Mechanisms of B Cell Responses in Autoimmune Disease

描述（由申请人提供）：该申请是杜克大学卓越自身免疫中心（ACE）的竞争性更新。其研究重点将继续是自身免疫性疾病中B细胞反应的调节。ACE将由医学和免疫学教授E. William St. Clair博士领导。在过去的5年里，杜克大学一直是ACE网络的多产成员，为B细胞的发育途径和B细胞定向治疗的机制提供了新的见解。拟议的ACE建立在这些发现的基础上，将支持2个新的基础科学项目，5个正在进行的和2个新的临床试验，以及一个行政核心，并继续强调实验室和床边之间强大而流畅的整合。Tedder及其同事最近发现，分泌IL-10的B细胞的一个表型独特的亚群（称为B10细胞）在适应性CD4+ T细胞反应中起关键的负调节作用，并显著抑制小鼠的Th1免疫反应和自身免疫性疾病。在基础研究项目1中，他们将检验抗原特异性调节性B10细胞调节小鼠和人类自身免疫反应的假设，并且可以操纵它们以获得治疗效果。关于自身免疫性疾病中自身反应性B细胞的前体，人们逐渐有了新的认识。Kelsoe和同事在基础研究项目2中将研究人类胎儿和新生儿前、中、未成熟/过渡B细胞中活化胞苷脱氨酶（AID）的发育调节表达及其与人类自身免疫性疾病中自身反应性B细胞产生的关系，潜在地阐明正常耐受机制范围之外的B细胞自身反应性的另一途径。我们提出两项新的临床试验，研究淋巴毒素- β受体融合蛋白治疗原发性Sj"gren's综合征和利妥昔单抗治疗大疱性类天疱疮。提出了一项试点研究项目，以设计自身抗原四聚体，使其能够识别和表征自身反应性B细胞，这将对临床和其他基础研究项目的目标产生影响。总的来说，杜克大学ACE将在这些基础和临床研究之间架起桥梁，以促进我们对自身免疫性疾病的理解。

DESCRIPTION (provided by applicant): This application is a competitive renewal of the Autoimmunity Center of Excellence (ACE) at Duke. Its research focus will continue to be modulation of B cell responses in autoimmune disease. The ACE will be under the leadership of Dr. E. William St. Clair, Professor of Medicine and Immunology. For the past 5 years, Duke has been a productive member of the ACE network, contributing new insights into the developmental pathways of B cells and the mechanisms of B cell directed therapy. The proposed ACE builds on these discoveries and will support 2 new basic science projects, 5 ongoing and 2 new clinical trials, and an Administrative Core, and continue to emphasize a strong and fluid integration between the bench and the bedside. Tedder and colleagues have recently found that a phenotypically unqiue subset of B cells secreting IL-10 (called B10 cells) serve as critical negative regulators during adaptive CD4+ T cells responses, and dramatically suppress Th1 immune responses and autoimmune disease in mice. For Basic Research Project 1, they will examine the hypothesis that antigen-specific regulatory B10 cells modulate autoimmune responses in mice and man and that they can be manipulated for therapeutic gain. A picture is gradually emerging about the precursors of self-reactive B cells in autoimmune disease. Kelsoe and coworkers in Basic Research Project 2 will investigate developmentally regulated expression of activated cytidine deaminase (AID) in human fetal and neonatal pre-, pro, and immature/transitional B cells and its relationship to the generation of self-reactive B cells in human autoimmune disease, potentially eludidating another pathway of B cell self-reactivity outside the confines of normal tolerance mechanisms. We propose two new clinical trials to investigate lymphotoxin-beta receptor fusion protein as a treatment for primary Sj"gren's syndrome, and rituximab therapy for bullous pemphigoid. A Pilot Research Project is also proposed to engineer tetramers of self-antigen enabling the identification and characterization of self-reactive B cells, which will have implications for the goals of the clinical and other basic research projects. Overall, the Duke ACE will bridge these basic and clinical studies to advance our understanding of autoimmune disease. The B cell is a type of immune cell essential to autoimmunity. The goal of the proposed Autoimmunity Center of Excellence at Duke is to improve our understanding of the roles played by B cells in human autoimmune disease. The projects are designed to be highly integrative between the bench and the bedside, with collaborations between basic and clinical scientists. These studies may lead to better treatments.