group A represent a greater degree of immunological activation, and may represent a subgroup of patients with a greater potential for articular destruction.     

In vitro IgG rheumatoid factor production by CD5-negative murine B cells in response to immune complexes of lipopolysaccharide.

We studied the in vitro production of rheumatoid factor (RF) by spleen cells of normal adult mice. IgG RF cross-reactive with rabbit IgG was produced in response to immune complexes of TNP-lipopolysaccharide (LPS) with murine IgG anti-TNP antibody in an Fc-specific manner, but not to a mixture of IgG and LPS. Antibody-uncomplexed LPS induced little IgG RF production, but suppressed the subsequent IgG RF response to antibody-complexed LPS, whereas IgM RF was induced by either LPS or antibody-complexed LPS. The IgG RF production followed as rapid a time course as IgM RF production; the rate of IgG RF production reached its maximum soon after a lag period of 1 day and declined after 5 days. Treatment of splenic B cells from BALB/c mice with anti-Ly-1.2 antibody and rabbit complement resulted in a selective reduction of IgM RF production by 90%, with little effect of IgG RF production. These results suggest that IgG RF is derived primarily from CD5- memory B cells which have been developed in normal mice by an unknown mechanism. Unlike the CD5+ precursor cells for IgM RF, these memory cells are unresponsive to polyclonal stimulation by LPS but are activated by simultaneous stimulation by aggregated Fc epitopes and the mitogenic stimulus from LPS.     

Expression of vascular endothelial growth factor by synovial fluid neutrophils in rheumatoid arthritis (RA)

Most of the leucocytes infiltrating rheumatoid synovial fluid (SF) are neutrophils capable of producing a variety of inflammatory mediators known to contribute significantly to the disease process during active RA. In the present study, we investigated the contribution made by SF neutrophils to the elevated levels of vascular endothelial growth factor (VEGF) seen in rheumatoid SF. Rheumatoid SF neutrophils were found to contain significantly larger amounts of both VEGF protein and its mRNA than peripheral blood neutrophils from either RA patients or healthy controls. Levels of cell-associated VEGF were well correlated with free VEGF in SF, which was significantly higher than in SF from osteoarthritis patients. Levels of SF neutrophil-associated VEGF also correlated with RA disease activity and cell surface integrin expression. Thus, SF neutrophil-associated VEGF may be considered an indicator of both local and systemic inflammation of RA, contributing to the neovascularization seen during RA synovitis.     

Cytolytic activity in T cell clones derived from human synovial rheumatoid membrane: inhibition by synovial fluid.

A panel of T cell clones was derived from the synovial membrane of a patient with rheumatoid arthritis (RA). We investigated whether T cell clones with cytolytic properties were present and whether T cell cytotoxicity was influenced by the presence of synovial fluid. These issues were studied using anti-CD3 and lectin-induced cytotoxicity assays. The majority of the T cell clones derived from the synovial membrane showed cytotoxic properties although non-cytotoxic clones were also found. Three clones (N11, N6 and N15) showed strong cytotoxicity (more than 40% lysis at an effector-to-target cell ratio of 10:1) whereas three clones (N16, N4 and N14) were non-cytotoxic (less than 20% lysis at an effector-to-target cell ratio of 10:1). The induction of cytotoxicity in the anti-CD3-driven system was shown to be dependent on the dose of anti-CD3 present. When synovial fluid was added to these assays a strong inhibition of cytotoxicity was found. This inhibition of cytotoxicity was found with synovial fluid samples of RA patients, as well as with non-RA synovial fluids. Both anti-CD3 and lectin-dependent cytotoxicity assays were strongly inhibited. In conclusion, T cell clones with cytotoxic activity can be isolated from rheumatoid synovial membrane. In the presence of synovial fluid these cytotoxic cells are inhibited to exert their cytotoxic function.     

Expression of TIM‐3 on CD4+ and CD8+ T cells in the peripheral blood and synovial fluid of rheumatoid arthritis

Rheumatoid arthritis (RA) is characterized by a chronic inflammatory process that targets the synovial lining of diarthrodial joints. TIM‐3 plays a key role in the negative regulation of the immune response. In this study, we investigated the expression of TIM‐3 on CD4+ and CD8+ T cells from systemic (peripheral blood) and local (synovial fluid) perspectives of RA. Level of TIM‐3+ cells from peripheral blood and synovial fluid of patients as well as peripheral blood of healthy controls was measured by flow cytometry. Results showed that TIM‐3 expression was significantly increased in both CD4+ and CD8+ T cells in the peripheral blood of RA (p < 0.001 and p < 0.001, respectively). Furthermore, patients revealed even higher expression of TIM‐3 in CD4+ and CD8+ T cells in synovial fluid than in peripheral blood. When comparing TIM‐3 level with the severity of RA, we identified that the percentage of TIM‐3 on both peripheral CD4+ and peripheral CD8+ T cells was negatively correlated with disease activity score 28 (DAS28) of the patients. Similarly, TIM‐3 on synovial fluid CD4+ and CD8+ T cells also revealed inverse correlation with DAS28 of the cases. Our data demonstrate a negative correlation between TIM‐3 and the disease progression of RA.     

Functional characterization of SV40-transformed adherent synovial cells from rheumatoid arthritis.

A total of 14 transformed cell clones were obtained by micro-injecting origin-defective SV40 DNA into three types of cloned adherent synovial cells (ASC) (dendritic cells (DCs), macrophage-like cells (MCs), and fibroblast-like cells (FCs)) from two rheumatoid arthritis patients (five DC clones (SV40-DCs), five MC clones (SV40-MCs) and four FC clones (SV40-FCs)). All the transformed cell nuclei expressed SV40-specific T antigen. The cells which formed a colony had a few times shorter doubling time than the original cells. IL-1 alpha, IL-1 beta and prostaglandin E2 were detected in the culture supernatant from the unstimulated transformed cells like untransformed cells. The SV40-DCs showed the most potent accessory cell function in oxidative mitogenesis assay among the three types of SV40-ASCs. Granulocyte macrophage colony stimulatory factor (GM-CSF) was detected only in the culture supernatant from the SV40-MCs without stimulation. Extensive phenotypic analysis revealed relatively cell-specific markers. SV40-DCs were HLA-DP+ and glial fibrillary acidic protein positive. SV40-MCs stained positive for 5'-nucleotidase and nonspecific esterase. These transformed ASCs retained much of the original cellular physiology of rheumatoid arthritis (RA) ASCs and may be a useful tool for characterizing the role of ASCs in the pathogenesis of RA.     

Differential sensitivity to transforming growth factor (TGF)-{beta} of CBA and of CBA/N B cells demonstrates that the IgG2b inducing factor in synovial fluid from rheumatoid arthritis patients is not identical to TGF-{beta}

Synovial fluid from patients with rheumatoid arthritis (RA-SF)contains in vivo produced cytokines and inflammatory mediators,including a factor that induces IgG2b production of lipopolysaccharide(LPS) preactivated murine B lymphocytes. In order to determinethe mechanism by which RA-SF acts on LPS activated mouse B cells,CBA/N mice were used as an experimental model. The X-linkedimmunodeficiency of these mice is caused by a point mutationin the Bruton's tyrosine kinase (btk) gene. We have earliershown that RA-SF can reconstitute the CBA/N B cell deficiencyin vitro and in vivo, with regard to IgG2b production afterLPS stimulation. Since transforming growth factor (TGF)-ßhas been suggested to be a switch factor for IgG2b, we aimedat investigating the role of TGF-ß in our experimentalsystem. We found that TGF-ß could not mimic the effectof RA-SF on CBA spleen cells. A small increase of IgG2b secretionwas observed with spleen cells from normal CBA mice, whereasIg secretion of all isotypes was suppressed in CBA/N spleencells treated with TGF-ß at any concentration. Neutralizingantibodies against TGF-ß suppressed the response ofCBA B cells, whereas the response by CBA/N B cells was enhancedby the same antibody preparation. Here we also show that theabnormal B cell responsiveness to TGF-ß, typical ofCBA/N, co-segregates with the btk mutation in male (CBA x CBA/N)F₂spleen cells. This was determined by allele specific PCR recognizingthe identified base substitutions of the btk gene, typical ofthe two strains. We propose that RA-SF contains a factor, separatefrom TGF-ß, that is involved in the differentiationof IgG2b expressing cells.     

Local synthesis of both macrophage and T cell cytokines by synovial fluid cells from children with juvenile rheumatoid arthritis.

The production of tumour necrosis factor-alpha (TNF-alpha), TNF-beta and IL-6 in synovial fluid was studied in 50 samples of synovial fluid from 44 children with juvenile rheumatoid arthritis (JRA) by identifying cytokine production at a single-cell level. Post Ficoll-separated synovial fluid mononuclear cells were permeabilized and then intracellular TNF-alpha, TNF-beta and IL-6 protein production was examined using indirect immunofluorescence and murine anti-cytokine MoAbs. All three cytokines were measured in 37 of the 50 samples. In 25 of the 37 samples there was complete concordance; all three cytokines were present in six and absent in 19 samples. At least one cytokine was present in 27/50 (54%) of synovial fluid samples. Overall, TNF-alpha was detected in 22/49 (45%) samples, TNF-beta in 15/41 (37%) and IL-6 in 16/45 (36%) samples. Five patients had serial arthrocentesis, and in these samples there were two patients who had initially positive cytokine production, which on subsequent measurement was negative; in the other three patients there was no change from the previous cytokine production. We provide evidence that synovial fluid mononuclear cells produce monocyte and T cell cytokines in JRA. These findings suggest a role for both T cell and macrophage products in the pathogenesis of JRA, and the potential for modulation of cytokine production as a target for therapeutic intervention.