THURSDAY, June 19 (HealthDay News) -- Researchers have uncovered
cellular proteins that may be key to certain autoimmune and
inflammatory diseases, according to a new study.
The findings, performed so far only in mice, point to potential
new treatments for a range of human diseases that are mediated by
immune system T-cells. These include many inflammatory and
autoimmune disorders, illnesses that involve an immune system run
amok.
More important, such a treatment might provide patients with all
the benefits of existing drugs, without the general immune
suppression that often accompanies them.
"It has an effect on an autoimmune disease -- a mouse model of
multiple sclerosis -- and an inflammatory disease -- a mouse model
of asthma -- but does not seem to interfere with protective
immunity against toxoplasma, a parasite," said one expert, Dr. Noel
Rose, director of the Johns Hopkins Center for Autoimmune Disease
Research in Baltimore.
"This is what everyone is driving for, to selectively block
pathological [immune] responses but not normal responses," added
the study's lead author, Dr. Richard Siegel of the U.S. National
Institute of Arthritis and Musculoskeletal and Skin Diseases.
The findings were published in the July issue of
Immunity.
At the center of this effort are a pair of proteins, DR3 and
TL1A. Expressed on the surface of white blood cells called T
lymphocytes, DR3 induces T-cells to proliferate and release
inflammatory cytokines (signaling proteins) when it binds TL1A,
which is like the "key" to DR3's "lock."
TL1A and DR3 are also related to tumor necrosis factor (TNF),
and its receptor, respectively. TNF has been implicated in
inflammatory and autoimmune disease, and drugs that target TNF and
its receptor are used to treat rheumatoid arthritis and
inflammatory bowel disease and are generally quite effective, said
Rose.
Still, they are not perfect.
"The problem with that treatment is it is not effective against
all autoimmune diseases," he said. "But more importantly, it may
predispose to infection, because you downgrade the entire
inflammatory response."
Siegel, with colleagues at the U.S. National Institute of
Allergy and Infectious Diseases and at Cardiff University in Wales,
U.K., asked what would happen to mouse models of asthma and
multiple sclerosis that were genetically engineered to lack DR3.
(Asthma is an inflammatory condition largely attributed to a subset
of T-cells called Th2; multiple sclerosis is an autoimmune disorder
caused by two different T-cell populations, Th1 and Th17.)
The answer: Both disease pathologies were "reduced" in the
DR3-deficient mice, said Siegel, and fewer T-cells were found in
the tissues that should have been affected. Yet, the DR3-deficient
animals did not suffer from a generalized immunodeficiency and thus
were able to mount immune responses to both a chicken egg protein
and the parasite that causes toxoplasmosis.
"The essence of the paper is that not only are DR3-deficient
mice not horribly immunodeficient," said Siegel, "if you look at
their immune system in general, it is normal."
Indeed, the animals appeared to have no shortage of T-cells
capable of responding to the inflammation-inducing antigens.
Instead, for whatever reason, they were not being activated and
dividing in the tissues normally affected by disease (such as the
lung in the asthma model).
"It looks as if, for reasons this article does not make clear,
the cells do not proliferate in the target organ," said Rose. "They
can proliferate elsewhere, but they do not elicit an inflammatory
response in the target organ."
Siegel said the combination of anti-inflammatory activity in
DR3-deficient mice with sustained immune system function is
unusual, and suggests that DR3 might make a good drug target for a
range of inflammatory and autoimmune diseases.
"This is potentially a huge finding," said Rose. "Companies
would salivate to have something like this."
Yet Rose also noted that drugs against DR3 or TL1A likely would
only help against diseases for which inflammation is the primary
problem. "In autoimmune diseases in which antibodies play a major
role [such as hemolytic anemia and Graves' disease], this probably
would not be useful," he said.
Further, Rose noted that, in general, inflammation serves a
useful, healthy purpose, immunologically speaking, and dampening it
down might have undesirable effects. For example, there might be
diseases or infections that could thrive in the absence of DR3
signaling.
One such case is tuberculosis, which can become active in
individuals treated with TNF receptor blockers. Siegel said he is
now testing to see whether the immune response to TB, or any other
kind of infection, is weaker in mice without DR3 than normal
mice.
A pair of recent studies -- one from the University of Miami and
the other from M.D. Anderson Cancer Center in Houston and Biogen
Idec in Cambridge, Mass. -- separately established a role for
DR3/TL1A in both asthma and multiple sclerosis. The current study
establishes that, in fact, the molecules do play a role in both
diseases, said Siegel.
More information
For more on autoimmune disorders, visit
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