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  • 1
    In: Arthritis & Rheumatology, Wiley, Vol. 67, No. 1 ( 2015-01), p. 51-62
    Abstract: Rheumatoid arthritis therapies that are based on inhibition of a single cytokine, e.g., tumor necrosis factor α (TNFα) or interleukin‐6 (IL‐6), produce clinically meaningful responses in only about half of the treated patients. This study was undertaken to investigate whether combined inhibition of TNFα and IL‐17 has additive or synergistic effects in the suppression of mesenchymal cell activation in vitro and inflammation and tissue destruction in arthritis in vivo. Methods Cultures of human fibroblast‐like synoviocytes (FLS) were stimulated with TNFα, IL‐17, or a combination of both. Single/combined neutralizing antibodies against TNFα and IL‐17 were used to examine in vitro cytokine responses and in vivo development of arthritis and bone and cartilage destruction in TNFα‐transgenic mice. Bispecific anti–TNFα/IL‐17 antibodies were designed, and their potential to block cytokine responses in human FLS was tested. Results TNFα and IL‐17 had additive/synergistic effects in promoting production of IL‐6, IL‐8, and granulocyte colony‐stimulating factor, as well as matrix metalloproteinases, in FLS. Bispecific anti–TNFα/IL‐17 antibodies showed superior efficacy in blocking cytokine and chemokine responses in vitro. Furthermore, dual versus single inhibition of both cytokines using neutralizing antibodies was more effective in inhibiting the development of inflammation and bone and cartilage destruction in arthritic mice. Conclusion Combined blockade of TNFα and IL‐17 was more effective than single blockade in inhibiting cytokine, chemokine, and matrix enzyme responses from human mesenchymal cells and in blocking tissue destruction associated with arthritis, and additionally showed a positive impact on rebalance of bone homeostasis. Bispecific anti–TNFα/IL‐17 antibodies may have superior efficacy in the treatment of arthritis and may overcome the limited therapeutic responses obtained with single cytokine neutralization.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2754614-7
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  • 2
    In: Arthritis & Rheumatology, Wiley, Vol. 74, No. 1 ( 2022-01), p. 150-162
    Abstract: Antinuclear antibody (ANA)–positive juvenile idiopathic arthritis (JIA) is characterized by synovial B cell hyperactivity, but the precise role of CD4+ T cells in promoting local B cell activation is unknown. This study was undertaken to determine the phenotype and function of synovial CD4+ T cells that promote aberrant B cell activation in JIA. Methods Flow cytometry was performed to compare the phenotype and cytokine patterns of PD‐1 high CD4+ T cells in the synovial fluid (SF) of patients with JIA and T follicular helper cells in the tonsils of control individuals. TCRVB next‐generation sequencing was used to analyze T cell subsets for signs of clonal expansion. The functional impact of these T cell subsets on B cells was examined in cocultures in vitro. Results Multidimensional flow cytometry revealed the expansion of interleukin‐21 (IL‐21) and interferon‐γ (IFNγ)–coexpressing PD‐1 high CXCR5–HLA–DR+CD4+ T cells that accumulate in the joints of ANA‐positive JIA patients. These T cells exhibited signs of clonal expansion with restricted T cell receptor clonotypes. The phenotype resembled peripheral T helper (Tph) cells with an extrafollicular chemokine receptor pattern and high T‐bet and B lymphocyte–induced maturation protein 1 expression, but low B cell lymphoma 6 expression. SF Tph cells, by provision of IL‐21 and IFNy, skewed B cell differentiation toward a CD21 low/– CD11c+ phenotype in vitro. Additionally, SF Tph cell frequencies correlated with the appearance of SF CD21 low/– CD11c+CD27–IgM– double‐negative (DN) B cells in situ. Conclusion Clonally expanded CD4+ Tph cells accumulate in the joints of ANA‐positive JIA patients and, in particular, promote CD21 low/– CD11c+ DN B cell differentiation. The expansion of Tph cells and DN B cells might reflect the autoimmune response in the joints of ANA‐positive JIA patients.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Issue
    RVK:
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2754614-7
    Location Call Number Limitation Availability
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