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Immunotolerance Christoph Mueller [email protected] • Molecular mechanisms of immune tolerance • Central tolerance induction in the B cell and T cell compartment • Immune tolerance in the periphery • Immunopathology vs. Autoimmunity • Immune Tolerance vs. Immune Privilege vs. Immune Ignorance No or very low Intermediate Negative Selection Positive Selection No Selection Number of T cells Selection of T cells in the Thymus based on the affinity of their TCR for MHC + peptide High Affinity of TCR for MHC + peptide AutoImmune Regulator AIRE Central and peripheral Tolerance in B cells Rregulatory T cell subsets Natural regulatory T cells express the cell-surface marker CD25 and the transcriptional repressor FOXP3 (forkhead box P3). These cells mature and migrate from the thymus and constitute 5–10% of peripheral T cells in normal mice. Other populations of antigen-specific regulatory T cells can be induced from naive CD4+CD25- or CD8+CD25- T cells in the periphery under the influence of semimature dendritic cells, interleukin-10 (IL-10), transforming growth factor- (TGF-) and possibly interferon- (IFN-). The inducible populations of regulatory T cells include distinct subtypes of CD4+ T cell: T regulatory 1 (TR1) cells, which secrete high levels of IL-10, no IL-4 and no or low levels of IFN-; and T helper 3 (TH3) cells, which secrete high levels of TGF-. Although CD8+ T cells are normally associated with cytotoxic T-lymphocyte function and IFN- production, these cells or a subtype of these cells can secrete IL-10 and have been called CD8+ regulatory T cells. Postulated mechanisms of autoimmunity Various genetic loci may confer susceptibility to autoimmunity in part by influencing The maintenance of self-tolerance. Environmental triggers, such as infections and other stimuli promote the influx of lymphocytes into the tissues and the activation of self-reactive T cells Role of infections in the development of autoimmunity Examples of Diseases caused by cell and tissue specific antibodies Examples of T cell-mediated Immunological diseases Examples of Gene Mutations that Result in (an Enhanced Risk for) Autoimmunity • Table 18-6 Autoimmune: general principles and observations • Autoimmunity results from a failure or breakdown of the mechanisms normally responsible for maintaining self-tolerance in B cells, T cells, or both. • The major factors that contribute to the development of autoimmunity are genetic susceptibility and environmental triggers, such as infections. • Autoimmune diseases may be either systemic or organ specific. • Various effector mechanisms are responsible for tissue injury in different autoimmune diseases. • Epitope spreading: Autoimmune reactions initiated against one self antigen that injure tissues may result in the release and alterations of other tissue antigens, activation of lymphocytes specific for these other antigens, and exacerbation of the disease. Autoimmune disease vs. Immunopathology: Crohn‘s disease Inflammatory Bowel Diseases (IBD) Ulcerative colitis Crohn’s disease Ulcerative colitis • Continuous inflammation of the colonic mucosa • Hyperemic, edematous mucosa, often associated with crypt abscesses • Incidence: 2-3 new cases Crohn‘s disease • Entire gastrointestinal tract may be affected • Discontinuous, transmural, granulomatous inflammation • Incidence: 4-5 new cases per 100'000 persons per CM 4/2007 Inflammatory Bowel Diseases: Incidence rates (based on prospective studies) Wisconsin (USA): Stockholm (Sweden): CD: UC: 4.56 per 100’000 2.14 per 100’000 CD: UC: 4.9 per 100’000 2.2 per 100’000 IBD: 7.05 per 100’000 IBD: 7.4 per 100’000 J. Pediatr. 2003; 143: 525-531 Gut. 2003; 52:1432-1434 Mutant mice that spontaneously develop colitis • TCR-a-/• TCR-b-/• MHC class II-/• TGF- b -/• IL-2-/• IL-10-/• Smad3-/- • GFAP- targeted enteric glia cell depletion • cathepsin D-/• Gai2-/- • N-cadherin dominant negative mutant • TNF DARE • NF-kB p55-/• trefoil factor -/- Etiology of Inflammatory Bowel Disease Psychosocial Factors Vascular factors Environmental Factors Bacterial / Viral Infections Immunological Factors Genetic Predisposition Nutrition Etiopathogenesis of Inflammatory Bowel Diseases Induction and perpetuation of IBD is generally considered to depend on: - aberrant local immune responses to luminal antigens - in genetically predisposed individuals. Genetic loci identified in inflammatory bowel disease linkage studies Locus name Chromosomal region Disease type IBD1 IBD2 IBD3 IBD4 IBD5 Chromosome 16q Chromosome 12q Chromosome 6p Chromosome 14q Chromosome 5q IBD6 IBD7 IBD8 IBD9 Chromosome 19 Chromosome 1p Chromosome 16p Chromosome 3p Genetic association CD only NOD2/CARD15 UC>CD Not established CD and UC HLA, TNF or IRF4? CD Not established CD; UC (?) OCTN1/SLC22A4, OCTN2/SLC22A5 CD>UC Not established CD and UC IL23R CD and UC Not established CD and UC Not established Inflammatory Bowel Diseases (IBD) Ulcerative colitis Crohn’s disease Ulcerative colitis • Continuous inflammation of the colonic mucosa • Hyperemic, edematous mucosa, often associated with crypt abscesses • Incidence: 2-3 new cases Crohn‘s disease • Entire gastrointestinal tract may be affected • Discontinuous, transmural, granulomatous inflammation • Incidence: 4-5 new cases per 100'000 persons per CM 4/2007 Generalized pathway of the mucosal inflammation underlying inflammatory bowel disease (IBD) and potential points of therapeutic intervention. Immune Tolerance vs. Immune Privilege vs. Immune Ignorance Maintaining immune homeostasis: To respond, or not to to respond.... Nature Reviews Immunology 8, 74-80, 2008 Immune Tolerance: - Central tolerance mechanisms - Peripheral tolerance mechanisms Immune Privilege vs. Immune Ignorance Immune privilege • Organs with limited access to effector cells of the adaptive (and innate) immune system (passive) and/or Organs with enhanced immunoregulatory properties that generally prevent the induction of effector immune functions (active) Nature Reviews Immunology 8, 74-80, 2008 Nature Reviews Immunology 8, 74-80, 2008 Immune Ignorance Immune ignorance by the adaptive immune system outside the GALT of antigens, taken-up in the intestinal mucosa Macpherson & Smith J Exp Med. 203(3): 497–50; 2006 Functional anatomy of induction of immune responses by intestinal antigens. Abundant protein antigens and live commensal bacteria are present in the intestine. Antigenic peptides can pass into the bloodstream through one of the tributaries of the hepatic portal vein or are taken up by DCs in the subepithelial region of the Peyer's patches and carried to the MLNs via the afferent lymphatics. Although it is possible for circulating peptides to tolerize T cells in the liver or peripheral lymph nodes, presentation in the MLNs is the dominant tolerogenic pathway. Commensal bacteria are also sampled by intestinal DCs and induce IgA responses in the Peyer's patches; although very small numbers of commensals can be carried to MLN by DC, systemic tolerance to these organisms is not induced. Because the commensal laden DCs do not penetrate further than the MLN, the systemic immune system is protected from unwanted priming reactions from live bacteria.