Journal Article

Innate and Adaptive Immunity in Giant Cell Arteritis

Goronzy, Jörg J., Weyand, Cornelia M., Akiyama, Mitsuhiro, Ohtsuki, Shozo, Liang, David H., Berry, Gerald J.

2021

Overview

Autoimmune diseases can afflict every organ system, including blood vessels that are critically important for host survival. The most frequent autoimmune vasculitis is giant cell arteritis (GCA), which causes aggressive wall inflammation in medium and large arteries and results in vaso-occlusive wall remodeling. GCA shares with other autoimmune diseases that it occurs in genetically predisposed individuals, that females are at higher risk, and that environmental triggers are suspected to beget the loss of immunological tolerance. GCA has features that distinguish it from other autoimmune diseases and predict the need for tailored diagnostic and therapeutic approaches. At the core of GCA pathology are CD4 + T cells that gain access to the protected tissue niche of the vessel wall, differentiate into cytokine producers, attain tissue residency, and enforce macrophages differentiation into tissue-destructive effector cells. Several signaling pathways have been implicated in initiating and sustaining pathogenic CD4 + T cell function, including the NOTCH1-Jagged1 pathway, the CD28 co-stimulatory pathway, the PD-1/PD-L1 co-inhibitory pathway, and the JAK/STAT signaling pathway. Inadequacy of mechanisms that normally dampen immune responses, such as defective expression of the PD-L1 ligand and malfunction of immunosuppressive CD8 + T regulatory cells are a common theme in GCA immunopathology. Recent studies are providing a string of novel mechanisms that will permit more precise pathogenic modeling and therapeutic targeting in GCA and will fundamentally inform how abnormal immune responses in blood vessels lead to disease.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Adaptive Immunity / Adoptive Transfer / Aneurysms / Animals / Antibodies, Monoclonal, Humanized - therapeutic use / Antigen Presentation / Antigens / Arteries / Arteries - transplantation / Arteritis / Autoimmune diseases / B7-H1 Antigen - physiology / Blood vessels / CD28 antigen / CD4 antigen / CD8 antigen / Cell differentiation / Chemokines / Coronary vessels / Cytokines / Dendritic Cells - immunology / Effector cells / endothelial cell / Extracellular Traps - immunology / Female / Giant Cell Arteritis - drug therapy / Giant Cell Arteritis - immunology / Giant Cell Arteritis - pathology / Humans / Immune response / Immunity, Innate / Immunologic Memory / Immunological tolerance / Immunology / Immunoregulation / Inflammation / Jagged1 protein / Lesions / Lymphocyte Activation / Lymphocyte Subsets - immunology / Lymphocytes / Lymphocytes T / macrophage / Macrophages / Macrophages - immunology / Macrophages - pathology / Male / Matrix Metalloproteinase 9 - physiology / Mice / Mice, SCID / Monocytes - immunology / Monocytes - pathology / NOTCH / Pathogenesis / PD-1 protein / PD-L1 / PD-L1 protein / Polymorphism / Programmed Cell Death 1 Receptor - physiology / Signal transduction / Smooth muscle / T cell / Therapeutic targets / Translational Research, Biomedical / Vasculitis / Vein & artery diseases